Summary
Overview
Work History
Education
Skills
Languages
Accomplishments
Affiliations
Certification
Timeline
Barista

SUSAN KUKIC

PITTSBURGH,PA

Summary

Organized Resident Accounts Coordinator (Biller) and Patient Service Representative with 11 years of experience in healthcare. Adept at patient advocacy and education with commitment to efficiency. Skilled at coordinating busy offices and maintaining professionalism in stressful situations.

  • Dedicated administrative professional well-versed in communication and team building. Knowledgeable in medical terminology and scheduling. Ready to bring 18 years of relevant work experience to your team.
  • Enthusiastic about helping patients get necessary medical support by obtaining authorizations, scheduling procedures and coordinating paperwork. Detail-oriented and proactive with good relationship-building skills, a hardworking nature and an adaptable approach. Proficient in Epicore , Point Click Care ,EHR and EMR .
  • Encouraging manager and analytical problem-solver with talents for team building, leading and motivating, as well as excellent customer relations aptitude and relationship-building skills. Proficient in using independent decision-making skills and sound judgment to positively impact company success. Dedicated to applying training, monitoring and morale-building abilities to enhance employee engagement and boost performance.
  • Efficient Accounts Receivable Specialist offering 4 years of experience in accounts receivable functions. Excellent knowledge of collection and claims procedures with strong communication skills utilized in resolving customer queries. Skilled in accurately preparing weekly and monthly reports within tight deadlines.
  • Reliable Medical Biller with coding and medical terminology knowledge. Polished and hardworking performer with background overseeing accounts and handling records management tasks. Team-oriented person with great decision-making skills.

Overview

11
11
years of professional experience
1
1
Certification

Work History

Resident Accounts Coordinator

Little Sisters Of The Poor
Pittsburgh, PA
Jan.2020 - Current
  • Applied HIPAA privacy and security regulations while handling patient information.
  • Coordinated communications between patients, billing personnel and insurance carriers.
  • Reviewed account information to confirm patient and insurance information is accurate and complete.
  • Contacted insurance providers to verify insurance information and obtain billing authorization.
  • Communicated with insurance representatives to complete claims processing or resolve problem claims.
  • Completed and submitted appeals for denied claims.
  • Submitted appeals using provider portals and phone communication.
  • Reviewed claims for coding accuracy.
  • Input details into accounts and tracked payments.
  • Handled billing, waivers and claims for private and commercial clients.
  • Distributed or posted financial data to appropriate accounts and prepare simple reconciliations.
  • Monitored reimbursement from managed care networks and insurance carriers to verify consistency with contract rates.
  • Organized information for past-due accounts and transferred to collection agency.
  • Leveraged EMR software to post payments received for medical services.
  • Interpreted medical terminology and pharmacological information to translate information into coding system.
  • Maintained billing software by updating rate change, cash spreadsheets and current collection reports.
  • Answered customer questions to maintain high satisfaction levels.
  • Submitted claims to insurance companies.
  • Managed all payments processing, invoicing and collections tasks.
  • Monitored past due accounts and pursued collections on outstanding invoices.
  • Collected, posted and managed patient account payments.
  • Processed invoice payments and recorded information in account database.
  • Entered procedure codes, diagnosis codes and patient information into billing software to facilitate invoicing and account management.
  • Investigated past due invoices and delinquent accounts to generate revenues and reduce number of unpaid and outstanding accounts.
  • Performed insurance verification, pre-certification and pre-authorization.
  • Input statement information, reconciled accounts and resolved discrepancies.
  • Trained new team members on company policies and accounting systems to keep team operations productive and efficient.
  • Generated and distributed month-end statements for customers and resolved related concerns.
  • Maintained accounting ledgers by verifying and posting account transactions.
  • Developed strong professional rapport with vendors and clients.
  • Gathered information to produce accounts payable reports for review.
  • Participated in workshops, seminars and training classes to gain stronger education in industry updates and federal regulations.
  • Performed accurate and fully compliant monthly closing processes, accruals and journal entries.
  • Reconciled codes against services rendered.
  • Reconciled financial accounts using excel .
  • Skilled at working independently and collaboratively in a team environment.

