Jesus Pacelli
Tampa
Summary
Healthcare operations professional with 5 years of experience managing administrative teams in pain management and cardiology offices. Skilled in leading Prior Authorization and Insurance Verification departments, and in developing and implementing OKRs, KPIs, and SOPs to drive efficiency and ensure compliance. Hands-on leader with a strong focus on problem-solving, staff training, and process improvement. Proven ability to maintain organized, patient-centered environments while overseeing team performance, insurance workflows, and regulatory requirements. Committed to leveraging technology and collaboration to streamline operations, enhance patient care, and improve overall practice efficiency.
Overview
5
5
years of professional experience
1
1
Certification
Work History
Office Manager
Best NP Practice
Tampa
09.2024 - Current
- Manage front desk operations, including greeting patients, scheduling appointments, answering inquiries, and directing individuals to appropriate services.
- Patient notes creation and charge capture.
- Place lab orders, and coordinate with external labs to ensure timely processing and follow-up.
- Analyze business performance metrics to support forecasting, strategic planning, and reporting to upper management.
- Resolve patient and client inquiries promptly while fostering a supportive and welcoming environment.
Operation Supervisor
RV Staffing
Miami (Remote), FL
08.2022 - 08.2024
- Manage a team of 8 employees across 4 clients, including 2 pain management offices and 2 cardiology offices, overseeing daily operations and team performance.
- Managed the Prior Authorization (PA) and Insurance Verification departments, including handling PA requests for vein ablations in cardiology, ensuring compliance, and efficient processing.
- Served as a customer-facing leader, guiding employees in understanding and meeting evolving customer needs and expectations, with a focus on high-quality service.
- Developed and implemented Standard Operating Procedures (SOPs) to standardize processes, improving productivity, and operational efficiency.
- Mentored team members in handling complex customer inquiries, delivering solutions that ensured positive outcomes and client satisfaction.
- Collaborated with clients to develop strategies that aligned with sales and service goals, fostering strong relationships, and enhancing retention.
Team Lead and Insurance Specialist
RV Staffing
Medellín, Colombia
11.2021 - 08.2022
- Led a team of 3 employees for a cardiology office, including 2 patient coordinators and 1 insurance specialist, ensuring smooth operations and high-quality service delivery.
- Worked closely with cross-functional teams to streamline workflows and enhance collaboration between departments.
- Reviewed and processed prior authorization requests for medical procedures and diagnostic tests, ensuring compliance with established guidelines and timely approvals.
- Engaged in client-facing communication, providing updates and maintaining strong relationships with clients to ensure satisfaction and effective service.
Prior Authorization Specialist
RV Staffing
Medellín, Colombia
04.2021 - 11.2021
- Analyzed trends in authorization denials and provided detailed reports to management to support quality improvement initiatives.
- Reviewed and processed prior authorization requests for medical procedures accordance with established guidelines.
- Conducted insurance verifications to ensure accurate coverage information and eligibility before processing authorizations.
- Assisted healthcare providers with appeals for denied authorizations, gathering additional information and documentation to support the appeal process.
Prior Authorization Specialist
HRMD Management
Medellín, Colombia
06.2020 - 04.2021
- Reviewed and processed prior authorization (PA) requests for medical procedures including pain management treatments, in accordance with established guidelines.
- Managed authorization denials and appeals, collaborating with healthcare providers to gather necessary documentation and support the appeal process.
- Conducted insurance verifications to ensure accurate coverage information and eligibility prior to processing PA requests.
Education
Bachelor of Arts - Psychology
Yacambu (UNY)
Barquisimeto, Lara, VEN01-2019
Skills
- Interpersonal communication
- Google/Microsoft Suite
- Medical Office Management
- Healthcare Management
- Project Management
- Six sigma methodologies
- Conflict resolution
- EHR (ECW, Athena, Tebra, NextGen)
- Medical Terminology
- CPT, Dx, Coding
- Coaching and mentoring
- Change management
- Recruitment and hiring
- Team Motivation
- Problem solving
- Adaptability
- Digital Innovation
- KPI's
- OKR's
- Tech Saavy
- Workforce planning
- Workflow optimization
- Team leadership
- Web Development (WIX)
- Marketing Campaigns (FB/IG paid Ads)
- Sales
Languages
Spanish
Native/ Bilingual
English
Professional
Projects
- Prior Authorization Department: The establishment of a prior authorization department for a client, integrating streamlined workflows and processes. Through the implementation of these refined workflows and optimized procedures, we successfully heightened efficiency and precision, ultimately elevating the overall operational effectiveness of our client.
- Client Onboarding: Implementation of workflows and proper documentation for client onboarding facilitated the seamless transition of new clients into our system. By streamlining these processes and ensuring thorough documentation, we effectively minimized errors and delays, thereby enhancing the client experience and fostering long-term satisfaction.
Profesional References
- Natalia Perez | Office Manager of Abella Heart, FL | (786) 727-7224
- Amina Lakhal | Comprehensive Spine & Joints, MI | (313) 802-6032
- Waskar Tejeda | RV Staffing CEO | (646) 533-4946
Personal Reference
Santiago Puerta |
Certification
- Google Project Management (Coursera)
Timeline
Office Manager
Best NP Practice
09.2024 - Current
Operation Supervisor
RV Staffing
08.2022 - 08.2024
Team Lead and Insurance Specialist
RV Staffing
11.2021 - 08.2022
Prior Authorization Specialist
RV Staffing
04.2021 - 11.2021
Prior Authorization Specialist
HRMD Management
06.2020 - 04.2021
Bachelor of Arts - Psychology
Yacambu (UNY)
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