JOB
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 State is resolute in non-discriminatory practices in everything we do, including hiring, employment, and advancement opportunities.
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.
As part of the State of Colorado, HCPF offers a 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. For more information, go to https://www.colorado.gov/pacific/dhr/student-loan-forgiveness-programs.https://dhr.colorado.gov/dhr-resources/student-loan-forgiveness-programs
We are looking for an Appeals Program Assistant to join our Legal Division 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. Overall, the work unit coordinates transfer of cases from the Office of Administrative Courts, recordkeeping, docketing of Initial Decisions and mailing, handling post hearing filings and answering phone calls and emails from parties concerning the department’s appeal process (providing information to parties regarding the final stage of the department’s appeal process in compliance with state and federal law). The end work product is issuance of a Final Agency Decision and preserving cases for judicial review by the District Court. Due to the legal nature of the recipient appeals process (both substantively and procedurally), the Appeals Office is housed in the legal division.
**Please note - equipment provisioning and certain onboarding tasks will take place in person, in our downtown Denver office, on the first day of employment.** EXAMPLE OF DUTIES
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. This position manages appeal case records throughout the administrative and judicial review process, prepares official correspondence and legal documents, maintains case management systems, coordinates records for court proceedings, assists with ADA accommodations and HIPAA compliance, and provides technical guidance regarding appeals processes. The position requires strong organizational skills, sound judgment, attention to detail, and the ability to interpret and apply complex legal and program requirements while providing excellent customer service.
Key Responsibilities
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Receive, review, research, assign, and process new appeal filings received from the Office of Administrative Courts.
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Enter and maintain appeals information within the case management system, ensuring records remain accurate and current throughout the life of each case.
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Monitor appeal case status, deadlines, and notifications to ensure compliance with statutory and regulatory timelines.
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Review incoming correspondence, identify improperly filed appeals, and reroute cases to the appropriate office or program.
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Prepare and distribute notices, correspondence, and mailings to appellants, representatives, attorneys, county departments, and other parties.
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Maintain complete and accurate case records throughout the administrative appeal and judicial review process.
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Apply knowledge of state regulations, department policies, administrative hearing procedures, and legal principles when responding to inquiries.
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Interpret appeals procedures and provide technical guidance to members, representatives, Department staff, attorneys, and Office of Administrative Courts personnel.
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Research Medicaid program policies, regulations, and legal authorities to support case processing and issue resolution.
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Assist management and staff by resolving technical case management issues and providing procedural guidance.
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Serve as the primary liaison between the Office of Appeals and the Office of Administrative Courts regarding case processing, scheduling, electronic records, transcripts, and case status.
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Coordinate with the Colorado Attorney General's Office regarding judicial review requests, certification of administrative records, and District Court filings.
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Review Initial Decisions received from Administrative Law Judges and coordinate all post-decision processing activities.
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Prepare case materials and records for Appeals Officers in accordance with statutory and agency requirements.
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Respond to inquiries regarding appeal status, hearing processes, deadlines, and procedural requirements.
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Contact members requesting expedited hearings to communicate case status and next steps.
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Assist clients requesting ADA accommodations by coordinating appropriate services.
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Work with members and authorized representatives to obtain required documentation and ensure HIPAA compliance.
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Build effective working relationships with internal staff, county partners, legal representatives, and external stakeholders.
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Maintain the integrity, organization, retention, scanning, storage, and disposition of paper and electronic appeal files.
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Process incoming and outgoing physical mail, including printing, scanning, copying, and mailing official correspondence.
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Publish and distribute statistical and operational reports as requested.
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Monitor case reports to identify processing delays and coordinate follow-up with the Office of Administrative Courts.
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Assist with Colorado Open Records Act (CORA) requests by identifying, reviewing, and producing responsive records.
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Maintain accurate documentation supporting agency reporting and record retention requirements.
SUPPLEMENTAL INFORMATION
How to Apply (PLEASE READ CAREFULLY)
Please note that ONLY your State of Colorado job application will be reviewed during the initial screening; if you submit a resume and cover letter, they will be reviewed in later stages of the selection process. Therefore, it is paramount that you clearly describe all your relevant experience on the application itself. Applications left blank or marked "SEE RESUME" will not be considered.
Your application will be reviewed against the minimum qualifications for the position. If your application demonstrates that you meet the minimum qualifications, you will be invited to the comparative analysis process, which is described below.
Comparative Analysis Process
The comparative analysis process will consist primarily of a review of applications against the minimum and preferred qualifications of this position. Applications will be reviewed in comparison to all others in the applicant pool in order to identify a top group of candidates who may be invited for a final interview. Depending on the size of the applicant pool, additional selection processes may be utilized to identify a top group of candidates. Applicants will be notified of their status via email.
Failure to submit properly completed documents by the closing date will result in your application being rejected.
ADAAA Accommodations: The State of Colorado believes that equity, diversity, and inclusion drive our success, and we encourage candidates from all identities, backgrounds, and abilities to apply. The State of Colorado is an equal opportunity employer committed to building inclusive, innovative work environments with employees who reflect our communities and enthusiastically serve them. Therefore, in all aspects of the employment process, we provide employment opportunities to all qualified applicants without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity or expression, pregnancy, medical condition related to pregnancy, creed, ancestry, national origin, marital status, genetic information, or military status (with preference given to military veterans), or any other protected status in accordance with applicable law.
The Department of Health Care Policy & Financing is committed to the full inclusion of all qualified individuals. As part of this commitment, our agency will assist individuals who have a disability with any reasonable accommodation requests related to employment, including completing the application process, interviewing, completing any pre-employment testing, participating in the employee selection process, and/or to perform essential job functions where the requested accommodation does not impose an undue hardship. 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].
The Department of Health Care Policy & Financing does not offer sponsored visas for employment purposes.
