Carolyn Copeland
Birmingham,AL
Summary
Professional with strong background in care coordination. Skilled in patient advocacy, healthcare planning, and resource management. Known for effective team collaboration and achieving measurable results. Adaptable to changing needs with robust communication and organizational skills. Reliable and focused on delivering high-quality care outcomes.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Care Coordinator
Archwell Health
02.2024 - Current
- Manage scheduling of specialty appointments for primary care providers, coordinating with patients and other specialty facilities to ensure smooth and efficient operations
- Provide exceptional customer service by guiding patients through the scheduling process with empathy and professionalism, addressing their needs and concerns promptly and effectively
- Act as a point of contact for patients, offering personalized assistance and clear communication throughout their journey, from initial scheduling to follow-up
- Developed strong relationships with community partners, facilitating referrals and collaboration on behalf of patients.
- Conducted regular evaluations of care plan effectiveness, making necessary adjustments based on feedback from patients and providers.
- Maintained accurate and up-to-date documentation of patient records in accordance with HIPAA regulations.
- Advocated for patients'' rights within the healthcare system, working diligently to address concerns or barriers to care.
- Coordinated discharge planning, ensuring a smooth transition from hospital to home or other facilities.
Authorizations Specialist
Cooper Green Mercy Hospital Service Affiliates
04.2021 - 01.2024
- Collaborated with healthcare providers to obtain necessary documentation for prior authorization requests.
- Supported clinical staff by providing timely updates on the status of prior authorizations for various services.
- Assisted in training new team members on company policies and procedures for handling authorization requests.
- Reduced processing times by effectively managing a high volume of authorizations, referrals, and appeals.
- Consistently demonstrates outstanding customer service to CGMHSA patients, visitors, physicians, and staff
- Ensured prompt resolution of denied claims through comprehensive analysis of denial reasons and timely submission of necessary documentation for reconsideration or appeal.
- Demonstrated adaptability with changing insurance requirements, maintaining up-to-date knowledge through continuous education efforts.
- Enhanced departmental efficiency with thorough knowledge of insurance guidelines and medical terminology.
- Conducted regular audits of authorization records to verify accuracy and adherence to regulatory requirements, minimizing risk of noncompliance.
- Processed and certified documents for accuracy and compliance with government regulations.
- Scheduled appointments with applicants to gather information and explain benefits processes.
Insurance Verification Specialist
Cardiology P.C.
11.2019 - 03.2020
- Ensured compliance with HIPAA regulations while managing sensitive patient information during the verification process.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Updated patient records with accurate, current insurance policy information.
- Ensured prompt reimbursement from insurers by submitting clean claims that met payer requirements for accurate coding and documentation.
- Boosted departmental performance metrics through consistent achievement of targeted goals for claim submission timelines, denial rates, and collections ratios.
- Contributed to a positive patient experience by providing clear explanations of insurance benefits, coverage limitations, and out-of-pocket costs.
- Expedited claim resolution by collaborating with healthcare providers to obtain necessary documentation for appeals.
Scheduling Specialist
Affinity Physician Services-Call Center
07.2018 - 10.2019
- Coordinate the scheduling, referral management, registration, prior authorization and insurance verification processes for patients
- Identify and handle customer needs, providing exceptional customer service in a timely and efficient manner while working in a team environment
- Screen and update established patient information for accuracy, and schedule procedures according to procedure description
- Work closely with clinical department staff to schedule procedures in an efficient manner based on departmental scheduling protocols
- Increased schedule adherence through consistent monitoring and real-time adjustments as needed.
- Maintained accurate records of employee attendance, time-off requests, and other relevant scheduling data for efficient tracking purposes.
- Resolved scheduling conflicts promptly, minimizing disruptions to daily operations.
- Streamlined communication between departments by serving as a liaison for scheduling-related inquiries and concerns.
Patient Encounter Specialist
Callahan Eye Hospital
03.2016 - 07.2018
- Report to the Operations Manager
- Followed all company policies and procedures to deliver quality work.
- Improved customer satisfaction rates through proactive problem-solving and efficient complaint resolution.
- Enhanced claim processing efficiency by verifying patient insurance coverage and eligibility.
