Barbara PATRICK
Lithonia,GA
Summary
Experienced healthcare professional prepared for role, specializing in patient support and care coordination. Strong focus on team collaboration and achieving results, adaptable to changing needs. Skilled in-patient advocacy, healthcare navigation, medical terminology and effective communication. Reliable and compassionate, ensuring seamless patient experiences and optimal outcomes.
Overview
10
10
years of professional experience
Work History
Patient Navigator
BLUE CROSS BLUE SHIELD
04.2023 - 04.2024
- Delivered high-quality care coordination by managing 75-80 daily outbound calls, ensuring recently discharged senior patients received personalized recovery support.
- Proactively facilitated access to Medicare benefits and health management programs, streamlining recovery processes and enhancing patient outcomes.
- Achieved patient adherence by ensuring proper medication accesses and addressing compliance barriers.
- Enhanced continuity of care by scheduling follow-up appointments, resolving conflicts and overcoming logistical challenges.
- Identified critical care gaps, connecting members to community resources and achieving comprehensive case closure.
Patient Care Coordinator
US BIOSERVICES
01.2022 - 06.2022
- Advocated for patients by aligning their drug therapies with healthcare provider plans, achieving consistent and effective therapy outcomes.
- Demonstrated expertise in insurance verification co-pay assistance medication cycles, and financial aid, reducing patient financial burdens.
- Resolved complex patient and payer issues promptly, providing seamless communication between physician and patients.
- Maintained impeccable documentation standards, proactively identifying and address potential issues in pharmacy care.
Client Services Specialist I Health Concierge
CVS HEALTH
09.2021 - 11.2021
- Led benefit enrollment process for major clients (Bose, Visa, Sony Pictures, etc.), achieving a 95% registration completion rate.
- Expertly administered medical, dental, and vision plans while adhering to stringent regulatory standards.
- Provided concierge-level support, creating cases and escalating complex requests, ensuring exceptional client satisfaction
Claims Analyst
USA Benefit's Administer LLC
06.2017 - 11.2020
- Verify document authenticity and determine eligibility for administering medical insurance claims based on membership benefit provisions
- Conduct a thorough investigation of unpaid claims to ascertain coverage levels and make an informed decision on claim approvals or denials
- Maintain precise documentation of inquiry outcomes for exact tracking and comprehensive analysis
- Manage the coordination of benefits (COB), high dollar special pricing, and adjustments for claim adjudication ensuring compliance with HIPPA privacy information decide the status of medical-related claims related to physician and hospital services
- Gather, analyze, and report verbal and written members and provider complaints, grievances, and appeals-related information to overturn denied claims
- Verified that all required medical documentation, such as physician notes, lab results, and imaging studies, are included in the prior authorization request
- Instrumental in driving continuous improvement initiatives and special projects to refine operations
- Supported internal audit initiatives by providing detailed documentation of claims handling procedures as required for compliance purposes.
- Demonstrated a high level of accuracy and attention to detail in reviewing claim documentation for approval or denial decisions.
Benefits Member Service Representative
Morneau Shepell
01.2016 - 01.2017
- Navigated State of Illinois employees through open enrollment periods, ensuring informed decision-making and seamless transitions.
- Supported retired employees with Medicare Advantage Plans, resolving complex queries with professionalism and clarity
- Applied extensive knowledge of governmental regulations (ACA, ERISA, QMCSO) to deliver accurate,compliant assistance.
Customer Support/MSABC Recruiter
American Cancer Society
Atlanta, Georgia
04.2015 - 08.2015
- Successful recruited participants for the Making Strides Against Breast Cancer Walk surpassing fundraising goals.
- Enhances event participation through effective coaching, achieving a 95% registration rate and receiving the "Pink Ribbon Award"
Remote Customer Service Representative
Teleperformance Inc.
10.2014 - 03.2015
- Delivered exceptional customer service through efficient issue resolution and upselling, earning recognition as the #1 Home Agent.
- Exceeded performance metrics by handling high call volumes and provided tailored solutions to customer inquiries
Education
Healthcare Information Technology -
DeVry University
Decatur, GASkills
Training
- Customer Service
- Sales Strategies
- Inventory Control
- Loss Prevention
- Time Management
- Leadership
- Performance Assessment
Timeline
Patient Navigator
BLUE CROSS BLUE SHIELD
04.2023 - 04.2024
Patient Care Coordinator
US BIOSERVICES
01.2022 - 06.2022
Client Services Specialist I Health Concierge
CVS HEALTH
09.2021 - 11.2021
Claims Analyst
USA Benefit's Administer LLC
06.2017 - 11.2020
Benefits Member Service Representative
Morneau Shepell
01.2016 - 01.2017
Customer Support/MSABC Recruiter
American Cancer Society
04.2015 - 08.2015
Remote Customer Service Representative
Teleperformance Inc.
10.2014 - 03.2015
Healthcare Information Technology -
DeVry University
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