The Hartford Customer Service Rep- Group Benefits in OMAHA, Nebraska

Title: Customer Service Rep- Group Benefits

Location: United States-Nebraska-Omaha

Other Locations: United States-Oregon-Portland, United States-Florida-Plantation, United States-Maine-South Portland

Job Number: 1801341

ABOUT THIS OPPORTUNITY

To increase member satisfaction, retention, and growth by efficiently delivering competitive services to members and providers through a fully-integrated organization staffed by knowledgeable, customer-focused professionals supported by exemplary technologies and processes.

START DATE: June 21, 2018

TRAINING: 5 weeks paid training. Training Hours:

8:00am – 4:30 EST

8:00am – 4:30 CST

7:00am – 3:30 PST

POST TRAINING: Monday – Friday, must be available for 8 hours of work between the hours of 8:00 AM EST to 8:00 PM EST. *Work hours are not determined until after training and are based on business need.

RESPONSIBILITIES:

  • Handles customer questions and resolves issues via telephone, internet, or written correspondence from members, providers, and plan sponsors.

  • Triages resulting rework to appropriate staff. Documents and tracks contacts with members, providers and plan sponsors.

  • Explains member's rights and responsibilities in accordance with contract.

  • Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system.

  • Educates providers on our self-service options; Assists providers with credentialing and re-credentialing issues.

  • Responds to requests regarding litigation; lawsuits.

  • Handles extensive file review requests. Assists in preparation of complaint trend reports.

  • Assists in compiling claim data for customer audits.

  • Determines medical necessity, applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal referrals.

  • Handles incoming requests for appeals and pre-authorizations

  • Performs review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible. Performs financial data maintenance as necessary.

  • Uses applicable system tools and resources to produce quality letters and spreadsheets in response to inquiries received.

Qualifications:

QUALIFICATIONS

  • Customer Service experience in a transaction based environment such as a call center or retail location preferred.

  • Experience working in a fast paced, production driven environment.

  • Ability to multi-task to accomplish workload efficiently.

  • Analytical skills.

  • Ability to maintain accuracy and production standards.

  • Computer skills: Microsoft office, navigating through multiple screens

  • Oral and written communication skills.

  • Understanding of medical terminology.

  • Problem solving skills.

  • Attention to detail and accuracy.

  • Negotiation skills.

  • High School or GED equivalent required.

BENEFITS ARE EFFECTIVE DAY 1 OF EMPLOYMENT!

Your salary is just one component of your total rewards package. We also offer traditional benefits, and: Paid Volunteer Opportunities, 152 hours of PTO year 1, Domestic Partner Benefits, Employee Recognition, Adoption Expense Benefits, Wellness Program, Tuition Reimbursement and more.

BEHAVIORS AT THE HARTFORD:

  • Deliver Outcomes – Demonstrate a bias for speed and execution that serves our shareholders and customers.

  • Operate as a Team Player – Work together to drive solutions for the good of The Hartford.

  • Build Strong Partnerships – Demonstrate integrity and build trust with others.

  • Strive for Excellence – Motivate yourself and others to achieve high standards and continuously improve.

Equal Opportunity Employer/Females/Minorities/Veterans/Disability/Sexual Orientation/Gender Identity or Expression

*No Agencies Please

Job: Customer Service Star

Primary LocationUnited States-Nebraska-Omaha

Other LocationsUnited States-Oregon-Portland, United States-Florida-Plantation, United States-Maine-South Portland

ScheduleFull-time

Job LevelEntry Level

Education LevelHigh School Diploma/GED (±11 years)

Job TypeStandard

ShiftDay Job

Employee StatusRegular

Overtime StatusNon-exempt

TravelNo

PostingApr 30, 2018, 10:51:38 AM

Remote Worker OptionNo

The Hartford is an equal employment and affirmative action employer. All qualified applicants will receive consideration without regard to race, color, sex, religion, age, national origin, disability, veteran status, sexual orientation, gender identity or expression, marital status, ancestry or citizenship status, genetic information, pregnancy status or any other characteristic protected by law. The Hartford maintains a drug-free workplace and is committed to building inclusion and leveraging diversity.