JUSTO ALVAREZ
Miami,Florida
Summary
Analytical professional prepared for this role with extensive experience in data analysis and interpretation. Known for delivering actionable insights and driving process improvements that align with business goals. Highly collaborative team player with focus on achieving results and adapting to changing needs.
Overview
7
7
years of professional experience
1
1
Certification
Work History
MEDICARE, APPEALS AND GRIEVANCES ANALYST
ELEVANCE HEALTH
02.2018 - Current
- Investigate and resolve grievances from members and providers by conducting thorough research, reviewing case files, health plan documentation, and medical records, and collaborating with internal departments.
- Ensure that all grievances cases adhere to regulatory and contractual requirements, including timelines and resolutions mandated by CMS (Center for Medicare and Medicaid Services), state laws, and other governing bodies.
- Maintain clear, detailed communication with members, and providers to clarify grievance procedures, findings, and resolutions.
- Identify recurring issues from grievances, and collaborate with quality assurance or operations teams to recommend improvements to internal processes, thereby enhancing member satisfaction.
- Prepare case documentation for internal and external audits, ensuring that grievance resolutions are supported by complete and accurate records.
MORTGAGE LOAN ORIGINATOR
NETWORK CAPITAL FUNDING
10.2022 - 02.2023
- Meet with prospective borrowers to understand their financial goals, review creditworthiness, and recommended mortgage loan products tailored to their specific needs.
- Assist clients in completing and submitting montage loan applications, ensuring all required documentation is provided, including income verification, credit reports, and other financial statements.
- Analyzed clients' financial status and collaborated to ensure pre-approval. Provide necessary support throughout the underwriting process to ensure timely loan approval.
- Maintain an in-depth understanding of various mortgage loan products, including convectional, FHA, VA, USDA, and refinancing options. Educate clients on interest rates, loan terms, and down payments requirements to help them make informed decisions.
Education
Associate of Arts -
Miami Dade College
Miami, FLSkills
- Strong understanding of health plan benefits, medical terminology
- Excellent investigative, problem-solving, and decision-making skills
- Excellent communication, interpersonal, and customer service skills
- Self-motivated, with strong sales and negotiation abilities
Certification
Mortgage Loan Originator License, 2259875
Timeline
MORTGAGE LOAN ORIGINATOR
NETWORK CAPITAL FUNDING
10.2022 - 02.2023
MEDICARE, APPEALS AND GRIEVANCES ANALYST
ELEVANCE HEALTH
02.2018 - Current
Associate of Arts -
Miami Dade College
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