Carlos Spence Wilburn
Baltimore
Summary
Dynamic healthcare professional with extensive experience at Everother Health Services, specializing in appointment scheduling and patient engagement. Achieved significant improvements in patient access to services while ensuring meticulous record-keeping. Strong communication and active listening skills enhance coordination and foster high levels of customer satisfaction in fast-paced settings. Aiming to leverage expertise to further elevate patient care standards.
Overview
18
18
years of professional experience
Work History
Provider Scheduler
Everother Health Services
Baltimore
01.2011 - Current
- Coordinate provider's schedule to meet three daily appointments target, aiming for twenty-five weekly.
- Monitored office services mailbox for business support needs and requests.
- Scheduled and confirmed appointments.
- Manage reschedules/cancellations/no shows
Patient Engagement Specialist
Evernorth Health Services
Baltimore
01.2011 - Current
- Organized timely and accurate referrals to help patients obtain health care services and access available resources.
- Maintained up-to-date records of all interactions with patients using appropriate software systems.
- Updated and maintained databases with current information.
Care Coordinator
Cigna HealthSpring
Baltimore
01.2011 - Current
- Responsible for the fulfilment of case request for medical appointments, authorizations, transportation, procedures, and any medical needs for institutional based members.
- Enter authorizations for transportation, DME, and medical procedures ordered by the nurse practitioner or primary care physician for the institutional based member.
- Assist the nurse practitioner with locating and scheduling specialist appointments for IB members via the primary care physician or the medical director.
- Monitor and complete case records in an automated database system to ensure accurate, timely and complete documentation on all case requests made by the medical provider for institutional based members.
Pharmacy Technician
HealthSpring
Baltimore
01.2011 - Current
- Assist members with all pharmaceutical issues (denied claims, overrides, coverage determinations, etc.)
- Assist with training new employees who are assigned to the prescription drug department and answered calls on the supervisor’s help line.
- Monitored and complete case records in an automated database system to ensure accurate, timely and complete documentation on all case requests made by the medical provider, pharmacy and the members.
Behavioral Health Specialist
Bravo Health
Baltimore
01.2011 - Current
- Answering incoming calls from members and providers concerning eligibility, benefits, claims, and all other account services.
- Assist members with locating behavioral health providers, specialists, and facilities for all mental health needs.
- Assist with training all other specialists who are assigned to the behavioral health queue.
- Monitored and complete case records in an automated database system to ensure accurate, timely and complete documentation on all case requests made by the medical provider and the members.
Call Centre Work Lead / Job Coach
Maryland E Z Pass
Baltimore
01.2007 - 01.2011
- Monitoring and development of customer service representatives for a high-volume call center for the state of Maryland.
- Responsible for weekly team meetings, team building exercises, review of OA grading, bi-weekly performance reviews, and one on one personal development.
Education
High School Diploma -
Mergenthaler
Baltimore, MD06.1988
Skills
- Appointment scheduling
- Database management
- Referral coordination
- Patient record maintenance
- Scheduling coordination
- Teamwork and collaboration
- Customer service
- Communication skills
- Active listening
- Patient scheduling
- Excellent communication
References
Available upon request
References
References available upon request.
Timeline
Provider Scheduler
Everother Health Services
01.2011 - Current
Patient Engagement Specialist
Evernorth Health Services
01.2011 - Current
Care Coordinator
Cigna HealthSpring
01.2011 - Current
Pharmacy Technician
HealthSpring
01.2011 - Current
Behavioral Health Specialist
Bravo Health
01.2011 - Current
Call Centre Work Lead / Job Coach
Maryland E Z Pass
01.2007 - 01.2011
High School Diploma -
Mergenthaler
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