Exceptions Specialist I

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

Benefits offered by this job

Medical, Dental, and Vision insurance

Employer Paid Life Insurance

401(k) Retirement Savings Plan with 1:

Paid Time Off

Tuition Reimbursement

Employee Discounts

Job summary

Modivcare is seeking an Exception Specialist to manage transportation service requests and approvals, and to oversee standing orders before and after transport. You will help with cost-saving data, maintain the facility rolodex, and assist with patient transport-related tasks under supervision.

Responsibilities include investigating customer service issues, assisting with benefit utilization, processing pre-authorizations, and participating in denial/appeal processes.

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

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

Skills

Customer service

Teamwork

Learning agility

Instruction following

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 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.You will...Assist in creating, modifying, and recertifying standing orders under supervision.Support the management of standing orders and hospital discharge trip assignments.Assist in ensuring cost-saving measures are in place by providing data for review.Maintain and updates the facility rolodex with guidance.Assist in investigating and reporting customer service issues and exceptions.Provide initial assistance with benefit utilization issues, verifications, waivers, and pre-authorizations.Participate in the denial and appeal process under supervision.Assist in conducting cancelation audits to ensure reporting accuracy.Support the management team in basic tasks related to provider liquidated damages andrecoupment.Assist with handling and investigating straightforward issues related to utilization.Participate in reviewing utilization and billing trends and reporting findings to senior colleagues.Participate in other projects or duties as assigned.We are excited to speak to someone with the following...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: $16 - $16.75/hrThe 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’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. We encourage our prospective candidates to submit their application(s) expediently so as not to miss out on our opportunities. We frequently post new opportunities and encourage prospective candidates to check back often for new postings.We value our team members and realize the importance of benefits for you and your family.Modivcare offers a comprehensive benefits package to include the following:Medical, Dental, and Vision insuranceEmployer Paid Basic Life Insurance and AD&DVoluntary Life Insurance (Employee/Spouse/Child)Health Care and Dependent Care Flexible Spending AccountsPre-Tax and Post -Tax Commuter and Parking Benefits401(k) Retirement Savings Plan with Company MatchPaid Time OffPaid Parental LeaveShort-Term and Long-Term DisabilityTuition ReimbursementEmployee Discounts (retail, hotel, food, restaurants, car rental and much more!)Modivcare is an Equal Opportunity Employer.EEO is The Law - click here for more informationEqual Opportunity Employer Minorities/Women/Protected Veterans/DisabledWe 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. If you need assistance, please reach out to us at [e-mail]