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.
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.
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.
Ability to maintain accuracy and production standards.
Oral and written communication skills.
Understanding of medical terminology.
Problem solving skills.
Attention to detail and accuracy.
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***