Customer Services Representative

Nemours Children's Health • Jacksonville, FL

6d

About The Position

Nemours is seeking a Customer Service Representative in Jacksonville, Florida. The role answers questions from guarantors and insurance companies about provider- and hospital-related matters, and resolves their questions and issues according to established guidelines and procedures. The representative provides excellent customer service, aiming to make each caller’s experience satisfying.

The position works in a high-pressure call center and involves researching and resolving issues for guarantors, insurance companies, and internal customers. Duties include maintaining accounts and demographic information, processing insurance coverage and adjustments, reviewing account balances, arranging payment plans and recurring payments, transferring funds, and troubleshooting the guarantor online payment portal. Issues that cannot be resolved are escalated as appropriate. The representative also completes annual system upgrades and computer-based training.

Nemours Children's Health is an internationally recognized pediatric health system serving more than 1.7 million patient encounters annually across six states. It includes two freestanding children's hospitals, more than 80 primary, urgent, and specialty care practices, and more than 40 hospital partnerships. The $1.7 billion nonprofit system is backed by the Nemours Foundation and Alfred I. duPont Trust and focuses on clinical care, research, education, advocacy, and prevention. Its Whole Child Health approach emphasizes both prevention and treatment in partnership with communities. Nemours is committed to culturally relevant care, reducing health disparities, and creating an environment where associates, patients, and families feel supported and valued.

Requirements

• High school diploma.
• 1–3 years of healthcare experience.

Nice To Haves

• Thorough knowledge of insurance payors, including Commercial, Government, HMO/PPO, and Indemnity.

Responsibilities

• Answer incoming calls from guarantors and insurance companies in a high-pressure call center.
• Research and resolve issues for guarantors, insurance companies, and internal customers.
• Perform account maintenance, verify demographics, update guarantor information, and fulfill customer or insurance company requests.
• Verify and process insurance coverage information, perform insurance adjustments, and change the insurance filing order as needed.
• Review credit and debit balances to determine whether the guarantor or insurer owes money or a refund is due.
• Establish payment plans, set up recurring payments, and transfer guarantor funds to clear outstanding balances.
• Troubleshoot issues with the guarantor online payment portal.
• Escalate issues when they cannot be resolved by the Customer Service Representative.
• Perform required annual system upgrades and complete computer-based training.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED