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Customer Service Rep - Group Benefits. South Portland ME - (Job Number: 1802095)

06/27/2018Call Center
Job Location:
South Portland, ME
Metro Area:
ME - Portland/Auburn
Company Name: The Hartford
Website:  Click to Visit

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: August 16, 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.


  • 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.



  • 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.


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.



  • Deliver Outcomes Drive exceptional performance to move the company forward.
  • Work as a Team Collaborate inclusively to achieve the best results.
  • Build Strong Partnerships Create lasting value through trusted relationships.
  • Strive for Excellence Always look for ways to continuously improve.


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

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