Bernadette Paguio

Education Bachelor of Science in Computer of Science DON HONORIO VENTURA STATE UNIVERSITY- Computer Programming Bernadette Paguio Medical Biller/Coder Contact - AMACLC Guagua- Experience MEDICAL BILLER /CODER VOLUSIA MEDICAL CENTER LLC March 2022-August 2025 - Processed and submitted 80+ claims per day with 95% first-pass accuracy, reducing delays and denials in EHR/EMR systems (eClinicalWorks). Accurately assigned ICD-10, CPT, and HCPCS codes to patient diagnoses and About Me procedures. Conducted insurance verification and pre-authorization, cutting claims rejections by 20% Clearinghouse Rejection Detail-oriented Medical Billing & Coding Specialist with 5 years of experience in EHR/EMR systems, insurance verification, coding accuracy, and denial management. Proven track record of reducing claim denials, accelerating reimbursements, and ensuring compliance with ICD-10, CPT, and HCPCS standards. Adept at collaborating with healthcare teams and payers to optimize revenue cycle management and maintain accurate financial reporting. Tools Google Workspace (Docs, Sheets, Drive) eClinicalWorks (eCW) Waystar Availity AAPC Coder Microsoft Office Suite (Excel, Word, Outlook) Skills Management Skills Time Management & Multitasking Detailed-Oriented Computer literate (Microsoft Office, Google Workspace, EHR/EMR Systems) Record-Keeping & Compliance Strong Communication with Patients, Providers, and Insurers Team Collaboration & Independent Work Denial Management: Reviewed denied claims, identified issues such as coding errors or missing documentation, and worked with insurance companies to correct and resubmit claims for payment. Payment Posting: Posted payments from insurance carriers and patients to accounts, ensuring correct adjustments and balances were made based on payments received. October 2021- February 2022 INSURANCE VERIFICATION DISCOVER VEIN & VASCULAR CENTER Verified patient coverage and benefits, ensuring error-free claim submission Obtain and document copay, deductible, coinsurance, and out-ofpocket maximums. Coordinated with patients and insurers, preventing claim disputes and saving staff 10+ hours per week. Communicate insurance benefits, coverage limitations, and patient financial responsibility clearly to patients. Patient Scheduling MEDICAL BILLER/CODER January 2019-September 2021 PHOENIX VIRTUAL STAFFS Prepared and submitted medical claims with 98% accuracy, minimizing errors and expediting reimbursements. Ensured 100% accuracy in patient medical records, maintaining compliance with HIPAA and organizational standards. Processed and generated bills/invoices, documenting all charges for medical procedures and services with 99% accuracy. Monitored and recorded late payments, improving tracking efficiency by 20%. Followed up on missed payments and resolved financial discrepancies, increasing payment recovery rate by 25%. Identified and corrected billing errors, reducing rejected claims by 15% and improving claim approval turnaround time. Investigated and appealed denied claims, achieving a 20% claim reversal success rate. Managed collections and payment follow-ups, recovering 95% of outstanding balances within 30 days. Certification HIPAA Certificate of Completion JUNIOR ACCOUNTING AND BOOKKEEPING 101 HEALTHCARE WASTE MANAGEMENT CAREER PLANNING WORKSHOP Amazon FBA : The 2023 Business Model & Strategies Finishing Course for Call Center Agent dsd ADMITTING CLERK Aprl- DIOSDADO MACAPAGAL MEMORIAL HOSPITAL Conducted patient admission interviews, achieving 100% accuracy in recording demographic, insurance, and emergency contact information, ensuring compliance and reducing intake errors by 25%. Educated patients and families on hospital policies and billing procedures, improving understanding and reducing disputes by 30%. Prepared and processed bills and invoices with 98% accuracy, accelerating reimbursements and reducing claim rejections by 15%. Coordinated patient escorts and room assignments, cutting average admission wait times by 20% and enhancing patient satisfaction scores. Entered and routed admitting information into the hospital database, maintaining error-free records across 5+ departments for seamless coordination. Secured signed consent and financial responsibility statements, safeguarding hospital compliance and reducing legal risks by 10%. Compiled and verified occupancy and census records with 99% accuracy, supporting effective resource planning and regulatory reporting. Collected and applied patient account payments, contributing to a 12% improvement in revenue cycle efficiency. On-the-Job Trainee Royce Motor Nissan Data Entry/ Billing 300 hrs