Appeals Officer

STATE OF COLORADO RESIDENCY REQUIRED AT TIME OF APPLICATION

NOTE:

This announcement may be used to fill multiple openings.

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.

• 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 Eco Pass 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, visit https://(Use the "Apply for this Job" box below). and .

The Office of Appeals issues Final Agency Decisions for Medicaid recipient appeals (known as the State Fair Hearing process). The State Fair Hearing process is an interagency process where the member’s appeal is initiated at the Office of Administrative Courts and an Administrative Law Judge issues an Initial Decision. Once the Initial Decision is written, the case is transferred to the Office of Appeals for conclusion of the State Fair Hearing process.

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.

We are onboarding new employees using a hybrid approach. The Department supports flexible work arrangements. Depending on the business need and description of the position, we have options that range from fully remote, hybrid, to full-time in the office. Specific discussions about the schedule will be discussed during the offer stage.

The Appeals Officer is responsible for issuing all written Final Agency Decisions in Medicaid recipient/applicant appeals on behalf of the State Department as part of the federally mandated State Fair Hearing process. This position is responsible for communicating with other legal representatives, the Office of Administrative Courts, the Attorney General’s Office, and State Department personnel. Because of the judicial role, the Appeals Officer must remain independent from the Department and may not directly communicate with employees concerning pending appeal matters.

• Review and analyze the record, exhibits, Initial Decision, and any exceptions or transcripts to determine the correctness of the Initial Decision.
• If the Appeals Officer finds that there was an error in a finding of fact or conclusion of law, the Appeals Officer has the authority to overturn or modify the Initial Decision or remand the matter back to the Office of Administrative Courts for further proceedings.
• Use independent legal decisions to analyze the Initial Decision in each individual case.
• Resolve all…