Jahely Guzmán Morales

HR professional with 5+ years across healthcare insurance and HR administrative support, skilled in employee onboarding, payroll, HRIS, and compliance (CMS, HIPAA). Bilingual (English/Spanish) and with an MBA concentrated in Human Resources, seeking to grow in HR operations and talent management.

Customer Service Representative

Carelon Global Solutions – San Juan, PR | Oct 2024 – Present

• Resolved 40+ member inquiries daily across eligibility, claims, pharmacy, billing, authorizations, and grievances.
• Assisted members with enrollment, benefits, and provider assignments (HMO, POS & PPO), ensuring compliance with CMS and HIPAA.
• Handled patient appointment scheduling, referrals, insurance verification, care coordination, and medical billing/data entry (ICD-10, CPT).
• Collaborated with finance and collections teams on billing, payments, and account adjustments.

HR Administrative Assistant

Airline Services – Carolina, PR | Sep 2023 – Oct 2024 (Full time)

• Supported employee onboarding including orientations, scheduling, and department assignments with HRIS and Excel support.
• Conducted payroll audits, validated overtime and processed incentives with high accuracy.
• Coordinated flight and work schedules across 12 departments, ensuring smooth workforce operations.
• Monitored attendance, prepared compliance reports and supported disciplinary actions.

Airline Services – Carolina, PR | Jul 2021 – Sep 2023 (Part-Time)

• Assisted HR team with payroll entry, vacation/sick leave tracking and manual punch corrections.
• Provided administrative support for employee engagement and scheduling initiatives.