Fair Hearing Specialist

State of Vermont•Waterbury, VT

6d•Onsite

About The Position

Provide superior customer service to members who are in disagreement with Medicaid or Vermont Health Connect health eligibility determinations. The Health Care Appeals unit at the Department of Vermont Health Access (DVHA) is looking for a Fair Hearing Specialist (FHS) to fill this rewarding role. Work in a supportive work environment with a Monday-Friday schedule, eleven paid state holidays, in addition to a robust benefits package.

Requirements

Bachelor's degree AND one (1) or more years at or above a technical level role that includes research, customer service, review of healthcare services or similar field OR Associate's degree AND three (3) or more years at or above a technical level role that includes research, customer service, review of healthcare services or similar field. OR High School diploma or equivalent AND five (5) or more years at or above a technical level role that includes research, customer service, review of healthcare services or similar field.
Candidates must pass any level of background investigation applicable to the position. In accordance with AHS Policy 4.02, Hiring Standards, Vermont and/or national criminal record checks, as well as DMV and adult and child abuse registry checks, as appropriate to the position under recruitment, will be conducted on candidates, with the exception of those who are current classified state employees seeking transfer, promotion or demotion into an AHS classified position or are persons exercising re-employment (RIF) rights.

Responsibilities

Conduct detailed review of cases brought by members who are in disagreement with a Medicaid or Vermont Health Connect healthcare eligibility determination.
Track changes to policies and rules.
Correct errors in the system and in some instances outreach customers to confirm disappointing decisions.
Work closely with the Assistant Attorney General's office, who represent the department in hearings.
Manage conflicting priorities.
Meet deadlines and provide superior customer service under difficult circumstances.
Multi-task as needed.

Benefits

80% State paid medical premium and a dental plan at no cost for employees and their families
11 paid holidays each year
generous leave plan
State Paid Family and Medical Leave Insurance (FMLI)
A State defined benefit pension plan
a deferred compensation 457(b) plan
Tuition Reimbursement
Flexible spending healthcare and childcare reimbursement accounts
Low cost group life insurance
Incentive-based Wellness Program
Qualified Employer for Public Service Student Loan Forgiveness Program