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Benefits, Claims, Customer Service Healthcare Insurance Representative

Location:
Chicago, IL
Salary:
60,000
Posted:
July 24, 2022

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Resume:

Latoya Crayton

**** * **** **, #**

Chicago, ****3, Illinois,

US Mobile Phone: 773-***-****

E - mail: adru8j@r.postjobfree.com

Education: 1995-2000 Bachelor of Arts, Columbia College, Chicago, Illinois. Major: Broadcast Journalism/TV. 1995-1997 Work study in Records and Admissions dept. 1997-1998 Internship, WBBM Channel News Chicago, Illinois: Answers and transfers calls, makes beat checks, cris cross breaking stories. 2017 Roosevelt University, Criminal Justice. 2018 Harold Washington College, Paralegal Studies. Former Licensed Health Insurance Agent.

Qualifications: Knowledgeable in CMS tools like SalesForce, Microsoft Word, Office and XP, Outlook, PowerPoint, Excel, Windows, Access and Peoplesoft 8.0. Typing-30 wpm, Data Entry- 4500 alpha and numeric.

EMPLOYMENT

12/20/21-06/06/2022 Social Security Administration – Contact Representative: Answering unscreened calls for continuous periods of time on SSA's national 800 number. Providing quality customer service in a fast-paced, high call volume environment. Conducting interviews to determine the nature of the call. Identifying persons who may be eligible for various SSA programs by utilizing screening and interview methods effectively. Providing information on SSA's policies and procedures and resolving customer questions by identifying the issue and selecting the best option(s) for resolution. Determining eligibility for programs administered by SSA. Using automation tools to access and update information; and Delivering service to customers within agreed service levels and established performance standards. Temporary project

05/17/2021-09/10/2021 The Resurrection Project – Application Specialist: Temporary position doing the work of an Intake Specialist and Grant Processor, I ensured that all applications were completed with supporting documentation. I checked for duplication of benefits and based upon final application and revision of documents, I would submit a recommendation of approval or denial of grant award to Grant Closer. I monitored all initial applications in CRM software platform. I maintained data integrity and reporting systems to effectively track client and application progress. Adhere to all guidelines related to confidentiality of files and records. I maintained and encouraged a productive working relationship with all staff members.

09/21/2020-04/10/2021 Small Business Administration - Disaster Recovery Specialist: Responding to a variety of customer inquiries, ranging from routine to complex, and providing detailed information to the public regarding federally declared disaster and SBA's EIDL (Economic Injury Disaster Loan) program. Preparing written responses to email inquiries received through SBA's disaster customer service mailbox. Assisting lower graded or new employees with responding to customer service inquiries received by telephone or email. Assisting borrowers with completion of their loan closing documents and answering questions regarding the loan closing and disbursement process. Accepting borrower payments using online payment processing tools. Using a variety of computer systems to research customer inquiries, record call activity and prepare appropriate forms and letters. Contract project only.

07/2020-05/2021 Evolent Health - Customer Service Representative: Respond to Medicaid/County Care members, providers, agents and brokers inquiries via telephone regarding health insurance benefits, eligibility and claims. Analyze problems and provide correct information and solutions. Communicate monthly messages to providers on a specific needs' basis. Deal tactfully and empathetically with customers. Establish and maintain effective working relationships with physician office staff. Read, comprehend and verbalize processes and procedures of the organization and of health insurance coverage. Personal leave due to Covid 19 virus.

04/2020-06/2020 Andy Frain/DHL - NonContact Thermal Screener: Use an infra-red thermometer to obtain a temperature reading of employees, truckers and vendors who are reporting for work. Screeners will check the temperature reading and advise if they are clear to enter the facility or if they will be subjected to secondary screening measures by a supervisor or management. Temporary assignment ended due to OSHA investigation. 10/2019-12/2019 Medix/Bankers Life - Medical Underwriter Trainee: Responsibilities include reviewing insurance documents to determine whether an offer of health insurance should be made, determining insurance types and limits, and calculating premium costs. For healthcare open enrollment season only.

07/2019-10/2019 AT&T - Customer Care Representative: Answer inbound call from customers with billing issues, technical issues or general questions regarding service. Assists customers questions and concerns on all products and services offered by the Company through research and resolution using various tools and systems. Handles telephone customer contacts. Coordinates with all sales channels for retention efforts on existing customer base. May sell all products and services offered by the Company. May help collect past due balances or take payments from customers who have been disconnected. Processes credit applications and activates service. Maintains appropriate records, prepares required reports, and updates customer accounts. Performs other duties as assigned by management. Temporary project only.

09/2014-02/2019 Randstad/GoHealth - Insurance Agent: Inside sales for Blue Cross Blue Shield healthcare company. Proven experience providing customer support in busy call center environment for public insurance. An unwavering commitment to customer service, with the ability to build productive relationships, resolve complex issues and win customer loyalty. Strategic relationship and partnership-building skills. Listened attentively to solve problems creatively and use tact and diplomacy to achieve win-win outcomes. Seasonal, only during healthcare open enrollment season. 05/2018-09/2018 Swedish Covenant Hospital - Sitter: Monitors at risk patients on the Nursing Unit. Alerts the Nurse Manager or Resource Nurse of any relevant situations.

