Exception Specialist II (Transportation/Healthcare)

TL;DR

Exception Specialist II (Transportation/Healthcare): Managing fulfillment and approval procedures for transportation service requests with an accent on trip data accuracy and exception handling. Focus on investigating benefit utilization, resolving complex service issues, and detecting billing fraud or abuse.

Location: Onsite in Greenville, SC

Salary: $14.23 - $17.50/hr

Company

A service-oriented healthcare transportation logistics provider.

What you will do

• Ensure accurate trip data input and resolution in alignment with service guidelines.
• Investigate benefit utilization issues, pre-authorizations, process denials, and mileage validation.
• Handle inbound and outbound requests via fax, mail, email, and web.
• Identify and monitor trends in utilization and billing to detect and report potential abuse or fraud.
• Conduct outreach to medical facilities regarding member transportation and education.
• Collaborate with management to suggest improvements for phone operations and the denial/appeal process.

Requirements

• High School Diploma.
• 1+ years of experience in a similar role or equivalent combination of education and experience.
• English: C1 (Fluent) required in reading, writing, and speaking.
• Strong attention to detail, accuracy, and ability to follow complex instructions.
• Excellent interpersonal and customer service skills.
• Ability to work independently and manage multiple tasks simultaneously.

Culture & Benefits

• Comprehensive Medical, Dental, and Vision insurance.
• 401(k) Retirement Savings Plan with Company Match.
• Paid Time Off and Paid Parental Leave.
• Tuition Reimbursement program.
• Employer-paid Basic Life Insurance and AD&D.
• Various employee discounts for retail, hotels, and car rentals.