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Customer Services Representative

NemoursCustomer Support
Hiring from
United States
Work type
Hybrid
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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

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