Luisa Montoya
Sacramento
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
12
12
years of professional experience
Work History
Appeal and Grievances Specialist 2
Western Health Advantage
Sacramento, CA
07.2024 - Current
- Analyzed healthcare data to identify trends and improve patient outcomes.
- Collaborated with cross-functional teams to resolve complex case issues efficiently.
- Implemented quality control measures to enhance appeal resolution accuracy.
- Led initiatives to streamline workflows, reducing processing time by optimizing procedures.
- Managed high-stress situations with professionalism, ensuring that appeals were handled promptly and accurately even under tight deadlines or heavy caseloads.
- Paid attention to detail while completing assignments.
- Strengthened communication skills through regular interactions with others.
- Proved successful working within tight deadlines and a fast-paced environment.
- Demonstrated strong organizational and time management skills while managing multiple projects.
- Expedited resolution times for appeals cases by efficiently managing workload and prioritizing urgent matters.
- Worked effectively in fast-paced environments.
- Skilled at working independently and collaboratively in a team environment.
- Proven ability to learn quickly and adapt to new situations.
- Excellent communication skills, both verbal and written.
- Worked well in a team setting, providing support and guidance.
- Demonstrated respect, friendliness, and willingness to help wherever needed.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Passionate about learning and committed to continual improvement.
- Managed time efficiently in order to complete all tasks within deadlines.
- Conducted research to support decision-making for organizational strategies and initiatives.
- Followed all company policies and procedures to deliver quality work.
Appeal and Grievances Specialist 1
Ultimate Staffing / Western Health Advantage
Sacramento, CA
02.2024 - 07.2024
- Reviewed and processed appeals for accuracy and compliance with regulatory standards.
- Collaborated with cross-functional teams to resolve complex case issues efficiently.
- Implemented quality control measures to enhance appeal resolution accuracy.
- Led initiatives to streamline workflows, reducing processing time by optimizing procedures.
- Managed high-stress situations with professionalism, ensuring that appeals were handled promptly and accurately even under tight deadlines or heavy caseloads.
- Paid attention to detail while completing assignments.
- Strengthened communication skills through regular interactions with others.
- Learned and adapted quickly to new technology and software applications.
- Proved successful working within tight deadlines and a fast-paced environment.
- Demonstrated strong organizational and time management skills while managing multiple projects.
- Expedited resolution times for appeals cases by efficiently managing workload and prioritizing urgent matters.
- Worked effectively in fast-paced environments.
- Skilled at working independently and collaboratively in a team environment.
- Proven ability to learn quickly and adapt to new situations.
- Excellent communication skills, both verbal and written.
- Worked well in a team setting, providing support and guidance.
- Demonstrated respect, friendliness, and willingness to help wherever needed.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Passionate about learning and committed to continual improvement.
- Managed time efficiently in order to complete all tasks within deadlines.
Customer Service Associate
Med Aid Pharmacy
Sacramento, CA
04.2020 - Current
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Developed and actualized customer service initiatives to decrease wait times.
- Communicated with patients to collect information about prescriptions and medical conditions or arrange consultations with pharmacists.
- Established and maintained patient profiles, updating organizational database with current information.
- Processed incoming drug orders by checking deliveries against paperwork and updating computer system.
- Counted and labeled prescriptions with correct item and quantity.
- Prepared packaging and labels for prescriptions, verifying accuracy of dosage, side effects, interactions and refill instructions.
- Assisted pharmacist by filling prescriptions for customers and responding to patient questions regarding prescription and medication-specific issues.
- Monitored inventory levels to inform pharmacists of shortages and facilitate resupply.
- Completed cash register transactions by handling credit and cash payments using pharmacy register system.
- Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity.
Store Manager
CosmoProf Beauty Supply
Sacramento, CA
06.2014 - 08.2019
- Managed inventory control, cash control and store opening and closing procedures.
- Managed store employees successfully in fast-paced environment through proactive communication and positive feedback.
- Completed point of sale opening and closing procedures.
- Maximized sales and minimized shrinkage through excellent customer service and adherence to standard practices.
- Maintained proper product levels and inventory controls for merchandise and organized backroom to facilitate effective ordering and stock rotation.
- Coached sales associates in product specifications, sales incentives and selling techniques, significantly increasing customer satisfaction ratings.
- Set effective store schedules based on forecasted customer levels, individual employee knowledge and service requirements.
- Approved regular payroll submissions for employees.
- Rotated merchandise and displays to feature new products and promotions.
- Promoted team collaboration, performance and efficiency by fostering healthy environments focused on mutual success.
- Reconciled daily sales transactions to balance and log day-to-day revenue.
- Scheduled and led weekly store meetings for all employees to discuss sales promotions and new inventory while providing platform for all to voice concerns.
- Protected store from loss or theft by setting and enforcing clear security policies.
- Developed new store location from ground up by hiring and training efficient team.
Education
Bachelor of Science - Health Science
California State University - Sacramento
Sacramento, CA05-2024
Skills
- Bilingual
- Quality assurance
- Multitasking Abilities
- Critical thinking
- Analytical thinking
- Teamwork and collaboration
- Friendly, positive attitude
- Time management
- Attention to detail
- Problem-solving
Languages
Spanish
Native or Bilingual
English
Native or Bilingual
Timeline
Appeal and Grievances Specialist 2
Western Health Advantage
07.2024 - Current
Appeal and Grievances Specialist 1
Ultimate Staffing / Western Health Advantage
02.2024 - 07.2024
Customer Service Associate
Med Aid Pharmacy
04.2020 - Current
Store Manager
CosmoProf Beauty Supply
06.2014 - 08.2019
Bachelor of Science - Health Science
California State University - Sacramento