Exception Specialist

Are you passionate about making a difference in people's lives? Do you enjoy working in a service-oriented industry? If so, this opportunity may be the right fit for you! This position is responsible for the accurate fulfillment and approval procedures related to transportation service requests/reservations before and/or after the transport has taken place, through the use of internal and external resources as well as outreaching to members, facilities, clients, and other parties.You will

Ensures accurate trip data input and resolution as it relates to the service guidelines.

Identifies and advises management team on issues relating to customer service and the exceptions process.

Investigates and provides comprehensive solutions on benefit utilization issues, verification, waivers, urgent trip requests, pre-authorization, process denials, eligibility, mileage validation, meals & lodging, and level of service.

Manages and suggests improvements in the denial and appeal process.

Assists other specialists in faxes, mail, email, and web requests (inbound and outbound).

Suggests improvement of quality and efficiency with the department's phone activity (inbound and outbound).

Investigates complex issues to confirm the utilization.

Identifies and monitors utilization and billing trends that may signal abusive practices.

Reports and may provide support to management on the need to address abusive or fraudulent situations.

Reports member dissatisfaction to appropriate team members and/or management.

Provides outreach regarding members, transportation, education, and other subjects as needed to medical facilities.

Support specialists by providing guidance and knowledge sharing to improve skills and department efficiencies.

Participates in other projects or duties as assigned.

We are looking for someone with the following

High School Diploma required.

One (1) plus years of experience.

Or equivalent combination of education and/or experience.

Excellent customer service and people skills.

Works independently or with a team.

Quickly learns new technology and processes.

Understands and follows complex instructions; handle complex issues.

Proficient in writing, reading, and fluency in speaking English.

Accurate and attention to detail.

Ability to handle multiple tasks without compromising the quality of service.

Pay Range: $14.23 - $19.21/HourlyModivcare’s positions are posted and open for applications for a minimum of 5 days. Positions may be posted for a maximum of 45 days dependent on the type of role, the number of roles, and the number of applications received. We encourage our prospective candidates to submit their application(s) expediently so as not to miss out on our opportunities. We frequently post new opportunities and encourage prospective candidates to check back often for new postings. We value our team members and realize the importance of benefits for you and your family. Modivcare offers a comprehensive benefits package to include the following:

Medical, Dental, and Vision insurance

Employer Paid Basic Life Insurance and AD&D

Voluntary Life Insurance (Employee/Spouse/Child)

Health Care and Dependent Care Flexible Spending Accounts

Pre-Tax and Post Tax Commuter and Parking Benefits

401(k) Retirement Savings Plan with Company Match

Paid Time Off

Paid Parental Leave

Short-Term and Long-Term Disability

Tuition Reimbursement

Employee Discounts (retail, hotel, food, restaurants, car rental and much more!)

Modivcare is an Equal Opportunity Employer.

EEO is The Law - click here for more information (https://www.eeoc.gov/laws-guidance)

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled

We consider all applicants for employment without regard to race, color, religion, sex, sexual orientation, national origin, age, handicap or disability, or status as a Vietnam-era or special disabled veteran in accordance with federal law. If you need assistance, please reach out to us at hr.recruiting@modivcare.com

Due to system issues, if you are unable to search for your application, please reach out to the Talent Acquisition team via email at hr.recruiting@modivcare.com and a member of the Talent Acquisition team will reach out to you within the next 48 business hours. We appreciate your interest in joining Modivcare!

Our goal isn’t a number. It’s a difference.

Modivcare is leading the transformation to better connect people with care, wherever they are. We serve the most underserved by facilitating non-emergency medical transportation (https://www.modivcare.com/offerings/nemt) and personal and home care (https://www.modivcare.com/offerings/personal-care) to enable greater access to care, reduce costs and improve outcomes.Please note, Modivcare will never ask any potential applicant for employment for any Personal Identifiable Information via social media. Additionally, Modivcare will never ask any applicant for money. Please be cautious of any individual posing as a recruiter for Modivcare requesting personal identifiable information. If you suspect someone is attempting to collect your personal information or solicits money from you via any social media platform, we encourage you to report such scammers to that platform.Not finding the right fit? Let us know you're interested in a future opportunity by clicking Get Started below or create an account by clicking 'Sign In' at the top of the page to set up email alerts as new job postings become available that meet your interest!