Appeals Office Assistant

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.

The Department of Health Care Policy & Financing (HCPF) oversees and operates Health First Colorado, Child Health Plan Plus, 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.

• 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

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 after hearing, and coordinates with the Office of Administrative Courts, the Colorado Attorney General's Office, department staff, county agencies, community partners, members (appellants), and their authorized representatives. The incumbent manages appeal case records through the administrative and judicial review process, prepares official correspondence, maintains case management systems, and provides technical guidance regarding appeals processes.

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

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.

• 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, ensuring records remain accurate and current throughout the life of each case.
• Monitor appeal case status, deadlines, and notifications to ensure compliance with statutory and regulatory timelines.
• Review incoming correspondence, identify improperly filed appeals, 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.
• Assist management and staff by resolving technical case management issues and providing procedural guidance.
• Serve as the primary…