LATOYA SHIELDS
Phoenix,USA
Summary
Enthusiastic Senior Customer Service Representative with more than 20 years of customer service and order management experience adds value to business by providing outstanding customer service, engaging customers and building relationships with buyers. Exhibits strong command of company's customer service policies and remains well-trained in product knowledge to offer quick and accurate assistance to customers. Operates at high level to consistently meet or exceed business quality and productivity standards.
Overview
29
29
years of professional experience
Work History
Benefits Specialist
Blue Cross Blue Shield of Arizona
02.2023 - Current
- Resolved issues and inquiries from plan participants regarding health and welfare benefits and deductions through telephone, email, and in-person interactions.
- Explained benefits to plan participants in easy to understand terms in order to educate each on available options.
- Assisted in resolving complex benefits issues, leading to increased employee satisfaction and retention rates.
- Processed employee life event changes, ensuring timely updates to benefits and coverage for qualifying events such as marriage or the birth of a child.
- Enhanced understanding of benefit offerings with effective communication materials and presentations.
- Worked productively in fast-moving work environment to process large volumes of claims.
- Processed eligibility and benefits verification and authorization requests.
- Resolved discrepancies in insurance payments by collaborating with carriers.
Clinical Authorization Specialist
CVS Pharmacy
11.2021 - 06.2022
- Educated patients on eligibility and affordability options by offering insightful information
- Reviewed applications for different aid programs and determined which qualification criteria for individuals
- Assisted with medication, and pharmacy benefit information
- Fax, email, and inbound calls from members regarding pharmacy authorizations
- Assisted with clinical authorizations questions from providers
Hardware Software Specialist
PELOTON INC
08.2019 - 05.2020
- Guide our Support team to resolve hardware and software inquiries from Members regarding our Bike, Tread, and App offerings
- Call/Chat/Email with Members and manage tickets through to completion
- Assist the Support team with live interactions
- Significant experience dealing with complex customer-service issues involving potentially escalated Members
Provider Service Specialist
TRIWEST HEALTH CARE ALLIANCE
11.2017 - 04.2018
- I speak to providers daily regarding becoming contracted with the veteran's affairs department
- I work on dual monitors on multiple systems daily
- I speak to many provider offices daily
- Multiple email, fax, and correspondence letters are sent to me as well
- I work on a dual monitor system using 6-11 programs each day
- Problem, multi taking, and first call resolution is what I provide as a provider specialist
- I make in and outbound calls in a call center environment
- I discuss authorizations, claims, and EOB's
- I work closely with other department to process request from providers, and veterans
Market Specialist
HOUZZ DESIGN
01.2015 - 04.2016
- I received inbound calls, and emails from Houzz customers regarding merchandise they purchased on the company website from vendors and third-party sellers
- I handled vendor related tickets, problem solved, refunded customers, and corrected damaged orders
- I used Zen desk, and Sales force computer-based systems on dual monitors
- I was required to hit a monthly commission, and certain performance goals
- I provided product, and logistic shipping information to customers
- I had daily goals and cases to handle
- I worked closely with vendors, sellers, and shipping companies to handle customer related request and inquiries
Benefits Specialist
XEROX SOLUTIONS
01.2014 - 12.2014
- I worked as a Benefit Specialist assisting Delta Airline employees with their human resource needs
- I gathered information researched/resolved inquiries and logged customer calls
- I educated and enrolled employees into their heath saving accounts, reimbursement, and spending accounts, Medicare part D enrollment and authorizations
- CMS, Avaya, Tesseract and CICS are the systems I used in this position
- I assisted with health and welfare, pension, travel needs, canceling coverage, and advising employees of effective dates
- I went over coverages, authorizations, deductibles, enrollment, and other insurance questions
Credit Consultant
CENTURY LINK
12.2006 - 07.2011
- I worked as a credit consultant team leader I oversaw 15 employees whose jobs were to collect revenues owed from residential customers and to assist with basic billing inquiries, receive inbound calls from
- Century link residential customers for collections, payment arrangements, and billing inquiries
- I also processed customer supervisor request, negotiated payment plans
- I worked on a dual monitor system with as many as 6-12 programs open during my workday
- I supervised and was responsible for agent schedules, monitoring calls, audits, statistics, and daily goals
- Keeping agents trained and updated on changes and client and management request was a part of my position as well as monthly goal requirements
Administrative Assistant
TRUCK LLC
04.1996
- My duties included customer service, clerical, data entry, invoices, PC, phones, faxing, and email, quick books account receivable and payable
- My duties were to assist the manager and owner at a small family automotive business with administrative office help
- Payroll, correspondence, record keeping, filing
Reservation Agent
SOUTHWEST AIRLINES
08.1995 - 02.1996
- I worked as a customer service agent at Southwest Airlines answering customer inquiries regarding all aspects of their travel, ticketing, car, and hotel rentals
- I also was responsible for assisting customers with travel requests and inquiries by answering incoming calls
- Helping customers with Flight information, lost baggage, checking in customers by operating a computerized point-of-sale system, boarding, reservations for scheduled domestic flights with the highest degree of courtesy and professionalism
Education
GED - General Education
Arizona Department of Education
Phoenix, AZ05.1996
Medical Assistant -
Brookline College
Phoenix, AZ05.1996
Skills
- One call resolution
- Communication
- Teamwork
- Positive attitude
- Zendesk
- Sales Force
- CRM
- CICS
- Fax
- Outlook
- Computer PC
- Insurance
- Medicare
- Benefits specialist experience
- Prior authorization
- Health care administrative
- Proficient in all Microsoft office suites
- Complaint resolution
- Customer Relations
- Customer Service
- Data Entry
- Computer Skills
- Office Administration
- Microsoft Word
- Customer and client relations
Timeline
Benefits Specialist
Blue Cross Blue Shield of Arizona
02.2023 - Current
Clinical Authorization Specialist
CVS Pharmacy
11.2021 - 06.2022
Hardware Software Specialist
PELOTON INC
08.2019 - 05.2020
Provider Service Specialist
TRIWEST HEALTH CARE ALLIANCE
11.2017 - 04.2018
Market Specialist
HOUZZ DESIGN
01.2015 - 04.2016
Benefits Specialist
XEROX SOLUTIONS
01.2014 - 12.2014
Credit Consultant
CENTURY LINK
12.2006 - 07.2011
Administrative Assistant
TRUCK LLC
04.1996
Reservation Agent
SOUTHWEST AIRLINES
08.1995 - 02.1996
GED - General Education
Arizona Department of Education
Medical Assistant -
Brookline College
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