Exceptions Specialist II

Posted 5 Hours Ago
Be an Early Applicant
Hiring Remotely in CA
Remote
Junior
Food • Healthtech • Social Impact • Transportation
Our complementary healthcare technologies and services connect the underserved more equitably with care.
The Role
As an Exceptions Specialist II, you will manage and process transportation service requests, ensuring compliance with service guidelines. Your role involves monitoring billing trends, assisting with denial and appeal processes, investigating issues, and providing outreach to various stakeholders to enhance member experience.
Summary Generated by Built In

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!

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 looking for individuals with the following...

  • High School Diploma required.
  • One (1) plus years of experience.
  • Or equivalent combination of education and/or experience.
  • Excellent customer service and people skills.
  • Works independently or with a team.
  • Quickly learns new technology and processes.
  • Understands and follows complex instructions; handle complex issues.
  • Proficient in writing, reading, and fluency in speaking English.
  • Accurate and attention to detail.
  • Ability to handle multiple tasks without compromising the quality of service.

Pay rate:$14.23- $19.21

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 [email protected]
The Company
Denver, CO
28,000 Employees
Hybrid Workplace
Year Founded: 1996

What We Do

Modivcare is leading the transformation to better connect people with care, wherever they are. We serve the most underserved by facilitating non-emergency medical transportation, remote patient monitoring, meal delivery, and personal and home care to enable greater access to care, reduce costs and improve outcomes.

We believe social and economic factors such as where you live, work or learn should never be a barrier to care. These factors, known as the social determinants of health, lead to inequities in our healthcare system and it’s our mission to close that gap by making connections to care. To make a world of difference, one patient at a time. That’s what drives us.

Why Work With Us

We work with a range of clients: public and private payers, health systems, hospitals and universities. All united in purpose to better connect people with care.

If you want your work to positively impact the lives of others, we want to hear from you.

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