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Appeals Specialist

at Logisticare in Dover, Delaware, United States

Job Description

The Appeals Specialist works with customers, subcontractors and ModivCare staff to ensure quality service. The Appeals Specialist will identify root causes of issues and will provide real time solutions for members that have a high risk for service failure. This position will be in-office for training and will transition to hybrid.
ESSENTIAL FUNCTIONS
Handles high risk members complaints and grievances intake
Monitors MET members trips
Collects all necessary supporting information to accurately provide a resolution
Partners with other work streams leaders to find a permanent solution for members that are high risk
Engages stakeholders, government agencies, clients and our legal department in order to handoff issues that are outside our scope of work and are causing transportation roadblocks.
Monitors the complaint aging report in order to comply with turnaround requirements on resolution
Performs other duties as assigned
POSITION QUALIFICATIONS
Education
High School Graduate or General Education Degree (GED) required
Skills & Experience
2+ years customer service experience in a medical environment preferred
Prior front office medical experience, medical case management and/or medical social work experience a plus
Excellent customer service and phone etiquette skills
Strong verbal communications, problem solving, time management and organizational skills
Must be able to handle heavy work volume
Ability to quickly learn new technology
Ability to accurately type 35+ corrected words wpm
Read and write English fluently
Proficient in Microsoft Word, Excel and Outlook
Ability to work independently or with a team a must
Bi-lingual a plus
We value our team members and realize the importance of benefits for you and your family.
We offer 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 $16.10/hour
ModivCare is an Equal Opportunity Employer.

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled

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Job Posting: 897605

Posted On: Jan 15, 2022

Updated On: Feb 14, 2022