The AM Agency



Department of Health & Human Services

Period of Performance

The period of performance is for a 6-month base period and three 6-month option periods.


Paralegal Specialist (4 Vacancies)

Anticipated Start Date

Dec 13, 2020

Place of Performance

U.S. Department of Health and Human Services

Office of the Secretary, Departmental Appeals Board

330 C Street, Southwest, Washington, DC 20201

Mary E. Switzer Building

Security Clearance

Must Pass a Federal Background

Job Description

To provide a wide range of administrative support to concentrate on their core functional and operational objectives within the Department of Health and Human Services (DHHS) Departmental Appeals Board’s (DAB) Medicare Operations Division (MOD) on behalf of the Office of the Secretary is the requirement for 4 – Paralegal Specialist Vacancies, Equivalent to Grade 9. The incumbent(s) of this position services as technical support for the Medicare Operations Division (MOD) and the Civil Remedies Division (CRD).



●       Prepares certified administrative record for U.S. Federal Court or U.S. District Court, screens claim files for completeness, proper jurisdiction, and other designated elements; dockets new appeals in the electronic case filing system MODACTS and/or e-Filing system;

●       Contacts HHS contractors to obtain ALJ claim files and/or retrieving electronic ALJ file from HHS secure server downloading document(s) to the Medicare Appeals File;

●       Converting AAJ final action documents into PDF format utilizing Adobe Pro and uploading to MODACTS and/or e-Filing system; and

●       Other paralegal duties as assigned from Program Support Branch Chief in the MOD Division.


Tasks to be performed

1.      Appeals Review Processing: Completes appeals review processing tasks, including but not limited to:

·         Conducts initial screening of Medicare appeals within seven (7) working days of assignment.

·         Cures claim file defects by requesting missing ALJ hearing files and missing ALJ decisions within seven (7) working days of assignment. Upon receipt of missing items, uploads items to File Cabinet on the same day the item is received.

·         Prepares interim letters prepares interim letters to cure a case processing error. Letters are prepared within seven (7) working days of assignment and uploaded into MODACTS with the correct event recorded.

·         Requesting authorization to email decisions: Contacting parties to request consent to email Council decisions while the Departmental Appeals Board is in telework status in response to COVID-19.

·         Saving closed cases: Saving copies of the Council decisions issued the previous week to the shared J drive.

·         Shipping files to CMS contractors: preparing and shipping boxes of closed cases to CMS contractors and/or paper files to be digitized to QAI. (On-site Only).

·         Preparing cases for telework: scanning/uploading paper components of files to the MODACTS File Cabinet in order to process cases in telework status. (On-site Only)

2.      Onsite Case Processing Duties & Evaluation Measures: Tasks that are performed onsite and may require the safeguarding of confidential information\data.

·         Prepare Claim Files for Telework. Scans and uploads paper components of files to the MODACTS File Cabinet in order to process cases in telework status.

·         Process Mail. Processes incoming appeal requests and correspondence.

a.       Opens, then scans all incoming mail and logs it in the MODACTS Mail Log within 2 business days. Refers unusual correspondence, and questions management.

b.      Completes docketing of requests for review, requests claim files and, for paper requests for review, prepares Acknowledgment Letter within 2 business days of the request for review being prepared for docketing.

c.       Updates MODACTS to reflect receipt of claim files within 2 business days of receipt. Upon receipt of the case file, updates missing Case Menu information and case location in MODACTS.

·         Issue Counsel Decisions. Prepares and mails final decisions, orders and letters within the prescribed period, pursuit to the provided Release Instructions. All issued documents (except in IRMAA cases) must be uploaded to the File Cabinet of the related case.

3.      Interaction with Others (Teamwork and Interpersonal Skills): Performs all tasks in a manner which promotes effective communication and interaction with others, including but not limited to:

·         Provides prompt, appropriate, courteous and professional services to the Departmental Appeals Board (DAB), Administrative Appeals Judges (AAJs), MOD management, attorneys, paralegals, legal technicians and other colleagues in MOD and the DAB. Upon request for MOD management, actively participates in DAB or MOD sponsored training and meetings.


Job Category: Legal Professional
Job Type: Full Time
Job Location: Washington DC

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