- Streamlined communication with insurance providers, obtaining prior authorizations for medical procedures.
- Contributed to a positive patient experience by providing clear explanations of insurance benefits, coverage limitations, and out-of-pocket costs.
- Maintained up-to-date knowledge of industry regulations, ensuring compliance with HIPAA, COBRA, and other relevant laws.
- Refined department workflows through regular audits of insurance verification processes and implementing improvements as needed.
- Reduced claim denials by thoroughly reviewing and analyzing patients'' insurance benefits for accuracy.
Certified Pharmacy Technician
St. Vincent's Hospital Birmingham
07.2014 - 03.2016
- Trained new pharmacy technicians on proper procedures and best practices, ensuring consistent quality of service.
- Answered incoming phone calls and addressed questions from customers and healthcare providers.
- Stocked, labeled, and inventoried medication to keep accurate records.
- Completed paperwork, entering prescription and insurance or billing information into patient profiles.
- Enhanced patient care by accurately filling and dispensing prescriptions in a timely manner.
- Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
- Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items.
- Counted, measured and compounded medications following standard procedures.
- Assisted in preparation, distribution and storage of pharmaceuticals.
- Ensured medication safety with thorough verification of prescription orders and drug interactions.
Certified Pharmacy Technician
Walgreens Pharmacy
07.2008 - 10.2014
- Trained new pharmacy technicians on proper procedures and best practices, ensuring consistent quality of service.
- Answered incoming phone calls and addressed questions from customers and healthcare providers.
- Completed paperwork, entering prescription and insurance or billing information into patient profiles.
- Stocked, labeled, and inventoried medication to keep accurate records.
- Enhanced patient care by accurately filling and dispensing prescriptions in a timely manner.
- Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
- Increased customer satisfaction by delivering friendly, personalized service during transactions.
- Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items.
- Counted, measured and compounded medications following standard procedures.
- Assisted in preparation, distribution and storage of pharmaceuticals.
Student Work
Jefferson State Community College
08.2007 - 05.2008
- Assist financial aid clerks by filing, completing data entry, operated copiers, fax machines, and other office equipment; prepare mailings, proofread documents, and delivered messages
- Took and followed detailed directions from others.
- Worked in team environment to maintain high levels of productivity.
- Maintained tidy and organized environment to comply with cleanliness standards.
- Collaborated with team members to execute successful campus events, ensuring smooth operations from planning to execution.
- Contacted families and students about late payments and account statements.
- Performed wide-ranging administrative, financial and service-related functions.
- Supported the development of targeted financial aid outreach programs, leading to increased awareness among potential applicants.
Education
Associates in Applied Science - Business Administration Specialist
Jefferson State Community College
Birmingham, AL05.2010
Diploma -
Jackson-Olin High School
05.2007
Skills
- Case management
- Documentation
- Patient education
- Organizational skills
- Documentation proficiency
- Medical terminology understanding
- Healthcare operations
- Scheduling
- Claims processing
- Quality assurance
- Care planning
- Time management
Certification
- PTCB Certified Pharmacy Technician, 07/01/15, 07/31/17, 5601-0701-0221-544, Expired
- Pharmacy Technician, 01/01/15, 12/31/17, T27218, Expired
Timeline
Care Coordinator
Archwell Health
02.2024 - Current
Authorizations Specialist
Cooper Green Mercy Hospital Service Affiliates
04.2021 - 01.2024
Insurance Verification Specialist
Cardiology P.C.
11.2019 - 03.2020
Scheduling Specialist
Affinity Physician Services-Call Center
07.2018 - 10.2019
Patient Encounter Specialist
Callahan Eye Hospital
03.2016 - 07.2018
Certified Pharmacy Technician
St. Vincent's Hospital Birmingham
07.2014 - 03.2016
Certified Pharmacy Technician
Walgreens Pharmacy
07.2008 - 10.2014
Student Work
Jefferson State Community College
08.2007 - 05.2008
Diploma -
Jackson-Olin High School
- PTCB Certified Pharmacy Technician, 07/01/15, 07/31/17, 5601-0701-0221-544, Expired
- Pharmacy Technician, 01/01/15, 12/31/17, T27218, Expired
Associates in Applied Science - Business Administration Specialist
Jefferson State Community College
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