Appeal Specialist - Child Care Services

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The Appeal Specialist is responsible for reviewing, investigating, and resolving appeals submitted by parents, guardians, or applicants regarding Child Care Services (CCS) eligibility determinations, benefit reductions, suspensions, terminations, co-payment assessments, and other program-related decisions. This position ensures appeals are processed fairly, consistently, and in compliance with applicable federal, state, and local regulations, contractual requirements, and established program procedures.

The Appeal Specialist serves as a neutral and objective reviewer, conducting fact-finding activities, evaluating eligibility documentation, interpreting Child Care Services policies, facilitating appeal hearings when required, and preparing written determinations. The role is critical to ensuring due process and maintaining the integrity of the Child Care Services program.

• Receive, review, and process Child Care Services appeal requests within established time frames.
• Conduct comprehensive reviews of eligibility determinations, supporting documentation, and case records.
• Investigate disputed decisions involving income eligibility, family composition, employment status, residency requirements, participation requirements, and other program eligibility factors.
• Analyze applicable Child Care Services policies, Texas Workforce Commission regulations, and local board procedures to ensure accurate appeal decisions.
• Communicate with applicants, parents, guardians, eligibility specialists, providers, workforce staff, and other stakeholders to obtain information necessary for case resolution.
• Schedule, coordinate, and facilitate informal reviews, appeal hearings, or administrative review conferences as required.
• Prepare detailed case summaries, findings of fact, recommendations, and written appeal determinations.
• Maintain complete and accurate appeal records in case management systems and ensure documentation meets audit standards.
• Initiate, establish payment plans and document recoupments
• Monitor appeal deadlines and ensure all required actions are completed within regulatory time frames.
• Draft and issue appeal outcome letters and related correspondence.
• Identify trends related to eligibility determinations and recommend process improvements.
• Assist with quality assurance reviews, audits, monitoring activities, and corrective action initiatives.
• Provide technical guidance regarding appeal procedures and Child Care Services eligibility policies.
• Ensure compliance with all federal, state, local, and contractual requirements governing Child Care Services programs.
• Maintain confidentiality of participant information and records.
• Perform other duties as assigned.

• Associate's degree required;
  Bachelor's degree preferred in Public Administration, Social Services, Business Administration, Human Services, Education, Legal Studies, or a related field.
• Equivalent combination of education and experience may be considered.
• Two (2) years of experience in eligibility determination, case management, appeals processing, social services, workforce development, public assistance programs, or a related field.
• Experience interpreting policies, regulations, or program requirements.
• Experience handling confidential or sensitive information.
• Experience working with child care assistance programs, public benefits, or government-funded programs preferred.

Knowledge, Skills, and Abilities

• Knowledge…