CARLO PAVON

*** **. ******** ***. # ***

West Orange, NJ 07052

(m) 201-***-****

acgb14@r.postjobfree.com

Seeking a position with a progressive company that may have use for my specific skills and accomplishments. Strengths as evidenced by job history, are in data maintenance and reporting. Strongly support open effective communication, task prioritization, and accurate and consistent reporting as key to achieving and exceeding goals. Note experience in many industries, which can positively be beneficial if given the opportunity to advance with your organization.

Work Experience

HORIZON BLUE CROSS & BLUE SHIELD OF NEW JERSEY

Product Administration Consultant I/ Product Engineer I, 05/10 - 01/14

Responsible for researching, maintaining and supporting product information within the Enterprise.

Responded to internal/external inquiries on product benefit information, providing accurate interpretation of benefits and ensures correct benefits are loaded to downstream applications and supporting areas.

Supported the product development, implementation and maintenance for assigned products.

Assisted with the creation of new product introduction presentations and training.

Assisted in monitoring product performance.

Assisted in identifying supporting data for product steerage options.

Supported the Account Implementation/Sales team to ensure accurate understanding of the source document.

Performance Guarantee Accounts Auditor, 01/08 - 05/10

Auditing for accuracy of sales documents, institutional and/or professional claim processes, and payment and reimbursement transactions for Performance Guarantee Accounts.

Collecting a selected number of samples to cover a vast scope of audit transactions.

Citing inaccuracies to involved areas in order to ensure correct documentation and claim processing as per benefit sales agreements.

Policy Support Specialist, 07/06 - 01/08

Resolving dental, institutional and/or professional claims by determining the appropriate method of claim payment.

Rendering prompt and accurate medical policy determinations regarding claims payments.

Responding promptly and appropriately to requests for information on trends, system performance issues to medical review staff or other members of management.

Institutional Claims Specialist, 01/05 - 07/06

Processing and delicately analyzing medical claims submitted by Healthcare Facilities.

Boosted my department’s productivity and quality since arriving to the company.

POPULAR CLUB

Sales/Customer Satisfaction Supervisor/Trainer, 04/02 - 11/04

Responsible for staff of 25 Telephone Sales and Customer Satisfaction Associates.

Monitored ACD system to ensure high productivity and allocated resources to achieve sales and service level goals.

Oversaw payroll process, and provided monthly, quarterly and annual reviews for direct reports.

Developed incentives and rewards plans to recognize and retain employees.

Received the Circle of Excellence award for outstanding contribution towards achievement of Popular Club Goals, including employee and customer retention.

Interviewed, hired and trained new employees.

Quality Assurance Leader, 04/02 - 04/03

Supervised call center quality assurance process.

Implemented quality assurance compliance initiatives.

Assisted in the development of employee communications and retention strategies.

Audited web chat, email, telephone and written correspondence and provided timely feedback to Associates.

NEXTEL COMMUNICATIONS

Corporate Accounts Assistant Supervisor, 06/01 - 04/02

Trained and mentored staff.

Recommended changes to workflow and procedures to ensure maximum productivity.

Implemented and evaluated customer retention initiatives.

Interfaced with customers to resolve complaints relative to billing and service.

Created and maintained an environment which fostered empowerment and flexibility with customers to accomplish corporate goals and achieve unparalleled customer service.

Technical Support Specialist, 09/99 - 06/01

Accessed Nextel subsystems to correct improper provisioning.

Responsible for timely and effective resolution of high-priority escalations.

Trained and mentored Tier 1 Associates.

Educated customers on technical hardware/software specifications.

VOCALL COMMUNICATIONS

Operations Assistant Technician, 09/97 -09/99

Researched and resolved technical support issues.

Assisted in the development of telecommunications routing initiatives.

Education

MIDDLESEX COUNTY COLLEGE

Human Resources Certificate 2014

ST PETER’S COLLEGE OF NJ

Bachelor of Business Administration, Projected by 2015-2016

Dean’s List: Fall 2008

Skills

Read, write and speak fluent Spanish, NASCO systems, QBLUE claim processing system, Microsoft Office, Nortel Switching Systems, AS400, Unix-based applications, Novell NetWare 3.12, Internet Research, Lotus Notes

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