The mission of MassHealth is to improve the health outcomes of our diverse members, their families and their communities by providing access to integrated health care services that sustainably promote health, well-being, independence and quality of life.
Duties and Responsibilities (these duties are a general summary and not all inclusive):
Answer incoming telephone calls to the Board of Hearings' main telephone line, assist and answer inquiries from Appellants, Appeal Representatives, Authorized Representatives (including attorneys), EOHHS staff, and others.
Clear withdrawal line to ensure timely notification of appeal withdrawals for hearing officers and parties.
Determine and handle disposition tasks related to appeal packets, including delivery of time-sensitive materials.
Perform data entry operations on the office's computerized Appeals Processing System (APS), including reviewing of appeals for completeness of all required information, checking for proper basis, timeliness, and authorization. Determine proper coding within APS system using discretion and judgment within BOH policies and procedures. Data enter new appeals into APS so that appeals are entered and accounted for as soon as possible after receipt. Assess and compile reports as needed related to volume of new mail received by intake portion of unit.
Assess and handle responsibilities related to Aid Pending requirements for those individuals with pending appeals. Assist with appeal dismissal procedures for untimely and unable appeals. Provide support and physical assistance with all aspects of the office's record retention and archive process. Provide assistance and support with data and organization-related tasks related to provider appeals.
Manage reschedule requests and certain procedures related to expedited hearing request processes.
Handle certain tasks related to intake of new matters, including assistance with determining whether proper jurisdiction and basis for appeal exists within certain requests.
Aid with supervision of other clerical staff. Provide general administrative support and backup as needed for intake, scheduling, and disposition tasks that arise, including special projects related to changing volume and time-sensitive needs of office.
Experience with the rules and regulations of the MassHealth program and/or appeal process.
Based on assignment, possession of a current and valid Massachusetts Class D Motor Vehicle Operator’s license or the equivalent from another state may be required.
A criminal background check will be completed on the recommended candidate as required by the regulations set forth by the Executive Office of Health and Human Services prior to the candidate being hired. For more information, please visit http://www.mass.gov/hhs/cori and click on "Information for Job Applicants".
Education, licensure and certifications will be verified in accordance with the Human Resources Division’s Hiring Guidelines
Education and license/certification information provided by the selected candidate(s) is subject to the Massachusetts Public Records Law and may be published on the Commonwealth’s website.
For questions, please the contact the CYF Office of Human Resources at 1-800-510-4122 and select option #2.
First consideration will be given to those applicants that apply within the first 14 days.
Applicants must have at least (A) five years of full-time, or equivalent part-time, experience in office work, of which (B) at least two years must have been in a supervisory or administrative capacity, or (C) an equivalent combination of the required experience and the substitutions below:
I. A diploma as evidence of graduation from the commercial or business course of a recognized high school or vocational/technical high school may be substituted for a maximum of one year of the required experience. *
II. A diploma as evidence of graduation from a course other than the commercial or business course of a recognized high school or vocational/technical high school or possession of a Massachusetts high school equivalency certificate may be substituted for a maximum of eight months of the required experience. *
III. A diploma for completion of a one year, full-time, or equivalent part-time, program in a recognized, non-degree granting business or secretarial school above the high school level may be substituted for a maximum or one year of the required experience. *
IV. A diploma for completion of a two-year, full-time, or equivalent part-time, program in a recognized, non-degree granting business or secretarial school above the high school level may be substituted for two years of the required experience.*
- Education toward such a degree or diploma will be prorated on the basis of the proportion of the requirements actually completed.