Summary
Overview
Work History
Education
Skills
Timeline
Generic

Aileen Grundy

Atlanta,GA

Summary

Customer service professional with extensive experience in high-volume merchant support, enhancing client relationships through effective problem-solving and communication. Proven track record of reducing churn and achieving an 80% first-call resolution rate while leveraging JIRA for process improvement and escalation management.

Overview

12
12
years of professional experience

Work History

Concierge, Priority Support for High-Volume Merchants

Square / Block, Inc.
Atlanta, GA
01.2022 - 06.2026
  • Provided priority technical and operational support for high-value merchants, resolving payment, integration, payroll processing, and product configuration issues to ensure seamless operations.
  • Partner closely with Account Managers to resolve escalated merchant concerns and strengthen long-term client relationships.
  • Successfully reduced merchant churn by improving communication, resolving service concerns, and rebuilding trust with dissatisfied accounts.
  • Supported merchant onboarding and product adoption by recommending tailored solutions, such as Square for Restaurants and Square for Retail, enhancing user engagement.
  • Serve as a subject matter resource for peers by assisting with complex escalations and process-related questions.
  • Conduct root-cause analysis for hardware, software, network, and payroll-related issues to ensure timely resolution.
  • Identified recurring customer concerns and recommended process improvements, driving enhancements to customer experience and product performance.

Payroll Support Specialist (Contractor)

Check Technologies
Louisville, KY
07.2026 - 10.2026
  • Managed high volume of partner requests via written communication, ensuring timely responses.
  • Balanced urgent requests within SLA timeframes to maintain operational efficiency.
  • Investigated complex payroll issues, tracing root causes through in-depth tax analysis.
  • Collaborated with engineering, product, tax, and risk teams to troubleshoot payroll problems.

Recovery Analyst, Payment Integrity

Equian
Louisville, KY
07.2018 - 04.2020
  • Reviewed audit reports and medical claims to identify overpayments and ensure billing accuracy.
  • Researched contracts, verified claim information, and resolved audit discrepancies according to company procedures and client guidelines.
  • Managed recovery efforts for overpaid medical claims while ensuring provider appeals were processed accurately and on time.
  • Improved audit accuracy by approximately 35% through detailed claim analysis and quality review processes.
  • Verified HCPCS coding accuracy and utilized multiple client systems including Aetna Citrix, UHC, Summacare, and AuditPoint.

Resolution Specialist, Grievance & Appeals

Humana, Inc.
Louisville, KY
11.2015 - 11.2017
  • Managed complaints, grievances, and appeals for Medicare, prescription drug, and commercial insurance plans.
  • Ensured compliance with regulatory requirements, accreditation standards, and internal processing timelines.
  • Investigated and analyzed complex customer concerns, identifying trends and routing issues appropriately for resolution.
  • Utilized internal systems including CCP2, GCP, HOD, and MOD to document and manage cases.

MRA Customer Care Specialist Records Retrieval Specialist

Humana, Inc.
Louisville, KY
06.2014 - 11.2015
  • Requested and reviewed medical records for HEDIS, Medicare, and commercial insurance audits to support accurate diagnosis reporting and documentation.
  • Verified claims data, dates of service, provider information, and facility records to ensure compliance and reporting accuracy.
  • Supported special projects and additional record review initiatives as assigned.

Education

Associates Degree - Communication

Jefferson Community College
Louisville, KY

Skills

  • JIRA
  • Ticketing, bug tracking, escalation management
  • Root-cause analysis and engineering documentation
  • Cross-functional issue resolution tracking
  • Claims & Audit Platforms
  • CCP2 (claims processing and resolution)
  • GCP (grievance and appeals processing)
  • HOD MOD (case management and regulatory workflows)
  • AuditPoint (payment integrity and audit review)
  • Aetna claims systems (audit and verification)
  • UnitedHealthcare systems (claims review and processing)
  • SummaCare systems (audit and claims validation)
  • Technical Systems
  • Citrix virtual environments (multi-client systems access)
  • Multi-platform navigation for healthcare and fintech workflows
  • Payment processing
  • Issue resolution
  • Process improvement
  • Customer relationship management

Timeline

Payroll Support Specialist (Contractor)

Check Technologies
07.2026 - 10.2026

Concierge, Priority Support for High-Volume Merchants

Square / Block, Inc.
01.2022 - 06.2026

Recovery Analyst, Payment Integrity

Equian
07.2018 - 04.2020

Resolution Specialist, Grievance & Appeals

Humana, Inc.
11.2015 - 11.2017

MRA Customer Care Specialist Records Retrieval Specialist

Humana, Inc.
06.2014 - 11.2015

Associates Degree - Communication

Jefferson Community College

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Aileen Grundy