Fair-Hearing Eligibility Officer

Dept of Med Assistance Svcs; Richmond (VA); On-site; USD 86,000 - 93,000; Full time

Job summary

Dept of Medical Assistance Services (DMAS) is seeking an Eligibility Hearing Officer in the Appeals Division to review appeals, prepare findings, and render legally sound decisions within timeframes. The role requires strong knowledge of administrative law, legal research methods, and the ability to manage multiple cases with due process considerations.

Responsibilities include conducting hearings, applying applicable laws, and delivering written decisions.

Qualifications

• Experience independently managing a caseload to meet established time frames.
• Considerable work-related experience applying rules to facts to reach logical, legally supportable conclusions.
• Knowledge of administrative law and / or appeals procedures.
• Considerable knowledge of legal research methodologies, including computerized legal research.
• Considerable experience with technology, including MS Office.
• Considerable experience interpreting, applying, and analyzing federal and state complex laws, regulations, policies, or case law.
• Experience in meeting deadlines.
• Experience with internal/external stakeholders.
• Considerable experience in legal analysis and legal writing.

Responsibilities

• Review appeal requests, case documents, and other appropriate evidence to prepare for and conduct client eligibility appeal hearings.
• Render written appeal decisions at the highest administrative level in accordance with fair hearing principles and within established timeframes.
• Apply knowledge of laws, rules, and regulations in the decision process to independently render decisions based on findings of fact and conclusions of law.
• Apply knowledge of administrative procedures for conducting hearings, due process standards, and legal research methods.
• Conduct legal research; engage in thorough, accurate analysis and evaluation of facts, evidence, and law.
• Independently manage a caseload to ensure timely compliance with deadlines.
• Provide excellent customer service, ensuring due process for every appellant.
• Support a collaborative and positive work environment and produce a quality work product.

Skills

Caseload management

Legal research

Administrative law

Legal writing

Technology proficiency

Stakeholder management

Time management

Deadline-driven

Analytical thinking

Tools

MS Office

Legal research databases

Job description

Dept of Medical Assistance Services (DMAS) is seeking an Eligibility Hearing Officer in the Appeals Division to review appeals, prepare findings, and render legally sound decisions within timeframes. The role requires strong knowledge of administrative law, legal research methods, and the ability to manage multiple cases with due process considerations.

Responsibilities include conducting hearings, applying applicable laws, and delivering written decisions.