1. CARLOS M. ORTUNO
3011 SW 27th St
Miami, FL 33133
uno1charlie@gmail.com
Objective
A position where I can use the best of my skills.
Ability Summary
I have held jobs that deal directly with the public in emergency situations, and referred
them to the appropriate relief agencies. I obtain this experience while working in the
New York City Fire Departement, Salvage Unit, 1979-89.
I have also had experience in an adoption agency, handling stressful incidents, when
biological parents have been separated from their siblings because of negligence or
drug abuse. This experience was obtained in New York City while employed Spence-
Chapin Adoption Services, 1973-1977.
I also helped inmates in pro se litigation, dealing with post conviction, appellate
procedures. I obtained certification of Paralegal/Legal Assistant with the Blackstone
School of Law.
Employment History
Customer Care Specialist
08/2016 - Current Florida
Blue
8400 NW 33rd Street, Doral, FL
This job entailed six week training on Medicare, and Florida Blue plans. Providing
information to prospective Medicare members according to their medical needs
and demographics. Identifying their medication according the tiers that
pharmaceuticals are dispenced and priced.
Survey Interviewer
01/2016 - 08/2016 Nors Surveys Inc 3155 NW 82nd Ave # 201,
Doral, FL
CALLING COLD CALLS TO INTERVIEW FOR SURVEYS.
Customer Service Representative (CSR)

2. 04/2016 - 08/2016 Navarro
Discount
Pharmacies
9400 NW 104th St, Medley, FL
The job entails taking orders for CVS Pharmacies for OVER THE COUNTER
HEALTH SOLUTIONS(OTCHS). Educating members on the program and
resolving claims pertaining to the lost orders. Resending orders with the approval
of the supervisors. Writing commentaries on the lost orders and the actual details
of the incident.
Member Services Representative
09/2015 - 01/2016 Florida
Blue,
Doral,
Florida
8400 NW 33rd Street, DORAL, FL
Triaging all inbound calls to redirect them to the appropriate departments. Create
lead forms with all pertinent information of the prospective member, and routing
them to the appropriate license agent. Medicare members are routed to the
appropriate Medicare parts, Part A, hospital inpatients, Part B, Medical Care, Part
C, Medicare Advantage, and Part D, Prescriptions.
Using a new CRM system, Salesforce 59, that is more expeditious in handling all
inbound calls for Florida Blue(Blue Cross,Blue Shield), and QuickServe, guiding
the user to expediously help guide the member to the appropriate part of Florida
Blue.
Member Service Representative
04/2014 - 03/2015 Preferred
Medical
Plan
4950 SW 8th Street, Miami, FL
Helping members with health plans and medical procedures. Educating members
in Spanish/English on benefits, and information on retaining prescriptions. Finding
Primary care physicians, specialists and urgent care assistance.
Verifying payments on three different computer systems to give providers
eligibility on the member' status to authorize visits. Call delinquent members to
obtain payments.
Coordinating payment investigations for lost payments with other departments,
requesting banking statements for proof of payments with members.
Conducting conference calls with the Market Place, members to resolve issues on
different type of health plans, termination of insurance policies to stop double
billing from our insurance.
Evaluating the member's call to resolve the issue at hand. Conducting
investigations towards issues that have been provided with documentation to
resolve the issue, payments, claims of services rendered, bills from providers.

3. Started with this organization with 7,000 members and the transition of over
100,000 members with the Affordable Care Act
RETAIL COVERAGE MERCHANDISER
01/2014 - 04/2014 ACOSTA
SALES &
MARKETING
2941 COMMERCE PKWAY, MIRAMAR,
FL
I was in charge of nine (9) Walmart supercenters, and had to scan 400 items
within the four (4) hours allotted. I had stores from Doral, Florida to Pompano
Beach, Florida, putting 275 miles a week. The items that did not sell were to be
scanned and displays were assembled to increase sales. This was done using
Microsoft Word, Quickbooks, scanner and Excel.
Customer Service Agent
10/2013 - 11/2013 CAREER USA 8375 NW 12th ST, DORAL, FL
TAKING ORDERS FOR BOSTON MARKET FOR THE THANKSGIVING
HOLIDAYS.
Customer Service Representative (CSR)
06/2011 - 09/2013 Midea
America
11800 N.W. 100th Road, Suite #4, Medley,
FL
I would open contact accounts and register the unit for warranty on a CRM,
driven.
I would help customers trouble-shoot units that were defective, and obtain service
for them. I would canvass the area customer lived in and get service for
them. Also canvassed repair centers and solicit them to join our service network,
by service agreement. I would also take part orders, and take the credit card
information to process the part order for payment.
Telemarketer
04/2006 - 08/2008 XENTEL INC. Doral, FL
I solicited funds for Law Enforcement, and Fire department charities.
Education and Training
Issuing Institution Location Qualification Course of
Study
BLACKSTONE
SCHOOL OF LAW
TX Vocational School
Certificate
Parlegal/Legal
Assistant

4. I completed a Parlegal/Legal Assistant certificate program. I
have specialized in Federal Criminal Law.
John Jay College of
Criminal Justice
New York,
NY
3 Years of College or a
Technical or Vocational
School
Criminal Justice
I have completed 101 credits towards a bachelorette in Criminal
Justice at the above mentioned college in New York City. I do
intend to continue in Miami-Dade College.
Occupational Licenses & Certificates
Certification Title Issuing Organization Completion Date
Construction Safety &
Health
U.S. Department of Labor;
OSHA
04/2006