Bernadette Aguilera
Hicksville
Summary
Detail-oriented and analytical Healthcare Revenue Cycle Specialist with over 20 years of expertise in medical billing, insurance authorization, and office management. Proven track record in optimizing front-end revenue cycle operations within major health systems (Northwell Health). Demonstrated technical leadership as an Epic Super User, driving system implementations and staff training. Expert at navigating complex payer rules, reducing claim denials, and managing accounts receivable to maximize practice revenue.
Overview
28
28
years of professional experience
Work History
Sr. Physician Account Representative
Northwell Health
New York
03.2016 - Current
- Manage front-end revenue cycle operations, accurately verifying and securing authorizations for high-volume patient appointments.
- Utilize advanced healthcare software including Soarian, eCare Next, Allscripts, Athena, and various carrier websites to gather crucial authorization data.
- Selected as a Wave 1 Epic Implementation Super User; actively participated in system rollout and successfully trained Wave 2 end-users.
- Provide agile coverage across multiple medical service lines to maintain operational continuity and minimize billing delays.
Office Manager / Medical Biller
Bi-County Physical Therapy & Rehab
Williston Park, NY
11.2001 - 02.2016
- Directed daily billing operations and accounts receivable (A/R) management for major medical insurance companies.
- Utilized CPT and ICD-coded data to accurately produce, review, and submit clean claims to private insurance providers.
- Proactively reviewed, investigated, and appealed unpaid or denied claims, significantly accelerating reimbursement cycles.
- Managed insurance pre-certification, patient eligibility verification, and resolved complex patient billing inquiries.
- Supervised and trained physical therapy aides and administrative staff to ensure compliance and smooth workflow execution.
Assistant Medical Biller
Full Circle Physical Therapy Program for Breast Cancer Recovery
Williston Park, NY
01.2012 - 08.2015
- Collaborated directly with healthcare providers, insurance companies, and patients to streamline the claims submission and adjudication process.
- Audited patient accounts, handled collections on delinquent balances, and updated facility accounts receivable reports.
- Secured vital treatment authorizations and pre-certifications from private commercial insurance plans.
Front Desk / Bookkeeper
Bi-County Physical Therapy & Rehab
Floral Park, NY
11.1998 - 11.2001
- Managed time-sensitive financial transactions, daily bookkeeping, and facility administrative paperwork.
- Organized, updated, and filed patient medical records while maintaining strict confidentiality and scheduling protocols.
Education
Associate of Applied Science (A.A.S.) -
Nassau Community College
Garden City, NYSkills
- EMR/EHR & Billing Systems: Epic (Super User), Soarian, eCare Next, Allscripts, Athenahealth, PTOS Integrated Practice Management, WebMD/Emdeon
CORE COMPETENCIES
- Front-End Revenue Cycle Operations
- Denial Management & Appeals
- Insurance Verification & Pre-Certification
- Accounts Receivable (A/R) Management
- Epic Super User & System Implementation
- CPT, ICD-10, & HCPCS Coding Overview
- Payer Website Navigation & Claims Tracking
- Cross-Functional Team Training
Timeline
Sr. Physician Account Representative
Northwell Health
03.2016 - Current
Assistant Medical Biller
Full Circle Physical Therapy Program for Breast Cancer Recovery
01.2012 - 08.2015
Office Manager / Medical Biller
Bi-County Physical Therapy & Rehab
11.2001 - 02.2016
Front Desk / Bookkeeper
Bi-County Physical Therapy & Rehab
11.1998 - 11.2001
Associate of Applied Science (A.A.S.) -
Nassau Community College