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:
Job Requirements
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.
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