Health Insurance Advisor

Consumer Health Coalition
Pittsburgh, PA
09.2016 - 11.2019
  • Educated clients on options to assist in making informed decisions.
  • Advocated for clients to resolve medical or personal crises.
  • Referred client or family to appropriate community resources to obtain support for mental or physical illness.
  • Provided information to access financial assistance, legal aid or housing.
  • Advised on policy development and assisted in community program implementation.
  • Assisted customers by phone and scheduled appointments and treatments.
  • Maintained confidential patient documentation to prevent data compromise and comply with HIPAA regulations.
  • Answered questions and responded to inquiries to deliver high level of service to patients.
  • Proofread documents carefully to check accuracy and completeness of all paperwork.
  • Performed careful reviews of applicant data to ascertain compliance with eligibility criteria for economic assistance.
  • Informed applicants of other agencies providing useful or related assistance.
  • Maintained positive working relationship with fellow staff and management.
  • Conversed with people from different cultures daily, providing high level of respect and patience with each interaction.
  • Explained eligibility details and affordability options to patients with kindness and respect.
  • Conducted interviews with applicants, explaining benefits process and which programs were available.
  • Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
  • Understood and followed oral and written directions.
  • Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
  • Demonstrated leadership by making improvements to work processes and helping to train others.
  • Prioritized and organized tasks to efficiently accomplish service goals.
  • Identified needs of customers promptly and efficiently.
  • Planned and completed group projects, working smoothly with others.
  • Assisted with customer requests and answered questions to improve satisfaction.
  • Provided direct service and support by handling referrals for advocacy issues or resolving complaints.
  • Researched and analyzed community needs to determine program directions and goals.
  • Spoke to community groups to explain and interpret purposes, programs and policies.

Project Implementation Coordinator

Parallon Workforce Management Solutions
St Louis, MO
03.2016 - 09.2016
  • Collaborated with internal teams to develop project solutions resulting in on-time execution.
  • Assessed, monitored and reported on work progression.
  • Assisted project manager in drafting schedules and related documentation.
  • Prioritized needs and delegated assignments to simultaneously handle multiple projects.
  • Liaised between departments, vendors and clients to monitor project expenses.
  • Coordinated with department leads to identify and outline solutions to client-specified challenges.
  • Produced status reports for customers and senior management.
  • Developed and implemented project tracker or calendar to meet and maintain standards.
  • Served as point-of-contact to support order management, testing and reporting.
  • Introduced change improvement plans to achieve goals, methodologies and initiatives.

Medicare Part A and Part B Claims Processor

Aetna
Pittsburgh, Pa
2015.09 - 2016.03
  • Assured timely verification of insurance benefits prior to patient procedures or appointments.
  • Calculated adjustments, premiums and refunds.
  • Checked documentation for accuracy and validity on updated systems.
  • Collected premiums and issued accurate receipts.
  • Verified client information by analyzing existing evidence on file.
  • Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
  • Coordinated with contracting department to resolve payer issues.
  • Maintained strong knowledge of basic medical terminology to better understand services and procedures.
  • Posted payments to accounts and maintained records.
  • Made contact with insurance carriers to discuss policies and individual patient benefits.
  • Maintained confidentiality of patient finances, records, and health statuses.
  • Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
  • Generated, posted and attached information to claim files.
  • Prepared insurance claim forms or related documents and reviewed for completeness.
  • Determined appropriateness of payers to protect organization and minimize risk.
  • Processed and recorded new policies and claims.
  • Reviewed outstanding requests and redirected workloads to complete projects on time.

Medicaid Specialist

Parallon Workforce Solutions
Monroeville, PA
08.2014 - 03.2015
  • Scheduled appointments with applicants to gather information and explain benefits processes.
  • Followed guidelines when reviewing applicant data to determine eligibility for economic assistance.
  • Selected qualified applicants to refer to employers for possible job placement purposes.
  • Sorted out jobs relevant to interests of candidates to forward information to candidates.
  • Interviewed applicants and explained scope of different available benefits.
  • Assisted clients with completion of applications and paperwork.
  • Communicated with people from various cultures and backgrounds on application process.
  • Reviewed applications for different aid programs and determined which qualification criteria for individuals.
  • Identified issues, analyzed information and provided solutions to problems.
  • Delivered services to customer locations within specific timeframes.
  • Developed strong organizational and communication skills through coursework and volunteer activities.
  • Excellent communication skills, both verbal and written.

