NICOLE GONZALES
Summary
Dynamic Practice Manager with a proven track record at Joshua Medical Group, excelling in practice management and patient advocacy. Enhanced operational efficiency through strategic project management and conflict resolution, leading to improved patient care and revenue growth. Proficient in CMS and OSHA compliance, fostering a compliant and patient-focused environment.
Overview
21
21
years of professional experience
Work History
Practice Manager/Business Administrator
Joshua Medical Group
02.2020 - 02.2021
- Directed and coordinated business, administrative, and staffing operations for a healthcare organization comprising 26 employees.
- Managed budget and finances to ensure fiscal responsibility and efficiency.
Oversaw payroll processing, verifying and approving timecards for accuracy.
Coordinated employee and physician staffing, including evaluations and credentialing.
Maintained master scheduling system to optimize resource allocation.
Ordered and maintained medical and office supplies to support operations.
Ensured compliance with State, Federal, OSHA, and health insurance regulations.
Updated knowledge of regulations and policies to align practices with industry standards. - Facilitated communication between outsourced HR and employees to address employee conflicts
- Engaged with patients to resolve complaints and concerns while facilitating additional outreach and advocacy needs
- Investigated, evaluated, and deployed new EMR system alongside Accountable Care Organization to enhance accountability with Medicare standards, elevate patient care, and expand patient population and revenue
- Facilitated negotiations with service providers, suppliers, and medical sales representatives to cut overhead costs and elevate revenue
- Streamlined office and departmental workflows to enhance efficiency, elevate employee productivity, and optimize patient care
HIM Supervisor / Front Office Lead
Joshua Medical Group
02.2018 - 01.2020
- Administered Health Information Management Department and team, managing chart accuracy, storage solutions for patient records, and adherence to HIPAA standards to protect sensitive information
- Oversaw front office operations, managing staff and enhancing workflow efficiency.
- Assisted Office Manager with recruiting, interviewing, and recommending candidates for department vacancies.
- Analyzed and implemented automated appointment reminder and payment solutions software, increasing patient engagement, minimizing no-shows, boosting revenue, and maximizing front-office productivity and efficiency.
- Restructured front office procedures to streamline processes and improve overall efficiency.
- Orientated and trained new employees, ensuring seamless integration into the team.
Medical Records and Front Office Assistant
Joshua Medical Group
09.2015 - 01.2017
- Operated across the front office and medical records department, handling calls, emails, and text messages, directing each to the pertinent staff.
- Cataloged, indexed, reproduced, faxed, and recovered medical records alongside preparing and filing all paper charts for appointments.
- Registered and greeted patients while updating demographic information.
Scheduled appointments to optimize clinic workflow.
Processed patient payments efficiently to maintain financial accuracy.
Made appointment reminder calls to enhance patient attendance.
Provided administrative assistance to back office and providers for streamlined operations.
Denial Coordinator /Patient Referral Coordinator
High Desert Medical Group
04.2009 - 08.2012
- Monitored and issued denial or modification letters in compliance with guidelines.
- Evaluated denial rationale from UM Director to confirm medical necessity criteria.
- Served as primary contact for inquiries regarding denials and issues.
- Reviewed specialty care referrals for adherence to health plan guidelines and benefit coverage.
Interim Referral Dept Supervisor
High Desert Medical Group
03.2008 - 03.2009
- Supervised a staff of 12 coordinators, enhancing operational efficiency in Referral Department.
- Provided administrative support to UM Director by facilitating review processes and audits.
- Implemented new office procedures that improved time management and productivity.
- Created an instructional manual detailing operational procedures for ongoing staff training.
Family Caregiver
IHSS In Home Support Services
LANCASTER, CA
02.2021 - Current
- Assisted with feeding and monitored intake to help patients achieve nutritional objectives.
- Assisted patients with self-administered medications.
- Cleaned house, cooked, ran errands, managed laundry, and completed weekly grocery shopping.
- Turned and positioned bedbound patients to prevent bedsores and maintain comfort levels.
- Monitored client vital signs, administered medications, and tracked behaviors to keep healthcare supervisor well-informed.
- Assisted clients with daily living needs to maintain self-esteem and general wellness.
- Provided safe mobility support to help patients move around personal and public spaces.
- Changed dressings, bandages, and binders to maintain proper healing and sanitary measures.
- Transported individuals to events and activities, medical appointments, and shopping trips.
- Recognized and reported abnormalities or patient health status changes to the Home Health Physician / Nurse.
- Built strong relationships with clients to deliver emotional support and companionship.
- Supported clients with mental support and physical activities to accomplish quality of life and sustain needs.
- Engaged patients in meaningful conversation, socialization, and activity while providing personal care assistance.
- Assisted with dressing guidance and grooming.
- Handled incoming mail, bills and invoices and completed appropriate actions.
- Entrusted to handle confidential and sensitive situations in professional matter.
- Implemented physical therapy to support patient improvement in muscle tone, range of motion and injury recovery.
Referral Coordinator & Coder
High Desert Medical Group
03.2004 - 03.2008
- Processed patient referrals and ensured they were routed to the appropriate specialist or facility.
- Validated patient details and insurance eligibility to enhance referral management efficiency.
- Maintained accurate and up-to-date patient records within the healthcare database.
- Coordinated and scheduled appointments for patients with specialists.
- Collaborated with medical staff to ensure that referrals were processed in a timely manner.
- Implemented efficient coding protocol for handling referral requests across Referral Management and IPA Referral departments.
Referral Dept Administrative Assistant
High Desert Medical Group
11.2003 - 02.2004
- Coordinated extensive administrative services for supervisors, staff, and UM physicians, responding to calls and emails, and connecting them with suitable staff members.
- Organized paper and electronic filing systems, correspondence, and additional materials.
- Analyzed and rectified diverse patient/member concerns and grievances.
Education
Certificate - Medical Billing & Coding/Health Claims Examiner
California Health Institute
Palmdale, CA01.1995
High School Diploma -
Highland High School
Palmdale, CA06-1993
Skills
- Goal-oriented approach
- Client-focused strategies
- Patient advocacy
- Practice management
- Project management
- Conflict resolution
- Policy development
- CMS knowledge
- ACO knowledge
- MIPS understanding
- OSHA compliance
- HR and payroll administration
- Microsoft Office proficient
- DBMS adaptable
- Centricity, EZ-Cap, Crystal, Athena One, and Epic systems experienced
Timeline
Family Caregiver
IHSS In Home Support Services
02.2021 - Current
Practice Manager/Business Administrator
Joshua Medical Group
02.2020 - 02.2021
HIM Supervisor / Front Office Lead
Joshua Medical Group
02.2018 - 01.2020
Medical Records and Front Office Assistant
Joshua Medical Group
09.2015 - 01.2017
Denial Coordinator /Patient Referral Coordinator
High Desert Medical Group
04.2009 - 08.2012
Interim Referral Dept Supervisor
High Desert Medical Group
03.2008 - 03.2009
Referral Coordinator & Coder
High Desert Medical Group
03.2004 - 03.2008
Referral Dept Administrative Assistant
High Desert Medical Group
11.2003 - 02.2004
Certificate - Medical Billing & Coding/Health Claims Examiner
California Health Institute
High School Diploma -
Highland High School
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