Victoria Puga

Healthcare operations professional with 13 years of progressive experience in customer service, claims, Medicare operations, revenue cycle, process improvement, and team support. Recognized as a Subject Matter Expert for three business processes with experience training employees, improving workflows, resolving complex issues, and collaborating across departments. Proven ability to analyze problems, implement solutions, support operational excellence, and lead through influence.

Seeking opportunities in leadership, operations, training, quality, or business process improvement.

Medicare Regulatory & Revenue Cycle Analyst - Health Care Service Corporation

(2022-01)

• Serve as Subject Matter Expert (SME) for three core business processes, providing guidance and support across multiple workgroups.
• Lead annual process training and provide ongoing coaching, clarification, and knowledge sharing to team members.
• Develop, document, and improve workflows to increase operational efficiency, consistency, and compliance.
• Communicate process updates, procedural changes, and operational impacts to internal and offsite teams.
• Analyze complex issues and perform root cause analysis to identify solutions and prevent recurring errors.
• Act as a resource for escalated issues requiring advanced research and resolution.
• Partner with leadership and stakeholders to support operational goals and continuous improvement initiatives.
• Resolve complex billing discrepancies and claims issues to ensure accurate reimbursement and compliance.

Broker Service Advocate - Health Care Service Corporation

(2018-01 - 2022-12)

• Supported insurance producers with billing, policy, and operational inquiries.
• Educated stakeholders on benefits, policies, and procedural requirements.
• Resolved escalated issues through effective communication, research, and problem-solving.
• Reviewed applications for accuracy and compliance.
• Collaborated across departments to ensure timely and accurate issue resolution.

Customer Service Advocate II - Health Care Service Corporation

(2013-01 - 2018-12)

• Handled claims, billing, and benefit inquiries while maintaining quality and productivity expectations.
• Investigated discrepancies and processed adjustments to ensure accurate outcomes.
• Worked with providers on denied claims and complex account issues.
• Conducted audits to support accuracy and compliance standards.
• Mentored and assisted new hires with onboarding and training.

Associate of Science - Waubonsee Community College (2013-01)

Certificate - Medical Records - University of Phoenix (2024-01)