Litigation LEGAL Assistant

Appeals Litigation Legal Assistant

Nashville, TN / Hybrid – 3+ Months. Candidate must be within 30 miles and able to commute to the office when needed.

The Division of Tenn Care is seeking an Appeals Litigation Legal Assistant Representative for the Appeals Operations Group within Member Services. The Representative will work to resolve appeals prior to hearing by identifying appeals that are prime for outreach and conducting outreach to explain the state’s position or obtain further information to assist in processing appeals. The Representative will document actions in TEDS (and other systems) when necessary.

Additionally, the Representative will ensure that due process standards are met in Medicaid appeals by the accurate and timely processing of appeals and all appeals‑related documents. Finally, the Representative will work collaboratively with management to identify workflow issues and accomplishments.

• Maintain a high‑volume caseload and adhere to the timeliness standard of appeals while conducting due process review.
• Assist in the achievement of a high‑performing and positive work environment that promotes the Tenn Care Mission.
• Receive and review appeals daily for potential resolution within policy guidelines. If a resolution cannot be found, make outreach.
• Conduct outreach to explain the state’s actions related to Tenn Care Medicaid programs and coordinate with other staff for prompt resolution of appeals when necessary.
• Demonstrate attention to detail in researching appeal cases and documenting notes for proper case processing. Attend and actively participate in all unit meetings and problem‑solving discussions for workflow improvements.
• Navigate TEDS.

Education and Experience:

Graduation from an accredited college or university with a bachelor's degree in a related field (preferred degree in business administration, management, public health, health policy, paralegal, or legal assistant studies) and 2 years of relevant work experience. OR an equivalent combination of education and work experience may be considered.

• Ability to foster and maintain cohesive working relationships.
• Ability to adapt to changing priorities and deadlines.
• Ability to exercise sound judgment.
• Strong organizational skills necessary, including the ability to prioritize, multi‑task and manage workload to meet specific time frames and deadlines.
• Advanced writing and communication skills.