Customer Service Assistant Project
Resume:
ISABELA PAGAN
HIGHLY MOTIVATED AND DEPENDABLE PROFESSIONAL WITH EXPERIENCE IN MEDICAL
COORDINATING, APPEALS & GRIEVANCES, PROJECT MANAGEMENT, DATA ANALYSIS, AND
CUSTOMER SERVICE. EXCEPTIONAL SKILLS IN RESOLVING COMPLEX ISSUES, OPTIMIZING
WORKFLOWS, AND ENSURING REGULATORY COMPLIANCE. COMMITTED TO DELIVERING TOP-TIER
CUSTOMER SERVICE, ATTENTION TO DETAIL AND ENHANCING TEAM PERFORMANCE THROUGH
COLLABORATIVE LEADERSHIP AND COMMUNICATION. ADEPT IN MANAGING DENTAL AND MEDICAL
CLAIMS, AS WELL AS SUPPORTING CLINICAL RESEARCH AND HEALTHCARE ANALYTICS INITIATIVES
Summary
W% = *************@*****.***
Q Williamstown NJ, 08094
Core Competencies
e Appeals & Grievances Resolution
¢ Dental & Medical Claims Processing
¢ Clinical & Healthcare Data Analysis
e Regulatory Compliance (HIPAA, NCQA)
e Project & Office Management
¢ CRM & ERR Software (Epic, Salesforce, etc.)
e Research Coordination & Report Writing
e Scheduling and Audits
¢ Customer Service Excellence
e Payroll & Benefits Administration
¢ Microsoft Office Suite Adobe Creative Suite
References
SEMEIN GOODALL - CUF STUDIO
MANAGER
YNNEJ PORRO- AETNA HEALTH
AETNA MANAGER
Professional Experience
APPEALS AND GRIEVANCES MEDICAL COORDINATOR
AETNA- REMOTE
e Knowledge of clinical terminology, regulatory and accreditation requirements
e Responsible for intake, investigation and resolution of appeals, complaints and
grievances scenarios for all products, which may contain multiple issues and,
may require coordination of responses from multiple business units
e Identifies trends and emerging issues and reports on and gives input on potential
solutions
e Ability to meet demands of a high paced environment with tight turnaround times
ASSISTANT PROJECT MANAGEMENT
CUF Studio and Boutique
e Reported project status on budget, resources, technical issues, or customer
satisfaction.
e Received and processed incoming merchandise, including quality checking and
coordinated with external vendors for resource needs.
e Experienced with setting and styling photoshoots, as well as social media and
communications platforms.
e Skilled in using various software applications and programs including Microsoft
Office and Adobe Creative Suite.
Assistant Manager
LOFT - Mount Laurel
e Process payroll information, manage employee benefits programs, assist with new
employee training and conduct performance reviews to track overall progress.
e Coordinated with vendors, supported in-store visual merchandising and social
media marketing.
e Processed merchandise, ensured quality assurance, and provided customer
support.
e Gained exposure to brand communications and analytics software for consumer
behavior insights.
Contact this candidate