Resolution Specialist

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Lake St. Louis, MO
In-Office
Healthtech • Transportation
The Role

What will your job look like?

The Resolution Specialist is responsible for managing complaints, incidents and accidents for designated Clients, in accordance with Client requirements and MTM Policies and Procedures for Quality & Compliance.

Location:  Work From Home

Hours: 8am – 5pm Monday - Friday (Schedule may vary slightly.)

What you’ll do:

  • Document, review, investigate, resolve and provide follow up for all complaints and complaint issues reported for assigned clients within the specified timeframe

  • Closely adhere to client service level agreements to ensure complaints do not go out of compliance

  • Obtain responses within 24-48 hours from Transportation Providers to complaints and complaint issues

  • Provide immediate follow up for complaint responses that are not submitted within the specified timeframe

  • Respond to client, Program Director, or Account Executive inquiries sent via email, or fax, within the specified timeframe

  • Ensure accuracy of information in report prior to deadline submission

  • Triage issues and provide assistance to MTM’s internal departments with complaint issues

  • Assist with monthly trending information in regards to potential network inadequacies, transportation provider deficiencies, and training opportunities to applicable departments; report trends to leadership for further review

  • Monitor and report incident/accident issues

  • Monitor and report issues of non-compliance to the leadership staff and Network Management as indicated

  • Compile weekly/monthly summaries of incident/accident investigations, findings, and resolutions as required

  • Send out monthly Quality & Compliance Tips to transportation providers and Network Management regarding prevention measures identified

  • Ensure all training documents received per Q&C request

  • Create relevant workflows, and tracking mechanisms as assigned

  • Perform activities and participate in quality improvement projects for the Quality Improvement Program(s) as assigned to ensure ongoing compliance with URAC standards

  • Compile daily/weekly/monthly complaint reports to be submitted to designated clients per contract

What you’ll need: 
Experience, Education & Certifications:

  • High School Diploma or G.E.D.

  • 2 years of customer service experience

Skills:

  • Proficient in Microsoft Suite

  • Strong and effective communication skills, with an emphasis on grammar and spelling

  • Ability to tactfully question and obtain information

  • Excellent organizational skills

  • Excellent interpersonal skills

  • Ability to manage multiple priorities required

  • Ability to handle confidential information in a professional manner

  • Strong problem solving skills

Even better if you have...

  • Previous Quality & Compliance experience preferred

  • Some college preferred

  • A minimum of six months in the MTM Customer Service Center preferred

  • Working knowledge of MTM Customer Service protocols and procedures  preferred

What’s in it for you: 

  • Health and Life Insurance Plans

  • Dental and Vision Plans

  • 401(k) with a company match 

  • Paid Time Off and Holiday Pay

  • Maternity/Paternity Leave 

  • Casual Dress Environment

  • Tuition Reimbursement

  • MTM Perks Discount Program 

  • Leadership Mentoring Opportunities 

Rate of Pay: $18.50/hr

This information reflects the base salary pay range for this job based on current national market data. Ranges may vary based on the job's location. We offer competitive pay that varies based on individual skills, experience, and other relevant factors. We encourage you to apply to positions that you are interested in and for which you believe you are qualified. To learn more, you are welcome to discuss this with us as you move through the selection process.

Equal Opportunity Employer: MTM is an equal opportunity employer.  MTM considers qualified candidates with a criminal history in a manner consistent with the requirements of applicable local, State, and Federal law.  If you are in need of accommodations, please contact MTM’s People & Culture. 

#MTM

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The Company
St. Louis, MO
1,899 Employees
Year Founded: 1995

What We Do

MTM is a medical and transportation management company whose mission is to partner with our clients in developing innovative solutions for accessing healthcare, increasing independence, and connecting community resources in the most cost-effective manner. To achieve our mission and overarching mission of communities without barriers, we leverage our core competencies in managing customer service operations and building provider networks. MTM provides management of transportation, care coordination through home and community based services, call center operations, ambulance claims, and functional assessments and travel training to state and county governments, Medicaid and Medicare managed care organizations (MCOs), third-party administrators, and healthcare providers

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