Health Care Operations Manager
Open To Work
MARY HILL
Clinic for Special Children
Wilmington,NC
Work Preference
Desired Job Title
Clinical Care + TMS CoordinatorBusiness Office ManagerPractice ManagerMedical Records TechnicianOffice Manager
Work Type
Full TimePart TimeContract Work
Location Preference
On-SiteRemoteHybrid
Location:
Wilmington, NC
Open to relocation:
No
Important To Me
Work-life balanceCompany CulturePaid time offPaid sick leaveFlexible work hours
1
Certification
9
years of professional experience
Dynamic healthcare management professional with over 8 years of experience specializing in Revenue Cycle Management and Human Resources. Proven track record in optimizing billing processes, insurance claims, and reimbursement negotiations, leading to significant revenue recovery and operational efficiency improvements. Skilled in managing end-to-end RCM processes, including insurance verification, clean claims submission, coding, and collections. Strong leadership in team management, payroll administration, employee development, and compliance with federal and state regulations, including HIPAA, Medicare, and Medicaid. Adept at analyzing key performance indicators (KPIs) and implementing process improvements to drive financial performance and staff productivity. Seeking to leverage expertise in RCM and HR to contribute to operational excellence and sustainable growth.
Work History
Clinical Care + TMS Coordinator
7 Months- Managed revenue cycle operations including claims resolution, denial management, payer communication, insurance verification, and billing workflow optimization for specialized healthcare services.
- Served as a liaison between clinical teams, billing staff, and insurance payers to improve reimbursement outcomes and resolve complex authorization and claims issues.
- Obtained insurance approvals for high-cost, specialized therapies, including Medicaid authorization for TMS services, expanding access to care and increasing clinic revenue opportunities.
- Supported payer contract negotiations and reimbursement strategy to strengthen financial performance and maximize collections.
- Oversaw EMR documentation, chart audits, compliance requirements, and medical record accuracy to support clean claims and regulatory standards.
- Developed Letters of Medical Necessity and clinical documentation to support appeals, authorizations, and reimbursement requests.
- Managed workflows for pediatric and special-needs patient populations while collaborating with providers, families, and multidisciplinary care teams.
Business Office Manager
7 Months- Managed the end-to-end revenue cycle process, from insurance verification to claims submission and collections, recovering $700,000+ in outstanding claims.
- Negotiated insurance contracts and ensured adherence to Medicare, Medicaid, and private insurance policies, optimizing reimbursement rates.
- Negotiated insurance contracts and ensured adherence to Medicare, Medicaid, and private insurance policies to optimize reimbursement rates.
- Developed and implemented revenue cycle policies and procedures to enhance workflows and operational efficiency.
- Tracked KPIs and analyzed data using Excel to monitor financial performance, project completion, and identify process improvements.
- Tracked KPIs and performed data analysis using Excel to monitor financial performance, project completion, and process improvements.
Practice Manager
1 Year 1 Month- Oversaw the revenue cycle by managing insurance verification, claims submission, and billing processes for high-cost procedures.
- Administered payroll and employee scheduling, ensured compliance with labor laws, and optimized staffing for full-time, part-time, per diem employees to meet operational needs.
- Developed and implemented employee handbook for compliance with federal and state labor laws, and coordinated HR compliance training for staff.
- Conducted recruitment and onboarding, handling HR processes from hiring to performance evaluations, FMLA claims, and employee relations.
- Managed accounts receivable, effectively communicated with patients and established financial arrangements to reduce outstanding balances.
- Streamlined the EHR setup for new employees, ensuring proper access and compliance with HIPAA standards for patient data handling.
Medical Records Technician
7 Months- Managed medical record preparation and data entry, supporting accurate and timely patient appointments by updating Electronic Health Records (EHR).
- Managed medical record preparation and data entry to ensure accurate and timely patient appointments through effective updates to Electronic Health Records (EHR).
- Processed Release of Information (ROI) requests in compliance with HIPAA regulations, ensuring protection of sensitive patient information.
- Utilized eClinicalWorks and Availity systems for efficient patient data entry, chart preparation, and insurance coordination.
Office Manager
2 Years- Administered payroll and HR functions, from recruiting and onboarding to compliance training, performance reviews, and employee relations.
- Managed provider credentialing to ensure compliance with insurance requirements and streamlined reimbursement processes.
- Handled provider credentialing, ensuring compliance with insurance provider requirements and streamlining the reimbursement process.
- Conducted mental health billing using ICD-10 and CMS 1500 forms, ensuring accurate coding and submission to clearinghouses.
- Executed mental health billing with ICD-10 and CMS 1500 forms, ensuring accurate coding and timely submission to clearinghouses.
- Leveraged QuickBooks for accounts payable, reconciliations, and tax preparation, enhancing overall financial operations for the counseling practice.
- Stonebridge Counseling is a mental health practice offering a wide range of therapeutic services, including individual, family, and group counseling. Focused on providing compassionate, client-centered care, the practice supports patients in managing mental health challenges and improving overall well-being.
Office Administrator & Dental Biller
1 Year 11 Months- Managed revenue cycle by verifying insurance, submitting claims, and addressing denials and appeals, effectively recovering outstanding claims.
- Handled daily billing and collections, ensuring accurate posting of payments and write-offs while balancing day sheets for financial integrity.
- Coordinated patient scheduling for dental treatments and collaborated with specialists such as oral surgeons, periodontists, and orthodontists.
- Processed primary and secondary insurance claims, ensuring HIPAA compliance and facilitating proper patient aftercare follow-up.
Education
Master of Science - Integrative Medicine
Bachelor of Science - Business Administration
- Magna Cum Laude
- Dean's List
- Provost's List Full Academic Scholarship Recipient
Skills
Revenue Cycle Management
Insurance verification
Clean Claims Processing & Denial Management
Provider Credentialing
Payer Enrollment & Reimbursement Negotiation
EHR systems
Clearinghouse Portals
Compliance (HIPAA
Medicare
Medicaid
JHACO)
Workflow optimization
Financial reporting
Data analysis
Team Leadership & Development
Cross-department collaboration
Policy Development & Implementation
Employee onboarding
Performance management
Payroll management
Medical coding
Certification
- SHRM Certified Professional (SHRM-CP) Industry-recognized certification from the Society for Human Resource Management demonstrating expertise in HR operations, employment law, talent acquisition, employee relations, performance management, compliance, and strategic human resource practices.
- Gamma Beta Phi Honor Society National collegiate honor society recognizing academic excellence, leadership, and service. Membership awarded based on outstanding GPA and Dean's List academic achievement.
Timeline
Clinical Care + TMS Coordinator
Clinic for Special Children
01.2026 - CurrentRead More
Business Office Manager
Wilmington Health ASC
01.2024 - 08.2024Read More
Practice Manager
Privvy Modern Health
07.2022 - 08.2023Read More
Medical Records Technician
Northern Valley Indian Health
07.2021 - 02.2022Read More
Office Manager
Stonebridge Counseling
07.2019 - 07.2021Read More
Office Administrator & Dental Biller
Chico Dental Design Studio
12.2017 - 11.2019Read More
Maharishi University of Management
Master of Science from Integrative Medicine
Read More
Chapman University
Bachelor of Science from Business Administration
Read More