HIPAA-Certified Medical Billing Specialist

Josephine Peraino

Lindenhurst, NY • ************@*****.*** • 631-***-****

PROFESSIONAL SUMMARY

Experienced billing specialist with 10+ years of experience in medical sector, adept with medical billing software such as ADS, Epic Systems, Citrix, Elegance, NEIC, STARS, MEDCOMP, and Fusion. HIPAA Certified and Medicare Certified. Specializes in compliance auditing, and electronic health record optimization. Reduced claim denial rates through implementation of standardized coding protocols. Works independently while maintaining collaborative relationships with clinical and billing teams. SKILLS AND QUALIFICATIONS

• ICD-10-CM/PCS Coding

• CPT/HCPCS Coding

• Medical Terminology

• Electronic Health Records (EHR)

• Medical Billing Software

• Windows Fast Track

• Clinical Documentation Improvement

• Accounts Receivable Knowledge

06/2025-09/2025

PROFESSIONAL EXPERIENCE

Stony Brook Medical Center, World Trade Center Victims, Commack, NY Medical Biller "TEMP" POSITION

• Processed medical claims for World Trade Center victims and responders, ensuring accurate and timely reimbursement.

• Coordinated with healthcare providers and insurance payers to resolve billing issues and facilitate payment.

• Verified and authenticated referrals for medical services, including laboratory tests and hospital care.

• Applied knowledge of World Trade Center-related health conditions, including PTSD, stress, and cancer, to ensure proper billing and coding.

UNITED MEDICAL MONITORING, IONM, Melville, 07/2024-04/2025 NY Medical Biller - Downsized

• Processed Workers' Compensation and No-Fault medical billing claims for major carriers

(Allstate, Progressive, Zurich, NJM).

• Tracked claim status, conducted follow-up with insurance carriers and adjusters, and ensured timely payment.

• Prepared and submitted appeals, supporting documents, and Letters of Protection (LOPs) to secure reimbursement.

• Resolved denied claims due to policy benefits exhaustion, Negative IMEs, and other issues through coordination with surgeon offices, attorneys, and adjusters.

• Verified private insurance coverage, updated insurance information, and re-submitted claims electronically as needed.

L.I. Surgical, Bethpage, NY 02/2024-06/2024

Medical Biller Ofc closed

• Processed and followed up on denied claims across Commercial carriers (e.g., UnitedHealthcare, Fidelis, Healthfirst), Medicaid, Workers’ Compensation, and No-Fault insurance.

• Reviewed Explanation of Benefits (EOBs) and denial spreadsheets provided by the Billing Supervisor to identify and address claim issues.

• Retrieved and submitted medical records to support appeals for denied claims due to lack of authorization, demonstrating medical necessity for treatment.

• Uploaded supporting documentation, including proof of timely claim submission, to insurance portals to facilitate claim reprocessing and ensure reimbursement. Massapequa Pain Management and Rehab, Massapequa, 03/2022-12/2023 NY Medical Biller - They outsourced

• Resolved denials for various reasons, including authorization issues, coding mismatches, policy terminations, and timely filing errors.

• Recovered unposted insurance payments, improving revenue recovery.

• Secured $4,000 in previously denied payments for a single patient through knowledge of payer guidelines and persistent follow-up.

• Demonstrated adaptability to departmental changes, including staff turnover and outsourcing. Medical Billing Consults, Commack, 05/2021-12/2021 NY Medical Biller - COVID

• Resolved claim rejections, edited, and re-submitted claims for timely reimbursement.

• Conducted follow-up on outstanding accounts, adhering to guidelines and standards. Catholic Health Services, West Islip, NY - TEMP

Medical Biller/Patient Account Representative

• Researched and resolved rejections from electronic claim submissions; corrected errors and re- submitted claims to ensure proper reimbursement.

Medysis Management, Catholic Health Services 10/2013-04/2018 Medical Biller

• Constructed accounts receivable reports on EPIC and CITRIX billing software for patient demographics and account history.

EARLIER PROFESSIONAL EXPERIENCE

Medical Billing Specialist, Zwanger-Pesiri Radiology Group

• Processed and managed accounts receivable reports using three different billing software systems to track and resolve outstanding balances. Northport Veterans Affairs Medical Center, Northport, NY Eligibility Clerk

• Processed veteran registrations by verifying eligibility using DD214 discharge papers and service-connected disability documentation.

• Set up veterans in the VAMC system for inpatient admissions and outpatient clinic services.

• Provided administrative coverage in the Emergency Room, including completing lab slips and coordinating patient intake and disposition.

Prosthetic Purchasing Agent (Billing Role)

• Coordinated delivery of durable medical equipment (DME), prosthetics, and medical supplies based on physician orders and eligibility.

• Collaborated with clinics and vendors to organize Prosthetic and Wheelchair Clinics.

• Managed billing and authorization processes for medical supplies, ensuring accuracy and compliance.

Quality Assurance/Risk Management/Medical Records Technician

• Collected and analyzed quality statistics and patient care data for Joint Commission (JCAHO) accreditation reviews

• Conducted medical record audits for documentation quality, compliance, and utilization review EDUCATION

High School Diploma, Northport High School, Northport, NY

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