Erika Kurpis
Glen Gardner
Summary
Detail-oriented Document Retrieval Specialist II with extensive experience in high-volume documentation retrieval and HIPAA compliance. Streamlined claims processing and enhanced operational workflows through effective collaboration and mentoring of junior staff. Skilled in EMR systems, delivering results that improve efficiency.
Overview
21
21
years of professional experience
1
1
Certification
Work History
Document Retrieval Specialist II
ZELIS HEALTHCARE
Morristown
09.2022 - Current
- Manages high-volume retrieval of medical records and supporting documentation for DRG validation, technical denial reviews, and post-pay claims audits
- Manages high-volume retrieval of medical and insurance related documentation from providers, payers, and third-party systems, ensuring accuracy and compliance with HIPAA regulations
- Analyze, validate, and index incoming documents in accordance with HIPAA and payer-specific guidelines to ensure compliance, completeness, and accuracy for payment integrity, adjudication processes, audits, and claims processing workflows
- Collaborate cross-functionality with assigned nurses, internal audit, coding, and claims teams to resolve discrepancies, missing records, claims determinations, and escalated retrieval requests related to DRG assignments, denied claims, or under-reviewed claims
- Communicate with healthcare providers and facilities to request, follow up, and secure required documentation for technical denial overturns and post-payment review outcomes
- Identified and escalated missing or insufficient documentation affecting DRG coding and claim determinations.
- Utilize internal systems and databases to track retrieval status, maintain audit-ready documentation, and ensure timely turnaround
- Identify process inefficiencies and contribute to workflow improvements that enhance efficiency in retrieval processes, speed of claims processing, and accuracy tied to DRG, post-pay, and denial review operations
- Train and mentor junior team members on retrieval protocols, audit requirements, documentation standards, compliance standards, and system tools
- Knowledge of insurance claims, denials, and appeals workflows
- Ability to work with clinical staff, especially nurses and auditors
- Proficiency with EMR systems and claims management tools
- Exhibited discipline as a remote employee by adhering to schedules and communication protocols.
- Extensive knowledge of internal systems such as AutoFax, Appsmith, Prizem, Datavant, Geisinger, Sharecare, and other document retrieval platforms
- Maintains awareness of and ensures adherence to Zelis and HIPAA standards regarding policies and procedures regarding patient PHI privacy
- Demonstrated detail orientation by maintaining organized documentation in compliance with standards.
Administration & AR/Managed Care Specialist (Contract)
Hearing Life
Somerset
10.2021 - 05.2022
- High claim processing output (100+ claims daily through third party vendor portals)
- Managed AR third party billing and collected payments from processed hearing aid claims.
- Processed patient accounts receivable (AR), including billing, claims submission, payment posting, and follow-up on outstanding balances
- Coordinated with managed care organizations and insurance providers to resolve claim denials and discrepancies, ensuring timely reimbursements
- Monitored aging AR reports and implemented proactive strategies to reduce outstanding balances and enhance collection rates
- Verified insurance eligibility and benefits for hearing services, ensuring accurate authorization and coverage compliance
- Processed and filed hearing aid claims through third party payer portals in a timely manner.
- Facilitate communication between third party payers and clinics regarding correct claim processing and payment status
- Ensured proper coding and documentation of hearing aid services and related medical procedures for reimbursement accuracy
- Collaborated with corporate billing teams to streamline revenue cycle processes and improve financial performance.
- Maintained accurate patient statuses in the Citrix portal regarding claim status by applying managed care resolution and purpose codes.
- Processed accounts receivable (AR) functions, including insurance billing, payment posting, reconciliation, and follow-up on outstanding claims to optimize cash flow
- Collaborated with insurance providers and patients to resolve billing discrepancies, denials, and appeals in a timely manner
- Maintained accurate patient records and financial documentation in accordance with HIPAA and company standards
- Provided exceptional customer service by addressing patient inquiries related to billing, insurance coverage, and appointments
- Acquired in-depth knowledge of hearing aids and durable medical equipment to assist in patient inquiries.
