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/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]