Portal Monitoring Specialist Position Summary The Portal Monitoring Specialist is responsible for monitoring member trips scheduled through the member portal and verifying that the destinations are legitimate, approved medical facilities or other authorized locations. This position plays a critical role in helping prevent fraud, waste, and abuse (FWA) by identifying and addressing trips scheduled to unapproved or potentially inappropriate destinations. The Specialist will review trip destinations, validate addresses using approved resources and established procedures, and take appropriate action when a destination does not meet program requirements. When an unapproved location is identified, the Specialist is responsible for canceling the trip in accordance with company policy and contacting the member to explain that transportation cannot be provided to the requested destination because it is not an approved location. Essential Duties and Responsibilities Monitor trips scheduled through the member portal to identify destinations requiring verification. Review and validate member trip addresses to determine whether they correspond to legitimate medical facilities or other approved locations. Use approved databases, internal systems, mapping tools, provider information, and other authorized resources to verify destination legitimacy. Confirm that medical facilities and destinations meet established program and transportation requirements. Identify trips scheduled to residential addresses, businesses, non-medical locations, or other destinations that are not approved under program guidelines. Recognize potential indicators of fraud, waste, and abuse associated with member transportation activity. Cancel trips when the requested destination is determined to be unapproved or otherwise does not meet established requirements. Contact members when a trip is canceled due to an unapproved destination and clearly explain the reason for the cancellation. Provide members with appropriate guidance regarding approved destinations and transportation requirements. Document all destination-verification activities, trip cancellations, member contacts, and actions taken accurately and timely. Escalate questionable or potentially fraudulent activity to the appropriate department or leadership team for further review. Maintain confidentiality and comply with applicable privacy, security, regulatory, and company requirements. Follow established workflows, policies, procedures, and quality standards related to portal monitoring and FWA prevention. Identify recurring trends or patterns involving questionable destinations and communicate findings to leadership. Work collaboratively with Operations, Member Services, Compliance, Transportation, and other applicable teams when issues require additional review. Maintain a high level of accuracy while monitoring a potentially high volume of portal activity. Fraud, Waste & Abuse Prevention A primary responsibility of this position is to serve as an early control point for preventing inappropriate use of the transportation benefit. The Specialist is expected to exercise sound judgment when determining whether a requested destination is legitimate and approved. The Specialist should be able to: Identify suspicious, inconsistent, or unusual destination patterns. Distinguish legitimate medical facilities from locations that do not appear to provide qualifying medical services. Recognize potential attempts to use the transportation benefit for non-covered or non-medical purposes. Take immediate action when a destination clearly falls outside established guidelines. Escalate potential FWA concerns rather than making assumptions when additional investigation is warranted. Maintain detailed documentation to support decisions and provide an appropriate audit trail. Member Communication The Portal Monitoring Specialist will occasionally need to contact members regarding trips that cannot be fulfilled because the destination is not an approved location. Communication should be professional, respectful, and clear while maintaining the integrity of program requirements. The Specialist should : Clearly explain that the requested destination does not meet transportation program requirements. Avoid accusatory or judgmental language when communicating with members. Provide information about approved destination requirements when appropriate. Answer basic member questions regarding the transportation benefit and approved locations. Escalate complex member concerns or disputes to the appropriate team.

Pay:

$16.50 - $17.50 per hour Expected hours: 40.0 per week

Benefits:

401(k) 401(k) matching Dental insurance Health insurance Life insurance Paid time off Vision insurance

Education:

High school or equivalent (Preferred)

Experience:

Call center: 2 years (Required)

Member Portal:

1 year (Required)

Work Location:

In person