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Customer Service Rep-Group Benefits - (Job Number: 1703276)

01/02/2018Call Center
Job Location:
Omaha, NE
Metro Area:
NE - Omaha
Company Name: The Hartford
Website:  Click to Visit
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: February 26th, 2018

TRAINING: 5 weeks paid training with a start time of 8:30 AM EST.

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. 

 

JOB 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

JOB QUALIFICATIONS   

  • Experience in a production environment.

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

  • High School or GED equivalent required.

  • Ability to multi-task to accomplish workload efficiently.

  • Analytical skills.

  • Ability to maintain accuracy and production standards.

  • Technical skills.

  • Oral and written communication skills.

  • Understanding of medical terminology.

  • Problem solving skills.

  • Attention to detail and accuracy.

  • Negotiation skills. 

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***

 
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