Exceptions Specialist II (Healthcare Transportation)

TL;DR

Exceptions Specialist II (Healthcare Transportation): Managing the fulfillment and approval of transportation service requests for members with an accent on exception handling and issue investigation. Focus on resolving benefit utilization discrepancies, detecting fraud, and coordinating with medical facilities to ensure service efficiency.

Location: Onsite in Charleston, WV

Salary: $14.23 - $17.50/hr

Company

hirify.global is a service-oriented company specializing in the coordination and fulfillment of transportation service requests for healthcare members.

What you will do

• Execute accurate trip data input and resolve service request exceptions in alignment with guidelines.
• Investigate benefit utilization, pre-authorizations, mileage validations, and process denials.
• Manage and recommend improvements for the denial and appeal processes.
• Coordinate with medical facilities and stakeholders via fax, mail, email, and web.
• Monitor billing trends to identify and report potential abuse or fraud.
• Mentor peers by sharing knowledge and contributing to overall team development.

Requirements

• High School Diploma.
• 1+ years of professional experience or equivalent combination of education and experience.
• Must be based in Charleston, WV for onsite work.
• English: C1 proficiency (fluent reading, writing, and speaking).
• Exceptional attention to detail and ability to follow complex instructions.
• Strong customer service and interpersonal skills.

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 and a variety of employee discounts.
• Employer Paid Basic Life Insurance and AD&D.
• Flexible Spending Accounts for health and dependent care.