Nancy Patino
PHOENIX,AZ
Summary
Healthcare customer service specialist with experience resolving disputed claims, handling escalated member calls, and supporting benefit and eligibility questions. Brings bilingual English/Spanish communication, strong records management, and a calm approach to compliance-sensitive situations. Also supports new hire training and cross-trained coverage across Medicare Advantage and supplemental health products.
Overview
1
1
Language
9
9
years of professional experience
Work History
Customer Service Specialist/SME
Cigna Medicare/HCSC
10.2018 - Current
- Answered telephone inquiries and provided quality service to customers and associates asking about benefit availability and claim issues.
- Resolved claim adjudication concerns and customer complaints, improving overall customer satisfaction.
- Identified recurring customer concerns from prior Cigna interactions and provided effective solutions during escalated calls.
- Reviewed disputed medical claims and coordinated reprocessing to resolve issues promptly.
- Answered Advocate chat support questions and assisted customers with accurate inquiry support.
- Processed member disenrollment from healthcare plans and reviewed available options to support regulatory compliance.
- Cross-trained across Medicare Advantage and supplemental health products to support high call volume.
- Supported new hire classes as subject matter specialist.
child care aide
Phoenix Childrens Academy
09.2017 - 10.2018
- Maintained detailed records of child activities and observations to support developmental assessments for state departments and parents
- Organized and updated accurate records for staff and child enrollments and emergency contacts to ensure compliance and safety
- Maintained a child-friendly environment with access to a variety of activities
- Continually kept abreast of toy and child-related recalls and safety warnings
- Verified daycare coverage for AHCCS and ensured timely claims completion for efficient service delivery
Education
Bachelor of Science - Health Administration
Grand Canyon University
Phoenix, AZ11-2027
Skills
- Child development
- Child safety protocols
- Records management
- Regulatory compliance
- Claims processing
- Customer service
- Customer support
- Patient scheduling
Languages
Bilingual in English/Spanish.
Personal Attributes
- Effective communication skills: Understanding of the different communication styles between customers and team members
- Honest and reliable: Strong morals and ethics help ensure the honesty, being able to take any task given ensures reliability
Languages
Spanish
Professional
Timeline
Customer Service Specialist/SME
Cigna Medicare/HCSC
10.2018 - Current
child care aide
Phoenix Childrens Academy
09.2017 - 10.2018
Bachelor of Science - Health Administration
Grand Canyon University