Complaint & Incident Resolution Specialist (Quality)

MTM, Inc; Norton (VA); On-site; USD 25,000 - 29,000; Full time

Benefits offered by this job

Health and Life Insurance Plans

Dental and Vision Plans

401(k) with company match

Paid Time Off and Holidays

Casual Dress Environment

Job summary

MTM, Inc is seeking a Resolution Specialist to manage complaints, incidents, and accidents for designated clients at our Norton, VA office. The role requires adherence to MTM policies, timely follow-up, and collaboration with providers and leadership.

You will document, investigate, and resolve issues, ensure reports are accurate, and provide monthly trend insights for quality improvement while maintaining URAC standards.

Qualifications

• High School Diploma or GED required.
• 2 years of customer service experience.
• Proficient in Microsoft Suite.

Responsibilities

• Document, review, investigate, resolve and provide follow up for all complaints and complaint issues reported for assigned clients within the specified timeframe.
• Closely adhere to client service level agreements to ensure complaints do not go out of compliance.
• Obtain responses within 24-48 hours from Transportation Providers to complaints and complaint issues.
• Provide immediate follow up for complaint responses that are not submitted within the specified timeframe.
• Respond to client, Program Director, or Account Executive inquiries sent via email, or fax, within the specified timeframe.
• Ensure accuracy of information in report prior to deadline submission.
• Triage issues and provide assistance to MTM’s internal departments with complaint issues.
• Assist with monthly trending information in regards to potential network inadequacies, transportation provider deficiencies, and training opportunities to applicable departments; report trends to leadership for further review.
• Monitor and report incident/accident issues.
• Monitor and report issues of non-compliance to the leadership staff and Network Management as indicated.
• Compile weekly/monthly summaries of incident/accident investigations, findings, and resolutions as required.
• Send out monthly Quality & Compliance Tips to transportation providers and Network Management regarding prevention measures identified.
• Ensure all training documents received per Q&C request.
• Create relevant workflows, and tracking mechanisms as assigned.
• Perform activities and participate in quality improvement projects for the Quality Improvement Program(s) as assigned to ensure ongoing compliance with URAC standards.
• Compile daily/weekly/monthly complaint reports to be submitted to designated clients per contract.

Skills

Communication skills

Organizational skills

Interpersonal skills

Multitasking

Confidential information handling

Problem solving

Quality & Compliance experience

Some college

MTM CS Center experience

Customer service experience

Education

High School Diploma or GED

Some college preferred

Tools

Microsoft Office

Job description

MTM, Inc is seeking a Resolution Specialist to manage complaints, incidents, and accidents for designated clients at our Norton, VA office. The role requires adherence to MTM policies, timely follow-up, and collaboration with providers and leadership.

You will document, investigate, and resolve issues, ensure reports are accurate, and provide monthly trend insights for quality improvement while maintaining URAC standards.