- Billing portal experience with EPIC, United Healthcare Hearing, and Nations Hearing
- Assisted in reporting and tracking key performance metrics related to revenue cycle management and administrative efficiency
- Supported cross-functional teams, including audiologists and regional management, to streamline operations and improve patient experience
- Supported cross-functional teams, including audiologists and regional management, to streamline operations and improve patient experience
Program Support Assistant, Social Work Department
Veterans Health Administration
East Orange
03.2021 - 06.2021
- Providing information about the organization as well as Social Work Service Programs
- Assisted Veterans, families, and caregivers by providing information and referrals to connect them with appropriate resources
- Help direct Veterans to appropriate social work or VA services
- Support social work programs such as homelessness services, mental health coordination, caregiver support, or discharge planning
- Schedule Veteran appointments with social workers and community agencies
- Coordinate meetings, trainings, and case conferences
- Manage calendars for supervisors or program staff
- Providing calendar maintenance and clerical services such as record keeping, scanning into the clinical record, filing, minutes, room reservations and ensuring that equipment is available for meetings
- Arrange travel and logistics for staff when needed
- Maintained and organized patient and program records using VA systems like CPRS/Vista to ensure accurate information access
- Enter and update data in VA databases and tracking systems
- Run basic reports on caseloads, program activity, or service utilization
- Tracked program outcomes and contributed to quality improvement data collection to enhance service delivery
- Monitor deadlines for documentation or program requirements
- Type, edit, and format reports, memos, and meeting minutes
- Processing all incoming correspondence, faxes, and action documents
- Performing office automation duties by using software applications, such as electronic mail, desk-top publishing, schedules, calendars, spreadsheets and/or databases
- Using software applications to draw information to prepare/assist in preparation of reports, including productivity tracking
- Communicate referral status or documentation needs between teams
- Performing data collection and tracking support to the service by collection, compilation, and statistical information in support of the management of the staff database
- Maintain office supplies and ensure program materials are available
- Work closely with social workers, nurses, physicians, and other VA departments
- Assist in onboarding or administrative orientation for new staff
- Answer phones, respond to inquiries, and direct calls appropriately
- Serving as the primary timekeeper for Social Work Service
- Assisted team with various operational tasks to enhance efficiency
- Follow HIPAA and VA privacy regulations
- Maintain secure handling of Veteran records and sensitive information
- Performing other related duties as assigned
Front Desk Concierge, Administrator
Beverly Friedlander, M.D.
Short Hills
12.2019 - 05.2020
- Acted as the first point of contact for a high-end plastic surgery and medical spa practice, delivering exceptional customer service in a luxury, patient-focused environment
- Managed daily front desk operations, ensuring efficient patient check-in/check-out, appointment scheduling, and effective use of multi-line phone systems
- Coordinated patient flow between consultation, treatment, and surgical services to ensure seamless clinic operations
- Verified patient information, insurance details (if applicable), and completed intake paperwork in compliance with HIPAA regulations
- Handled scheduling for consultations, cosmetic procedures, and follow-up appointments using electronic medical record (EMR) systems
- Educated patients on procedures and pre- and post-operative instructions, fostering informed decision-making and improving patient experience
- Processed payments, managed billing inquiries, and maintained accurate financial transaction records
- Supported providers and clinical staff by preparing charts, organizing patient files, and ensuring exam rooms were ready for procedures
- Addressed patient concerns with discretion, empathy, and professionalism to enhance overall patient experience and satisfaction
- Promoted spa services, memberships, and skincare products, enhancing patient engagement and contributing to practice revenue growth
- Preparing patient charts and procedure consents for appointments
Unit Coordinator, Patient Care Assistant
Hunterdon Medical Center
Flemington
12.2015 - 02.2018
- Coordinated daily unit operations, managing patient admissions, discharges, and transfers to ensure seamless care transitions and accurate documentation
- Facilitated communication between nurses, physicians, and ancillary departments to enhance patient care delivery
- Responded promptly to call lights and patient needs, contributing to a safe and supportive care environment
- Provided daily nursing care under the direction of Registered Nurses
- Assisted patients with their activities of daily living such as bathing and eating
- Provided 1 on 1 care to patients considered safety risks
- Monitored and maintained electronic health records (EHR), ensuring compliance with hospital policies and confidentiality standards (HIPAA)
- Interpreting, clarifying, and entering physician orders into patient EMR regarding treatment, medications, and transfers between units
- Prepared patient charts, processed physician orders, and ensured accurate data entry into hospital systems
- Ensured proper documentation of telemetry monitor usage to support patient monitoring needs
- Supported infection control and safety protocols by maintaining a clean, organized unit and adhering to clinical guidelines
- Collaborated with interdisciplinary teams to streamline workflows and enhance overall patient satisfaction
- Organized follow-up appointments with patients’ primary care physicians upon discharge
- Managed scheduling, answered multi-line phones, and handled administrative duties such as supply ordering and record keeping
- Maintained unit supplies by working directly with vendors and Purchasing Department
- Prioritized and executed responsibilities in a fast-paced healthcare setting, ensuring effective task management and patient support
- Unit liaison between physicians, nurses, and other department medical staff
- Reported directly to Registered Nurses with all patient feedback and requests
Boatswain Mate 3rd Class
United States Coast Guard
Southwest Harbor
06.2005 - 07.2010
- Certified Coxswain, operated and commanded small boats during high-risk missions including search and rescue (SAR), maritime law enforcement, and security operations
- Qualified Boarding Officer, leading federal law enforcement boardings to enforce U.S. maritime laws, conduct safety inspections, and ensure regulatory compliance
- Executed maritime law enforcement missions, conducting vessel interdictions and contraband enforcement to enhance security in coastal and port environments
- Collaborated with federal agencies including U.S. Immigration and Customs Enforcement, Drug Enforcement Administration, and U.S. Customs and Border Protection to facilitate joint operations and intelligence sharing, bolstering national security efforts
- Applied Incident Command System (ICS) principles to coordinate multi-agency response efforts, ensuring efficient communication and mission execution
- Applied Federal Emergency Management Agency certifications to coordinate crisis response activities.
