Exception Specialist
Exception Specialist
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Job Description
Are you passionate about making a difference in peoples lives Do you enjoy working in a serviceoriented industry If so this opportunity may be the right fit for you!
This position
- Ensures accurate trip data input and resolution as it relates to the service guidelines.
- Observes and advises management team on issues relating to customer service and the exceptions process.
- Researches and resolves work that requires further action such as benefit utilization issues verification waivers urgent trip requests preauthorization process denials eligibility mileage validation meals & lodging and level of service.
- Manages the denial and appeal process.
- Processes faxes mail email and web requests (inbound and outbound).
- Oversees the departments phone activity (inbound and outbound) for quality and efficiency.
- Investigates all issues to confirm the actual utilization.
- Identifies and monitors utilization and billing trends that may signal abusive practices.
- Reports to management 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.
- Participates in other projects or duties as assigned.
We are interested in speaking with individuals with the following...
- High School Diploma required.
- Zero 0 plus years of experience.
- Or equivalent combination of education and/or experience.
- Excellent customer service and people skills.
- Ability to work independently or with a team.
- Ability to quickly learn new technology and processes.
- Ability to understand and follow complex instructions.
- Ability to read write and understand English fluently.
Salary: $12.37 $17.55 hourly
Modivcares 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 candidatesto submit their application(s) expediently so as not to miss out on our opportunities. We frequently post new opportunities andencourage 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
- PreTax and Post Tax Commuter and Parking Benefits
- 401(k) Retirement Savings Plan with Company Match
- Paid Time Off
- Paid Parental Leave
- ShortTerm and LongTerm 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
- 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 Vietnamera or special disabled veteran in accordance with federal law. If you need assistance please reach out to us at
Required Experience:
Unclear Seniority
Employment Type
Full-Time
