Alex Tapullima castro

Bilingual Legal Administrator and Healthcare Support Specialist with 3+ years of experience supporting U.S. healthcare providers, legal teams, and clients. Skilled in case management, legal documentation, insurance verification, medical records, claims coordination, and HIPAA compliance. Proficient in Microsoft Office, Google Workspace, CRM systems, and administrative operations.

Recognized for strong organizational skills, attention to detail, and delivering exceptional client service in fast-paced environments.

Legal Administrator - Claim Processor - Simpluris

(2025-02 - 2026-02)

• Managed high-volume claimant communications and processed approximately 150 claims daily, providing support on settlement processes, case status, eligibility, and payment inquiries.
• Reviewed and processed legal claims, ensuring compliance with court-approved procedures, documentation requirements, and quality standards.
• Maintained accurate case records, resolved documentation deficiencies, and tracked claim progress across multiple settlement projects.
• Safeguarded confidential legal and financial information while delivering exceptional client service and maintaining data integrity.
• Collaborated with attorneys and cross-functional teams to meet deadlines, ensure regulatory compliance, and support efficient case administration.

Provider Services Representative - Teleperformance - CENTENE - Ambetter Health

(2022-10 - 2025-02)

• Provided support to 500+ customers monthly, resolving inquiries related to claims, benefits, eligibility, coordination of benefits, and authorization status with empathy and professionalism.
• Reviewed and explained claims denials, member benefits, eligibility requirements, and authorization processes, reducing escalations and improving customer satisfaction.
• Maintained accurate documentation of member interactions and case resolutions in CRM systems while ensuring HIPAA compliance.
• Consistently achieved 95–100% Quality Assurance scores and maintained an average handling time (AHT) of 680 seconds, demonstrating efficiency and adherence to service standards.
• Served as a Floor Support Specialist, providing real-time assistance with escalated cases, delivering coaching to team members, and preparing daily attendance reports to support workforce operations.
• Mentored and trained 20+ new hires on internal systems, HIPAA compliance, insurance procedures, and call-handling best practices, improving onboarding success and team performance.

English as a Second Language (ESL) - ICPNA (2014 - 2017) Peru