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Exceptions Specialist

Company: LogistiCare
Location: Dover
Posted on: January 15, 2022

Job Description:

The Exceptions Specialist receives, researches, and processes transportation service requests for a reservation that requires approval procedures to be executed before and/or after transportation has taken place. In addition, the Exceptions Specialist is required to identify and monitor utilization and billing trends that may signal abusive practices. The Exceptions Specialist will leverage internal and external resources as well as outreaching to members, facilities, clients and other parties to accurately fulfill reservations.

ESSENTIAL FUNCTIONS

* Ensures accurate trip data input and resolution as it relates to the service guidelines
Observes and advises management team on issues relating to customer service and the Exceptionss process
* Researches and resolves work that requires further action (e.g. benefit utilization issues, verification, waivers, urgent trip requests, pre-authorization, process denials, eligibility, mileage validation, meals & lodging, level of service Exceptionss).
Manages the denial and appeal process
* Processes faxes, mail, email and web requests (inbound and outbound)
Oversees the department's phone activity (inbound and outbound) for quality and efficiency
* Investigates all issues to confirm the actual utilization
* Reports to management the need to address abusive or fraudulent situations
* Report Member Experience dissatisfaction to appropriate team members and/or management.
* Provide outreach regarding members, transportation, education and other subjects as needed to medical facilities
* Additional duties as assigned including assisting and performing functions for other departments

REQUIREMENTS

Education

* High School Graduate or General Education Degree (GED)

Experience

* 2 to 5 years contact center customer service experience is strongly preferred

Skills

* Excellent customer service and people skills and must be able to work independently or with a team
* Ability to quickly learn new technology and processes
* Must be able to understand and follow complex instructions
* Read, write and understand English fluently

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!!)

Salary: Starting at $14.33/hour

ModivCare is an Equal Opportunity Employer.

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled

Keywords: LogistiCare, Wilmington , Exceptions Specialist, Other , Dover, Delaware

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