Exception Specialist I

ModivCare Solutions, LLC; Dover (DE); On-site; USD 20,000 - 26,000; Full time

Benefits offered by this job

Medical, Dental, and Vision insurance

Employer Paid Basic Life Insurance and

AD&D

401(k) with Company Match

Paid Time Off

Tuition Reimbursement

Employee Discounts

Job summary

Modivcare is seeking an Exception Specialist I to handle accurate fulfillment and approval procedures for transportation service requests and reservations, before or after transport. Responsibilities include supporting standing orders, hospital discharge trip assignments, cost-saving data reviews, and maintaining provider contacts.

The role requires strong customer service, the ability to work independently or with a team, quick learning of new technology, and fluency in English.

Qualifications

• 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.

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 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 cancellation 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.

Skills

Customer service

Teamwork/Independent

Tech literacy

Follow complex instructions

English fluency

Education

High School Diploma

Job description

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! 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 role...

Responsibilities

• This role... 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.

The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of the position. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of the job. Extended periods of sitting; frequent telephone, headset, and computer use; data entry; occasional standing and walking; lifting up to 10 lbs.

Qualifications

• 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. Or equivalent combination of education and/or experience.

Salary: $14.23-$19.21

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.

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.

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.