Modivcare

ExceptionSpecialistII

$0–0k Charleston, West Virginia, United States FULL TIME
Market Sentiment
HIGH DEMAND

Neural analysis suggests this role is
optimal for Mid+ candidates.

The Brief

“Exception Specialist II at Modivcare. Skills: exception handling, issue investigation, continuous process improvement, customer service. accurate fulfillment and approval procedures related to transportation service requests and reservations. use of internal and external resources”

What You'll Achieve.

Ensure accurate trip data input and resolution in alignment with service guidelines.; Ensure service efficiency and resolution.

Industry & Context.

Problems you'll solve

provides effective solutions; investigates complex service issues to ensure proper utilization

What They're Looking For.

Must Have

High School Diploma required., One (1) plus years of experience, or an equivalent combination of education and experience., Excellent customer service and interpersonal skills., Ability to work independently or within a team setting., Fast learner with adaptability to new technologies and workflows., comprehension and ability to follow complex instructions., Proficient in reading, writing, and speaking English fluently., Exceptional attention to detail and accuracy., Capable of managing multiple tasks while maintaining service quality.

What You'll Do.

accurate fulfillment and approval procedures related to transportation service requests and reservations

use of internal and external resources

direct outreach to members

and other stakeholders

comprehensive support in customer service

and issue investigation

contributing to continuous process improvement

supporting team collaboration

accurate trip data input and resolution in alignment with service guidelines

investigates benefit utilization issues

and provides effective solutions

advises management on customer service concerns and exception trends

manages and recommends improvements to the denial and appeal process

assists with handling inbound and outbound requests via fax

suggests enhancements for the department’s phone operations and overall efficiency

investigates complex service issues to ensure proper utilization

identifies and monitors trends in utilization and billing to detect abusive practices

reports potential abuse or fraud and supports follow-up actions as needed

escalates member dissatisfaction to the appropriate team or management personnel

conducts outreach to medical facilities regarding member transportation and education

supports peers by sharing knowledge

and contributing to team development

participates in additional projects and duties as assigned

How You'll Work.

Team & Collaboration

supporting team collaboration; Ability to work independently or within a team setting.; supports peers by sharing knowledge, mentoring, and contributing to team development.

Communication Scope

Proficient in reading, writing, and speaking English fluently.

Full Job Description

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 experienced Exception Specialist II to join our team. This role is responsible for the accurate fulfillment and approval procedures related to transportation service requests and reservations before and/or after the transport has taken place. It involves the use of internal and external resources, as well as direct outreach to members, facilities, clients, and other stakeholders to ensure service efficiency and resolution. The Exception Specialist II will provide comprehensive support in customer service, exception handling, and issue investigation, while contributing to continuous process improvement and supporting team collaboration. **This role…** * Ensures accurate trip data input and resolution in alignment with service guidelines. * Investigates benefit utilization issues, pre-authorizations, process denials, mileage validation, meals & lodging, level of service, and provides effective solutions. * Advises management on customer service concerns and exception trends. * Manages and recommends improvements to the denial and appeal process. * Assists with handling inbound and outbound requests via fax, mail, email, and web. * Suggests enhancements for the department’s phone operations and overall efficiency. * Investigates complex service issues to ensure proper utilization. * Identifies and monitors trends in utilization and billing to detect abusive practices. * Reports potential abuse or fraud and supports follow-up actions as needed. * Escalates member dissatisfaction to the appropriate team or management personnel. * Conducts outreach to medical facilities regarding member transportation and education. * Supports peers by sharing knowledge, mentoring, and contributing to team development. * Participates in additional projects and duties as assigned. **We are inte

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