Appeal Specialist Child Care Services

The Appeal Specialist is responsible for reviewing investigating and resolving appeals submitted by parents guardians or applicants regarding Child Care Services (CCS) eligibility determinations benefit reductions suspensions terminations co-payment assessments and other program-related decisions. This position ensures appeals are processed fairly consistently and in compliance with applicable federal state and local regulations contractual requirements and established program procedures.

The Appeal Specialist serves as a neutral and objective reviewer conducting fact-finding activities evaluating eligibility documentation interpreting Child Care Services policies facilitating appeal hearings when required and preparing written determinations. The role is critical to ensuring due process and maintaining the integrity of the Child Care Services program.

• Receive review and process Child Care Services appeal requests within established timeframes.
• Conduct comprehensive reviews of eligibility determinations supporting documentation and case records.
• Investigate disputed decisions involving income eligibility family composition employment status residency requirements participation requirements and other program eligibility factors.
• Analyze applicable Child Care Services policies Texas Workforce Commission regulations and local board procedures to ensure accurate appeal decisions.
• Communicate with applicants parents guardians eligibility specialists providers workforce staff and other stakeholders to obtain information necessary for case resolution.
• Schedule coordinate and facilitate informal reviews appeal hearings or administrative review conferences as required.
• Prepare detailed case summaries findings of fact recommendations and written appeal determinations.
• Maintain complete and accurate appeal records in case management systems and ensure documentation meets audit standards.
• Initiate establish payment plans and document recoupments
• Monitor appeal deadlines and ensure all required actions are completed within regulatory timeframes.
• Draft and issue appeal outcome letters and related correspondence.
• Identify trends related to eligibility determinations and recommend process improvements.
• Assist with quality assurance reviews audits monitoring activities and corrective action initiatives.
• Provide technical guidance regarding appeal procedures and Child Care Services eligibility policies.
• Ensure compliance with all federal state local and contractual requirements governing Child Care Services programs.
• Maintain confidentiality of participant information and records.
• Perform other duties as assigned.

Qualifications :

• Associates degree required; Bachelors degree preferred in Public Administration Social Services Business Administration Human Services Education Legal Studies or a related field.
• Equivalent combination of education and experience may be considered.
• Two (2) years of experience in eligibility determination case management appeals processing social services workforce development public assistance programs or a related field.
• Experience interpreting policies regulations or program requirements.
• Experience handling confidential or sensitive information.
• Experience working with child care assistance programs public benefits or government-funded programs preferred.

Knowledge Skills and Abilities

• Knowledge of Child Care Services eligibility requirements and applicable program regulations.
• Ability to interpret policies procedures laws and eligibility guidelines.
• Strong analytical investigative and critical thinking skills.
• Excellent written and verbal communication skills.
• Ability to conduct objective reviews and make impartial decisions.
• Strong attention to detail and organizational skills.
• Ability to manage multiple cases and meet established deadlines.
• Experience preparing professional reports determinations and correspondence.
• Proficiency with Microsoft Office Suite and case management systems.
• Strong customer service and conflict-resolution skills.
• Ability to maintain confidentiality and professionalism when dealing with sensitive matters.

Additional Information :

All your information will be kept confidential according to EEO guidelines.

Equus Workforce Solutions is a leading provider of workforce development services in North America. With a dedicated and passionate team Equus puts the industrys best practices to work by focusing on the development design and delivery of demand-driven workforce solutions.

When you join Equus you can expect extensive learning opportunities and networking programs. But most of all you can expect to make a lasting impact on the lives of others.

APM including Equus Workforce Solutions Ross Innovative Employment Solutions Dynamic Workforce Solutions DESI AGELIC and Grant Associates is committed to providing equal employment opportunities to all applicants and employees. Qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin age disability protected veteran status genetic information or any other characteristic protected by applicable federal state or local law.

APM is committed to providing reasonable accommodations to qualified individuals with disabilities throughout the application and hiring process. If you require a reasonable accommodation during the application interview or selection process please contact

Remote Work :

No

Employment Type :

Full-time