Kislev Paguada
Summary
Certified Medical Interpreter (NBCMI) and CPC Candidate with 15+ years of clinical experience. Expert in medical terminology, anatomy, and pathophysiology, with a strong background in claims adjudication and pharmacy operations. Proven track record of ensuring 100% documentation accuracy and HIPAA compliance in high-pressure hospital environments. Leveraging a heavy clinical background and a degree in Computer Science to drive precision in medical coding and revenue cycle management.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Medical Interpreter (NBCMI Certified)
Voyce Global / CyraCom / Several LSP .
Houston, TX
08.2010 - Current
- Facilitated precise communication between healthcare providers and patients, ensuring 100% accuracy in the interpretation of complex medical terminology, diagnoses, and surgical procedures.
- Maintained strict HIPAA compliance and confidentiality while handling sensitive Protected Health Information (PHI) across emergency, outpatient, and surgical environments.
- Acted as a "Language Bridge" to ensure patient safety and informed consent, directly supporting physicians in delivering accurate treatment plans.
- Leveraged deep knowledge of Anatomy, Physiology, and Pathophysiology to translate clinical encounters into clear, actionable information for both providers and patients.
Medical Claims Associate
Sedgwick Claims Management
Houston TX
01.2018 - 11.2020
- Processed and adjudicated complex medical claims, ensuring strict alignment with policy coverage and HIPAA compliance.
- Audited clinical documentation for accuracy and completeness to support proper reimbursement and prevent claim denials.
- Verified claimant eligibility and provider information to ensure timely and accurate claims adjudication.
- Maintained high-volume processing standards while meeting rigorous quality and turnaround time benchmarks.
Pharmacy Technician
Walgreen's Pharmacy
Houston, TX
02.2014 - 10.2014
- Interpreted and processed physician prescriptions, ensuring accurate data entry and medication dispensing for a high volume of patients.
- Navigated insurance rejections and managed prior authorizations, gaining foundational experience with HCPCS Level II (J-codes) and billing requirements.
- Maintained detailed patient records and pharmacy logs in strict accordance with HIPAA and state regulatory standards.
- Communicated directly with healthcare providers to clarify prescription orders, ensuring clinical accuracy and patient safety.
Education
Certified Professional Coder (CPC) - Candidate. - Medical Coding And Revenue Cycle
AAPC (American Academy of Professional Coders)
Houston, TX09-2026
Bachelor of Science - Computational Science
Southern New Hampshire University
Hooksett, NH08-2026
Certified Medical Interpreter (CMI) - Medical Interpretation - Spanish
National Board of Certification For Medical Interpreters
Houston, TX06-2023
Skills
- ICD-10-CM, CPT, and HCPCS Level II
- Medical Billing & Claims Adjudication
- Revenue Cycle Management (RCM)
- Medical terminology
- Anatomy and physiology
- HIPAA Compliance & PHI Protection
- Accuracy verification
- Bilingual communication
- Physician communication
- Attention to detail
Certification
- Certified Professional Coder (CPC) – Candidate | AAPC
- Certified Medical Interpreter (CMI-Spanish) | National Board of Certification for Medical Interpreters (Credential ID: 103670)
Languages
Spanish
Native or Bilingual
English
Native or Bilingual
Timeline
Medical Claims Associate
Sedgwick Claims Management
01.2018 - 11.2020
Pharmacy Technician
Walgreen's Pharmacy
02.2014 - 10.2014
Medical Interpreter (NBCMI Certified)
Voyce Global / CyraCom / Several LSP .
08.2010 - Current
Certified Professional Coder (CPC) - Candidate. - Medical Coding And Revenue Cycle
AAPC (American Academy of Professional Coders)
Bachelor of Science - Computational Science
Southern New Hampshire University
Certified Medical Interpreter (CMI) - Medical Interpretation - Spanish
National Board of Certification For Medical Interpreters