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
