Exception Specialist II - Transportation Support

Modivcare; Greenville, Northern (SC, KY); Hybrid; USD 20,000 - 24,000; Full time

Benefits offered by this job

Medical, Dental, and Vision insurance

Employer Paid Basic Life Insurance and

AD&D Voluntary Life Insurance (Empl/Sp

Job summary

Modivcare is seeking an experienced Exception Specialist II to join our team in Greenville, SC. This role focuses on accurate fulfillment and approval of transportation service requests and reservations, using internal and external resources while engaging members, facilities, clients, and stakeholders to ensure timely service.

You will investigate issues, support process improvements, and collaborate with peers to deliver reliable, high-quality transportation services.

Qualifications

• High School Diploma required.
• 1+ years of experience or an equivalent combination of education and experience.
• Excellent customer service and interpersonal skills.
• Ability to work independently or within a team setting.
• Fluent reading, writing and speaking English.

Responsibilities

• Ensures accurate trip data input and resolution in alignment with service guidelines.
• Investigates benefit utilization issues, pre-authorizations, process denials, mileage validation, meals & lodging, level of service, and provides effective solutions.
• Advises management on customer service concerns and exception trends.
• Manages and recommends improvements to the denial and appeal process.
• Assists with handling inbound and outbound requests via fax, mail, email, and web.
• Suggests enhancements for the department’s phone operations and overall efficiency.
• Investigates complex service issues to ensure proper utilization.
• Identifies and monitors trends in utilization and billing to detect abusive practices.
• Reports potential abuse or fraud and supports follow-up actions as needed.
• Escalates member dissatisfaction to the appropriate team or management personnel.
• Conducts outreach to medical facilities regarding member transportation and education.
• Supports peers by sharing knowledge, mentoring, and contributing to team development.
• Participates in additional projects and duties as assigned.

Skills

Customer service

Attention to detail

Multitasking

Independent worker

Fluent English

Fast learner

Teamwork

Education

High School Diploma

Job description

Modivcare is seeking an experienced Exception Specialist II to join our team in Greenville, SC. This role focuses on accurate fulfillment and approval of transportation service requests and reservations, using internal and external resources while engaging members, facilities, clients, and stakeholders to ensure timely service.

You will investigate issues, support process improvements, and collaborate with peers to deliver reliable, high-quality transportation services.