Customer Services Representative

Nemours is seeking a Customer Service Rep in Jacksonville, FL

Answering incoming calls from guarantors and insurance companies for provider and hospital related questions. Resolution of guarantor and/or insurance company questions and issues in accordance with established guidelines and procedures. Provide excellent customer service at all times ensuring each contact is a uniquely satisfying experience for the caller.

Essential Functions

• Answer incoming calls from guarantors and insurance companies in a high pressure call center
• Research and resolve issues for guarantors, insurance companies and our internal customers.
• Perform necessary account maintenance functions, verify demographics, update guarantor information and fulfill the customer or insurance companies requests.
• Verify and process insurance coverage information, perform insurance adjustments and/or change the insurance filing order as needed.
• Review and analyze balances (credit or debit) to determine if the guarantor or insurance owes additional money or if a refund is due.
• Establish payment plans, set-up recurring payments and transfer guarantor funds as needed to clear any outstanding guarantor balances. Troubleshoot issues with the online payment portal for guarantors.
• If resolution is not possible by the Customer Service Representative, the issue will be escalated as appropriate.
• Perform annual required system upgrade and computer based training
• Thorough knowledge of insurance payors (Commercial, Government, HMO/PPO and Indemnity) preferred

Requirements

• High School Diploma
• 1-3 years of healthcare experience