Latoya Crayton
Chicago,IL
Overview
30
30
years of professional experience
Work History
CUSTOMER SERVICE ADVOCATE
Centene
Chicago, IL
05.2023 - Current
- 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
Elevance Health
Chicago, IL
12.2022 - 02.2023
- 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
Social Security Adminstration
Chicago, IL
12.2021 - 06.2022
- 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
Resurrection Project
Chicago, IL
05.2021 - 09.2021
- 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
Evolent Health
Chicago, IL
07.2020 - 05.2021
- 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
Small Business Administration
Chicago, IL
09.2020 - 04.2021
- 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
Randstad/GoHealth
Chicago, IL
09.2014 - 02.2019
- 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
Chicago Police Department
Chicago, IL
07.2016 - 01.2018
- 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
The Warranty Group
Chicago, IL
02.2016 - 12.2016
- 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
SpectraForce/Bswift
Chicago, IL
03.2015 - 12.2015
- 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
AppleOne/Maximus
Chicago, IL
07.2013 - 07.2014
- 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
Myfootpath
Chicago, IL
03.2011 - 08.2012
- 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
Spherion/Colorado Tech University
Chicago, IL
04.2010 - 03.2011
- 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
Sykes/(LaSalle) Bank of America
Chicago, IL
06.2008 - 03.2009
- 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
Kelly Services/JP Morgan Chase Bank
Chicago, IL
12.2007 - 06.2008
- 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
Corestaff/Landmark
Chicago, IL
02.2006 - 11.2007
- Contact new and existing business owners for Visa/MasterCard processing equipment
- Temporary assignment.
CASHIER AND ASST MANAGER
Walgreens
Chicago, IL
07.1994 - 06.2005
- 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
Classified Ventures-Cars.com
Chicago, IL
04.2001 - 04.2004
- 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
Bachelor of Arts - BROADCAST JOURNALISM/TV
COLUMBIA COLLEGE
Chicago, IL06.2000
Some College (No Degree) - CRIMINAL JUSTICE
ROOSEVELT UNIVERSITY
Chicago, ILSome College (No Degree) - PARALEGAL STUDIES
HAROLD WASHINGTON COLLEGE
Chicago, ILSkills
Knowledgeable in CMS tools like Salesforce, Omni, Amisys, Portico, Market Prominence, TruCare, Marx, Microsoft Word, Office, Outlook, PowerPoint, Excel, Windows, Access and Peoplesoft 80 Typing-30 wpm, Data Entry- 4500 alpha and numeric
Timeline
CUSTOMER SERVICE ADVOCATE
Centene
05.2023 - Current
REFERRAL SPECIALIST I
Elevance Health
12.2022 - 02.2023
CONTACT REPRESENTATIVE
Social Security Adminstration
12.2021 - 06.2022
APPLICATION SPECIALIST
Resurrection Project
05.2021 - 09.2021
DISASTER RECOVERY SPECIALIST
Small Business Administration
09.2020 - 04.2021
CUSTOMER SERVICE REPRESENTATIVE
Evolent Health
07.2020 - 05.2021
POLICE ADMINISTRATIVE CLERK
Chicago Police Department
07.2016 - 01.2018
CLAIMS CUSTOMER SERVICE REPRESENTATIVE
The Warranty Group
02.2016 - 12.2016
BENEFITS CUSTOMER SERVICE REPRESENTATIVE
SpectraForce/Bswift
03.2015 - 12.2015
HEALTH INSURANCE AGENT
Randstad/GoHealth
09.2014 - 02.2019
HEALTHCARE CUSTOMER SERVICE REPRESENTATIVE
AppleOne/Maximus
07.2013 - 07.2014
COLLEGE REFERRAL REPRESENTATIVE
Myfootpath
03.2011 - 08.2012
INQUIRY RESPONSE COORDINATOR
Spherion/Colorado Tech University
04.2010 - 03.2011
CUSTOMER SERVICE REPRESENTATIVE
Sykes/(LaSalle) Bank of America
06.2008 - 03.2009
CUSTOMER SERVICE REPRESENTATIVE
Kelly Services/JP Morgan Chase Bank
12.2007 - 06.2008
MARKETING ASSOCIATE
Corestaff/Landmark
02.2006 - 11.2007
INTERNET SUPPORT AND TEAM LEAD
Classified Ventures-Cars.com
04.2001 - 04.2004
CASHIER AND ASST MANAGER
Walgreens
07.1994 - 06.2005
Bachelor of Arts - BROADCAST JOURNALISM/TV
COLUMBIA COLLEGE
Some College (No Degree) - CRIMINAL JUSTICE
ROOSEVELT UNIVERSITY
Some College (No Degree) - PARALEGAL STUDIES
HAROLD WASHINGTON COLLEGE