Open To Work
DELIA LEON-AGUILAR
Project Manager Implementation
Peoria,AZ
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Work Type
Full TimePart TimeContract WorkGig WorkLocation Preference
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Career advancementWork-life balanceCompany CultureFlexible work hoursPersonal development programsWork from home option4-day work weekSummary
Results-driven Project Manager | Scrum Master | Business System Analyst with extensive experience leading technology-driven projects, system implementations, and process improvements in the healthcare industry. Adept at Agile methodologies, software testing, FACETS SQL analytics, and regulatory compliance. Proven ability to manage cross-functional teams, optimize workflows, and drive project delivery while ensuring compliance with CMS, AHCCCS, HIPAA, and HEDIS regulations. Strong expertise in Scrum, Agile frameworks, stakeholder communication, and risk mitigation. Holds a Master of Science in Project Management and is currently pursuing Agile Scrum Master Certifications.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Project Manager – Skilled Nursing Facilities (Contract Work)
Sante Operations
10.2023 - 05.2024
- Managed two skilled nursing facilities, overseeing billing, claims processing, and revenue cycle operations.
- Led daily census tracking, insurance authorizations, and month-end financial reconciliations.
- Conducted Triple Check audits, AR management, and billing accuracy reviews, reducing aging accounts by 30%.
- Improved cross-departmental communication with Administrators, MDS Nurses, and Guest Services.
System Analyst | Business System Analyst (Contract Work)
CureIS
12.2022 - 05.2023
- Provided business process optimization, system testing, and enterprise policy implementation.
- Led multiple technology-driven projects, including software deployment, network integration, and system migrations.
- Managed data analysis and reporting dashboards, ensuring data accuracy and performance improvements.
- Payer Domain skill, I.T, testing of medical claims.
Technical Analyst (Contract Work)
Sutter Health
02.2022 - 07.2022
- Supported the migration of 3,000+ servers from Microsoft 2007 to 2009 & 2012.
- Led enterprise-wide software testing and compliance audits for system upgrades.
- Provided end-user support, system configuration, and data analysis for network optimization.
- Developed SQL-based reports and insights, improving IT service management efficiency.
Project Manager | Provider System & Billing Specialist (Contract Work)
Banner Healthcare
11.2020 - 02.2022
- Led end-to-end software implementation for provider system integrations, claims processing, and Contract negotiations.
- Managed contract compliance and reimbursement negotiations, ensuring accurate billing practices.
- Developed test plans and executed system audits, improving claims accuracy by 95%.
- Conducted training sessions for providers on CMS, Medicaid (AHCCCS), and HEDIS compliance.
- Payer Domain skills, including Private, Managed Care, and Third-party administrators (TPAs)
- Regulatory compliance: Adhering to CMS, HIPAA, HEDIS, Medicaid, and other payer-related regulations.
Project Manager | Medical Billing Manager
Stamp Medical
05.2019 - 05.2020
- Implemented process improvements, KPI reporting, and cost-saving initiatives, reducing expenses by 15%.
- Managed financial reporting, budgeting, and contract negotiations with third-party payers.
- Conducted root-cause analysis on denied claims, improving revenue recovery.
- Led EHR system upgrades and training for staff on new billing procedures.
- Worked with all insurances, Private, Managed Care, and TPAs.
Medical Collector | Team Lead – Customer Service (Contract Work)
United Surgical Partners International
01.2019 - 04.2019
- Resolved medical billing discrepancies, insurance denials, and claim reprocessing.
- Improved customer satisfaction scores by implementing efficiency-driven payment solutions.
Senior Claims Analyst (Contract Work)
Cognizant Technology Solutions
10.2017 - 10.2018
- Led medical claims audits and software configuration for payer reimbursement optimization.
- Developed automated testing scripts in FACETS, ensuring 99% claim accuracy.
- Conducted data analysis on provider reimbursement trends, driving cost-saving initiatives.
Account Receivable Representative Specialist (Contract Work)
Integrated Medical Services
01.2017 - 05.2017
- Decreased aging Medical Claims, AR days 0 to 60 days and 120 to 180 days
- Established a positive process and flow of high dollar claims, challenging claims, which decreased the rebuttal process and made for a clean claim payable in less than 30 days.
- Created three processes for claim, which were denied for coding errors within the Allergy Department.
- Collaborated with the operational team to update processes and procedures for the new CPT code.
