Verification Specialist Job 2024 Full Time

At MTM, we are not just colleagues; we are collaborators on a shared mission; communities without barriers. We have exciting opportunities to join our growing team where your work has a direct impact on the communities we serve. Our company culture is one of innovation, collaboration, and growth. If you are passionate, driven, and ready to join a team where your work will directly transform and shape our industry, then we want to talk to you!

What will your job look like?

The Verification Specialist is responsible for identifying fraudulent data patterns. The Verification Specialist will also make timely and accurate decisions to initiate payments to recipients and Providers. In addition, the Verification Specialist will also enter Gas Log and Meals/Lodging data before releasing trips for payment.

This is a part-time, work from home position.

What you’ll do:

• Request verification for scheduled medical appointments from Medical Providers and facilities
• Approve and add new providers (Doctors/Facilities) that are entered into the database
• Process eligibility changes from Customer Service Center into database
• Document detailed information in database
• Verify pickup and drop-off times in database
• Enter all Trip logs and information
• Based upon obtained data, determine if trip is eligible for payment
• Assist with member and/or provider inquiries (missing checks etc.)
• Void or reissue payments based on established criteria
• Drive high client satisfaction through courtesy, helpfulness and positive interaction with Medical Providers, Health Plan members and Medicaid recipients
• Review disputed signatures
• Approve or deny trip signatures
• Report findings to the Transportation Provider
• Comply with established departmental metrics
• Must keep information protected by conforming to MTM’s HIPAA standards
• Work closely with Network Team and Quality Management Department
• Process cancelled trips and adjustments into database

What you’ll need:

Experience, Education & Certifications:

• High school diploma or G.E.D. equivalent
• Knowledge of Microsoft applications, including Word, Excel, and Outlook

Skills:

• Strong organizational skills
• Ability to tactfully question and obtain necessary required information
• Ability to make solid judgment calls
• Ability to handle escalated calls appropriately and professionally
• Exemplary communication skills
• Ability to relate to and handle diverse members
• Previous experience dealing with the public
• Data entry experience helpful
• Ability to maintain high level of confidentiality

Salary Min: $17.50/hr

Salary Max: $17.50/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.

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