Appeals Specialist - Human Services Program Specialist 2

Minnesota Department of Human Services; Saint Paul (MN); Remote; USD 37,000 - 54,000; Full time

Job summary

Minnesota Department of Human Services is seeking an Appeals Specialist to support the Eligibility Appeals Unit in processing MHCP eligibility appeals. You will conduct intake, perform initial reviews, and coordinate information with multiple stakeholders to ensure accuracy and timeliness.

The role requires interpreting health care policies, applying statutes, and exercising independent judgment in a deadline-driven environment. Telework is eligible for Minnesota residents with approval.

Qualifications

• Three (3) years of recent experience determining eligibility for Minnesota Health Care Programs such as Medical Assistance and MinnesotaCare.
• Experience with eligibility and financial technology systems (such as METS, MAXIS, MMIS).
• Proven experience communicating complex health care policies and program constraints effectively, both orally and in writing to a broad audience.
• Experience reading, interpreting and implementing health care eligibility policies and procedures.

Responsibilities

• Conduct appeal intake and preliminary review, determine continued benefit eligibility and coordinate appeal information.
• Coordinate with Appeals Division, service agencies, MNsure, DHS program areas, appellants and stakeholders to ensure appeals are processed accurately and timely.
• Maintain accurate appeal information, identify process improvements and refer applicable cases for potential overpayment assessment.

Skills

Eligibility experience

Tech systems (METS/MAXIS/MMIS)

Policy communication

Education

Bachelor’s degree or higher in health care administration or related field

Job description

Working Title: Appeals Specialist

Job Class: Human Services Program Specialist 2

Agency: Human Services Dept

• Job ID: 97919
• Location: St. Paul
• Telework Eligible: Yes
• Full/Part Time: Full-Time
• Regular/Temporary: Unlimited
• Who May Apply: Open to all qualified job seekers
• Date Posted: 10/22/2026
• Closing Date: 10/28/2026
• Hiring Agency/Seniority Unit: Human Services Dept / MAPE DHS Central Office
• Division/Unit: Health Care Administration / Integrity and Accountability
• Work Shift/Work Hours: Day Shift / 8:00am - 4:30pm
• Days of Work: Monday - Friday
• Travel Required: No
• Salary Range: $26.89 - $39.22 / hourly; $56,146 - $81,891 / annually
• Classified Status: Classified
• Bargaining Unit/Union: 214 - MN Assoc of Professional Empl/MAPE
• FLSA Status: Nonexempt
• Designated in Connect 700 Program for Applicants with Disabilities: Yes

The Department of Human Services is unable to provide sponsorship for work visas. Applicants must be eligible to work in the United States at the start of employment. DHS does not participate in E-Verify.

The work you'll do is more than just a job.

At the State of Minnesota, employees play a critical role in developing policies, providing essential services, and working to improve the well-being and quality of life for all Minnesotans. The State of Minnesota is committed to equity and inclusion, and invests in employees by providing benefits, support resources, and training and development opportunities.

This posting may be used to fill multiple openings.

This position is eligible for telework for applicants who reside in Minnesota or in a bordering state, with supervisory approval and satisfactory performance. If you live in a state bordering Minnesota, you must live within 50 miles or less from the primary work location to be eligible for telework.

This position exists within the Eligibility Appeals Unit (EAU) to support the unit’s response to Minnesota Health Care Programs (MHCP) eligibility appeals. The position conducts appeal intake and preliminary review, determines continued benefit eligibility, coordinates appeal information and documentation, implements agency appeal decisions, and independently researches and responds to certain appeals. The incumbent applies current and historical statutes, policies, and procedures to individual cases and coordinates with the Appeals Division, service agencies, MNsure, DHS program areas, appellants, and other stakeholders to ensure appeals are processed accurately, timely, and in accordance with applicable requirements.

Working in a high-volume, deadline-driven environment, the incumbent exercises independent judgment to analyze complex eligibility and procedural issues, identify required actions, monitor statutory deadlines, and ensure appropriate case actions are completed.

The position also supports EAU operations by maintaining accurate appeal information, identifying process improvement opportunities, and referring applicable cases for potential overpayment assessment.

