Carlotta Gomez
Davenport
Summary
Healthcare and revenue cycle professional with over 8 years of experience in pharmacy operations, insurance verification, claims support, and high-volume member services. Proven ability to manage payor communications, resolve claim discrepancies, and maintain HIPAA compliance in remote and on-site environments. Recognized for accuracy, professionalism, and strong cross-functional collaboration in fast-paced healthcare settings.
Overview
14
14
years of professional experience
Work History
Payor Specialist
McKesson
11.2025 - 02.2026
- Conducted insurance verification and managed payor communications for healthcare/pharmaceutical services.
- Reviewed and processed claims to ensure billing accuracy and compliance with payer guidelines.
- Resolved claim discrepancies and denials through direct coordination with insurance carriers.
- Documented and tracked case activity using Zendesk and Maestro systems.
- Maintained strict HIPAA compliance and protected sensitive patient information.
- Collaborated cross-functionally to ensure timely reimbursement and reduced turnaround times.
Health Advisor II
Concentrix
08.2025 - 11.2025
- Assisted members with benefit inquiries, eligibility verification, and claims support.
- Navigated complex healthcare coverage questions in a high-volume call environment.
- Maintained quality and compliance standards while delivering patient-focused service.
- Utilized CRM platforms including Zendesk and Maestro for documentation and case management.
- Escalated complex cases to ensure timely and accurate resolution.
Pharmacy Technician
AllianceRx Walgreens Pharmacy
Orlando
12.2021 - 03.2025
- Provided technical and prescription support to patients via website and mobile platforms.
- Assisted with order processing for pickup and home delivery services.
- Ensured accuracy in prescription handling while maintaining HIPAA compliance.
- Delivered professional customer service to maintain patient trust and retention.
- Collaborated with pharmacists and insurance teams to resolve coverage issues.
Customer Service Representative
Aston Carter / Lifeworks
Orlando
08.2021 - 11.2021
- Managed inbound calls regarding healthcare plan inquiries and benefit concerns.
- Protected confidential member information in compliance with HIPAA standards.
- Maintained high satisfaction scores through proactive issue resolution.
Telecom Operator
Johns Hopkins Hospital
Baltimore
10.2018 - 05.2020
- Managed high-volume incoming and outgoing communications for hospital staff.
- Coordinated emergency paging for physicians and medical personnel.
- Demonstrated professionalism and composure in critical and time-sensitive situations.
Customer Support Specialist
PC Problem Repair
Baltimore
11.2014 - 12.2016
- Prioritized and escalated technical support tickets based on urgency.
- Handled inbound and outbound customer communications to resolve service issues.
Fresh Foods Department Clerk
Harris Teeter
Baltimore
01.2012 - 08.2014
- Provided product knowledge and food preparation guidance to customers.
- Maintained quality standards and customer satisfaction.
Education
Kaplan University - Criminal Justice
Kaplan University
Northern High School -
Northern High School
Baltimore, MDSkills
- Zendesk
- Maestro
- Salesforce
- Microsoft Office Suite
- Microsoft Teams
- Kronos
- 40 wpm
- Data Entry & Documentation
- Insurance Verification
- Claims Support
- HIPAA Compliance
- Revenue Cycle Support
- High-Volume Call Center Operations
Personal Information
Authorized To Work: U.S.
Timeline
Payor Specialist
McKesson
11.2025 - 02.2026
Health Advisor II
Concentrix
08.2025 - 11.2025
Pharmacy Technician
AllianceRx Walgreens Pharmacy
12.2021 - 03.2025
Customer Service Representative
Aston Carter / Lifeworks
08.2021 - 11.2021
Telecom Operator
Johns Hopkins Hospital
10.2018 - 05.2020
Customer Support Specialist
PC Problem Repair
11.2014 - 12.2016
Fresh Foods Department Clerk
Harris Teeter
01.2012 - 08.2014
Kaplan University - Criminal Justice
Kaplan University
Northern High School -
Northern High School