Hi, I’m
Courtney Carlock
North Aurora
Summary
Professional in plan development and execution, with proven track record of impactful contributions. Known for strong focus on team collaboration and adapting to changing needs, ensuring reliable and flexible support. Possesses key skills in strategic planning, organization, and stakeholder communication.
Overview
15
years of professional experience
Work History
IUOE Local 150
Active Eligibility/Retiree Welfare and COBRA Plan Specialist
11.2022 - Current
Job overview
- Responsible for receiving correct demographic information to process initial or re-establishing eligibility.
- Determines members eligibility based on employer contributions or monthly hours completed.
- Responsible for maintaining and processing daily eligibility files and communicating information to multiple departments as well as third party vendors.
- Process life changing event eligibility changes for active members.
- Respond to written and verbal inquiries regarding eligibility, employer contract information, COBRA, effective/termination dates.
- Process eligibility files for third party vendors; CVS, Delta Dental and Blue Cross Blue Shield.
- Provide members with eligibility information, coverage, in/out of network providers, deductible and out of pocket accumulation.
- Responsible for all COBRA correspondence for Local 150 membership as well as internal staff.
- Provide back-up assistance to Member Service department.
- Participate in open enrollment, pre-retirement and pension seminars.
- Responsible for all plan document changes and updates correspondence sent to Local 150 membership.
- Process all payments for COBRA, Self Pays and retiree payments.
Central States Funds
Benefit Specialist
03.2021 - 04.2022
Job overview
- Responds to inquiries regarding TeamCare and Pension benefits, policies, and procedures.
- Determines the nature of the inquiry to provide accurate and concise answers.
- Follows department guidelines and rules of the organization to respond to customer inquiries on diverse topics.
- Complies with all HIPAA and Fund guidelines to confirm the identity of customer prior to the release of information and update indicative information as needed.
- Uses soft skills in all situations and to diffuse potentially escalated customers.
- Meets minimum production standard per the collective bargaining agreement.
- Quotes benefits for Medical, Dental, Vision, Pharmacy and provide authorization requirements.
- Adheres to quality assurance program guidelines set by Management.
- Efficiently manages time to achieve individual and department goals.
- Works within a restricted time environment that is based on shift bidding and seniority.
- Perform customer call backs as needed.
Scheck and Siress
Prosthetic Insurance Benefit Specialist
10.2019 - 03.2021
Job overview
- Utilizes the WIP (Work in Progress) worklist to prioritize and work eligibility, authorization and verification requests.
- Confirm accurate entry of patient demographic and insurance information into practice management software.
- Confirm and document insurance eligibility findings in software, in accordance with policy and procedures.
- Regularly communicates effectively with patients and internal staff. Initiates and submits required documentation to obtain authorization.
- Confirm authorizations received are accurate and appropriate.
- Corresponds professionally and timely with internal and external customers and staff.
- Maintains strict confidentiality and adheres to all HIPPA guidelines and regulations.
- Responsible for collecting deposits on orthotic and prosthetic devices.
- Excellent knowledge of guidelines for Medicare, Medicaid, BCBS, Land Out of state, Aetna, Cigna, United Health Care, Humana and many other commercial insurance plans.
- Manage verifications for 15 locations within Scheck and Siress Hanger Inc.
Illinois Center for Digestive and Liver Health
Patient Access Representative
11.2016 - 01.2020
Job overview
- Promptly and compassionately greet and assist all patients in a timely manner.
- Responsible for efficiently scheduling new and existing patients for office visits and procedures.
- Collect co-pays, patient balances and ensure deposits balanced at the end of shift.
- Reconcile cash and prepare cash transaction balancing sheet daily.
- Verify patients insurance eligibility.
- Responsible for obtaining prior authorization referral for all procedures, office visits, and any diagnostic imaging.
- Assigned ICD-10 and CPT codes for surgical and procedure authorizations.
- Responsible for answering multi-phone line and directing patients to appropriate staff.
- Enter patient and insurance data into hospital computer software program.
- Responsible for reviewing all hospital procedures with each individual hospital for all providers at Illinois Masonic, Good Shepherd Hospital, St. Joseph’s Hospital.
- Manage Patient Recall, Cancellation, and no-show list for all 7 providers.
- Call patients to review preparation instructions for procedure scheduled.
- Call patients to review test results for Labs, Radiology, and pathology.
- Coordinate peer-to-peer interviews for physicians and insurance companies with any denied testing required for patients.
Education
Harry D. JacobsAlgonquin, Illinois
High School Diploma
06-2010
Skills
- Excellent written and oral communication skills
- Proven ability to lead successful program and teams
- Skilled in problem resolution and customer relations
- Able to handle and prioritize multiple assignments
- Exceptional attention to detail
- Skilled in utilizing CRM platforms like Hubspot and Salesforce
- Teamwork and collaboration
- Honest and dependable
- Client interviews
- Customer expectations management
Timeline
Active Eligibility/Retiree Welfare and COBRA Plan Specialist
IUOE Local 150
11.2022 - Current
Benefit Specialist
Central States Funds
03.2021 - 04.2022
Prosthetic Insurance Benefit Specialist
Scheck and Siress
10.2019 - 03.2021
Patient Access Representative
Illinois Center for Digestive and Liver Health
11.2016 - 01.2020
Harry D. Jacobs
High School Diploma
Similar Profiles
Melyssa RidgwayMelyssa Ridgway
Heavy Equipment Operator at IUOE- International Union of Operating Engineers, Local 793Heavy Equipment Operator at IUOE- International Union of Operating Engineers, Local 793
Gracie CappsGracie Capps
Heavy Equipment Operator at IUOE Local 513Heavy Equipment Operator at IUOE Local 513
Benjamin M. ShapiroBenjamin M. Shapiro
Oiler/Operator at IUOE LOCal 147Oiler/Operator at IUOE LOCal 147
Mara CukovicMara Cukovic
Retail Store Sales Manager at Mobile-Tel LTDRetail Store Sales Manager at Mobile-Tel LTD
Solomon PittsSolomon Pitts
Team Manager at Chipotle Mexican GrillTeam Manager at Chipotle Mexican Grill