Appeals Specialist

Title: Appeals Specialist

State Role

Title:

Gen Admin Supv I/Coord I

Hiring Range: $20.00 - $25.00

Pay Band: UG

Agency: Dept of Med Assistance Svcs

Location: Dept of Medical Asst Services

Agency Website: (Use the "Apply for this Job" box below)..gov

Recruitment Type: General Public - G

The Department of Medical Assistance Services (DMAS) is excited to offer a competitive opportunity to serve as the Appeals Specialist in the Appeals Division.

Job responsibilities will include, but are not limited to:

• Monitor and work the Appeal Review Task Queue and Provider Appeal Review Queue in the Appeals Information Management System (AIMS) – verifying whether the correspondence is for a client or provider appeal; verifying that new appeals were entered accurately; identifying duplicate appeals; verifying that correspondence was attached to the appropriate appeal; researching, reviewing and analyzing statutes, regulations, or Medicaid policy to determine if additional documentation or information is needed to process an appeal;
  
  and obtaining missing information necessary to process an appeal.
• Utilize systems and databases including: the Appeals Information Management System (AIMS);
  Virginia Case Management System (VaCMS); and the Medicaid Management Information System (MMIS).
• Provide excellent customer service, treating everyone who interacts with the Division with respect and dignity; ensure every appellant receives full due process; support a collaborative and positive work environment; and produce a quality work product.
• Work as an Hourly/Wage employee, with limits on hours and no benefit package included.
• Be located in the Richmond area and enjoy proximity to the Blue Ridge Mountains, Virginia Beach, and Washington DC.

The Department of Medical Assistance Services (DMAS) is working to improve the health and well-being of Virginians through access to high quality health care coverage.

DMAS wants talented individuals who can align their experience with the mission of the agency and its core values – service, collaboration, trust, problem solving and adaptability.

At the Department of Medical Assistance Services (DMAS) we encourage and promote that you Come as you are | Become who you want to be | That is our promise.

Competitive candidates will meet these minimum qualifications:

• Experience applying knowledge of programs, operations, and administrative policies and procedures in a setting such as a law office, court system, or government agency.
• Experience gathering facts, analyzing findings, reaching logical conclusions, and recommending solutions.
• Experience planning and coordinating administrative and support services.
• Experience utilizing case management systems.
• Considerable experience with technology, including MS Office.
• Experience interpreting federal and state laws and regulations.
• Experience in managing competing priorities and meeting deadlines in a fast-paced environment.
• Experience with internal and external stakeholders.

There are no additional considerations for this position.

You will be provided a confirmation of receipt when your application and/or résumé is submitted successfully. Please refer to “Your Application” in your account to check the status of your application for this position.

The Virginia Department of Medical Assistance Services (DMAS) does not offer employment-based Sponsorship. Selected candidates will have their work authorization completed using the E‑Verify Program.

The Department of Medical Assistance Services (DMAS) is an Executive Branch agency that will adhere to all policies and procedures, to include the Commonwealth’s Department of Human Resource Management Policy 1.61 Teleworking. This position could be expected to work in the office as driven by business needs.

Telework arrangements are a privilege and may be rescinded at any time based on performance and/or business need. The agency reserves the right to modify or terminate a telework arrangement, provided that reasonable notice is given to the employee.

This position requires a fingerprint based Criminal History Background Check, Education Checks if applicable, Work History…