Appeals Support Specialist

Diversified Services Network, Inc.•Phoenix, AZ

19h•$41,600 - $41,600

About The Position

The Appeals Support Specialist provides administrative and programmatic support for the appeals process. The role reviews appeal cases for procedural accuracy, identifies potential errors, supports hearing operations, processes appeal-related actions, and assists with the resolution of overpayment referrals. The specialist maintains accurate case records, communicates with staff and stakeholders, and ensures appeal-related tasks are completed in accordance with applicable policies, procedures, regulations, and timelines.

Requirements

Associate degree.
Strong analytical and critical thinking skills, including the ability to identify discrepancies and procedural issues.
Experience documenting findings and preparing clear summaries and recommendations.
Proficiency with case management systems and Microsoft Office applications.
Ability to interpret and apply policies, procedures, and regulations.
Excellent written and verbal communication skills.
Strong organizational skills and ability to manage multiple priorities in a high-volume environment.

Nice To Haves

Experience working with eligibility determination, appeals, or hearing processes.
Experience reviewing case records, determining eligibility, or supporting administrative hearings.
Experience processing overpayments, claims, or recovery actions.
Familiarity with administrative hearing procedures and legal documentation requirements.

Responsibilities

Review appeals pending a hearing and take appropriate actions to ensure cases are processed according to established policies and timelines.
Analyze appeal cases to determine whether actions or errors contributed to the appeal filing.
Document findings, prepare detailed case summaries, identify corrective actions, and submit recommendations to designated staff for review and processing.
Support administrative hearings, including attending as a designated representative or hearing participant when required.
Assist in managing hearing schedules and maintaining coverage for scheduled proceedings.
Review appeal decisions and determine required follow-up actions based on hearing outcomes and procedures.
Process overpayment referrals resulting from appeal decisions, ensuring accuracy and compliance with applicable regulations.
Maintain accurate case records, documentation, and tracking information related to appeals and hearing activities.
Collaborate with staff, supervisors, and other stakeholders to resolve case issues and complete appeal-related tasks promptly.
Adhere to confidentiality requirements and applicable policies.