07/2016-01/2018 Chicago Police Dept - Police Administrative Clerk: Provides customer service to the public via the telephone or through front desk interaction responding to inquiries and providing referral services. Initiates police written reports from citizens. Receives incoming telephone and voice radio calls from officers in the field requesting information. Checks various law enforcement databases for verification of information including license plates, arrestee data, names and case reports. Distributes and collects hand radios, tasers, and keys to Police vehicles. Performs a wide variety of routine clerical work including filing, billing, checking, and recording information on records. Sorts and file documents and records maintaining alphabetical, index and cross reference files. Receives, sorts, and distributes incoming and outgoing correspondence.

02/2016-12/2016 The Warranty Group - Claims Customer Service Representative: Receive high volume consumer calls and answer questions regarding program benefits, coverage, and claims process. Gather information and details to understand the customers' needs, resolve issues, and advise on next steps. Start and/or follow-up on Citibank credit card benefits (property & travel) insurance claims by entering or verify customer information and/or program data into the computer system. Determine the appropriate solution, educate callers on policies, warranties, services and procedures.

03/2015-12/2015 Spectra Force/bswift (Aetna) - Benefits Customer Service Representative: Educate and advise employees on their employer-offered benefits, process enrollments, collect eligibility paperwork, create tickets for website and coverage issues and follow up with employees until issues are resolved.

07/2013-07/2014 AppleOne/Maximus - Healthcare Customer Service Representative/Office Asst: Enroll citizens for health insurance and provide information regarding the Affordable Care Act (Obamacare) and individual carriers participating in the Connecticut exchange. Also worked in mailroom performing clerical duties and processing mail for IL Dept Public Aid.

01/2013-07/2013 TMX Credit - Customer Service Sales Representative: Inbound/Outbound phone contact with (new/existing) customers regarding their loans. Provide account assistance for refinances, extensions and payment plans. Also made collection calls and provide information via online chat.

08/2012-01/2013 H&R Block - Receptionist: Greet clients in a personalized, friendly, and inviting manner. Matched clients with the best suited tax professional for their needs. Scheduled appointment, handling client exit payment and paperwork and maintained office cleanliness and organization of resources tax professionals.

03/2011-08/2012 MyFootPath.com - College Referral Representative: Heavy inbound & outbound phone contact with generated inquiries by company. Conducting interviews with prospective students to provide them with schools offering preferred courses/degree programs with schools in our network.

04/2010-03/2011 Spherion/Colorado Technical University – Inquiry Response Coordinator: Call prospective students who have requested information about the university. Screen inquiry to determine if they are qualified to speak with an admissions advisor and determine the type of admissions advisor.

10/2009-4/2010 Fieldwork Chicago - Telephone Interviewer: Contact people to conduct surveys on products and services from various companies.

04/2009-10/2009 Salem Group/Computershare - Proxy Representative

(CSR): Contact shareholders and record their vote for an upcoming shareholder meeting. Temporary project determined by the needs of the market and changes made to mutual funds.

06/2008-3/2009 Sykes/LaSalle (Bank of America) - Customer Service Representative: Assist customers with questions or issues regarding their accounts received via phone and/or correspondence. Use computerized system for tracking, gather information, troubleshooting (online/website functions), funds transfer and enter Regulation E claims. General knowledge of company, products and service preferred.

12/2007-06/2008 Kelly Services/JP Morgan Chase - Customer Service Representative: Handles incoming calls (orders, inquires, complaints, etc.) and directs calls for further problem resolution. Typically handles larger clients and more difficult issues. May be required to lead, teach, guide, and/or motivate teams and cross-train on various projects.

02/2006-11/2007 Corestaff/Landmark - Marketing Associate: Contact new and existing business owners for Visa/MasterCard processing equipment.

10/2005-12/2005 AppleOne/FEMA - Customer Service Representative: Perform registration intake for Hurricane (Katrina and Rita) victims for immediate assistance for damage to home, personal property, businesses, cars, etc. Contacted applicants daily (80-200 outbound calls per day) for FEMA's Travel Trailer program for those that needed immediate housing.

06/2005-10/2005 Apro Personnel/OEMC - Administrative Asst: Provided customer service for citizens regarding city events, new laws, restrictions, registrations, etc. Created excel reports for budgets and PDT/radio inventory (incoming/new, repaired/replaced) used by Chicago. 07/1996-06/2005 Walgreens - Asst. Manager & Cashier: Provided managerial customer service, processed refunds, and item exchanges, issue rain checks, resolve customer complaints, prevent shoplifting, process pay-outs, voids, conduct cash counts, pick-ups, checkouts and correct the safe working fund.

04/2002-04/2004 Classified Ventures/cars.com - Ad Production Coordinator Team Lead: Responsible for ensuring that all assigned orders for internet advertisements were fulfilled according the standards of Classified Ventures.

04/2001-04/2002 Classified Ventures/cars.com - Internet Support Specialist: Provided customer service for dealers and individual clients (For-Sell-By-Owner Ads). Answer 50-100 calls and emails, explained products and services, issue refunds and submit ideas/website feedback to technical staffed



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