Exception Specialist I

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.

This role…

• 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, pre-authorization, 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 department's 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 to 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- 16.70/hourly

Modivcare’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
• 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 [email protected]