ZERINA MEKIC

Prepared and submitted billing data and medical claims to insurance companies.

Evaluated patient's benefits eligibility using various databases and tools such as web portals, claims system, clearing houses such as Change Healthcare, Waystar, and Careisk. Used several different EMRs such as Epic, Medent, WebPT, TheraOffice, Chartmaker, Prompt.

• Verified patient insurance coverage, including eligibility, benefits and authorizations for medical services.
• Collected and reviewed referrals and pre-authorizations, ensuring timely processing for improved patient service.
• Processed prior authorization requests for medical services and procedures.
• Investigated and appealed denied claims, securing payments and minimizing revenue loss.
• Examined patient bills for accuracy and requested any missing information.
• Followed up on accounts receivable to optimize cash flow.
• Recorded insurance and patient payments accurately in billing system.
• Collaborated with healthcare providers to gather necessary documentation.
• Communicated with insurance companies regarding authorization statuses and requirements.
• Assisted in resolving discrepancies related to denied authorizations.

• Managed credentialing for medical providers, including insurance and CAQH enrollments, ensuring compliance with industry standards.
• Support and facilitate the credentialing process; inform the provider(s) of credentialing status.
• Initiated and maintained enrollment for medical providers.
• Prepared, submitted, and tracked insurance credentialing applications to streamline provider enrollment process.
• Reviewed practitioners' credentials to ensure that they are up to date.
• Reviewed and verified credentials of healthcare professionals to ensure accuracy.
• Keep an organized record of contracting communications and status updates for provider enrollment/credentialing/re-credentialing.
• Maintain CAQH and PECOS databases.
• Resolved inquiries from providers regarding credentialing requirements and processes.

• Reviewed prescriptions for appropriate dosage, drug interactions, allergies, and contraindications before dispensing to ensure patient safety.
• Completed new and updated patient profiles, including lists of patient medications.
• Assisted pharmacists with checking in and pricing drug orders and processing third-party transactions to ensure accurate and efficient operations.
• Hand counted control medications, measured liquids, and reconstituted antibiotics.
• Stocked shelves, rotated inventory, and checked for expired medications to maintain pharmacy compliance and safety.
• Translated pharmacy communications for Bosnian-speaking customers.

• Delivered patient-oriented clinical pharmacy services and pharmaceutical care to enhance patient outcomes.
• Providing instructions to educate patients on proper medication usage for improved adherence.
• Receiving and verifying the accuracy and authenticity of prescriptions.
• Disbursing completed and confirmed prescriptions to patients.
• Assisted pharmacy staff with drug inventory management, purchasing, and receiving to ensure accurate stock levels.
• Correctly completed pharmacy paperwork, including daily and weekly reports.
• Receptively answered customer questions and helped locate desired items in the pharmacy.
• Stocked pharmacy shelves with inventory to ensure product availability for customers.
• Supporting the Pharmacist in the daily operation of the pharmacy.
• Protecting employees and patients by adhering to infection-control protocols and policies.