Exceptions Specialist I: Care Coordination

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

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.