Latoya Shields
Phoenix,AZ
Summary
Customer service professional with strong background in managing customer interactions and resolving issues promptly. Committed to enhancing team collaboration and achieving consistent results. Recognized for adaptability in dynamic environments and proficiency in handling customer concerns and inquiries.
Overview
19
19
years of professional experience
Work History
Benefits Specialist
Xerox Solutions
- 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 coverage, authorizations, deductibles, enrollment, and other insurance questions.
Patient Care Coordinator
Optum
2025.09 - Current
- Coordinated patient appointments and managed schedules to optimize clinic workflow.
- Assisted patients with insurance verification and eligibility inquiries to enhance service delivery.
- Facilitated communication between medical staff and patients to ensure clarity of care plans.
- Developed and maintained patient records using electronic health record systems for accuracy.
Customer Care Advocate
Blue Cross Blue Shield of Arizona
2023.02 - 2025.06
- 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 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
2022.09 - 2022.11
- 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
2021.11 - 2022.06
- Guide our Support team to resolve hardware and software inquiries from Members regarding 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
2019.08 - 2020.05
- 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
2017.11 - 2018.04
- I received inbound calls, and emails from Houzz customers regarding merchandise they purchased on the company website from vendors and third-party sellers.
- I managed 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 collaborated closely with vendors, sellers, and shipping companies to handle customer related request and inquiries.
Credit Consultant
Century Link
2014.01 - 2014.12
- I worked as a credit consultant team leader I oversaw fifteen 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.
Reservation Agent
Southwest Airlines
2011.08 - 2012.03
- 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 assisted 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.
Administrative Assistant
Truck LLC
2006.12 - 2011.07
- 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.
Education
GED - General Education
Arizona Department of Education
Phoenix, AZ05.1996
Medical Assistant
Brookline College
Phoenix, AZ05.1996
Skills
One call resolution
Communication
Teamwork
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
Patient Care Coordinator
Optum
2025.09 - Current
Customer Care Advocate
Blue Cross Blue Shield of Arizona
2023.02 - 2025.06
Clinical Authorization Specialist
CVS Pharmacy
2022.09 - 2022.11
Hardware Software Specialist
Peloton Inc
2021.11 - 2022.06
Provider Service Specialist
TriWest Health Care Alliance
2019.08 - 2020.05
Market Specialist
Houzz Design
2017.11 - 2018.04
Credit Consultant
Century Link
2014.01 - 2014.12
Reservation Agent
Southwest Airlines
2011.08 - 2012.03
Administrative Assistant
Truck LLC
2006.12 - 2011.07
Benefits Specialist
Xerox Solutions
GED - General Education
Arizona Department of Education
Medical Assistant
Brookline College