Jesus Pacelli
Tampa,FL
Summary
Healthcare operations leader with 5+ years of experience optimizing administrative processes across psychiatry, pain management, and cardiology practices. Passionate about automating workflows, implementing OKRs/KPIs, and developing SOPs to boost efficiency and ensure regulatory compliance. Proven track record of designing and deploying digital solutions that reduce manual workload, minimize errors, and accelerate patient service delivery. Skilled at leading teams, driving continuous improvement, and fostering a culture of innovation and accountability. Committed to leveraging technology and data to streamline healthcare operations and enhance patient care.
Overview
5
5
years of professional experience
1
1
Certification
Work History
Office Manager
Best NP Practice
Tampa, FL
09.2024 - Current
- Manage front desk operations, including greeting patients, scheduling appointments, answering inquiries, and directing individuals to appropriate services.
- Place lab orders, and coordinate with external laboratories to guarantee timely processing and follow-up.
- Analyze business performance metrics to support forecasting, strategic planning, and reporting to upper management.
- Develop and implement workflow automations to streamline administrative and clinical processes, improving efficiency, and reducing manual errors.
- Oversee and coordinate direct communication with the billing company, including monitoring claim submissions, addressing billing discrepancies, and ensuring timely reimbursement.
- Generate and review billing reports to track financial performance and identify opportunities for process improvement.
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.
- Developed and implemented Standard Operating Procedures (SOPs) to standardize processes, improving productivity, and operational efficiency.
- Designed and implemented process automations within the PA workflow, resulting in a 30% reduction in processing time, and significantly decreasing manual errors.
- Developed and tracked key performance indicators (KPIs), such as approval rate, which improved by 20% through continuous training, workflow optimization, and proactive denial management.
- 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
- Tech Savvy
- Healthcare Management
- API integration
- Google Apps Script
- Google Workspace
- Zapier and Make (automation tools)
- Digital innovation
- Cybersecurity awareness
- Medical Office Management
- EHR Systems (ECW, Athena, Tebra, NextGen)
- Medical Terminology
- CPT, Dx Coding
- HIPAA Compliance
- Operations Management
- Workflow automation and optimization
- Time Management
- Change Management
- Project Management (Kanban, Agile)
- KPI and OKR Development
- Data Analysis & Reporting
- Workforce Planning
- Team Leadership & Motivation
- Coaching and Mentoring
- Recruitment and Hiring
- Client Relationship Management
- Interpersonal Communication
- Conflict Resolution
- Adaptability
Certification
- Google Project Management (Coursera)
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
Projects
Automated HIPAA-Compliant Clinical Documentation Workflow:
- Designed and implemented an automated system for generating, sending, and uploading clinical visitation forms using Google Workspace (appscript) and third-party APIs (Tebra, LuxSci).
- The solution creates custom PDFs from Google Forms responses, securely emails them, and uploads them directly to the EHR system.
- This automation reduced administrative processing time by over 80% and virtually eliminated errors associated with manual form creation and document scanning.
Automated Prior Authorization (PA) Status Notification System
- Designed and implemented an automated workflow to optimize the prior authorization process.
- Developed scripts to send patients real-time email notifications whenever the status of their PA changed, improving transparency and patient satisfaction. Additionally, built a follow-up reminder system that automatically alerted staff every three days about pending PA cases requiring attention, reducing delays and ensuring timely resolution.
- This automation reduced manual tracking workload, minimized communication gaps, and enhanced both patient experience and operational efficiency.
Languages
Spanish
Native/ Bilingual
English
Full Professional
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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