Gertrudis Puertas
Riverview
Summary
Experienced with patient care coordination, including assessment and planning of individualized care. Utilizes effective communication and organizational skills to ensure continuity of care. Track record of supporting patient needs and improving care processes through teamwork and problem-solving.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Care Coordinator
Centene
Tampa, FL
01.2025 - Current
- Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved.
- Interacts with members by performing member outreach telephonically or through home-visits and documents the plan for care/services of activities.
- Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member throughout care/service, as appropriate
Medicare Specialist
Diagnostic Clinic Medical Group
Largo, FL
06.2023 - 01.2025
- Assist with enrollment, plan changes, renewals, and disenrollment
- Provided beneficiaries with information about plan benefits and eligibility determinations.
- Conduct consultations via phone, virtual meetings, or in person
- Educate clients on Medicare options, including Original Medicare (Parts A & B), Medicare Advantage (Part C), Medicare Supplement (Medigap), and Part D prescription plans
- Support clients with basic claims, billing questions, and coverage issues
- Evaluated Medicare claims for accuracy, ensuring compliance with regulatory standards.
Medicare Customer Service Representative
Maximus Federal Services
Riverview, FL
09.2019 - 06.2023
- Answered incoming calls from Medicare beneficiaries, providing them with information regarding their benefits.
- Resolved customer complaints and concerns in a timely manner.
- Enrolled or disenrolled from any plans. Review health plans.
- Responded promptly to customer inquiries about coverage options, claims status, and other related topics.
Sales Customer Support Specialist
Air Rescue Air Condition
Tampa, FL
09.2018 - 09.2019
- Assisted customers with placing orders accurately and efficiently.
- Provided customer support for sales inquiries, resolving product and service related issues.
Collections Agent
Achieva
Clearwater, FL
07.2015 - 08.2018
- Negotiated payment plans with customers to ensure timely repayment of debt.
- Schedule and set it up payment plans.
- Contacted customers and explained debt management to encourage timely debt payments.
Office Assistant
Southwest Staffing
Clearwater, FL
06.2012 - 07.2015
- Maintained an organized filing system of paper documents and electronic files.
- Performed data entry tasks into various computer systems accurately and efficiently.
- Answered incoming calls in a professional manner and directed callers to the appropriate personnel.
- Organized office operations and procedures, such as managing calendars, scheduling appointments, preparing reports and maintaining records.
- Maintained business records by updating customer information.
- Assisted with special projects as needed by researching information on the internet or through other sources.
Education
Some College (No Degree) - ESOL
St.petersburg College
St. Petersburg, FLHigh School Diploma -
San Judas Tadeo
Lima, Peru12-2000
Skills
- Ability to explain complex information in simple terms
- Strong attention to detail and compliance awareness
- Empathy, patience, and professionalism when working with people
- Sales, consultative, or advisory skills (role-dependent)
- Proficiency with CRM systems and basic computer applications
- Time management and organizational skills
- Knowledge of ECW and Sales force
- Bilingual
- CMS Guidelines
Certification
- Licensed Health Insurance 2-20
Education and Training
other,other
Languages
Spanish
Native or Bilingual
Timeline
Care Coordinator
Centene
01.2025 - Current
Medicare Specialist
Diagnostic Clinic Medical Group
06.2023 - 01.2025
Medicare Customer Service Representative
Maximus Federal Services
09.2019 - 06.2023
Sales Customer Support Specialist
Air Rescue Air Condition
09.2018 - 09.2019
Collections Agent
Achieva
07.2015 - 08.2018
Office Assistant
Southwest Staffing
06.2012 - 07.2015
Some College (No Degree) - ESOL
St.petersburg College
High School Diploma -
San Judas Tadeo