Carol D Young
Central Intake Coordinator
Aurora,CO
Summary
Detail-oriented healthcare customer service and insurance professional with extensive experience supporting intake, eligibility verification, benefits interpretation, referral coordination, and high-volume call environments. Proven ability to triage inquiries, obtain and document accurate demographic and clinical information, educate patients on coverage and services, and collaborate across internal teams to ensure timely, compliant care coordination. Recognized for thorough documentation, regulatory compliance, and exceptional communication in complex healthcare settings.
Overview
24
24
years of professional experience
1
1
Certification
Work History
Licensed Real Estate Broker Associate
Brokers Guild Homes
01.2002 - Current
- Delivered high-touch client service through intake-style consultations, information gathering, and needs analysis.
- Managed multiple concurrent transactions requiring detailed documentation, regulatory compliance, and deadline tracking.
- Maintained accurate records and communicated status updates to all stakeholders.
Consumer Service Associate
Anthem Blue Cross Blue Shield
12.2020 - 02.2022
- Handled high-volume inbound and outbound calls, triaging member, provider, and facility inquiries with accuracy and professionalism
- Obtained, verified, and documented demographic, insurance, and clinical related information to support claims resolution, prior authorizations, and care coordination.
- Interpreted plan benefits, EOBs, EOC coverage limitations, and eligibility requirements for members and providers
- Researched coverage and payor requirements, including coordination of benefits and authorization processes
- Acted as an educator and trusted resource for health-related inquiries, explaining procedures, diagnosis codes, and claims workflows.
- Collaborated with internal departments, providers, and external entities to resolve complex cases and ensure timely outcomes.
- Maintained detailed documentation in compliance with HIPAA, CMS, and internal quality standards.
Customer Care Representative L and II (Promoted)
Anthem Blue Cross Blue Shield
06.2017 - 11.2019
- Managed high call volumes while maintaining service quality and compliance standards
- Served as first point of contact for healthcare inquiries, effectively routing and escalating issues as appropriate.
- Reviewed Evidence of Coverage (EOC) and Explanation of Benefits (EOB) documents to clarify benefits and claims processing.
- Supported prior authorization inquiries, approvals, denials, and utilization management processes.
- Resolved complaints and service issues through accurate information gathering, documentation, and follow-through.
Participant Services Representative
Business Solvers
06.2013 - 08.2015
- Provided intake support to COBRA participants and retirees, collecting and verifying eligibility and enrollment information.
- Explained benefit options, timelines, and internal processes to ensure timely informed decision making for enrollment.
- Maintained accurate records and documentation for benefit administration and account status updates.
Colorado Licensed Health Insurance Agent
Kaiser Permanente (thru Optum/Connextions)
06.2013 - 08.2015
- Conducted needs assessments to determine appropriate health plan enrollment options.
- Educated members on coverage, eligibility, and healthcare services under ACA guidelines.
- Ensured strict compliance with HIPAA, CMS regulations, and state insurance requirements.
- Collaborated with providers and internal teams to resolve enrollment and coverage issues.
Colorado Licensed Health Insurance Agent
United Healthcare (through Optum/Connextions))
10.2012 - 06.2013
- Enrolled members into health plans and provided ongoing support regarding benefits and prescription coverage.
- Coordinated with physicians, pharmacies, and payer representatives to facilitate appropriate services.
- Addressed claims inquiries, coverage questions, and service complaints with thorough documentation.
Education
Bachelor of Science in Business Administration - Business Administration
Columbia College (Denver Branch)
Columbia, Missouri, MO03-2022
Associate of Arts - Liberal Arts/Business Administration
Community College of Aurora
Aurora, Colorado, CO11-1996
Skills
- Central Intake & Referral Processing Patient & Provider Communication
- Insurance Verification & Benefits Interpretation
- Coverage Research & Payor Coordination
- HIPAA & Regulatory Compliance
- High-Volume Call Management
- Documentation & Data Accuracy
- Care Coordination Support
- Complaint Resolution & Service Recovery
- Cross-Functional Collaboration
Certification
- Formerly Licensed Colorado Life, Accident, and Health Insurance Producer (2002-2025)
- Licensed Colorado Real Estate Agent (Active since 2002)
- HIPAA-Compliant Healthcare Professional
Timeline
Consumer Service Associate
Anthem Blue Cross Blue Shield
12.2020 - 02.2022
Customer Care Representative L and II (Promoted)
Anthem Blue Cross Blue Shield
06.2017 - 11.2019
Participant Services Representative
Business Solvers
06.2013 - 08.2015
Colorado Licensed Health Insurance Agent
Kaiser Permanente (thru Optum/Connextions)
06.2013 - 08.2015
Colorado Licensed Health Insurance Agent
United Healthcare (through Optum/Connextions))
10.2012 - 06.2013
Licensed Real Estate Broker Associate
Brokers Guild Homes
01.2002 - Current
Bachelor of Science in Business Administration - Business Administration
Columbia College (Denver Branch)
Associate of Arts - Liberal Arts/Business Administration
Community College of Aurora
ADDITIONAL EXPERIENCE
- Workforce Contract Administrator – Denver Metro Wired Initiative
- Workforce Contract Administrator - Economic Development - City/County of Denver
- Technical Support Technician – IBM
- Manager, School-to-Career Services – Public Education & Business Coalition
- Program Assistant, Academic Affairs – Metropolitan State University