Job Title: Hearing Officer
Type of Company: I work for the state office of Medicaid (MassHealth).
Education: BA in Sociology, UMass JD from Northeastern University School of Law
Previous Experience: I worked as disciplinary counsel for the Board of Nursing, then Prosecuting Counsel for the Division of Professional Licensure and then Assistant Attorney General.
Job Tasks: I hold hearings on MassHealth issues that are appealed, such as terminations or denial of coverage, disability determinations, denial of prior authorization requests, and provider issues. For example, if a family is denied MassHealth because of their income, they may appeal the decision and they will have a hearing before me. I write the decisions and publish them. My decisions are appealable to the Superior Court.
On a typical day, I have 12 hearings scheduled. Routinely, several appellants fail to attend. This could be because the issue has been resolved, that the appellant understands why MassHealth took the action it did and they no longer dispute it, or they forget their appointment. The hearings are scheduled to take place in 15 - 60 minute increments, depending on the anticipated complexity of the matter. Generally, the shorter hearings are resolved by the appellant providing information that changes the determination, such as recent pay stubs, or other information that makes him/her eligible, for example, testimony that they no longer work.
Some hearings are much more complex. When an elderly person applies to MassHealth for nursing home care, their finances are scrutinized by MassHealth for the prior 60 months. Any transfers of resources must be looked at to determine whether they are permissible transfers or transfers that are disqualifying, and result in a penalty period of ineligibility. Those decisions are appealable and very often the appellants hire attorneys to argue "loopholes" in the regulations.
Best and Worst Parts of the Job: I enjoy meeting people and providing them with a direct answer to their questions about MassHealth. At times it is not the answer they want, but it is the correct answer.
However, sometimes I am overwhelmed with the writing portion of the job. At times I have as many as 20 decisions waiting to be written.
Job Tips: I would advise someone who is interested in my career to work with the public, take classes in administrative law and health care law. Also to read administrative decisions. It is always helpful to take classes in law school like civil trial practice where the student is forced to prepare, argue, and interact with witnesses.
These schools offer particularly quick info upon request, and we have written detailed profiles for each (click school names to see the profiles).
Request info from multiple schools, by clicking the Request Info links.
Hofstra University is a private institution whose primary mission is to provide a quality education to its students in an environment that encourages, nurtures and supports learning through the free and open exchange of ideas for the betterment of humankind.
The Santa Barbara and Ventura Colleges of Law is a regionally accredited nonprofit law school. Our school is accredited by both the Western Association of Schools & Colleges Senior College and University Commission and the Committee of Bar Examiners of the State Bar of California.
Turn your talents into a career at nationally recognized and accredited Platt College.
Earn a respected online degree from George Washington University.
Complete Your Bachelor's Degree 100% Online
Baker College is proud to be the largest independent college in Michigan with the most focused approach to education and training available. With one of the highest graduate employment rates in the country, our mission is to help our students find meaningful employment.
About Brightwood College
Brightwood College offers accelerated programs that combine flexible schedules and professional instruction to create a rewarding learning experience for individuals focused on gaining the skills for specific careers. Brightwood College is owned and operated by Education Corporation of America.
At UEI College, we want you to succeed. We’re like a family and we want you to be a part of it.
Making the decision to earn your degree and pursue your career goals could be the best decision you ever make. Enroll at ECPI University and you’ll join a collaborative and fostering learning environment, surrounded by faculty and staff who are there to support you through the entire process.
Pursue your education at Ohio Christian University.
The inside stories from people actually working in the field.
Click a story title to show the story, and click the title again to hide it.
Career Stories are concise, real-world career overviews written by people relating their personal career experiences and wisdom. They provide invaluable insights and mentoring advice to students and career changers.
Most stories include:
Please also see our detailed information about Lawyers, including: