LaToyia Sights
Fort Worth
Summary
PROFILE Qualifications: Hardworking employee with customer service, multitasking and time management abilities. Devoted to giving every customer a positive and memorable experience. Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Take-charge professional delivering executive support and team leadership to business operations. Dependable and detail-oriented to manage multiple tasks and priorities. Broad experience includes office management, accounting, accounts receivable, invoicing, dispatching, database management, vendor negotiations and contract management. Recognized for exemplary customer service and team collaboration.
Overview
22
22
years of professional experience
Work History
Manager of Provider Data & Credentialing
Christus Health
05.2024 - Current
- Managed and motivated employees to be productive and engaged in work.
- Accomplished multiple tasks within established timeframes.
- Resolved staff member conflicts, actively listening to concerns and finding appropriate middle ground.
- Defined clear targets and objectives and communicated to other team members.
- Maximized performance by monitoring daily activities and mentoring team members.
- Built high-performing teams through effective recruitment, onboarding, and talent development initiatives.
- Assisted in organizing and overseeing assignments to drive operational excellence.
- Enhanced team productivity by implementing agile methodologies, leading to more efficient project completion.
- Oversaw inventory, implemented new process to work down a back log and maintain the target SLA.
Provider Data Supervisor
CHRISTUS Health Irving
04.2021 - 05.2024
- Supervise a team of 10 associates.
- Delegated work to staff, setting priorities and goals.
- Provided leadership, insight and mentoring to newly hired employees to supply knowledge of various company programs.
- Coordinated with other supervisors, combining group efforts to achieve goals.
- Guided employees in handling difficult or complex problems.
- Trained employees on best practices and protocols while managing teams to maintain optimal productivity.
- Discussed job performance problems with employees, identifying causes and issues to find solutions.
- Reviewed employees' work to check adherence to quality standards and proper procedures.
- Implemented departmental policies and standards in conjunction with management to streamline internal processes.
- Recruited, interviewed and selected employees to fill vacant roles.
- Consulted with managers to resolve problems relating to employee performance, office equipment and work schedules.
- Collaborated with cross-functional teams to identify data requirements and ensure proper integration within the system.
- Trained team members in best practices for data handling, improving overall productivity and data integrity.
Provider Data Specialist Team Lead
CHRISTUS Health
12.2019 - 04.2021
- Assist team members and managers with tasks to maintain productivity and meet project milestones
- Review incoming credentialing files for mistakes to maintain accurate inventory levels prior to batch loading Address concerns quickly to avoid lasting issues
- Monitored processes and recommended methods for improvement
- Reviewed activities regularly to identify opportunities for improvement
- Managed daily tasks consistently and sought out opportunities to go beyond
- Trained user and answered questions regarding processes and procedures.
Provider Data Specialist
CHRISTUS Health Irving
02.2017 - 12.2019
- Inputting providers into the system within a timely manner for claim processing purpose
- Worked with programmers and analysts to understand the tasks to be performed as established with workflow chart
- Managed daily task consistently and sought out opportunities to go beyond requirement and support business targets
- Completed all required paperwork within anticipated time frame.
- Understood and followed oral and written directions.
- Demonstrated leadership by making improvements to work processes and helping to train others.
Claims Resolution Specialist
CHRISTUS Health Irving
09.2015 - 02.2017
- Answered incoming calls from providers office to provide claim status and resolve claim issues effectively
- Assisting the team with special projects to meet all assigned deadlines
- Followed established guidelines and procedures
- Utilized downtime to perform routine tasks, preventing service delays.
- Gathered and reviewed rejected claim information in order to develop successful resolutions.
- Communicated with other departments to establish action plans and manage open claims to closure.
- Documented specific claims by completing and recording forms, reports and logs.
Welcome Call Customer Service Rep
Humana Life Synch
08.2014 - 08.2015
- Receive, document and resolve member and provider inquiries by using established best practices
- Manage inbound and outbound contacts; including conducting a Health Risk Assessment to eligible members
- Build lasting relationships with Humana's members and providers
- Educate members, providers and employers about Humana's products and services over the telephone and online (email) Wells Fargo Dealer Services
- Promptly responded to customer inquiries and resolved complaints to promote loyalty.
- Demonstrated excellent communication skills in resolving product and consumer complaints.
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
Early Stage Collection Rep
Wells Fargo Dealer Services
09.2013 - 08.2014
- Exhibits exemplary customer service while initiating outbound and receiving inbound calls from customers
- Conduct conversations with customers regarding resolution of delinquency and education of contractual terms and obligations
- Verifying customer personal contact information and accurately document customer's conversation into collection system
- Researching payment history and setting up payment arrangements to bring accounts current.
- Recorded and updated customer personal accounts with accurate contact information.
- Remained calm, stayed professional and provided exceptional service on calls, even when interacting with difficult individuals.
- Notified customers of delinquent accounts with attempt to collect outstanding amounts.
- Received payment and posted to appropriate customer accounts.
- Processed payments over phone and set up recurring drafts.
- Negotiated credit extensions to assist customers in paying overdue accounts.
Insurance Verification Rep
DaVita RX Coppell
01.2013 - 08.2014
- Making 60 to 90 outbound calls per day to verify pharmacy benefits and eligibility for Dialysis patients
- Updating spreadsheets with the benefit information obtained from patients plan and/or pharmacy vendor to be sent over to patients Dialysis facility
- Collecting and processing payments for prescription orders on current and past due accounts
- Updated patient and insurance data and input changes into company computer system.
- Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.
- Checked documentation for appropriate coding, catching errors and making revisions.
- Retained strong medical terminology understanding in effort to better comprehend procedures.
Customer Service Rep
MEDCO Health Solution
01.2003 - 11.2012
- Assist members with refills, order status and billing questions
- Collecting payments for balance due on delinquent accounts to process current orders
- Possess soft skills that helps with de-escalating challenging callers
- Provide one call resolution for customer questions or inquiries
- Adhere to all company policies and procedures
- Challenge myself to meet Call Center goals
- Floor Walker (Team Lead)
- Assisting new hire CSRs by answering questions they may have to assist the members
- Helping navigate through the system to locate the information needed to assist the members in a timely manner and providing correct information.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
- Demonstrated excellent communication skills in resolving product and consumer complaints.
- De-escalated problematic customer concerns, maintaining calm, friendly demeanor.
- Upheld quality control policies and procedures to increase customer satisfaction.
Eligibility & Enrollment Specialist
Medco Health Solutions
11.2004 - 02.2005
- Solution Irving
- Assisting Medicare Part D members with selecting the lowest cost plan available to them
- Providing plan information such as: premium amounts, drug coverage information, and copays
- Comparing plans offered by the company and submitting application for enrollment
- Verifying within the CMS database members eligibility status and updating the system accordingly to match Medicare records.
- Handled new enrollments by entering customers' data and reviewing information.
- Listened to and understood customers' needs, explained and discussed options and outlined best-fit services.
- Completed and processed applications for enrollment.
Education
High School Diploma -
OD Wyatt High School
05.2002
Skills
- Ability to Multitask Expert
- Leadership Expert
- Teamwork Expert
- Time Management Expert
- Microsoft Excel Expert
- Computer Skills Expert
- Fast Learner Expert
- Adaptability Expert
- Microsoft Office Expert
- Communication Skills Expert
- Customer Service Expert
- Ability to Work in a Team Expert
- Ability to Work Under Pressure Expert
- Good Communication Expert
- Time Management
- Coaching and Mentoring
- Team Building
- Team Leadership
- Team Management and Supervision
- Microsoft Office
- Performance Management
- Recruitment and Hiring
- Handling Complaints
- Motivational Leadership
- Decision Making
- Phone and Email Etiquette
- Database Maintenance
- Goal setting
- Task delegation
- Staff management
- Performance management
- Policy implementation
- Performance evaluations
Timeline
Manager of Provider Data & Credentialing
Christus Health
05.2024 - Current
Provider Data Supervisor
CHRISTUS Health Irving
04.2021 - 05.2024
Provider Data Specialist Team Lead
CHRISTUS Health
12.2019 - 04.2021
Provider Data Specialist
CHRISTUS Health Irving
02.2017 - 12.2019
Claims Resolution Specialist
CHRISTUS Health Irving
09.2015 - 02.2017
Welcome Call Customer Service Rep
Humana Life Synch
08.2014 - 08.2015
Early Stage Collection Rep
Wells Fargo Dealer Services
09.2013 - 08.2014
Insurance Verification Rep
DaVita RX Coppell
01.2013 - 08.2014
Eligibility & Enrollment Specialist
Medco Health Solutions
11.2004 - 02.2005
Customer Service Rep
MEDCO Health Solution
01.2003 - 11.2012
High School Diploma -
OD Wyatt High School
Similar Profiles
Dedrick GossettDedrick Gossett
Patient Access Rep II at Christus HealthPatient Access Rep II at Christus Health
Mark CarterMark Carter
Patient Financial Specialist at Christus HealthPatient Financial Specialist at Christus Health
Angie CarnesAngie Carnes
Certified Medical Assistant at Christus HealthCertified Medical Assistant at Christus Health