Exception Specialist I - Onsite - Ridgeland, MS

ModivCare Solutions, LLC; Ridgeland (MS); On-site; USD 22,000 - 23,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Employer Paid Life Insurance

401(k) Retirement Savings Plan with 1:

Job summary

Modivcare is seeking an Exception Specialist in Ridgeland, MS to ensure accurate fulfillment and approval of transportation service requests and reservations. You will engage with members, facilities, clients, and other parties to process and resolve issues, while adhering to service guidelines.

The role requires a High School Diploma, strong customer service skills, and the ability to learn new technologies quickly.

Qualifications

• High School Diploma required.
• Zero (0) plus years of 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

• Responsible for accurate fulfillment and approval of transportation service requests and reservations before and/or after transportation.
• Uses internal and external resources and conducts outreach to members, facilities, clients, and other parties to ensure requests are processed and resolved.
• Ensures accurate trip data input and resolution in accordance with service guidelines.
• Observes and advises management 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, 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 department inbound/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.
• Reports member dissatisfaction to appropriate team members/management.
• Conducts outreach to medical facilities regarding members, transportation, education, and other topics as needed.
• Participates in other projects or duties as assigned.

Skills

Customer service

Interpersonal skills

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! Modivcare is looking for an experienced Exception Specialist to join our team.

Responsibilities

• 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.
• This role… 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.

Qualifications and 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.

Salary: $16 - $17/hr

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.

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.

Modivcare offers a comprehensive benefits package to include the following:

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!)

Equal Employment Opportunity

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.

We appreciate your interest in joining Modivcare! Our goal isn’t a number. It’s a difference. Modivcare is leading the transformation to better connect people with care, wherever they are. We serve the most underserved by facilitating non-emergency medical transportation and personal and home care to enable greater access to care, reduce costs and improve outcomes.

Please note, Modivcare will never ask any potential applicant for employment for any Personal Identifiable Information via social media. Additionally, Modivcare will never ask any applicant for money. Please be cautious of any individual posing as a recruiter for Modivcare requesting personal identifiable information. If you suspect someone is attempting to collect your personal information or solicits money from you via any social media platform, we encourage you to report such scammers to that platform.