Healthcare Administration & Customer Service Specialist
Resume:
PENNY C. MAESTAS
Fayetteville, NC *****
**********.*****@*****.***
PROFESSIONAL SUMMARY
Dedicated customer service and healthcare support professional with extensive experience in insurance,
medical billing, patient care, and administrative operations. Recognized for accuracy, empathy, and strong
problem-solving skills. Skilled in managing high-volume workloads, resolving complex issues, and delivering
exceptional service in fast-paced environments. Seeking a long-term role where reliability, professionalism,
and compassion make a meaningful impact.
CORE SKILLS- Customer Service & Call Center Expertise- Healthcare & Insurance Support- Medical Billing & Revenue Cycle- Administrative & Front Office Operations- Account Management & Case Resolution- Training, Coaching & Client Support- CRM & Multi-System Navigation- HIPAA Compliance & Data Accuracy- Problem-Solving & Conflict Resolution
PROFESSIONAL EXPERIENCE
Customer Service Agent - Alight Retiree Health Solutions (Temporary)
Instant Teams - Southern Pines, NC Sep 2025 - Dec 2025- Guided retirees transitioning to Medicare, explaining HRA benefits and plan options.- Scheduled appointments with Licensed Benefit Advisors during Open Enrollment.- Created and updated customer accounts to ensure accurate eligibility and enrollment.- Resolved HRA issues including balances, reimbursements, claim discrepancies, and documentation.- Assisted with portal navigation, login issues, password resets, and account setup.- Educated retirees on timelines, plan comparisons, and benefit activation steps.- Connected customers with employer benefit centers for 401(k) and retirement questions.
- Documented all interactions and case notes with accuracy and compliance.- Managed high call volumes with professionalism and empathy.- Escalated complex cases to senior teams for timely resolution.
Dental Receptionist
Dr. Thomas Autobee - Pueblo, CO Jan 2024 - Jan 2025-
Managed patient check-ins, intake forms, and appointment scheduling.- Verified insurance, processed claims, and collected payments.- Maintained accurate patient charts and ensured HIPAA compliance.- Supported dental staff with workflow coordination and patient communication.- Managed inventory, referrals, treatment plans, and front-office organization.
Dialysis Technician
Fresenius Medical Care Jan 2022 - May 2022-
Prepared dialysis machines and treatment stations per clinical standards.- Monitored and documented patient vitals throughout treatment.- Performed needle cannulation and maintained sterile technique.- Troubleshot machine issues and followed infection-control protocols.- Provided comfort, mobility assistance, and emotional reassurance to patients.- Completed flow sheets, charts, and inventory restocking.
Warehouse Worker (Temporary)
FedEx Ground Package Mar 2022 - May 2022-
Sorted, scanned, and processed high-volume packages accurately.- Loaded/unloaded trucks using safe lifting techniques.- Operated conveyor and scanning systems.- Identified damaged or misrouted packages and reported issues.- Maintained OSHA-compliant work areas and met productivity goals.
Customer Service Agent - Blue Cross Blue Shield
Concentrix Pueblo Nov 2021 - Jan 2022-
Assisted members with benefits, eligibility, claims, and coverage questions.- Explained deductibles, co-pays, prior authorizations, and out-of-pocket costs.
- Resolved billing discrepancies and provider network issues.- Documented all interactions accurately in CRM systems.- Met performance goals for call quality and customer satisfaction.
Customer Service Agent - Coach (Temporary)
Adecco Pueblo Nov 2021 - Jan 2022-
Supported clients with onboarding, account access, and service questions.- Resolved inquiries via phone, email, and internal systems.- Documented interactions and updated CRM records.- Identified recurring issues and recommended improvements.- Maintained confidentiality and quality standards.
Customer Service Back-Office Specialist
AT&T - Remote (Pueblo, CO) Mar 2019 - Mar 2021-
Processed account updates, billing adjustments, and escalated cases.- Resolved complex issues requiring research and multi-department coordination.- Analyzed customer data to identify trends and prevent recurring issues.- Supported fraud prevention and handled sensitive account information.- Met accuracy, turnaround time, and quality assurance metrics.
Customer Service Agent - Santander Bank
Concentrix Feb 2019 - Apr 2019-
Assisted customers with banking inquiries, online access, and account maintenance.- Resolved fraud alerts, unauthorized transactions, and debit card issues.- Processed account updates and card replacements.- Educated customers on banking products and fee structures.- Maintained compliance with federal banking regulations.
Customer Service - Blue Cross Blue Shield
Convergys Jan 2017 - Jun 2018-
Assisted members with benefits, eligibility, and claims inquiries.- Explained deductibles, co-insurance, and prior authorization requirements.- Resolved billing issues and coordinated with providers.
- Ensured HIPAA compliance and accurate documentation.- Met call quality and satisfaction goals.
Customer Service Rep / Email Agent (Temporary)
Adecco - Pueblo, CO Nov 2016 - Jan 2017-
Responded to customer inquiries via email with accuracy and professionalism.- Improved response times and customer satisfaction through efficient communication.
Department of Defense Patient Care Advocate
Express Scripts Sep 2014 - Sep 2016- Served as SME for training classes and special clients.- Supported military families with pharmacy and benefits issues.- Streamlined training processes and improved client understanding.
Home Health Aide
Feb 2012 - Feb 2014-
Provided in-home care and support for spouse.- Assisted with daily living activities, mobility, and medication reminders.- Maintained a safe, supportive environment with compassion and patience.
Accounts Receivable Specialist / Senior Biller
Zotec Partners Inc. Sep 2007 - Dec 2011-
Processed medical billing and resolved claim discrepancies.- Improved revenue cycle performance through accurate billing practices.
Drug Subsidy Coordinator / Pharmacy Technician
Cardinal Health - Pueblo South/Eastside Clinics Aug 2003 - Sep 2007-
Coordinated drug subsidy programs and improved patient medication access.- Collaborated with providers to resolve prescription issues.
Business Office Medical Biller
Arkansas Regional Medical Center - La Junta, CO- Processed claims, reduced billing errors, and improved revenue cycle accuracy.
- Reviewed billing data and ensured timely submissions.
EDUCATION
GED - Otero Junior College
La Junta, CO 1983
AAS - Medical Assistant (With Honors)
National College, Pueblo, CO 1989 - 1991
Certificate - Collectors Certification Prep School
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