State of Vermont Department of Vermont Health Access
Waterbury, VT
Overview DVHA Program Consultant in the Coordination of Benefit unit works, analyzes and oversees various reports and client cases. Program Consultants generates and pulls reports of claims where further investigation on a primary payer is required. The program consultant works reports as well as cases referred to the unit, regarding investigation of a primary commercial medical or pharmacy insurance or primary Medicare coverage. Program Consultant works with primary commercial and Medicare carriers, CMS, pharmacies, various DVHA departments and outside contractors, Medicaid's Pharmacy Benefit Manager and claims processor to help resolve caseload referrals. Program Consultant helps resolve live access to care billing issues to assist clients and their ability to obtain health coverage needed. Program Consultant will participate in projects or other related duties that relate to Coordination of Benefits. The position may require monthly financial reconciliation...
