Exception Specialist

Modivcare • Greenville, SC

23h • Onsite

About The Position

The Exception Specialist I 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 position is based in our Greenville, South Carolina office and requires on-site attendance five (5) days per week.

Requirements

• 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.
• High School Diploma required.
• Zero (0) plus years of experience.
• Equivalent combination of education and/or experience.

Responsibilities

• Assists in creating, modifying, and recertifying standing orders under supervision.
• Supports the management of standing orders and hospital discharge trip assignments.
• Assists in ensuring cost-saving measures are in place by providing data for review.
• Maintains and updates the facility rolodex with guidance.
• Assists in investigating and reporting customer service issues and exceptions.
• Provides initial assistance with benefit utilization issues, verifications, waivers, and pre-authorizations.
• Participates in the denial and appeal process under supervision.
• Assists in conducting cancelation audits to ensure reporting accuracy.
• Supports the management team in basic tasks related to provider liquidated damages and recoupment.
• Assists with handling and investigating straightforward issues related to utilization.
• Participates in reviewing utilization and billing trends and reporting findings to senior colleagues.
• Participates in other projects or 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