Carolyn Seabrook
Summary
Compassionate Patient Care Coordinator known for high productivity and efficient task completion. Excel in patient advocacy, care plan coordination, and healthcare administration. Possess strong communication, problem-solving, and organizational skills vital for navigating complex healthcare environments and ensuring optimal patient outcomes. Committed to leveraging empathy and collaboration to enhance patient care delivery.
Overview
10
10
years of professional experience
Work History
Patient Care Coordinator
Triwest Healthcare Alliance
06.2022 - 03.2025
- Initiates and receives phone calls, chat messages and emails from VA medical center staff, and providers to answer claims, eligibility, benefit and program questions
- Documents specific claims by completing and recording forms, reports, logs, and records using CareRadius and Salesforce and Referrals and Authorizations Database
- Records preferences, tracks Veteran questions thoroughly in the TriWest's Customer Relationship Management systems and Portal, as well as VA's HSRM systems
- Scheduled and confirmed patient diagnostic appointments, surgeries, and medical consultations
- Transmitted correspondence and medical records by mail, e-mail and fax
- Maintained accurate records of patient interactions, including notes on billing concerns, insurance policies, medical procedures and other related topics
- Assessed patient's need for additional resources such as home health aides or durable medical equipment suppliers in order to provide appropriate level of care
- Coordinated with healthcare providers to verify patient insurance coverage and obtain necessary pre-authorizations for treatments
- Analyzed denials received from third party payers to identify trends in denials and develop proactive measures for resolution.
- Performed data entry into various computer systems including but not limited to EMRs and CRMs.
- Compiled and maintained medical charts and reports in complex digital databases.
Patient Access Representative
Healthy IO
12.2020 - 06.2022
- Effectively communicate with patients to enhance kidney testing adherence and overall experience, thereby achieving quantifiable outcomes
- Performed diagnostics and Troubleshooting of system issues, document help desk tickets and resolutions
- Provide clear explanations regarding at-home kidney testing procedures, schedule appointments efficiently, and assist with app downloads to optimize patient comprehension
- Scheduled appointments, update patient records, fax reports to clinicians and primary care physicians utilizing Salesforce
- Maintained accurate records of patient interactions, including notes on billing concerns, insurance policies, medical procedures and other related topics
- Assisted with coding procedures and billing processes while ensuring compliance with HIPAA regulations
Benefits Service Representative
CVS Health
02.2018 - 11.2020
- Provided support during open enrollment periods by answering questions about plan options
- Educated providers on self-service options, streamlining credentialing processes for efficiency
- Reviewed eligibility for medical insurance coverage and other benefit plans
- Maintained records of employee participation in various benefits programs
- Analyzed financial statements to ensure accuracy of reported information regarding employee benefits
- Maintained client data accuracy in internal systems by monitoring account information and updating records as needed
- Assisted with claims processing and resolving any discrepancies or issues that arose
- Responded to benefit inquiries from employees on plan provisions, benefits enrollments and status changes
Patient Service Representative
Amerisource Bergen
09.2015 - 02.2018
- Reported adverse events using SharePoint, facilitating timely medical interventions
- Verified insurance information collected payments, and scheduled appointments
- Processed referrals and Authorizations from primary care physicians to specialists for further treatment or evaluation
- Informed patients about payment options, billing policies, and procedures related to their visit or procedure
- Accessed patient information through various software applications, maintaining strict confidentiality to remain compliant with HIPAA regulations
- Coordinated with patients and healthcare professionals to meet patient needs
- Obtained proper authorization and identification to release confidential medical records
- Updated reference materials with Medicare, Medicaid and third-party payer requirements, guidelines, policies and list of accepted insurance plans
Education
Bachelor of Arts - Criminology
John Jay College
New York, NY05.2014
High School Diploma -
Erasmus Hall High School
Brooklyn, NY06.2006
Skills
- Insurance verification
- Claims processing
- Patient scheduling
- CRM management
- Administrative supervision
Timeline
Patient Care Coordinator
Triwest Healthcare Alliance
06.2022 - 03.2025
Patient Access Representative
Healthy IO
12.2020 - 06.2022
Benefits Service Representative
CVS Health
02.2018 - 11.2020
Patient Service Representative
Amerisource Bergen
09.2015 - 02.2018
Bachelor of Arts - Criminology
John Jay College
High School Diploma -
Erasmus Hall High School