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 healthcare experience preferred Strong insurance knowledge and medical office background preferred