Paula Leuci
Everett,MA
Summary
Committed job seeker with a history of meeting company needs with consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
Overview
14
14
years of professional experience
Work History
Audit Coordinator
Audit Coordinator
Boston, MA
08.2023 - Current
- Log and maintain scheduled audits and all data pertaining to each audit in auditing software
- Provide copies of itemized bills, UB claims and pharmacy profiles to auditors and upload them into cobius an audit software
- Manage daily assignments and workloads using standardized protocols and work queues
- Inform department manager of internal or external issues and trends affecting accurate billing
- Contributes to problem-solving efforts to resolve receivable issues through feedback, information and research
Third Party Reviewer
Partners Healthcare
Somerville, MA
08.2018 - 08.2023
- Create and update documentation/information relating to the financial status of accounts in the hospital follow up systems
- Review assigned accounts by contacting insurance carriers to resolve any issues in a timely manner
- Process rejected claims through Epic systems
- Perform any other duties and assignments as requested or needed
- Promoted to Senior Third Party Reviewer on Oct.2021
- Work closely with the coordinator and supervisor on special projects and training
- Review, follow-up and resolve claims issues
- Contact third party representatives to secure additional information pertaining to reimbursement of accounts
- Update documentation/information relating to the financial status of accounts in the hospital follow up systems
Denials Coordinator
Newton Wellesley Hospital
Newton, MA
05.2021 - 06.2021
- Review assigned accounts by contacting insurance carriers to resolve denials
- Collaborates with insurance companies, central billing, case management, coding and physician offices
- Prepared documentation and worked on written appeal letters for claims that denied
- Analyze, Research and resolve claims denials for the hospital
- Perform all insurance verification for eligibility, coverage, and authorization requirements via Web or phone with third party payers to obtain retroactive authorization for payment
Store Supervisor
Delaware North Sports Services
Boston, MA
08.2017 - 06.2018
- Coordinate and organized goals for associates for their performance and deadlines
- Organized workflow and ensured employees understand their duties to delegate tasks at hand
- Executed store presentation of floor sets from one team to another
Sales Associate
Victoria’s Secret
Cambridge, MA
09.2010 - 03.2016
- Provided customer service by addressing customers’ questions and concerns
- Responsible for processing merchandise, executing floor sets and replenishing product throughout the store
- Responsible for processing merchandise efficiently
- Promoted to Merchandise flow supervisor on (10/04/2014-03/15/2016)
- Duties and responsibilities increased: appointed key holder for the store
- Organized the performance and operating tasks for associates
- Trained and supervised new employees regarding work ethic and company standards
Education
Bachelors - Health Science
UMASS Boston
Boston, Ma05.2018
Associates Degree - Liberal Arts
North Shore Community College
Danvers, Ma05.2015
Skills
- Audit Planning
- Data Analytics
- Report Writing
- Finance
- Internal Controls
Timeline
Audit Coordinator
Audit Coordinator
08.2023 - Current
Denials Coordinator
Newton Wellesley Hospital
05.2021 - 06.2021
Third Party Reviewer
Partners Healthcare
08.2018 - 08.2023
Store Supervisor
Delaware North Sports Services
08.2017 - 06.2018
Sales Associate
Victoria’s Secret
09.2010 - 03.2016
Bachelors - Health Science
UMASS Boston
Associates Degree - Liberal Arts
North Shore Community College
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