Exceptions Specialist Details

Exceptions Specialist

Modivcare - Garden Grove, CA

Employment Type : Full-Time

Modivcare is looking for an Exceptions Specialist who will receive, research, and process transportation service requests for a reservation that requires approval procedures to be performed before or after transportation has taken place. You will monitor use and billing trends that may signal abusive practices. You will use our resources and outreach to members, facilities, clients and other parties to fulfill reservations. You will report to the Exceptions Manager. You will .

• Ensure accurate trip data input and resolution as it relates to the service guidelines
• Observe and advise management team on issues relating to customer service and the exceptions process
• Manage the denial and appeal process
• Process faxes, mail, email and web requests (inbound and outbound)
• Oversee the department's phone activity (inbound and outbound) for quality and efficiency
• Investigate all issues to confirm the actual use
• Report to management the need to address abusive or fraudulent situations
• Report Member Experience dissatisfaction to management.
• Provide outreach regarding members, transportation, education and other subjects to medical facilities

We are excited to speak to some with the following.

• High School Graduate or General Education Degree (GED)
• 0-2 years previous contact center customer service experience

We value our team members and realize the importance of benefits for you and your family. Modivcare offers a comprehensive benefits package including the following:

• 3 Medical Plans with Prescription Drug Benefits
• 2 Dental Plans
• Vision Benefits
• 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
• Legal Services
• Critical Illness, Accident, Hospital Indemnity and Cancer Insurance
• Tuition Reimbursement
• Relocation Services
• Employee Discounts (retail, hotel, food, restaurants, car rental and much more!)

Modivcare. Because we care.always. Modivcare Inc. ("Modivcare") (Nasdaq: MODV) is a healthcare services company that provides a suite of integrated supportive care solutions for public and private payors and their patients. Our value-based solutions address the social determinants of health (SDoH), enable greater access to care, reduce costs, and improve outcomes. We are a leading provider of non-emergency medical transportation (NEMT), personal and home care, and nutritional meal delivery. Modivcare also holds a minority equity interest in CCHN Group Holdings, Inc. and its subsidiaries ("Matrix Medical Network"), which partners with leading health plans and providers nationally, delivering a broad array of assessment and care management services to individuals that improve health outcomes and health plan financial performance. Salary: Starting at $14.33/hour We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Modivcare requires all employees to be vaccinated for COVID-19. Modivcare is an equal opportunity employer and consistent with federal, state, and local requirements, will consider requests for exemptions from this policy as required under the law.