Biller & Follow up Medical Biller/Credit resolution Specialist
Mayo Clinic of Arizona
01.2011 - 10.2015
- Successfully implemented processes for Workers’ Compensation claims by utilizing Lean Six Sigma process and flow, which resulted in a clean claim process and paid within 45 days.
- Interfaced Hospital Contract with claims, assuring correct reimbursement and adjudication, to streamline the process and pay claims within 30 days, without rebuttal.
- Established a positive process and flow of high dollar claims, challenging claims, which decreased the rebuttal process and made for a clean claim payable in less than 30 days.
- Created three processes for claim, which were denied for coding errors within the Allergy Department.
- Collaborated with the operational team to update processes and procedures for the new CPT code.
Education
Master of Science - Project Management
03.2018
Graduated
Bachelor of Science - Project Management
02.2016
Graduated
Skills
- Agile & Scrum Methodologies (Scrum, Kanban, SAFe)
- Project Lifecycle Management (Initiation, Planning, Execution, Closure)
- Stakeholder Communication & Team Collaboration
- Process Improvement & Risk Management
- Software Development Life Cycle (SDLC)
- Quality Assurance & Software Testing (STLC)
- FACETS SQL Tested In all four areas Analytics & Data Analysis
- Healthcare Compliance (CMS, AHCCCS, HIPAA, HEDIS, NCQA)
- Revenue Cycle & Financial Reporting
- Vendor & Contract Negotiations
- Claims Processing (UB-04 & CMS-1500) & Billing Systems
- Change Management & Workflow Optimization
- Project Management Tools: Azure DevOps, Confluence, MS Project, Mondaycom
- Billing & Revenue Cycle Software: PointClickCare, FACETS, EPremis, eSinglePoint, Meditech, Cerner, PowerChart
- Programming & Database: FACETS SQL, Oracle, Splunk, DataNet
- Testing & Automation: Quality Assurance (QA), STLC, UAT, Bug Tracking
- Reporting & Analytics: Microsoft Office (Excel, Word, PowerPoint, Outlook), Power BI
- Project management
- Project planning
- Project planning and development
- Project scheduling
- Strategic planning
- Schedule management
- Client relations
- Team collaboration
- Stakeholder communications
- Team bonding
- Agile methodology
- Compliance monitoring
- Business analysis
- Root-cause analysis
- Issue resolution
- Business processes
- Software implementation
Certification
- Scrum Master Certification (In Progress) – EduHubSpot.com, Online
- Project Management Certification PM (In Progress) – EduHubSpot.com, Online
LANGUAGES
Fluent in Spanish (Read, Write, Speak)
Accomplishments
While working at Mayo Clinic in Phoenix, Arizona, I identified a recurring issue with workers’ compensation medical claims being denied due to missing documentation, such as medical records and purchase orders that matched diagnosis and procedure codes. To confirm the issue, I intentionally submitted a small batch of claims without the required attachments to track the denial patterns. Once verified, I initiated collaboration between the Claims, Medical Records, and Emergency Department leadership teams to streamline document submission.
Together, we developed a new process and procedure ensuring every workers’ compensation claim included all necessary records to qualify as a clean claim. Within 30 days, payments were successfully obtained, denials decreased significantly, and the Director of the Emergency Department personally thanked me for implementing a process that simplified workflows and improved claim turnaround times.
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Affiliations
- Member of the Project Management Institute (PMI) and currently pursuing PMP and Agile Scrum Master certification.
Timeline
Project Manager – Skilled Nursing Facilities (Contract Work) - Sante Operations
10.2023 - 05.2024
System Analyst | Business System Analyst (Contract Work) - CureIS
12.2022 - 05.2023
Technical Analyst (Contract Work) - Sutter Health
02.2022 - 07.2022
Project Manager | Provider System & Billing Specialist (Contract Work) - Banner Healthcare
11.2020 - 02.2022
Project Manager | Medical Billing Manager - Stamp Medical
05.2019 - 05.2020
Medical Collector | Team Lead – Customer Service (Contract Work) - United Surgical Partners International
01.2019 - 04.2019
Senior Claims Analyst (Contract Work) - Cognizant Technology Solutions
10.2017 - 10.2018
Account Receivable Representative Specialist (Contract Work) - Integrated Medical Services
01.2017 - 05.2017
Biller & Follow up Medical Biller/Credit resolution Specialist - Mayo Clinic of Arizona
01.2011 - 10.2015
Colorado Technical University - Bachelor of Science, Project Management
Colorado Technical University - Master of Science, Project Management