Elmira Suljic
Fenton,Missouri
Summary
Professional with solid background in processing and managing claims efficiently, prepared to make significant impact. Skilled in assessing and processing claims accurately, resolving complex issues, and ensuring customer satisfaction. Effective team collaborator with focus on achieving results and adapting to changing needs. Known for analytical thinking, communication skills, and attention to detail.
Overview
2025
2025
years of professional experience
Work History
Claims Representative
Beacon Hill Staffing
11.2023 - Current
- Working productively in fast-moving work environment to process large volumes of claims.
- Improving members and dental providers satisfaction by providing timely and accurate claim resolution.
- Maintaining compliance with DDMO regulations by adhering to established procedures and guidelines in claims handling.
- Demonstrated adaptability by handling various types of dental claims across multiple specialties while maintaining accuracy.
- Enhancing accuracy of processed claims with meticulous attention to detail and knowledge of systems.
- Evaluating dental claims for accuracy and completeness and researched missing data.
- Using administrative guidelines provided by DDMO as resource or to answer questions when processing dental claims.
- Generating, posting and attaching information to claim files.
- Maintaining strong knowledge of basic dental terminology to better understand services and procedures.
- Reducing claim processing time by implementing streamlined workflows and maintaining thorough documentation to follow up on daily / weekly basis, preventing accumulated claim volumes.
- Supporting departmental goals by working closely with team members to maintain consistent quality standards across all submitted claims.
- Developing strong relationships with management and team members facilitating trust and open communication during the claims process with high level of support and dedication to stay on the top of their goals.
- Collaborating with cross-functional teams to expedite complex claims investigations and resolutions.
- Reviewing with enthusiasm specific claims if requested by colleagues to help with resolution or advice.
- Reviewing outstanding requests and redirected workloads to complete projects on time assigned by supervisors.
- With meticulous attention to detail and adherence to the highest quality standards, processing efficiently general dental claims ranging from routine procedures to complex cases, Pre-D, Pre-D back to pay, resubmission, correction as well as escalating claims ensuring timely reimbursement.
- Proven clinical expertise in efficiently interpreting dental x-rays and other clinical documentation. Demonstrated ability to effectively manage second - level claims and provide exceptional support to dental consultants, ensuring prompt and accurate review, including second re-evaluation requests.
- Successfully managing dual insurance cases by verifying eligibility, ensuring members receive the maximum coverage available while preventing overpayment and accurately applying primary/ secondary payer rules to optimize reimbursement. Proactively identifying potential issues with coverage by promptly communicating members and/or providers.
- Strong commitments and participation in continuing education and constant improvement. Highly adaptable for any organizational changes and different assignments.
- Determined to research, learn and implement any assigned project related to my current work position.
Dental Office Coordinator
South Towne Dental
12.2017 - 08.2023
- Provided administrative support to staff members, assisting with daily tasks as needed to promote productivity across the organization.
- Tracked records, filed documents, and maintained communication between clients to manage office activities.
- Served as a point of contact for clients visiting the office, providing exceptional customer service that led to increased client retention rates.
- Improved customer satisfaction scores through application of superior conflict resolution and problem-solving skills.
- Maintained strict confidentiality of sensitive information, upholding the highest level of professionalism at all time.
- Increased efficiency by regularly evaluating office workflows and recommending improvements as necessary. Developed the system to scheduling 70% of high dollar amount appointments in first 2 quarter of the shift to minimize loss by last minute cancellations during the day. The timely prevention of appointment cancelations, and meticulous track of daily schedule goal are the core of the dental office production.
- Contributed to company growth by consistently looking for ways to improve office processes and maximize efficiency. The consistent search for high quality standards under my coordination, resulted to exceed yearly goal set by management, for five consecutive years by 15-20%
- Obtained approval from higher management to ensure quarterly bonuses for each employee if quarterly goal for production and collection has been met. Due to positive outcome for five consecutive years, the bonuses were distributed regularly ensuring high level of motivation and retention among employees.
- Enhanced communication within the team through regular meetings and detailed reporting. Encouraged each team member to write something positive about his colleagues and share with us on the next meeting. Also, encouraged smiles and coffee time during morning huddle.
- Coordinated company events, fostering team building and boosting overall morale. - Organized often out of office lunches with small thank you gifts signed by Dr or business owner, making sure everyone feels appreciated.
- Implemented inventory control measures for clinical supplies, reducing waste while maintaining adequate stock levels. Ensured that dental assistants and hygienists receive monthly bonuses if assigned budget for clinical supply is not exceeded for the month. The outcome was with none or minimum waste.
- Reconciled account files and produced monthly reports. Efficiently supervised and also directly worked in all financially related tasks, including: high amount dollar treatment plan presentations, payment plans, third party approvals, collections, insurance billing, insurance adjustments, dual insurance coordinations and statements. Due to prioritizing daily track of office collection, the final result on AR monthly report had a constant positive outcome with often just 5% of 90+ days outstanding balance.
- Assisted treating dentist in all general dental procedures. Participated in assisting with several complex oral surgeries. Trained as first assistant for Implant related oral surgeries performed in the office.
- Developed training materials for new hires, streamlining the onboarding process and promoting consistent practices throughout the office. Cross trained front office and clinical team members to learn basic skills by department in case of emergency coverage to effectively support patients present in the office.
- Hired, managed, developed and trained staff, established and monitored goals, conducted performance reviews.
- Coordinated individual duties after careful evaluation of each employee's skill level and knowledge.
No Work History in the USA Before 2015
Moved From the Europe in July 2015
July - July
Education
High School Diploma -
Srednja Mjesovita Skola
Zenica, Bosnia And Herzegovina05-1998
Skills
- Organizing and prioritizing work
- Policy analysis
- Reliability
- Adaptability and flexibility
- Self motivation
- Analytical thinking
- Goal setting
- Data analysis
- Decision-making
- Attention to detail
- Critical thinking
- Teamwork and collaboration
Languages
English
Full Professional
Italian
Full Professional
Croatian
Native or Bilingual
Interests
- Volunteer Work
- Homelessness Outreach
- Embracing outdoor adventures such a gardening and visiting parks and rivers
- Growing herbs, vegetables, or fruits in home gardens
- I enjoy cooking for friends and family gatherings
- I like trying new recipes and food trends
Timeline
Claims Representative
Beacon Hill Staffing
11.2023 - Current
Dental Office Coordinator
South Towne Dental
12.2017 - 08.2023
No Work History in the USA Before 2015
Moved From the Europe in July 2015
July - July
High School Diploma -
Srednja Mjesovita Skola
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