Joan Cuevas
Summary
I am a highly skilled and results-driven healthcare professional with over 8 years of experience in health services administration. My expertise lies in Medicare and Medicaid compliance, provider network management, financial reconciliation, and project management. As a bilingual (English/Spanish) professional, I have successfully led diverse teams and driven operational excellence in fast-paced environments.
With a Master’s degree in Health Services Administration and certifications in Scrum Fundamentals and Medicare Fraud Prevention, I am passionate about creating efficient healthcare systems that prioritize patient care and financial integrity. I am currently seeking opportunities to contribute my skills and experience to an innovative organization in healthcare industry
Overview
11
11
years of professional experience
Work History
Director of Ancillary Services (OPD)
Hospital Wilma N Vazquez.
Puerto Rico
04.2023 - 04.2024
Director of Provider and Services
VIP Professional Medical Billing and Audit LLC.
Puerto Rico
03.2022 - 06.2023
Provider Payment Specialist
Abarca Health
10.2021 - 03.2022
Appeals & Grievances, Compliance
Pharmpix. Corp
07.2017 - 10.2021
Internal Audit And Implementations
Pharmpix. Corp
08.2016 - 07.2017
Retail Network Credentials Provider
Pharmpix. Corp
03.2016 - 08.2016
Billing Analyst
MMM HealthCare LLC.
03.2013 - 01.2015
Education
Master's Degree - Health Services Administration (MHSA)
Ana G. Méndez University System USA
04.2024
SCRUM Fundamentals Certified (SFU) Project Manager
Scrum Study-Accreditation Body For Scrum And Agile
Scrum Study-Accreditation Body For Scrum And Agile12-2022
Bachelor of Arts - Bachelor's in Criminal Justice
Inter American University of Puerto Rico– San Juan
02-2016
Combating Medicare Part C And D Fraud, Waste, And
Department Of Health & Human Services (CMS)
Medicare Fraud & Abuse: Prevent, Detect And Report
Department Of Health & Human Services (CMS)
World Of Medicare
Department Of Health & Human Services (CMS)
Skills
- Power point
- Excel
- Knowledge in medical billing cycle
- Project Manager
- Medicare & Medicaid Compliance
- Medical Billing and Coding
- Financial Reconciliation
- Project Management
- Bilingual Communication (English/Spanish)
Volunteer Experience
- The National Society of Leadership and Success, Member, 2019-05, Present
- Shriners Hospital for Children, Member, 2011-07, Present
- Manati Medical Center, Collaborator, 2018-06, 2019-07
- United Way PR, Collaborator, 2016-02, Present
Interest
Administration, Finances, Reconciliation, Contracts, Analysis, Managed healthcare capitation rate
Languages
Spanish
First Language
English
Upper Intermediate
B2
Timeline
Director of Ancillary Services (OPD)
Hospital Wilma N Vazquez.
04.2023 - 04.2024
Director of Provider and Services
VIP Professional Medical Billing and Audit LLC.
03.2022 - 06.2023
Provider Payment Specialist
Abarca Health
10.2021 - 03.2022
Appeals & Grievances, Compliance
Pharmpix. Corp
07.2017 - 10.2021
Internal Audit And Implementations
Pharmpix. Corp
08.2016 - 07.2017
Retail Network Credentials Provider
Pharmpix. Corp
03.2016 - 08.2016
Billing Analyst
MMM HealthCare LLC.
03.2013 - 01.2015
Master's Degree - Health Services Administration (MHSA)
Ana G. Méndez University System USA
SCRUM Fundamentals Certified (SFU) Project Manager
Scrum Study-Accreditation Body For Scrum And Agile
Bachelor of Arts - Bachelor's in Criminal Justice
Inter American University of Puerto Rico– San Juan
Combating Medicare Part C And D Fraud, Waste, And
Department Of Health & Human Services (CMS)
Medicare Fraud & Abuse: Prevent, Detect And Report
Department Of Health & Human Services (CMS)
World Of Medicare
Department Of Health & Human Services (CMS)