Medical Appeals Hearing Officer

Dept of Med Assistance Svcs; Richmond (VA); On-site; USD 86,000 - 91,000; Full time

Job summary

The Department of Medical Assistance Services (DMAS) in Virginia invites applications for the Medical Hearing Officer within the Appeals Division. The role conducts client medical appeal hearings, reviews case documents, and renders decisions consistent with fair hearing principles and timeframes.

Ideal candidates will have strong legal analysis, research skills, and experience managing caseloads; in‑person hearings are required by business needs, with optional telework subject to policy.

Qualifications

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

Responsibilities

• Review appeal requests, case documents, and evidence to prepare for and conduct client medical appeal hearings.
• Render written appeal decisions at the highest administrative level in timeframes.
• Apply laws, rules, and regulations to independently render decisions based on findings and law; manage a caseload.
• Provide excellent customer service and ensure due process.
• In-office hearings are required as part of business needs.

Skills

Caseload management

Legal reasoning

Legal research

MS Office

Regulatory interpretation

Deadline driven

Stakeholder management

Legal writing

Education

Virginia State Bar admission

Tools

MS Office

Electronic legal research

Job description

The Department of Medical Assistance Services (DMAS) in Virginia invites applications for the Medical Hearing Officer within the Appeals Division. The role conducts client medical appeal hearings, reviews case documents, and renders decisions consistent with fair hearing principles and timeframes.

Ideal candidates will have strong legal analysis, research skills, and experience managing caseloads; in‑person hearings are required by business needs, with optional telework subject to policy.