Eligibility Coordinator

NCO Group
Pittsburgh, PA
10.2012 - 07.2014
  • Implemented strategies to increase public awareness of social and community service programs.
  • Coordinated individual referrals to obtain community services, advocate for client needs and resolve roadblocks.
  • Investigated issues and created solutions for new customers.
  • Educated clients about health insurance coverage options, benefits and costs.
  • Monitored changes in health insurance laws and regulations to verify continuous compliance.
  • Assisted clients with filing and tracking health insurance claims to facilitate swift settlements.
  • Answered inbound calls from existing and future policyholders to answer inquiries and discuss insurance options.
  • Developed relationships with providers and networks to achieve favorable client coverage.
  • Developed and maintained client databases to track customer service interactions and evaluate service quality.
  • Responded to customer inquiries regarding health insurance coverage and policies to assist with informed decision-making.
  • Provided comprehensive customer service to drive client satisfaction.
  • Developed tailored health insurance plans to meet individualized client needs.
  • Met with customers to provide information about available products and policies.
  • Educated clients on insurance policies and procedures.
  • Conducted annual reviews of existing policies to update information.

Education

Certificate - Nursing

Emerald Nursing School
El Paso, TX
09.1996

High School Diploma -

Ysleta High School
El Paso, TX
05.1990

Skills

  • Customer Service
  • CPT Code Modifiers
  • Multitasking and Organization
  • HIPAA Compliance Certification
  • Training and Development
  • Commercial and Private Insurance
  • Payer Contracts
  • Electronic Health Record Software
  • Records Management
  • Medical Billing
  • Medicaid and Medicare Knowledge
  • Medical Coding Understanding
  • CMS-1500 Billing Forms
  • HIPAA Compliance
  • Invoice Coding
  • Claim Review
  • Reimbursements
  • Insurance Billing
  • Payment Posting
  • Submission of Medical Claims
  • Insurance Claims Processing
  • Insurance Collections
  • Claims Processing
  • Patient Collections
  • Information Inputting
  • Account Reconciliation
  • Electronic Claims
  • SMS
  • Data Analysis
  • Billing and Collection Procedures
  • Claims Review
  • Teamwork and Collaboration
  • Critical Thinking
  • ICD-9
  • Operations Support
  • Records Maintenance
  • Billing Codes
  • Account Management
  • Insurance Claims
  • ICD-10
  • Medical Terminology
  • Regulatory Compliance
  • Verbal and Written Communication
  • Worker's Compensation Knowledge
  • Account Follow-Up
  • Knowledgeable in Point Click Care
  • Knowledgeable in EPIC
  • Knowledgeable in Promise

Languages

English
Native/ Bilingual
Spanish
Native/ Bilingual
Portuguese
Limited

Accomplishments

  • Consistently maintained high customer satisfaction ratings.
  • Created highly effective new program that significantly impacted efficiency and improved operations.

Affiliations

  • High Quality service and performance in successfully migrating RCPSME services in HCA hospitals
  • Member, Alumni Association

Certification

  • CNA Nursing Training - 1996

Timeline

Resident Accounts Coordinator

Little Sisters Of The Poor
Jan.2020 - Current

Health Insurance Advisor

Consumer Health Coalition
09.2016 - 11.2019

Project Implementation Coordinator

Parallon Workforce Management Solutions
03.2016 - 09.2016

Medicare Part A and Part B Claims Processor

Aetna
2015.09 - 2016.03

Medicaid Specialist

Parallon Workforce Solutions
08.2014 - 03.2015

Eligibility Coordinator

NCO Group
10.2012 - 07.2014

Certificate - Nursing

Emerald Nursing School

High School Diploma -

Ysleta High School

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SUSAN KUKIC