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