Healthcare investigation and quality
Investigating claims, benefits, and member-service issues; verifying records and documenting the next action.
Primary laneBilingual Customer Advocate
Remote roles at HCSC (HealthSpring), CVS, and Paylocity.
I’m Jose, a bilingual healthcare operations professional in Houston. I research member issues, coordinate with the right teams, and keep members updated.
Jun 2025 – Present
Bilingual Customer Advocate, Medicare Advantage → Medicare Supplement
Handling 200+ member calls per month while investigating Medicare claims, benefits, pharmacy, and billing questions; coordinating corrections and following up with members.
Read the coverage-restoration storyJan 2024 – Jun 2025
Collections Specialist
Resolving business and consumer account issues, including support in Spanish. Maintained a 100% quality score for seven months.
Sep 2022 – Dec 2023
Account Manager II
Helping customers use Paylocity’s payroll and HR products, set up payroll batches and codes, and troubleshoot payroll, onboarding, and reports. Handled 100+ client calls per month.
Explore my SaaS customer-support workAug 2021 – Sep 2022
Customer Service Representative
Handling medical claims and benefits inquiries in a high-volume environment. Reported 99%+ accuracy while meeting production requirements.
See my approach to claims inquiries2019 – 2021
Academic Advising Assistant
Supporting scheduling, student-record distribution, and enrollment and financial-aid questions.
English and Spanish are working languages for me. The goal is to preserve the meaning, explain what is still pending, and make the next action understandable.
Read a bilingual explanation sampleInvestigating claims, benefits, and member-service issues; verifying records and documenting the next action.
Primary laneI’m pursuing SaaS customer and product support and customer onboarding roles, particularly with payroll and HR software. My Paylocity platform work—helping customers get acclimated, set up payroll batches and codes, and troubleshoot products—informs this direction.
Secondary laneExploring how to check AI-assisted notes against source records, preserve unanswered questions, and keep people responsible for the final decision.
Learning practice