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 service-oriented industry If so this opportunity may be the right fit for you!
Modivcare is looking for an Exceptions Specialist who will receive research and process transportation service requests for a reservation that requires approval procedures to be performed before or after transportation has taken place. You will monitor use and billing trends that may signal abusive practices. You will use our resources and outreach to members facilities clients and other parties to fulfill reservations. You will report to the Exceptions Manager.
This role...
- 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 departments 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 interested in speaking with candidates with the following...
- High School Diploma or GED 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.
Salary: $14.23 - $19.21 per hour
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
- 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
- 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
Required Experience:
Unclear Seniority
Employment Type
Full-Time
