Summary: The primary responsibility of this role consists of reviewing member transportation requests that are over the contractual mileage guidelines. ESSENTIAL FUNCTIONS • Reviewing and making approval/denial determinations for all member transportation requests that are outside of the geographical mileage guidelines and reviewing requests to non-covered Medicaid services and or locations. • Review for approval/denial determinations for facilities wishing to participate in the organization’s Subscription/Standing Order Transportation Program. • Process subscription/Standing order transportation requests from approved facilities for NEMT. • Investigates transportation provider complaints lodged against Medicaid members during transportation and issuance of Member Warning Letters as warranted. • Responsible for completing the three departmental reports: daily denial letters, member no-show letters, and monthly denial summary. • Run Monthly Denial Summary Report for covered regions and send to the client. Required Skills and Abilities • Knowledge of Medicare and Medicaid, community resources, dialysis, and the nursing home placement process. • Must possess entry to mid-level proficiency in Microsoft Word and Excel. • Excellent written and verbal communication skills. • Possesses and demonstrates multi-tasking skills in a high-stress environment while working with multiple internal departments, as well as external entities. • Analytical thinker with good judgment. • Well-organized, self-directed individual, who is flexible and takes direction well. • Possesses a high level of interpersonal skills to handle sensitive and confidential situations. Minimum Required Education/Training • High School graduate or equivalent. • 2 years of customer service experience and or employment in the healthcare industry.