Minimum Qualifications

Three (3) years of recent experience determining eligibility for Minnesota Health Care Programs such as Medical Assistance and MinnesotaCare.

• Experience with eligibility and financial technology systems (such as METS, MAXIS, MMIS)
• Proven experience communicating complex health care policies and program constraints effectively, both orally and in writing to a broad audience.
• Experience reading, interpreting and implementing health care eligibility policies and procedures.
• Bachelor’s degree or higher in health care administration, business administration or related field may substitute for one (1) year of experience

Preferred Qualifications

• Experience working with the Minnesota Eligibility Technology System (METS) and MMIS, preferably administering Medical Assistance for families and/or MinnesotaCare.
• Strong research and problem-solving skills to allow him/her to provide effective solutions and make decisions in an expeditious manner.
• Organizational and time management skills sufficient to effectively manage work tasks
• Familiarity with Microsoft Office products (Word, Excel, Outlook, SharePoint) and the ability to navigate multiple software applications
• Variety of experiences working effectively with others from different backgrounds and cultures.

Additional Requirements

To facilitate proper crediting, please ensure that your resume clearly describes your experience in the areas listed and indicates the beginning and ending month and year for each job held.

REFERENCE/BACKGROUND CHECKS

The Department of Human Services will conduct reference checks to verify job-related credentials and criminal background check prior to appointment.

About Human Services Dept

WE MAKE A DIFFERENCE! The Minnesota Department of Human Services impacts the lives of 1.7 million people every year, helping them meet their basic needs so they can achieve their highest potential.

Working together to improve the state we love.

What do Minnesota's State employees have in common?

• A sense of purpose in their work
• Connection with their coworkers and communities
• Opportunities for personal and professional growth

Benefits

As an employee, you'll have access to one of the most affordable health insurance plans in Minnesota, along with other benefits to help you and your family be well.

Your benefits may include:

• Paid vacation and sick leave
• 12 paid holidays each year
• Low-cost medical, dental, vision, and prescription drug plans
• • Fertility care, including IVF
  • Diabetes care
  • Dental and orthodontic care for adults and children
• 6 weeks paid leave for parents of newborn or newly adopted children
• Pension plan that provides income when you retire (after working at least three years)
• Employer paid life insurance to provide support for your family in the event of death
• Short-term and long-term disability insurance that can provide income if you are unable to work due to illness or injury
• Tax-free expense accounts for health, dental, and dependent care
• Resources that provide support and promote physical, emotional, social, and financial well-being

Support to help you reach your career goals:

• Training, classes, and professional development
• Tuition reimbursement
• Federal Public Service Loan Forgiveness Program (Some positions may qualify for the Public Service Loan Forgiveness Program. For more information, visit the Federal Student Aid website at studentaid.gov)

Employee Assistance Program (EAP) for work/life support:

• A voluntary confidential program that helps employees and their families with life challenges that may impact overall health, personal well-being, or job performance
• Common sources of stress can be addressed through the EAP: mental health, relationship challenges (personal and work), grief and loss, finances, and legal issues
• Daily Living/Convenience Services: Chore services, home repair, trip planning, child/elder care

Programs, resources and benefits eligibility varies

based on type of employment, agency, funding availability, union/collective bargaining agreement, location, and length of service with the State of Minnesota.

EQUAL OPPORTUNITY EMPLOYERS

Minnesota state agencies are equal opportunity, affirmative action, and veteran-friendly employers. State agencies are committed to creating a workforce that reflects the diversity of the state and strongly encourages persons of color and Indigenous communities, members of the LGBTQIA2S+ community, individuals with disabilities, women, and veterans to apply. The varied experiences and perspectives of employees strengthen the work we do together and our ability to best serve Minnesotans.

All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, national origin, sex (including pregnancy, childbirth, and disabilities related to pregnancy or childbirth), gender identity, gender expression, marital status, familial status, age, sexual orientation, status regarding public assistance, disability, veteran status or activity in a local Human Rights Commission or any other characteristic protected by law.

Applicants With Disabilities

Minnesota state agencies make reasonable accommodations to their employees and applicants with disabilities. If you have a disability and need assistance in searching or applying for jobs with the State of Minnesota, call the Careers Help Desk at 651-259-3637 or email [e-mail] and let us know the support you need.