Appeals Office Assistant

STATE OF COLORADO RESIDENCY REQUIRED AT TIME OF APPLICATION

NOTE: This announcement may be used to fill multiple openings.

Envision yourself working at HCPF

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.

The Department of Health Care Policy & Financing (HCPF) oversees and operates Health First Colorado (Colorado's Medicaid Program), Child Health Plan Plus (CHP+), 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. 

As part of the State of Colorado, HCPF offers a competitive benefits package:

• 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 EcoPass 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, go to https://www.colorado.gov/pacific/dhr/student-loan-forgiveness-programs.https://dhr.colorado.gov/dhr-resources/student-loan-forgiveness-programs

We are looking for an Appeals Program Assistant to join our Legal Division Division of the Policy, Communications and Administration Office (PCA)!

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. This position manages appeal case records throughout the administrative and judicial review process, prepares official correspondence and legal documents, maintains case management systems, coordinates records for court proceedings, assists with ADA accommodations and HIPAA compliance, and provides technical guidance regarding appeals processes. The position requires strong organizational skills, sound judgment, attention to detail, and the ability to interpret and apply complex legal and program requirements while providing excellent customer service.

• 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 liaison between the Office of Appeals and the Office of Administrative Courts regarding case processing, scheduling, electronic records, transcripts, and case status.
• Coordinate with the Colorado Attorney General's Office regarding judicial review requests, certification of administrative records, and District Court filings.
• Review Initial Decisions received from Administrative Law Judges and coordinate all post-decision processing activities.
• Prepare case materials and records for Appeals Officers in accordance with statutory and agency requirements.
• Respond to inquiries regarding appeal status, hearing processes, deadlines, and procedural requirements.
• Contact members requesting expedited hearings to communicate case status and next steps.
• Assist clients requesting ADA accommodations by coordinating appropriate services.
• Work with members and authorized representatives to obtain required documentation and ensure HIPAA compliance.
• Build effective working relationships with internal staff, county partners, legal representatives, and external stakeholders.
• Maintain the integrity, organization, retention, scanning, storage, and disposition of paper and electronic appeal files.
• Process incoming and outgoing physical mail, including printing, scanning, copying, and mailing official correspondence.
• Publish and distribute statistical and operational reports as requested.
• Monitor case reports to identify processing delays and coordinate follow-up with the Office of Administrative Courts.
• Assist with Colorado Open Records Act (CORA) requests by identifying, reviewing, and producing responsive records.
• Maintain accurate documentation supporting agency reporting and record retention requirements.

RESIDENCY REQUIREMENT: 

This posting is only open to residents of the State of Colorado at the time of submitting your application.

Class Code & Classification Description:

MINIMUM QUALIFICATIONS:

There are two ways to qualify for this position:

Option 1:

Experience Only:

Four (4) years of professional experience in administrative and operational support, or an occupational field related to the work assigned to the position.

Option 2:

Education and Experience:

A combination of related education in public health, social sciences, or a field of study related to the work assignment and/or relevant experience in administrative and operational support,  or an occupation related to the work assigned equal to four (4) years.

Appropriate education will substitute for the required experience on a year-for-year basis. Relevant education will be calculated as the following:

• An associate will count as two years of experience

• A bachelors will count as four years of experience

• A masters degree will count for six years of experience

• A doctorate or juris doctorate degree will count for seven years of experience

Note: Per the Job Application Fairness Act, you may redact information that identifies your age, date of birth, or dates of attendance at or graduation from an educational institution on your transcripts.

PREFERRED QUALIFICATIONS

• Previous relevant professional state experience. 

• Professional experience with: 

  • Prior Medicaid experience

  • Prior Administrative Law Experience

  • Prior Legal Experience

  • Experience with Salesforce

Skills to Support Success

• Excellent customer service.

• Problem solving.

• Ability to be self-motivated and self-directed, while possessing the ability to work in a team environment.

• Ability to manage competing priorities and multiple tasks.

DEFINITION OF PROFESSIONAL EXPERIENCE: 

Work that involves exercising discretion, analytical skill, judgment, personal accountability, and responsibility for creating, developing, integrating, applying, and sharing an organized body of knowledge that characteristically is uniquely acquired through an intense education or training regimen at a recognized college or university; equivalent to the curriculum requirements for a bachelor's or higher degree with major study in or pertinent to the specialized field; and continuously studied to explore, extend, and use additional discoveries, interpretations, and application and to improve data, materials, equipment, applications and methods. 

CONDITIONS OF EMPLOYMENT:

• All positions at HCPF are security sensitive positions and require that the individuals undergo a criminal record background check as a condition of employment.

• Employees who have been disciplinary terminated, resigned in lieu of disciplinary termination, or negotiated their termination from the State of Colorado must disclose this information on the application.

APPEAL RIGHTS:

If you receive notice that you have been eliminated from consideration for this position, you may file an appeal with the State Personnel Board or request a review by the State Personnel Director.

An appeal or review must be submitted on the official appeal form, signed by you or your representative. This form must be delivered to the State Personnel Board by email ([email protected]), postmarked in US Mail or hand delivered (1525 Sherman Street, 4th Floor, Denver CO 80203), or faxed (303.866.5038) within ten (10) calendar days from your receipt of notice or acknowledgement of the department’s action.

For more information about the appeals process, the official appeal form, and how to deliver it to the State Personnel Board; go to spb.colorado.gov; contact the State Personnel Board for assistance at (303) 866-3300; or refer to 4 Colorado Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, at spb.colorado.gov under Rules.

How to Apply (PLEASE READ CAREFULLY)

Please note that ONLY your State of Colorado job application will be reviewed during the initial screening; if you submit a resume and cover letter, they will be reviewed in later stages of the selection process. Therefore, it is paramount that you clearly describe all your relevant experience on the application itself. Applications left blank or marked "SEE RESUME" will not be considered.

Your application will be reviewed against the minimum qualifications for the position. If your application demonstrates that you meet the minimum qualifications, you will be invited to the comparative analysis process, which is described below.

Comparative Analysis Process

The comparative analysis process will consist primarily of a review of applications against the minimum and preferred qualifications of this position. Applications will be reviewed in comparison to all others in the applicant pool in order to identify a top group of candidates who may be invited for a final interview. Depending on the size of the applicant pool, additional selection processes may be utilized to identify a top group of candidates. Applicants will be notified of their status via email.

Failure to submit properly completed documents by the closing date will result in your application being rejected.

ADAAA Accommodations: The State of Colorado believes that equity, diversity, and inclusion drive our success, and we encourage candidates from all identities, backgrounds, and abilities to apply. The State of Colorado is an equal opportunity employer committed to building inclusive, innovative work environments with employees who reflect our communities and enthusiastically serve them. Therefore, in all aspects of the employment process, we provide employment opportunities to all qualified applicants without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity or expression, pregnancy, medical condition related to pregnancy, creed, ancestry, national origin, marital status, genetic information, or military status (with preference given to military veterans), or any other protected status in accordance with applicable law.

The Department of Health Care Policy & Financing is committed to the full inclusion of all qualified individuals. As part of this commitment, our agency will assist individuals who have a disability with any reasonable accommodation requests related to employment, including completing the application process, interviewing, completing any pre-employment testing, participating in the employee selection process, and/or to perform essential job functions where the requested accommodation does not impose an undue hardship. If you have a disability and require reasonable accommodation to ensure you have a positive experience applying or interviewing for this position, please direct your inquiries to our ADAAA Coordinator, Minnie Kaur, at [email protected].

The Department of Health Care Policy & Financing does not offer sponsored visas for employment purposes.