Pilly Gonzalez
New York,NY
Summary
Health care management professional with 15+ years' experience. Proven ability to organize revenue cycle departments in a health care facility. Recognized for the ability to work with very diverse clients and staff. Diverse knowledge and exposure to all aspects of health care management revenue cycle. Outstanding skills in assessing what is needed, recommending sensible solutions, and effectively motivating direct reports and colleagues to implement them in a spirit of collaboration and accountability.
Overview
25
25
years of professional experience
1
1
Certification
Work History
Director of Patient Access- Nuvance West
Nuvance Health
02.2017 - Current
- Responsible for oversight of four Hospital locations, Vassar Brothers Medical Center, Putnam Hospital, Northern Dutchess Hospital and Sharon Hospital
- Directed a team of over 150 employees in the New York and Connecticut
- Coordinated day to day operations with onsite Hospital supervisors for all Patient Access Services activities related to the scheduling, pre-registration, registration, patient experience, admitting, insurance eligibility, point of service collections, cashiering and financial counseling
- Successfully developed and implemented new payment collection system at all locations
- Accomplishments: Created a three-level career ladder to increase staff retention
- Decreased initial registration related claims rejections from 45% to 18% in one fiscal year by targeting insurance eligibility training gaps with front line associates
- Reduced OR start time delays by decentralizing registration check in which led to an improvement in patient and department satisfaction
- Implemented Standardized patient access scripting and documentation of point of service collections across Nuvance health
- Implemented new tools and processes to capture opportunity to collect at time of service
- Increased Point of service collections by 15% in referred ambulatory areas by standardizing collections practice across all patient access areas
- Implemented primary care physician follow up scheduling in the emergency department in four hospitals
- Successfully updated all job descriptions with market share analysis to create competitive pay and improve employee retention
- Rotated Administrator of call responsibilities, while ensuring the safety of patients and employees during minor and major emergency situations.
- Collaborated with senior leadership to set long-term objectives for the company.
- Developed and implemented comprehensive strategies to improve operational processes and organizational efficiency.
- Directed the organization's daily operations, ensuring compliance with applicable laws and regulations.
- Recruited, trained, supervised, evaluated and mentored staff members.
Patient Financial Services Manager
Ellenville Regional Hospital
Ellenville, NY
06.2008 - 03.2015
- Managed a team of 15 associates and provided operational directives for all Business office activities related to the Medicare, Medicaid and HMO claim's management, AR follow up, Appeals, Cashiering, Financial Counseling, and Bad debt collections of Ellenville Regional Hospital
- Managed Patient Accounts Receivable Department to ensure timely and efficient cash collections to support the overall financial goals of the facility
- Created and monitored all patient care department financial statistical reports such as Aging, bad debt collections, patient pay and un-billed accounts
- Successfully implemented and Mastered Med-host EMR and Craneware systems
- Transitioned paper cash posting systems to electronic cash posting system
- Chaired Revenue Cycle and Denials Committee meetings with multidisciplinary departments to ensure that all aspects of the hospital revenue cycle were meeting goals and regulatory requirements
- Decreased the number of Hospital wide denials by 12% implementing new quality assurance processes in the Billing department and front-end patient access areas
- Appointed Chair of Studer group Leadership Development Institute and Chair of Communication and Measurement Quality Impact Team, based on strong leadership and management skills.
- Facilitated resolution of patient billing inquiries and complaints in a timely manner.
- Conducted audits to ensure accuracy of patient accounts, including charges and payments.
- Managed the daily operations of Patient Financial Services, ensuring compliance with all relevant laws and regulations.
- Developed strategies to improve patient financial services processes and procedures.
Office Manager
Rondout Valley Family Dentistry
Stone Ridge, NY
09.1999 - 05.2008
- Advanced to authoritative position, culminating in management role with oversight of private practice
- Successfully streamlined office processes to improve service
- Supervised 7 employees, managed insurance claims and reimbursements, sales, inventory, merchandising and cost controls
- Transformed mission of practice and improved on return of investment for the providers
- Introduced training programs that enhanced employee performance and helped build a motivated workforce.
- Supervised staff members, organized schedules and delegated tasks.
- Assisted with the preparation of budgets, forecasts and financial statements.
- Developed and implemented office policies and procedures.
Education
Masters in Healthcare Administration -
University of Phoenix
Phoenix, AZ08.2011
Bachelor of Science in Marketing and International Business -
Penn State University
State College, PA08.2003
Skills
- Strong leadership and analytical skills
- Fluent in Spanish
- Proficient in SQL building & reporting
- Financial Report & Data Analysis
- ICD-9/10, CPT Coding
- Charge master management
- Contract Management
- Dental Billing and Coding
- Online Insurance claims submission
- Windows OS (all)
- Business writing prose
- Insurance provider relations
- Budget Control
- Process Improvement
- Project Management
- Operations Management
- Patient Experience
- Business Development
- KPI Development & Tracking
- Provider Insurance Relations
Certification
- National Association of Healthcare Access Management, Certified Healthcare Access Manager (CHAM), 10/19 - Present
- Pivotal Resources, Six Sigma Green Belt Certified (SSGBC), 08/18
- Ulster County Leadership Development Institute, Award of Leadership Excellence, 05/12
Languages
English
Native/ Bilingual
Spanish
Native/ Bilingual
Timeline
Director of Patient Access- Nuvance West
Nuvance Health
02.2017 - Current
Patient Financial Services Manager
Ellenville Regional Hospital
06.2008 - 03.2015
Office Manager
Rondout Valley Family Dentistry
09.1999 - 05.2008
Masters in Healthcare Administration -
University of Phoenix
Bachelor of Science in Marketing and International Business -
Penn State University
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