Revenue Cycle Insurance Billing
Resume:
Erin K. Costella
**** ********* **** ****, ** ***04
717-***-**** ️ **********@*******.***
Professional Profile
Experienced Medicaid professional with a strong background in program compliance, claims auditing, provider education, and fraud prevention. Over five years of direct experience supporting federal and state agencies in identifying overpayments, conducting investigative reviews, and driving operational efficiency in Medicaid and Medicare programs. Proven ability to interpret complex policies and deliver accurate results under regulatory scrutiny.
Core Competencies
Medicaid & Medicare Policy and Compliance
Claims auditing & investigation
Fraud, Waste & Abuse Detection and Prevention
Provider Education
Appeals & Claims Resolution
CMS Guidelines & Regulatory Review
Healthcare Revenue Cycle Management
Microsoft Office Typing 75+ WPM
Professional Experience
Medicaid Auditor / Investigator
Purisolve Inc. – Atlanta, GA (Remote) Dec 2019 – Present
Contracted to the federal government to conduct Medicaid audits and provider investigations.
Analyze billing patterns and claims data to identify overpayments and egregious billing practices.
Assist state Medicaid agencies in identifying fraud, waste, and abuse (FWA).
Draft audit reports and provide clear guidance to providers for corrective actions.
Medicare / Medicaid Specialist
Cornerstone Adminisystems – New Cumberland, PA Apr 2017 – Dec 2019
Managed the lifecycle of Medicare/Medicaid ambulance service claims, from submission through appeals.
Used CMS portals and payer systems to track claim statuses, identify discrepancies, and ensure timely resolution.
Communicated across departments to ensure accuracy in billing and compliance with Medicaid guidelines.
Patient Account Representative – Level 2
Select Medical Corporation – Mechanicsburg, PA 2014 – 2016
Handled commercial insurance claims with high accuracy, contributing to timely collections.
Researched payer policies and documentation to support accurate billing and minimize denials.
Gained foundational experience in claims processing and health insurance procedures.
Additional Experience
Shipping/Receiving Clerk – Pennwood Products (Temporary), 2016
LPN Charge Nurse – Autumn House West, 2011 – 2014
LPN Staff Nurse – Leader Surgical Associates, 2008 – 2011
Education
Diploma, Practical Nursing
Hanover Practical Nursing Program – Hanover, PA 2006 – 2007
Bachelor of Arts, Psychology (Minor: Spanish)
Gettysburg College – Gettysburg, PA 1998 – 2002
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