July 17, 2025
An interview with Michael Gonzales, Executive Director of Client Relations
You’ve had an impressive career in revenue cycle leadership—what originally drew you to healthcare, and specifically to revenue cycle management?
It was purely by accident. After losing my job as a bookkeeper at a retail computer company I landed at a non-emergency transportation company to do billing. At the time, the goal was to get a job that would pay me enough to travel to ultimate frisbee tournaments throughout the country. Look where I ended up.
With over 30 years in the industry, how have you seen the revenue cycle space evolve, especially in radiology?
Back in the early days of my career, everything was manual and on paper. There were no electronic claims or ERAs, but when you did send a claim, you were pretty much guaranteed to get paid, and very well at that. Today, there is a greater dependence on technology and automation, which has been incredible to be a part of, but on the downside, radiology groups continue to face continual reimbursement rate cuts, increased volumes and administrative
burdens, which are resulting in burnout, staffing shortages and greater challenges that are only
going to get worse before they get better.
You’re now Executive Director of Client Relations—what does a typical day in that role look like for you?
No single day is the same. What I love about my role is that I get to be involved in all aspects of the revenue cycle. I have the opportunity every day to collaborate with clients, hospital partners, business associates, technical and operational teams, with the singular goal of removing barriers that allow for the maximization of revenue for the important and valuable work performed by our clients.
What sets PBS Radiology apart in the RCM world, from your perspective as both a leader and a client advocate?
At PBS Radiology we bring unsurpassed experience in the specialty of radiology. Each of the Executive Team Members have served in numerous executive leadership positions within radiology groups. It is that experience and expertise that is unmatched.
When working with new clients, what are the key early indicators you look for to identify revenue cycle improvement opportunities?
It starts with the quality of the documentation. By performing documentation audits before go-live, we can get a sense of any gaps so we can close them early in the relationship. Conducting Denial Analysis in the go-live timeline also plays a crucial role in maximizing revenue cycle performance.
What’s your approach to building strong client relationships, even in complex or high-pressure situations?
My approach starts with the mindset that I’m not just a vendor—I’m an extension of your practice. That means I share in the responsibility for your success, and I treat your challenges as my own. I believe in full transparency, especially when things are complicated or high-stakes. I communicate clearly and proactively, even when the news isn’t ideal, because honesty builds credibility.
I also recognize that strong relationships depend on clarity around roles and responsibilities. Clients have a role, and I have a role—and I commit to doing my part exceptionally well. I hold myself accountable, and I invite the same from the client side. This kind of mutual respect and accountability helps establish a foundation of trust, one that evolves beyond a typical client/vendor dynamic and into a true partnership.
When pressure is high, what sustains the relationship is that trust. Clients know I will be steady, responsive, and focused on solutions. They know I’m not going to disappear when things get tough. I show up, I stay engaged, and I help navigate the complexities with a calm, strategic presence.
If you could wave a magic wand and instantly fix one common issue across all RCM departments, what would it be and why?
If I could wave a magic wand and fix one common issue across all RCM departments, it would
be achieving true real-time adjudication. Right now, there’s a frustrating delay between when a service is performed and when we know what’s getting paid. We submit a claim, wait days—or weeks—for a response, then deal with
denials, rework, or chasing balances. That lag time drives up administrative costs, delays revenue, and frustrates both staff and patients.
With real-time adjudication, we’d know instantly: what’s covered, what the patient owes, and when payment is coming. That kind of visibility would transform the revenue cycle—streamlining workflows, reducing denials, cutting down on rework, and improving the patient financial experience. It’s how credit card transactions work, and there’s no reason healthcare can’t catch up.
The technology exists—we just need alignment across systems, payers, and providers to make
it standard.
What’s one fun or surprising fact people might not know about you?
I’m what many would call a foodie—I just love to eat. Whether it’s street food, casual bites, global cuisine, fine dining, or cooking at home, I’m all in. When I travel, I dive deep into researching the best food spots. In fact, when I’m on the road with my PBS partners, they always turn to “MG” for dining recommendations. So far, I haven’t let them down!
Michael Gonzales is an experienced executive revenue cycle leader with over 30 years of experience in the healthcare industry. He has a proven track record of successfully leading and engaging teams to identify and develop strategies that optimize revenue cycle performance in radiology, multi-specialty, and non-profit health systems. Michael is deeply involved with state and national advocacy and education efforts. He is a member of the Radiology Business Management Association (RBMA), where he is a Fellow. He has held numerous leadership roles in the organization at both national and state levels.
Michael is passionate about creating a positive and productive environment that enhances revenue cycle performance and improves the experience for both patients, clients and employees. He is dedicated to driving results and fostering collaboration to achieve organizational goals.