- Supervised and trained junior personnel in seamanship, tactical operations, use-of-force policy, and risk management procedures
- Maintained operational readiness of small boats and weapons systems through rigorous inspections and preventative maintenance, ensuring safety and effectiveness during missions
- Conducted navigation, watch-standing, and lookout duties in complex and dynamic maritime conditions
- Led emergency response operations including firefighting, damage control, and man-overboard recovery
- Demonstrated decisive leadership and sound judgment in high-pressure, time-sensitive environments
- Implemented, regulated, and ensured adherence to specified laws and boating safety for fisherman, leisure boaters, and the areas Native American Indian Tribes
- Extensive training in Search and Rescue Training (SAR) by working with local Law Enforcement agencies to successfully conduct SAR missions and prevent loss of life
- Certified in Incident Command Systems 100-800, specialized in response preparedness for natural or man-made disasters and acts of terrorism
- Efficiently trained in Fire Safety and OSHA to ensure proper handling of hazardous spills
- Achieved qualification as a marksman with small weapons, demonstrating proficiency and accuracy.
- Completed military service with honorable discharge, reflecting strong character and integrity.
Education
Bachelor of Science - Healthcare Administration And Health Informatics
Washburn University of Topeka
Topeka, KS01-2019
Associate of Science - Health Sciences
William Rainey Harper College
Palatine, IL01-2013
Bachelor of Science - Criminal Justice
Endicott University
Beverly, MA01-2008
Associate of Science - Criminal Justice
Raritan Valley Community College
Somerville, NJ01-1997
Skills
- EMR systems
- QCPR systems
- Nextgen
- Nextech
- Microsoft Office
- OneNote
- Microsoft Teams
- VATAS
- EPIC
- Nations Hearing
- Navinet
- ACORN Credentialing System
- CITRIX
- Availity
- Waystar
- Oticon
- Decibel
- NPPES/NPI Registry
- PDF management
- CISCO IP Communications
- CPRS
- HIPAA compliance
- OSHA reporting
- MSDS
- RC Fax
- MyMedLeads
- MD Ware
- DDMS systems
- KRONOS
- Detail-oriented
- Organizational skills
- Remote employment
- Brilliant Distinctions
- Aspire Galderma
- Care Credit
- Medical Terminology
- Appointment scheduling
- Medical records
- Claims verification
- Home healthcare
- Care management
- Accounts management
- Third party payer
- Bank reconciliation
- Clerical
- CMSgov
- Billing fee schedules
- Data entry
- Client communication
- Time optimization
- Payroll
- Data analytics
- Documentation review
- Presentation skills
- Incident response
- Typing 60wpm
- Document retrieval
- EMR administration
- Claims processing
- Customer relationship management
- Process improvement
- Cross-functional teamwork
- Mentoring junior staff
- Attention to detail
- Effective communication
- Organizational skills
- Indexing techniques
- Search optimization
- Records management
- Electronic filing
- Training facilitation
- Content evaluation
- Information management
- Document management
- Operational procedures
- Records management
- Sensitive document management
- Document management
- Document security
- Project Support
- Data accuracy
- Adobe acrobat
- SharePoint administration
- Teamwork and collaboration
- Multitasking Abilities
- Workflow optimization
- Analytical skills
Certification
- Emergency Management Institute FEMA ICS 100-800
- IHI Certified Professionals in Healthcare (84.25 hrs.)
- IHI Certified Faculty Development (10 hrs.)
- IHI Certified Graduate Medical Education GME201-206
- IHI Leadership Certified L101
- IHI Certified Patient Safety PS101-105, 201-203, PS x1-x2
- IHI Certified Person & Family Centered Care PFC101-103, 201-202
- IHI Quality & Safety Certified QI101-105, 201-202
- IHI Certified Triple Aim for Populations TA101-103
References
Upon Request
Accomplishments
- National Honor Society
Timeline
Document Retrieval Specialist II
ZELIS HEALTHCARE
09.2022 - Current
Administration & AR/Managed Care Specialist (Contract)
Hearing Life
10.2021 - 05.2022
Program Support Assistant, Social Work Department
Veterans Health Administration
03.2021 - 06.2021
Front Desk Concierge, Administrator
Beverly Friedlander, M.D.
12.2019 - 05.2020
Unit Coordinator, Patient Care Assistant
Hunterdon Medical Center
12.2015 - 02.2018
Boatswain Mate 3rd Class
United States Coast Guard
06.2005 - 07.2010
Bachelor of Science - Healthcare Administration And Health Informatics
Washburn University of Topeka
Associate of Science - Health Sciences
William Rainey Harper College
Bachelor of Science - Criminal Justice
Endicott University
Associate of Science - Criminal Justice
Raritan Valley Community College