Cindy LeBlanc
Summary
Compassionate Care Coordinator known for high productivity and efficient task completion. Skilled in patient advocacy, interdisciplinary communication, and care plan development. Excel in empathy, active listening, and problem-solving to ensure optimal patient care outcomes.
Overview
10
10
years of professional experience
Work History
Care Coordinator I
BCBSNJ
04.2024 - 06.2026
- Performs review of service requests for completeness of information, collection and transfer of non-clinical data, and acquisition of structured clinical data from physicians/patients.
- Handles initial screening for precertification requests from physicians/claimants via incoming calls or correspondence based on scripts and workflows, and under the oversight of clinical staff.
- Performs three-point contact, directs care into the network, follows up on status of treatment, corresponds with providers and documents the file consistently.
- Coordinates the treatment plans proposed by providers, in accordance with established HCS protocols.
- Upon collection of clinical and non clinical information CC can authorize medical treatment and associated diagnostic testing based upon scripts or algorithms used for pre-review screening.
- Acts as liaison with client to identify issues and problems relating to care management and claim processing and forwards concerns to appropriate parties, when necessary.
- Initiates calls and correspondence to claimants, providers, and the client to coordinate courses of treatment.
- Perform all tasks assigned.
Managed Care Coordinator
BCBSNJ
01.2020 - 04.2024
- Inbound call center screening for pre-certification requests from providers/members.
- Executed research on in-network providers and facilities, interpreting medical coverage and services to ensure members received appropriate benefits.
- Conducted thorough research on claims and adjudication processes, facilitating resolution for members and providers.
- Liaised with providers, members, and clinical staff to coordinate care and address inquiries effectively.
- Completed all tasks assigned to support team objectives.
Scripted Screener
Beacon Health Options
10.2018 - 01.2020
- Conducted concurrent reviews and authorized additional units on all levels of care.
- Completed pre-certifications for substance use disorder and behavioral health issues across all levels of care, ensuring compliance with state-mandated timeframes.
- Provided timely, accurate, and courteous response to a high call volume of inquiries from both members and providers. Achieved and maintained productivity and quality performance of expectations.
- Documented call inquiries and managed pending inventory accurately and promptly to maintain high quality and productivity standards.
- Managed tasks to support operational efficiency.
Assistant Care Coordinator
NCADD
08.2016 - 10.2018
- Vetted and registered clients deemed appropriate and employable for WFNJ SAI/BHI seeking inpatient and outpatient services and assigned their cases to a specialist on the clinical staff. Secured patient demographics, insurance and medical information and updated the Atlantis system. Ensured clients were aware of all appointments. Acted as conduit for coordination and communication with Welfare and other social services agencies.
- Supervised project to create Essex County directory for clients needing medical, dental, vision, and behavioral health services, preparing reports and participating in semi-annual DCP&P consortium case conferences.
- Completed all designated tasks with attention to detail.
Education
Bachelor - Psychology
Montclair State University
Upper Montclair, NJSkills
- Care coordination
- Health policy understanding
- ICD 10 code/HCPCS/CPT
- Documentation
- Researching
- Software proficiency
- Exceeds expectations
Timeline
Care Coordinator I
BCBSNJ
04.2024 - 06.2026
Managed Care Coordinator
BCBSNJ
01.2020 - 04.2024
Scripted Screener
Beacon Health Options
10.2018 - 01.2020
Assistant Care Coordinator
NCADD
08.2016 - 10.2018
Bachelor - Psychology
Montclair State University