Jose Landaverde
Houston, TX | [email protected]
joselandaverde.com | English and Spanish
Healthcare Claims Research | Appeals and Member Support
Bilingual healthcare operations professional experienced in researching Medicare Advantage and supplemental plan claims, benefits, and billing questions; coordinating member follow up; and explaining accurate next steps. Brings related claims inquiry, data preparation, and record review experience for claims and appeals support.
Professional Experience
HCSC (HealthSpring) — Remote (Houston, TX)
Customer Advocate, Medicare Advantage → Medicare Supplement | Jun 2025 – Present
- Handle 200+ member calls per month while researching Medicare Advantage and supplemental plan claims, benefits, pharmacy, billing, and questions about member files.
- Coordinate with pharmacies and internal teams, explain next steps, and follow up with members.
- Helped restore a member’s suspended coverage by investigating a billing error tied to an address and coordinating corrections with billing through resolution.
Bank of America — Houston, TX
Collections SpecialistJan 2024 - Jun 2025
- Maintained a 100% quality score for seven months in business and consumer collections.
- Reconciled customer-reported information with system records to resolve account discrepancies and address payment delays.
- Assisted customers who spoke English and Spanish with payment arrangements and account concerns.
Paylocity — Remote
Account Manager IISep 2022 - Dec 2023
- Helped new customers get acclimated to Paylocity’s payroll and HCM suite, including setting up payroll batches and earning and deduction codes.
- Troubleshot payroll, onboarding, reporting, and product questions by guiding assigned clients through the platform.
- Handled 100+ client calls per month as a primary contact for assigned clients and supported their use of Paylocity products.
CVS Health / Meritain Health — Remote
Customer Service RepresentativeAug 2021 - Sep 2022
- Reported 99%+ accuracy while responding to medical claims and benefits inquiries in a busy queue and meeting production requirements.
Phoenix College — Phoenix, AZ
Academic Advising Assistant2019 - 2021
- Helped students navigate enrollment and financial aid processes; coordinated staff scheduling, student record distribution, and office supplies.
Skills
Medicare claims and benefits research; billing discrepancy investigation; member service follow up; service request coordination; account reconciliation; Excel; Salesforce and CRM systems; English and Spanish
Education and Training
Phoenix College | College coursework, 2017 - 2020
HIPAA Privacy and Security training • FDCPA compliance knowledge