Exception Specialist I - Onsite - Ridgeland, MS

Modivcare • Ridgeland, MS

1d • Onsite

About The Position

Modivcare is looking for an experienced Exception Specialist to join our team. This position is responsible for the accurate fulfillment and approval of transportation service requests and reservations before and/or after transportation has taken place. This role uses internal and external resources and conducts outreach to members, facilities, clients, and other parties to ensure requests are accurately processed and resolved.

Requirements

• High School Diploma required.
• Zero (0) plus years of experience.
• Or equivalent combination of education and/or experience.
• Excellent customer service and interpersonal skills.
• Ability to work independently or as part of a team.
• Ability to quickly learn new technologies and processes.
• Ability to understand and follow complex instructions.
• Ability to read, write, and understand English fluently.

Responsibilities

• Ensures accurate trip data input and resolution in accordance with service guidelines.
• Observes and advises the management team on issues related to customer service and the exceptions process.
• Researches and resolves requests requiring additional action, including benefit utilization issues, verification, waivers, urgent trip requests, pre-authorization, process denials, eligibility, mileage validation, meals and lodging, and level of service.
• Manages the denial and appeal process.
• Processes inbound and outbound fax, mail, email, and web requests.
• Oversees the department’s inbound and outbound phone activity to support quality and efficiency.
• Investigates issues to confirm actual utilization.
• Identifies and monitors utilization and billing trends that may indicate abusive practices.
• Reports potentially abusive or fraudulent situations to management for appropriate action.
• Reports member dissatisfaction to appropriate team members and/or management.
• Conducts outreach to medical facilities regarding members, transportation, education, and other relevant topics as needed.
• Participates in other projects or performs other duties as assigned.

Benefits

• 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!)

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED