Customer Services Representative

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

• High School Diploma
• More than 1 year and up to 3 years experience

About Us

Nemours Children's Health is an internationally recognized pediatric health system serving more than 1.7 million patient encounters each year. We deliver care across six states through two freestanding children's hospitals - Nemours Children's Hospital, Delaware and Nemours Children's Hospital, Florida - along with a network of more than 80 primary, urgent, and specialty care practices and more than 40 hospital partnerships.

Backed by the Nemours Foundation and Alfred I. duPont Trust, our $1.7B nonprofit system is dedicated to improving children's health through clinical care, research, education, advocacy, and prevention. Our Whole Child Health approach focuses equally on prevention and treatment, partnering with communities to help every child thrive.

Inclusion and belonging guide our strategy and growth. We are committed to culturally relevant care, reducing health disparities, and fostering an environment where every associate, patient, and family feels supported and valued.

Learn more at Nemours.org .