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Jacksonville, FL

Customer Services Representative

Job Description:

Nemours is seeking a Customer Service Representative (Full-Time), to join our team in Jacksonville, Florida.

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.

This position is responsible for the following:
  • 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

Job Requirements
  • High School Diploma required.
  • Specialized (1 year of training beyond high school.
  • Two (2) or more years of Customer Service, Medical Call Center experience required.
  • Insurance knowledge preferred.

Job ID: 4687830798746494463

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