Exception Specialist I

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...

• 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.

We are excited to speak to an individual 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: $14.23-$19.21

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’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 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.

• 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. If you need assistance, please reach out to us at hr.recruiting@modivcare.com