Job Brief
The Appeals Examiner conducts hearings and evaluates claims related to government programs and matters, providing recommendations or decisions on liability, sanctions, penalties, and the acceptance or rejection of claims and settlements. This role requires a strong understanding of legal procedures, excellent analytical skills, and the ability to communicate complex information effectively. Ideal candidates will have experience in legal analysis, case assessment, and familiarity with administrative law.
Responsibilities
- Conduct hearings to evaluate and resolve claims related to government programs.
- Analyze evidence and documentation to determine liability and recommend sanctions or penalties.
- Prepare detailed reports and decisions based on findings from hearings.
- Collaborate with legal professionals and stakeholders to clarify case details and procedures.
- Communicate findings and decisions clearly to involved parties.
- Maintain up-to-date knowledge of relevant laws, regulations, and policies affecting claims processes.
- Ensure compliance with legal standards and organizational policies throughout the decision-making process.
- Provide training and guidance to junior staff on appeals processes and legal considerations.
Requirements
- Bachelor’s degree in law, public policy, or a related field; advanced degree preferred.
- Proven experience in legal analysis, claims assessment, or administrative hearings.
- Strong knowledge of government programs and relevant legal frameworks.
- Excellent analytical and critical thinking skills.
- Proficient in report writing and documentation practices.
- Strong interpersonal and communication skills, both verbal and written.
- Ability to manage multiple cases and deadlines effectively.
- Familiarity with case management systems and legal research tools.
Similar Job Titles
- Claims Examiner
- Legal Analyst
- Hearing Officer
- Administrative Law Judge
- Administrative Appeals Specialist
- Claims Adjudicator
- Regulatory Compliance Specialist
- Dispute Resolution Specialist
