1. Nevzeta Pitic
2541 East Pikes Peak Ave #G105
Colorado Springs, CO 80909
754-235-6097
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Education
Everest University Pompano Beach, FL
Medical Insurance Billing and coding, 2012/2013
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PROFESSIONAL EXPERIENCE
Medical Billing and Enrollment Specialist
First Source, Colorado Springs, CO 2016 - Present
• Provide information about insurance affordability programs and coverage options.
Processes daily enrollee invoices and premium reconciliation for members
• Reconciles unallocated payments, monies, and premiums received from the individual
subscriber or responsible party with the amount due for the healthcare program the
member is enrolled in.
• Resolves invoice discrepancies prior to monthly report run.
• Performs month-end invoicing and accuracy audits.
• Collaborates with enrollment team to resolve eligibility issues affecting premium billing.
• Generates reports and billing data using the premium billing module to be sent to print
and fulfillment vendor.
• Reconciles eligibility data to ensure that the member data loaded in system matches the
file (exception report).
• Works PCP exception report - assigns member to PCP.
• Works pharmacy exception report - validates eligibility updating system and website.
• Works vision exception report - validates eligibility and updates system.
• Works ID card exception report - validates member demographic information updating
system accordingly and regenerates ID card as needed.
• Complete member moves – reassigning member from one PCP to another.
• Works monthly eligibility reconciliation (audit file/baseline vs. system) – updates eligibility
data in system accordingly.
• Confirms monthly reporting. Validates eligibility by updating system accordingly using
premium file details.
• Posting payment-montly premiums
Pre-litigation analyst II 2014-2016
Law firm Ellen,Ged and Badden/Boca Raton, FL
Responsible for obtaining and reviewing required data necessary to create demands and assist
the PIP suit process, which includes, scanning, auditing, and calculating demands according to
set terms. Also responsible for reviewing data to make critical decisions according to protocol,
creating documents to be submitted to insurance carriers and Attorneys.

2. • Maintain organization and work quality in paperless environment.
• Ability to read and completely understand EOB’s, AOB’s, Patient ledgers, PIP logs, and
understand legal information listed within carrier response letters
• Understand and decipher policy language
• Understand the use of CPT codes, ICD 9/10 codes, modifiers, denial codes, and fee
schedules (Medicare/Workers’ Compensation)
• Ability to calculate the payment of claims according to fee schedule
• Ability to determine available benefits and/or if benefits are exhausted
• Knowledge of Florida State claim filing periods
• Knowledge of Statute of Limitations as it relates to the PIP Law
• Use of basic mathematical skills: Addition, Subtraction, Multiplication, Division,
proportions, and percentages
• Basic use of a calculator and/or adding machine
• Knowledge of the difference between an Auto Carrier, Health Insurance Carrier, and a
TPA
• Knowledge of the difference between a policy number/claim number, what they represent,
and how it affects the job function
• Excellent computer navigating skills
• Microsoft Office (Outlook, Excel, Word)
• Adobe Reader/Write
• Flash Drive Usage
• Moderate healthcare software knowledge
• Scan, Import, and Create file folders
• Good organizational skills with special attention to detail
• Excellent written and verbal communication (including email)
• Excellent time management skills
• Ability to meet deadlines and respond to requests in timely manner
• Self-management and ability to work independently
• Dress appropriate for professional office environment
• Maintains and upholds the privacy, confidentiality and security of protected health
information internal and external to the work environment for written, verbal and/or
electronic communication in compliance with HIPAA Privacy Rule §164.502(b).
Collection Account Manager 2012 - 2014
Medivance Billing inc. ,Sunrise, FL
• Research and resolve any electronic claim denials.
• Effectively utilizes various means for collections, including but hot limited to phone, fax,
mail and online methods
• Provide all necessary documentation required to expedite payments. This includes
demographic, authorization/referrals, NPI and referring physicians, etc.
• Verify that adjustments are posted
• Report any reimbursements trends/delays to manager (billing denials, claim denials,
pricing, errors, payment, etc)
• Payment posting and insurance verification
Medical Insurance Billing and Coding Extern
Great Expressions Dental Centers, Coconut Creek, FL
• Scheduled appointments and entered appointment date into computerized scheduler

3. • Greeted and directed patients
• Made appropriate entries in computer system and on patient's chart
• Prepared all billings in computerized system for processing
Sales Services Specialist January 2008 to June 2012
Bank of America, Pompano Beach, FL
• Establish, retain and deepen relationships with customers and prospects to achieve team
sales goals and provide quality customer service.
• Resolve complex service issues or refer to appropriate associate to guarantee customer
satisfaction and retention.
• Provide proactive sales activities of basic products while referring more complex requests
(e.g., complex small business accounts or mortgages) to an associate with more in-depth
expertise. Process transactions accurately and efficiently to build customer confidence
and trust, based on established policies and procedures.
Teller Senior Supervisor May 2004 to January 2008
Bank of America, Pompano Beach, FL
• Acted as the face of Bank of America and consistently sought to delight our customers by
demonstrating the Bank of America spirit.
• Contributed to a positive team environment in the banking center as well as assisted in
the development of associates through 360-degree coaching. Processed transactions
accurately and efficiently to build customers confidences and trusts.
Bank of America, Boca Raton, Fl November 2000 to May2004
• Processed transactions accurately and efficiently in accordance with established policies
and procedures. Identified customer needs and referred financial products and services
to consumer and small businesses.
• Acted as an ambassador of the bank and provided basic teller services by building
customer loyalty through courtesy and friendliness.
Bank of America, Seattle, WA November 1999 to November 2000
• Handled cash, provided excellent customer service, processed loan payments,
processed accurate and timely transactions, acted as vault and ATM custodian
SKILLS
• Medisoft software
• Payment posting
• Collection
• Refund verification
• Benefits verification
• ICD-9-CM, CPT
• Bilingual in English and Croatian
• Exceptional organization and follow-through

4. • Excellent computer navigating skills
• Microsoft Office (Outlook, Excel, Word)
• Adobe Reader/Write
• Flash Drive Usage
• Moderate healthcare software knowledge
• Scan, Import, and Create file folders
CERTIFICATION
• HIPAA , OSHA training Certifications, Everest University 2013
• CPR Certification, Everest University 2013
• Medical billing and coding, Everest University 2013
• NCCT Certification, Everest University 2013
PROFILE
A hard-working team player with good communication and problem-solving skills
A results-oriented professional who accepts new challenges, meets deadlines, possesses a
positive attitude and professional work ethic
REFERENCES AVAILABLE UPON REQUEST