Summary
Overview
Work History
Education
Skills
Timeline
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Sharely Montalvo

Kissimmee,FL

Summary

Detail-oriented and bilingual customer service professional with a background in healthcare and travel industries. Experienced in Medicare Part D case management, prescription coordination, and HIPAA-compliant communication. Demonstrated ability to thrive in high-volume, fast-paced environments while maintaining empathy, accuracy, and professionalism. Known for quickly adapting to new systems and processes, resolving complex issues, and providing exceptional member support in English and Spanish.

Overview

3
3
years of professional experience

Work History

Pharmacy Benefits Manager

CVS Caremark
09.2023 - Current
  • Process Medicare Part D coverage determinations and appeals, completing all case forms and documentation for timely submission in compliance with CMS guidelines.
  • Verify prescription drug coverage and costs, and explain plan benefits (deductibles, coverage gap, copays) clearly to members and providers.
  • Coordinate with CVS Mail Order and retail pharmacies to ensure timely medication fulfillment and resolve inventory issues.
  • Contact prescribers for new or corrected prescriptions to support claim approvals and prevent medication delays.
  • Ensure full HIPAA compliance when handling Protected Health Information (PHI) across all communications and systems.
  • Use internal platforms such as Compass, Microsoft Word, and proprietary pharmacy systems to manage case workflows and member records.
  • Adapt quickly to new tools and processes, with experience completing internal training programs and learning systems independently.
  • Provide efficient, compassionate support while meeting quality, speed, and compliance standards.

Customer Service Representative

JetBlue
04.2022 - 07.2024
  • Assisted customers with flight bookings, changes, cancellations, and upgrades across domestic and international routes using Sabre and the TrueBlue member portal.
  • Explained and managed TrueBlue loyalty accounts, including Points + Cash bookings, rewards redemptions, and Travel Bank credits and histories.
  • Resolved high-pressure travel issues involving delays, rebookings, baggage, and special accommodations with professionalism and empathy.
  • Delivered clear, accurate guidance on fare rules, travel policies, passport/visa requirements, and COVID-related restrictions.
  • Maintained full compliance with JetBlue and FAA regulations when handling passenger information and secure data.
  • Adapted quickly to frequent policy and system updates, completing JetBlue University training modules and learning new tools independently.
  • Balanced high call volume and performance targets while ensuring customer satisfaction remained top priority.

Education

Adult Learning Center Osceola
Kissimmee, FL
05.2021

Skills

  • Medicare Part D Coverage Determinations & Appeals
  • HIPAA Compliance Protected Health Information (PHI)
  • Customer Service Conflict Resolution High-Volume Call Handling
  • Prescription Coordination Provider & Pharmacy Outreach
  • CRM & Workflow Tools (Compass, Microsoft Word, Outlook, Excel)
  • Fast Learner System Adaptability Process Improvement
  • Clear Verbal & Written Communication Member Education
  • Bilingual: English & Spanish Remote Work Capable

Timeline

Pharmacy Benefits Manager

CVS Caremark
09.2023 - Current

Customer Service Representative

JetBlue
04.2022 - 07.2024

Adult Learning Center Osceola

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Sharely Montalvo