Customer Service Data Entry

Latoya Crayton

Chicago, IL ***** 773-***-**** ************@*****.***

Skills

Knowledgeable in CMS tools like Salesforce, Omni, Amisys, Portico, Market Prominence, TruCare, Marx, Microsoft Word, Office, Outlook, PowerPoint, Excel, Windows, Access and Peoplesoft 8.0. Typing-30 wpm, Data Entry- 4500 alpha and numeric.

Experience

CUSTOMER SERVICE ADVOCATE 05/2023 - Current

Centene - Chicago, IL

For (Wellcare) Medicare Advantage and (Ambetter) Marketplace plans: Receives and responds to routine member and/or provider inquiries, requests and/or concerns in an accurate and timely manner Mitigates and prevents complaints from being escalated to resolve in initial contact Serves as the front-line resolution advocate on various member and/or provider inquiries, requests, or concerns Resolves basic problems by communicating the requested information regarding the assessment of the member or provider needs, understanding the cause, and determining if problems need to be routed to other departments for further resolution

Maintains performance and quality standards based on established contact center metric Provides customer service in a high pace contact center environment over the phone, via live chats and emails Documents all member or provider information and communications for quality and performance tracking through the Customer Relationship Management (CRM) applications Remains up-to-date and adheres to quality standards, regulation, and all other policies to ensure quality, consistency, and compliance

REFERRAL SPECIALIST I 12/2022 - 02/2023

Elevance Health - Chicago, IL

Responsible for providing support to a clinical team to facilitate the administrative components of clinical referrals for various Carelon services

Initiates and manages clinical referrals for pre-authorization Acts as a liaison between hospital, health plans, physicians, patients, vendors and other referral sources Reviews referrals for completeness and follows up for additional information if necessary Assigns escalated referrals to staff as appropriate Verifies insurance coverage and completes pre-authorization process for radiology and other imaging exams (CT, MRI, MRA, PET, et.) following established process and procedures Responds to inbound calls initiating exam requests following established processes, meets quality and production standards

Contacts physician offices as needed to obtain demographic information or related data Enters referrals, documents communications and actions in system Temporary assignment

CONTACT REPRESENTATIVE 12/2021 - 06/2022

Social Security Adminstration - Chicago, IL

Answering unscreened calls for continuous periods of time on SSA's national 800 number Providing quality customer service in a fast-paced, high volume of call 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 Delivering service to customers within agreed service levels and established performance standards Temporary contract. Grade GS-07

APPLICATION SPECIALIST 05/2021 - 09/2021

Resurrection Project - Chicago, IL

Intake Specialist and Grant Processor for Chicago Emergency Rental Asst Program Insured that all applications were completed with supporting documentation Checked for duplication of benefits and based upon final review of documents, I would submit a recommendation of approval or denial of grant award to Grant Closer Temporary assignment.

CUSTOMER SERVICE REPRESENTATIVE 07/2020 - 05/2021 Evolent Health - Chicago, IL

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 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.

DISASTER RECOVERY SPECIALIST 09/2020 - 04/2021

Small Business Administration - Chicago, IL

Responding to a variety of customer inquiries, ranging from routine to complex, and providing detailed information to the public regarding federally declared disasters and SBA's EIDL (Economic Injury Disaster Loan) program Preparing written responses to email inquiries received through SBA's disaster customer service mailbox 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. Grade GS-09

HEALTH INSURANCE AGENT 09/2014 - 02/2019

Randstad/GoHealth - Chicago, IL

Inside sales for Blue Cross Blue Shield healthcare company Proven experience providing customer support in a busy call center environment for public insurance 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. POLICE ADMINISTRATIVE CLERK 07/2016 - 01/2018

Chicago Police Department - Chicago, IL

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 I resigned to further my education.

CLAIMS CUSTOMER SERVICE REPRESENTATIVE 02/2016 - 12/2016 The Warranty Group - Chicago, IL

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 verifying customer information and/or program data into the computer system Determine the appropriate solution, educate callers on policies, warranties, services, and procedures Resigned.

BENEFITS CUSTOMER SERVICE REPRESENTATIVE 03/2015 - 12/2015 SpectraForce/Bswift - Chicago, IL

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 Temporary assignment.

HEALTHCARE CUSTOMER SERVICE REPRESENTATIVE 07/2013 - 07/2014 AppleOne/Maximus - Chicago, IL

Enroll citizens for health insurance and provide information regarding the Affordable Care Act (Obamacare) and individual carriers participating in the Connecticut Healthcare Marketplace exchange Temporary assignment.

COLLEGE REFERRAL REPRESENTATIVE 03/2011 - 08/2012 Myfootpath - Chicago, IL

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

Laid off.

INQUIRY RESPONSE COORDINATOR 04/2010 - 03/2011

Spherion/Colorado Tech University - Chicago, IL

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

Temporary assignment.

CUSTOMER SERVICE REPRESENTATIVE 06/2008 - 03/2009 Sykes/(LaSalle) Bank of America - Chicago, IL

Assist customers bank merger/transition with questions or issues regarding their account received via phone and email correspondence

Use a computerized system for tracking, gathering information, troubleshooting (online/website functions), funds transfer and entering Regulation E claims

General knowledge of company, products and preferred service Temporary assignment.

CUSTOMER SERVICE REPRESENTATIVE 12/2007 - 06/2008 Kelly Services/JP Morgan Chase Bank - Chicago, IL

Handles incoming calls (orders, inquiries, 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 Temporary assignment.

MARKETING ASSOCIATE 02/2006 - 11/2007

Corestaff/Landmark - Chicago, IL

Contact new and existing business owners for Visa/MasterCard processing equipment Temporary assignment.

CASHIER AND ASST MANAGER 07/1994 - 06/2005

Walgreens - Chicago, IL

Provided managerial customer service, processed refunds, and item exchanges, issue rain checks, resolve customer complaints, prevent shoplifting, process pay-outs, voids, conduct cash counts, pickups, checkouts and correct the safe working fund

Manage recruiting, hiring, training as well as onboarding new hires and managing the orientation process to get employees set up in their new roles within my department I resigned to further my education.

INTERNET SUPPORT AND TEAM LEAD 04/2001 - 04/2004 Classified Ventures-Cars.com - Chicago, IL

Provided customer service for dealers and individual clients (For-Sell By-Owner Ads) Answer 50-100 calls and emails, explain products and services, issue refunds, and submit ideas/website feedback to technical staff

Promoted to team lead position

Responsible for ensuring that all assigned orders for internet advertisements were fulfilled according to the standards of Classified Ventures

Manage recruiting, hiring, training as well as onboarding new hires and managing the orientation process to get employees set up in their new roles within my department Resigned due to family illness relocation.

Education and Training

COLUMBIA COLLEGE - Chicago, IL Bachelor of Arts

BROADCAST JOURNALISM/TV, 06/2000

ROOSEVELT UNIVERSITY - Chicago, IL Some College (No Degree) CRIMINAL JUSTICE

HAROLD WASHINGTON COLLEGE - Chicago, IL Some College (No Degree) PARALEGAL STUDIES

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