Appeals Office Assistant.

Department Information

State Of Colorado Residency Required At Time Of Application

This position will work a hybrid model, with a minimum of two days on site, and based on the business needs.

NOTE: This announcement may be used to fill multiple openings.

Envision yourself working at HCPF

The State of Colorado strives to create a Colorado for All by building and maintaining workplaces that value and respect all Coloradans through a commitment to equal opportunity and hiring based on merit and fitness.

The Department of Health Care Policy & Financing (HCPF) oversees and operates Health First Colorado (Colorado's Medicaid Program), Child Health Plan Plus (CHP+), and other state public health programs for qualified Coloradans. Our mission is to improve health care equity, access and outcomes for the people we serve while saving Coloradans money on health care and driving value for Colorado.

Competitive Benefits Package

• PERA retirement benefits including PERA Defined Benefit Plan, PERA Defined Contribution Plan, plus 401K and 457 plans
• Medical, Dental, and Vision insurance coverage
• Automatic Short-Term and Optional Long-Term Disability Coverage
• Life and AD&D Insurance
• Flexible Spending Accounts (FSAs)
• Family Medical Leave Act (FMLA) job protection and State of Colorado Paid Family Medical Leave (PFML)
• 11 Paid Holidays Annually and Accrued Annual and Sick Leave
• Accrued Sick Leave for State of Colorado Temporary Employees
• Flexplace and Flextime work arrangements
• Variety of discounts on services and products available through the State of Colorado's Work-Life Employment Discount Program
• Free RTD EcoPass to all eligible State Employees
• Credit Union of Colorado Membership Eligibility
• Some positions may qualify for the Public Service Loan Forgiveness Program.

We are looking for an Appeals Program Assistant to join our Legal Division of the Policy, Communications and Administration Office (PCA)! The Office of Appeals issues Final Agency Decisions for Medicaid recipient appeals (known as the State Fair Hearing process) after hearing and an Initial Decision is issued by the Office of Administrative Courts.

Please note - equipment provisioning and certain onboarding tasks will take place in person, in our downtown Denver office, on the first day of employment.

Description Of Job

Position Summary

The Appeals Program Specialist provides comprehensive administrative and case management support for the Office of Appeals. This position serves as the primary point of coordination between the Office of Appeals, the Office of Administrative Courts (OAC), the Colorado Attorney General's Office, Department staff, county agencies, community partners, members (appellants), and their authorized representatives.

The incumbent ensures appeals are processed accurately, timely, and in compliance with applicable state and federal laws, regulations, policies, and legal procedures.

Key Responsibilities

• Receive, review, research, assign, and process new appeal filings received from the Office of Administrative Courts.
• Enter and maintain appeals information within the case management system.
• Monitor appeal case status, deadlines, and notifications to ensure compliance with statutory and regulatory timelines.
• Review incoming correspondence and reroute cases to the appropriate office or program.
• Prepare and distribute notices, correspondence, and mailings to appellants, representatives, attorneys, county departments, and other parties.
• Maintain complete and accurate case records throughout the administrative appeal and judicial review process.
• Apply knowledge of state regulations, department policies, administrative hearing procedures, and legal principles when responding to inquiries.
• Interpret appeals procedures and provide technical guidance to members, representatives, Department staff, attorneys, and Office of Administrative Courts personnel.
• Research Medicaid program policies, regulations, and legal authorities to support case processing and issue resolution.
• Serve as the primary liaison between the Office of Appeals and the Office of Administrative Courts.
• Coordinate with the Colorado Attorney General's Office regarding judicial review requests, certification of administrative records, and District Court filings.
• Review Initial Decisions received from Administrative Law Judges and coordinate all post-decision processing activities.
• Respond to inquiries regarding appeal status, hearing processes, deadlines, and procedural requirements.
• Assist clients requesting ADA accommodations by coordinating appropriate services.
• Work with members and authorized representatives to obtain required documentation and ensure HIPAA compliance.
• Build effective working relationships with internal staff, county partners, legal representatives, and external stakeholders.
• Maintain the integrity, organization, retention, scanning, storage, and disposition of paper and electronic appeal files.
• Assist with Colorado Open Records Act (CORA) requests.

Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights

Minimum Qualifications

There are two ways to qualify for this position:

1. Experience Only: Four (4) years of professional experience in administrative and operational support, or an occupational field related to the work assigned to the position.
2. Education and Experience: A combination of related education in public health, social sciences, or a field of study related to the work assignment and/or relevant experience in administrative and operational support equal to four (4) years.

Preferred Qualifications

• Previous relevant professional state experience.
• Prior Medicaid experience.
• Prior Administrative Law Experience.
• Prior Legal Experience.
• Experience with Salesforce.

Conditions Of Employment

• All positions at HCPF are security sensitive positions and require that the individuals undergo a criminal record background check as a condition of employment.
• Employees who have been disciplinary terminated, resigned in lieu of disciplinary termination, or negotiated their termination from the State of Colorado must disclose this information on the application.

Supplemental Information

How to Apply

Please note that ONLY your State of Colorado job application will be reviewed during the initial screening. Applications left blank or marked "SEE RESUME" will not be considered.

ADAAA Accommodations

The State of Colorado is an equal opportunity employer. If you have a disability and require reasonable accommodation to ensure you have a positive experience applying or interviewing for this position, please direct your inquiries to our ADAAA Coordinator, Minnie Kaur, at [email protected].