Summary
Overview
Work History
Skills
Accomplishments
Certification
Languages
Awards
Parallon Migrating RCPS ME
Timeline
Generic

Susan Kukic

Pittsburgh,PA

Summary

Dedicated healthcare professional with over 15 years of experience in medical billing, insurance verification, Medicaid eligibility, and prior authorization. Seeking to leverage extensive background in payer communications and claims resolution in a Sr. Authorization Specialist role at Magee Women's Hospital.

Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.

Overview

14
14
years of professional experience
1
1
Certification

Work History

Resident Accounts Coordinator

Little Sisters of the Poor
01.2020 - Current
  • - Manage Medicaid recertifications, resident personal funds, and payer communication for long-term care residents
  • - Collaborate with families and residents to obtain and process Medicaid applications
  • - Coordinate authorizations, eligibility verification, and payment resolutions for Medicaid/Medicare claims
  • - Maintain accurate records in PointClickCare; complete monthly reconciliations and financial reporting
  • - Liaise with state and county agencies on compliance and documentation

Health Insurance Enrollment Counselor

Consumer Health Coalition
09.2016 - 12.2019
  • - Assisted uninsured individuals in enrolling in Medicaid, CHIP, and marketplace plans
  • - Provided structured education on benefits and supported enrollment through outreach events
  • - Acted as liaison between healthcare providers, government agencies, and applicants
  • Allegheny County Jail

Project Implementation Coordinator (Remote)

Parallon Workforce Solutions
03.2016 - 09.2016
  • - Supported multi-state Medicaid eligibility rollouts for healthcare systems
  • - Provided training and workflow optimization to staff during system implementations

Medicare Enrollment Specialist

Aetna
09.2015 - 03.2016
  • - Processed Medicare applications, cancellations, and eligibility reviews under CMS guidelines
  • - Handled high-volume calls with Medicare beneficiaries to clarify benefits and resolve enrollment issues

Medicaid Eligibility Benefit Advisor

Parallon/RCPS
08.2014 - 03.2015
  • - Screened patients for federal/state aid, verified benefits, and obtained prior authorizations
  • - Filed and tracked Medicaid applications; coordinated documentation with government caseworkers

Eligibility Advocate & DME Coordinator

Various Healthcare Facilities
01.2011 - 01.2014
  • - Performed insurance verification, claim follow-ups, and patient financial counseling
  • - Assisted with DME claims, eligibility screening, and prior authorization for outpatient and inpatient services

Skills

  • - Prior Authorizations Insurance Verification Medicaid/Medicare Billing
  • - EHR/EMR: PointClickCare, Epic (basic), internal MCO portals
  • - Appeals & Denials Management Claims Resolution
  • - Payer Communication HIPAA Compliance Patient Advocacy

Accomplishments

  • engaged with consumers who are at-risk for experiencing barriers to the health care system, as well as the organizations that serve them..
  • Educated the migrant community about breast cancer awareness
  • address disparities in health access and outcomes through education, advocacy, and awareness raising
  • empowering consumers and improving their overall health and well-being within the community


Certification

  • - CNA Certification, 1996-1999
  • - Ongoing professional training in Medicaid billing, payer systems, and EHR tools

Languages

- English - Native | Spanish - Fluent

Awards

- Recognized by Parallon for high performance during HCA Medicaid service rollouts (2016)

Parallon Migrating RCPS ME

  • These processes include patient registration, insurance verification, billing, and collections.
  • The goal is to optimize financial performance for healthcare providers and improve the patient financial experience.

2. RCP Migrations and Parallon

  • Healthcare organizations often need to migrate to new or upgraded Revenue Cycle Platforms (RCPs).
  • These migrations can be complex, involving changes to software, processes, and workflows.
  • Parallon, as a RCM provider, would likely be involved in such migrations for its clients.

Timeline

Resident Accounts Coordinator

Little Sisters of the Poor
01.2020 - Current

Health Insurance Enrollment Counselor

Consumer Health Coalition
09.2016 - 12.2019

Project Implementation Coordinator (Remote)

Parallon Workforce Solutions
03.2016 - 09.2016

Medicare Enrollment Specialist

Aetna
09.2015 - 03.2016

Medicaid Eligibility Benefit Advisor

Parallon/RCPS
08.2014 - 03.2015

Eligibility Advocate & DME Coordinator

Various Healthcare Facilities
01.2011 - 01.2014
Susan Kukic