Bilingual Medicaid Customer Advocate

Maryanne Pantoja

Chicago, IL ***** 312-***-**** ********.*******@*****.***

EDUCATION

University of Michigan Ann Arbor, MI

Bachelor of Arts, Organizational Studies Major September 2019 - April 2023

● GPA: 3.0/4.0

WORK EXPERIENCE

Health Care Service Corporation Chicago, IL

Bilingual Customer Advocate II - Medicaid June 2024 - Present

● Manage 30-70+ inbound calls daily, providing bilingual support to Medicaid members regarding eligibility, claims, pre-authorizations, appeals, and care coordination.

● Maintain 96%+ First Call Resolution rate, reducing follow up requests and improving overall member experience.

● Ensure strict compliance with Medicaid regulations, HIPAA, and internal quality standards

● Coordinate with clinical and administrative teams to clarify benefits, resolve escalations, support appeals, and connect members with appropriate services.

● Document all interactions thoroughly in company systems, contributing to smooth case management. University of Michigan — Recreation Sports Ann Arbor, MI Building Supervisor/Membership Service Assistant October 2020 - April 2023.

● Oversaw daily facility operations, verified patron access, and ensured adherence to safety procedures.

● Utilized Fusion software for membership management, equipment checkout, and sales transactions

● Responded to patron issues, coordinated with supervisors, and provided clear communication to resolve concerns.

● Maintained a clean and safe environment by completing regular equipment sanitation and monitoring facility activity.

Edgewood Valley Country Club La Grange, IL

Server June 2019 - August 2022

● Delivered high-quality service to club members, managing multiple tables in a fast-paced environment.

● Coordinated with kitchen and bar staff to ensure accurate and timely order delivery.

● Communicated effectively to reduce wait times, verify meal accuracy, and prevent service issues.

● Performed closing duties including restocking, organization, and facility upkeep to support efficient operations.

LEADERSHIP EXPERIENCE

Spanish Language Internship Program Ann Arbor, MI

Online/In-person Tutor Volunteer August 2020 - December 2020; January 2023 - April 2023

● Delivered personalized Spanish tutoring sessions, both virtually and in person, enhancing student comprehension and confidence.

● Assessed student progress, provided constructive feedback, and recommended learning strategies to support improvement.

● Collaborated with students, parents, teachers, and administrators to tailor lesson plans and meet individual learning needs.

SKILLS

● Strong organizational, administrative, and communication skills

● Scheduling, documentation, and Microsoft Office Suite

● Fluent in English & Spanish

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