The Office of Medicare Hearings and Appeals (OMHA) administers the third level of appeals nationwide for the Medicare program, ensuring that beneficiaries, providers, and suppliers have access to an independent forum and an opportunity for a hearing. OMHA's mission is to be a responsible forum for fair, credible and timely decision-making through an accomplished, innovative and resilient workforce. Each employee makes a difference by contributing to shaping American health care.
Duties
The Legal Administrative Specialist performs the following duties. The position is located with the Appeals Policy and Operations Division (APOD). Organizes Medicare adjudication case files for distribution. Prepares responses to appellants on adjudication results and process. Identifies case processing challenges with pending appeals. Interprets data from appellants or their representatives. Tracks case file development.
Salary
Qualifications
Please limit your resume to 2 pages. If more than 2 pages are submitted, only the first 2 pages will be reviewed to determine your eligibility/qualifications. Your resume must include detailed information as it relates to the responsibilities and specialized experience for this position. Evidence of copying and pasting directly from the vacancy announcement without clearly documenting supplemental information to describe your experience will result in an ineligible rating. This will prevent you from receiving further consideration. Experience: To qualify for the GS-09 position, the incumbent must have one year of specialized experience that is equivalent to at least the GS-07 level or equivalent, performing the following duties: Organizing and managing legal administrative cases. Communicating with appellants or their representatives in writing or in person. Reviewing cases and making recommendations on case file organization. Working in an automated office environment. Tracking case development to verify case milestones are progressing. OR Education: Have successfully completed a master's or equivalent graduate degree or 2 full years of progressively higher-level graduate education leading to such a degree or LL.B or J.D., if related, in a field which demonstrates the knowledge, skills, and abilities necessary to perform the work of the positions. OR Combination of Education and Experience: Have the specialized experience described above, but less than one year; and have at least one year of graduate education as described above, but less than the required two years. (To compute the percentages, divide your total months of qualifying experience by 12. Then, divide your semester hours of graduate education beyond the first year (total graduate semester hours minus 18) by 18. Add the two percentages. The total percentages must equal at least 100% to qualify.) (Note: You must attach a copy of your transcripts.) AND Time-In-Grade: Current General Schedule (GS) federal employees, and those that have served in GS positions within the last 52 weeks, must have served 52 weeks at the next lower grade, or a combination of the next lower grade level and an equivalent band in the federal service. Provide a copy of your last or most recent SF-50, "Notification of Personnel Action" to indicate your current federal status. You must also submit additional SF-50(s) to clearly demonstrate one year time-in-grade as required in the announcement. If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate that you possess one year time-in-grade. In this instance, you must provide an additional SF-50 that clearly demonstrates one year time-in-grade. Documenting experience: In accordance with Office of Personnel Management policy, federal employees are assumed to have gained experience by performing duties and responsibilities appropriate for their official series and grade level as described in their position description. Experience that would not normally be part of the employee's position is creditable, however, when documented by satisfactory evidence, such as a signed memorandum from the employee's supervisor or an SF-50 or SF-52 documenting an official detail or other official assignment. The documentation must indicate whether the duties were performed full time or, if part time, the "percentage of times" the other duties were performed. It is expected that this documentation is included in the employee's official personnel record. In order to receive credit for experience in your resume that is not within the official series and grade level of your official position, you must provide a copy of the appropriate documentation of such experience as indicated above. Experience refers to paid and unpaid experience, including volunteer work done through national Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to gain employment. You will receive credit for all qualifying experience, including volunteer experience. If such experience is on a part-time basis, you must provide the average number of hours worked per week as well as the beginning and ending dates of the experience so it can be fully credited.
Education
If education is required or you are using education to qualify, you must submit a copy of your college transcripts. An unofficial copy is sufficient with the application; however, if you are selected, you will be required to submit official transcripts prior to entering on duty. Education must have been successfully obtained from an accredited school, college or university. Foreign Education: If you are using education completed in foreign colleges or universities to meet the qualification requirements, you must show that the education credentials have been evaluated by a private organization that specializes in interpretation of foreign education programs and such education has been deemed equivalent to that gained in an accredited U.S. education program; or full credit has been given for the courses at a U.S. accredited college or university. For further information, visit: https://www2.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html. All transcripts must be in English or include an English translation.
Required Documents
Submission of a resume alone IS NOT a complete application. You must provide a complete online Application Package which includes: Your Resume must clearly articulate how your skills and experiences align to the criteria defined in the qualifications section of this announcement and it must support your responses to the assessment questionnaire. For each position you must describe your duties, accomplishments, related skills, and responsibilities. Your resume must also include the month and year that you began and ended for each position held. Full-time employment will be assumed unless otherwise stated on your resume. Part-time employment will be prorated in crediting experience. Not providing this information may result in the lowering of your assessment score or an ineligible rating. For resume writing guidance, please visit the USAJobs Resource Center. SF-50 "Notification of Personnel Action" - you must submit an SF-50 to clearly demonstrate one year time-in-grade as required in the announcement. If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate that you possess one year time-in-grade. In this instance, you must provide an additional SF-50 that clearly demonstrates one year time-in-grade. A complete Assessment Questionnaire (https://apply.usastaffing.gov/ViewQuestionnaire/12899902) Other Supporting Documents: (Only Submit if applicable to you) Transcripts (if qualifying based on education). A transcript is required to substantiate possession of the required and claimed education. Unofficial transcripts (including screen-prints from your school's web portal) are acceptable for initial application; however the unofficial transcript must show your name, the name of the educational institution, the degree awarded, and the conferred/awarded date. Self-prepared transcripts will not be accepted. Official transcripts are required prior to appointment. CTAP documentation: you must submit the following documents at the time of application: (1) Proof of Eligibility (Reduction-in-Force separation notice, Notice of proposed removal for failure to relocate, notice of injury compensation termination, OR notice of disability annuity termination); (2) Your latest performance rating showing a rating of at least "fully successful" (level 3); AND (3) Your most recent Notification of Personnel Action, Standard Form 50 (SF-50), or equivalent personnel action, showing your tenure, position occupied, and duty station. You are not required to submit official documents at this time; copies are sufficient.
How to Apply
To apply for this position, you must complete the occupational questionnaire and submit the documentation specified in the Required Documents section. *To begin, click Apply Online to create a USAJOBS account or log in to your existing account. Follow the prompts to select your USAJOBS resume and/or other supporting documents and complete the occupational questionnaire. *Click the Submit My Answers button to submit your application package. *It is your responsibility to ensure your responses and appropriate documentation is submitted prior to the closing date. To verify your application is complete, log into your USAJOBS account at https://my.usajobs.gov/Account/Login, select the Application Status link, and then select the more information link for this position. The Details page will display the status of your application, the documentation received and processed, and any correspondence the agency has sent related to this application. Your uploaded documents may take several hours to clear the virus scan process. To return to an incomplete application, log into your USAJOBS account at https://my.usajobs.gov/Account/Login and click Update Application in the vacancy announcement. You must re-select your resume and/or other documents from your USAJOBS account or your application will be incomplete. If you are unable to apply online, please go to https://help.usastaffing.gov/Apply/index.php?title=Alternate_Application_Information for more information on our alternate application method. The complete Application Package must be submitted by 11:59 PM (EST) on 03/18/2026.
