JOHN J RIVERA
Zephyrhills
Summary
Ambitious Healthcare leader with excellent analytical and process improvement skills. Highly effective at promoting positive relationships and developing key performance teams. Track record of improving operations, reducing overhead and building value through quality analytics.
Overview
10
10
years of professional experience
Work History
Divisional Physician/APP Onboarding Director
AdventHealth
Tampa, FL
01.2023 - Current
- Served as the divisional point of contact for the Directors and campus C-Suites' in all projects relating to construction/expansion of services. My function was guiding strategy as it related to staffing the service lines and execution of new service lines/locations as it relates to construction.
- Monitored project performance to identify areas of improvement and provided process adjustments to correct areas of risk.
- Coordinated with cross-functional teams to resolve project issues and escalate items that could jeopardize our operational goals.
- Onboarded a Division historical high of 152 new providers in the year of 2023 (42% increase Year over Year with the same staffing levels in both years)
- Developed and implemented strategic project plans to meet patient needs within WFD.
- Scheduled and facilitated meetings between project stakeholders to discuss deliverables, schedules and conflicts.
- Simplified project plans and communication with stakeholders through the implementation of Smartsheet.
- Developed advanced Financial reporting to capture new provider performance and gauge coding successes in new service lines. Structures were used to display growth and project coming years in performance through service line POC's.
Hospitalist Operations Manager
AdventHealth
Tampa, FL
01.2021 - 01.2023
- Managed hospitalist billing operations for West Florida Division Campuses (Services accounted for 1,000,000+ wRVUs in Annual Production to WFD).
- Developed advanced dashboard reporting to better streamline the Credentialing processes and create larger visibility into financial opportunities
- Supervised the billing teams that oversaw the claims cycle for the hospitalist roster.
- Worked as the liaison between PMG leadership and AHMG executives to create solutions to medical staff schedules and census demand.
- Continually targeted and resolved complicated AR issues related to AR and business operations.
- Worked with Revenue cycle to consistently review opportunities for most effective AR collections.
- Managed onboarding and financial analysis for all hospitalists including government applications, Start Dates, and privileging processes (240 Physicians).
- Lead 40% reduction in weekly holding AR while doubling the amount hospitalist clinicians from 119 to 240 Physicians over the course of two years.
Regional Assistant Supervisor
AdventHealth
Tampa, FL
05.2019 - 01.2021
- Was accountable for approval of all outgoing refunds, recoupment correspondence, and payor refund projects for the West Region Advent hospitals.
- Constructed overhaul of refunds processes and implemented OneNote to better document regional expectations.
- Responsible for documenting all outstanding credit balance trends, systematic issues, and GL discrepancies to improve AR and cash goal attainability.
- Responsible for educating and teaching our refund/cash teams of implications of process actions on the month and year to date benchmarks.
- Reported to regional management with recommendations to improve reporting and account processing within the Revenue Cycle Refunds operations.
- Assisted in month end close by providing a reconciliation on all WFD credit balances, establishing total outstanding liability
Regional Managed Care Representative
AdventHealth
Tampa, FL
07.2018 - 05.2019
- Established workflow reporting and documentation tracking mechanisms for senior team members.
- Verified data integrity and accuracy as it relates to outgoing billing.
- Performed administrative tasks such as record keeping, writing correspondence and gathering materials.
- Generated and mailed updated statements.
- Managed follow up processes with patients to collect information and verify insurance details.
- Reviewed collection reports to determine status of collections and amounts of outstanding liability to the division.
- Led training of all new hires on daily procedures and processes.
Bariatric Coordinator/Financial Counselor
AdventHealth
Tampa, FL
05.2017 - 07.2018
- Verified data integrity and accuracy for incoming surgical patients.
- Generated and mailed patient responsibility statements to Bariatric Self-pay patients.
- Conducted standard follow up with patients to provide updates on charity status.
- Reviewed self-pay collection reports to determine status of collections and amounts of possible assistance.
- Assessed clients' financial situations to develop financial plans and payment solutions.
- Conducted Charity Applications for the at-risk Hospital Patient population.
- Worked with the AdventHealth Bariatrics team to outline all self-pay procedures and collect surgical dues prior to date of service.
- Determined Patient Eligibility for Charity Services and applied account adjustments/Write-Offs as needed in Cerner.
- Arranged Surgical Quotes for potential Self-Pay Surgeries.
- Worked with Senior leadership to Design and Implement Processes for Self-Pay Bariatric contracts.
Operations Manager
Xtreme Adventures Family Fun Center
Tampa, FL
02.2014 - 05.2017
- Managed facility operations, including hiring, training, team development and scheduling.
- Developed new processes to manage revenue and technology needs.
- Worked diligently with line staff to eliminate process inefficiencies.
- Oversaw all customer transactions including deposits and refunds.
- Continually sought to target and resolve complicated issues related to daily management and business operations.
- Solved customer concerns and complaints quickly and effectively to drive outstanding customer service rates, Increased customer satisfaction survey scores by 55% over the course of 3 years.
- Solicited feedback from clients to assess event success and uncover opportunities for improvement.
- Maximized event schedules by restructuring the facility EMR and managing customer itineraries by time bracket and building attraction.
Education
Bachelor of Science - Healthcare Supervision & Management
Pasco-Hernando State College
Wesley Chapel, FL05.2019
Associate of Arts -
Pasco-Hernando State College
Tampa, FL03.2016
High School Diploma -
Sunlake High School
Tampa, FL05.2015
Skills
- Project Management
- Cross Functional Team Training & Development
- PED/Cerner/Athena/Epic/Power BI experience
- Extensive Experience in A/R Reporting
- Trend forecasting
- Account Reconciliation
- Smartsheet automation
- Executive Debriefing
Additional Information
- Anne Frank Humanitarian Award for Outstanding Humanitarian Effort (400+ Community Service Hours within Pasco County)
- Multiple Advent Health Recognition Awards for Outstanding Stewardship and Teamwork
Timeline
Divisional Physician/APP Onboarding Director
AdventHealth
01.2023 - Current
Hospitalist Operations Manager
AdventHealth
01.2021 - 01.2023
Regional Assistant Supervisor
AdventHealth
05.2019 - 01.2021
Regional Managed Care Representative
AdventHealth
07.2018 - 05.2019
Bariatric Coordinator/Financial Counselor
AdventHealth
05.2017 - 07.2018
Operations Manager
Xtreme Adventures Family Fun Center
02.2014 - 05.2017
Bachelor of Science - Healthcare Supervision & Management
Pasco-Hernando State College
Associate of Arts -
Pasco-Hernando State College
High School Diploma -
Sunlake High School