Summary
Overview
Work History
Education
Skills
Timeline
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NICHOLE CROSS

Rossville,USA

Summary

Possesses versatile skills in project management, problem-solving, and collaboration. Brings fresh perspective and strong commitment to quality and success. Recognized for adaptability and proactive approach in delivering effective solutions.

Overview

13
13
years of professional experience

Work History

Practice Manager

Allied Pediatrics
05.2023 - 04.2025
  • Manage day-to-day operations of the practice consisting of 2 clinics and 27 employees
  • Recruit, interview, onboard & train staff
  • Collaborate with Admin team & staff to develop and assess business strategies
  • Manage inventory & orders
  • Ensure practice complies with industry standards, applicable laws & regulations
  • Manage & resolve patient issues / complaints
  • Utilize QuickBooks to complete payroll & manage invoices
  • Maintain provider credentialing, licensing, CME and certifications
  • Manage employee benefits such as health insurance and 401k plan
  • Conduct monthly staff and department meetings
  • Coordinate & execute communication between provider, staff and patients
  • Establish and implement effective workplace policies & procedures
  • Supervise daily practice operations such as billing, debt collections, scheduling, clinical workflow and occupational health and safety
  • Conduct ongoing education
  • Conduct coaching, counseling / implement Performance Improvement Plans, disciplinary action & terminations as needed
  • Assist in various roles as needed, such as medical assistant, medical receptionist, scheduler
  • Organize employee engagement activities
  • Utilize Athena daily to monitor provider schedules, complete charting & tasks, perform audits
  • Complete Prior Authorizations
  • Utilize Availity daily to ensure verification of patient insurance, view EOBs / claims and complete provider enrollment as needed
  • Manage clinic and provider memberships to various organizations such as the AAP & AMA
  • Coordinate with vendors and sales representatives to ensure the needs of the clinics are met
  • Reconcile and pay invoices
  • Process garnishment of employee wages as needed
  • Oversee and maintain VFC program & CLIA certification
  • Supervise staff, ensure that daily, weekly and monthly tasks / logs / QCs are completed
  • Complete ongoing OSHA training
  • Perform employee evaluations
  • Process changes in pay / benefits
  • Serve as a patient advocate
  • Educate on and ensure HIPAA compliance
  • Monitor QA
  • Provide conflict resolution for both staff and patients.

Area Operations Manager

Urgent Care for Children
03.2021 - 05.2023
  • Effectively manage day to day operations of 5 clinics throughout E TN & N AL consisting of 80 team members (MAs, LPNs, RNs, NPs, MDs)
  • Travel to W TN clinics to assist in management recruitment and clinic improvement efforts as needed
  • Recruit, interview, hire, onboard, train, coach, counsel & terminate staff as needed
  • Inspire & motivate employees to perform at their best through positive encouragement & incentive initiatives
  • Implement performance improvement plans & corrective action plans as needed
  • Communicate job expectations: planning, monitoring, appraising, & reviewing job contributions
  • Conduct employee performance reviews
  • Oversee employee relations & recognition efforts
  • Plan and execute employee engagement activities
  • Create employee schedules
  • Manage inventory & place orders
  • Monitor & maintain clinic budgets
  • Create, implement & enforce policy and procedure
  • Oversee collections, balancing of cash drawer, make deposits
  • Maintain various reports & spreadsheets
  • Schedule, attend & conduct various meetings
  • Ensure ongoing upkeep & maintenance of facilities
  • Oversee patient satisfaction & reviews for clinics
  • Create/Provide educational job aides
  • Grassroots marketing
  • Complete chart audits
  • Develop, implement & maintain quality assurance protocols (QA)
  • Review/Approve daily, weekly & monthly logs (lab logs, safety logs, equipment logs, etc.)
  • Process all medical records requests, request medical records as needed
  • Fulfill various roles as needed (MA or Medical Receptionist)
  • Timecard corrections, coding and approval
  • Maintain clinic compliance with UCA, COLA & CLIA
  • Enrollment in, implementation & maintenance of VFC / COVID-19 vaccine program
  • Contribute operations information to assist with strategic plans & reviews; prepare & complete action plans; implement production, productivity, quality, & customer-service standards; resolve problems
  • Completion of audits, verifying trends, conducting education on deficiencies & develop plan of action for improvement
  • Manage relationships with key operations vendors
  • Serve as primary point of contact for staff members & patient issues
  • Maintain constant communication with managers, staff, and vendors to ensure proper operations of the company
  • Identify potential problems, points of friction & work to find solutions in order to maximize efficiency and revenue
  • Utilize various Microsoft Office applications such as Excel, Word and PowerPoint on a daily basis
  • Utilize Google Workspace on a daily basis
  • Utilize ADP and Gusto on a daily basis
  • Utilize Eclinical Works on a daily basis
  • Utilize Siemens PACS system on a daily basis.

Primary Recruiter & HR Generalist

Hitachi Astemo
07.2019 - 03.2021
  • Identify future hiring needs
  • Collaborate with department managers to compile a consistent list of requirements
  • Attract suitable candidates through databases, online employment forums, social media, etc
  • Develop, facilitate, and implement all phases of the recruitment process
  • Collaborate w/ department managers to identify and draft detailed and accurate job descriptions and hiring criteria
  • Identify & implement efficient & effective recruiting methods and strategies based on the available role, industry standards, & the needs of the organization
  • Assist with job posting & advertisement processes
  • Screen applications & selects qualified candidates
  • Schedule & oversee interviews
  • Assist w/ the interview process, conduct interviews w/ managers
  • Collaborates with the COO to identify and recommend salary ranges, incentives, start dates
  • Ensure compliance with federal, state, and local employment laws and regulations, and company policies
  • Attend and participates in college job fairs and recruiting sessions
  • Perform onboarding to include: drug screens, background checks, obtaining demographic information, setting up direct deposit, I-9, E-Verify
  • Utilize Paycom daily
  • Perform new hire orientation
  • Oversee employee relations and recognition program
  • Oversee uniform management
  • Assist with payroll
  • Generate various memos, letters & announcements
  • Maintain employee files
  • Administer compensation and benefit plans
  • Monitor attendance
  • Conduct performance reviews
  • Conduct disciplinary action as needed
  • Create employee engagement plans
  • Provide support to employees in various HR-related topics and resolve any issues that may arise
  • Conduct staff meetings
  • Create 'promotional' materials, such as flyers and PowerPoints to advertise various upcoming events
  • Create and maintain weekly 'education & updates' PowerPoint presentation to be displayed on monitors in various employee areas
  • Conduct Plant Tours for potential candidates and new hires
  • Utilize various Microsoft Office applications such as Excel, Word and PowerPoint on a daily basis.

Privacy Officer, HIM Tech, Surgery Scheduler, Registration Specialist, Appeals Specialist

CHI Memorial Hospital
05.2016 - 07.2019
  • Evaluate the organization's existing policy & procedure for HIPAA compliance by performing HIPAA risk assessments
  • Collaborate w/ plan management, administration, & legal counsel to identify and address privacy policies & procedures that require improvement
  • Develop & assist w/ implementation of new & updated policies and procedures
  • Maintain policies & procedures related to PHI access & use; ensures strict adherence by all staff with access to PHI
  • Assess method & procedure used to store & transmit PHI; identify security or other compliance risks, research and recommend improvements
  • Maintain required records & supporting documentation including authorization forms, notices, & plan documents
  • Draft & implement procedures for addressing & resolving complaints regarding the organizations privacy policies & procedures
  • Serve as the internal subject matter expert on HIPAA, maintaining current knowledge of HIPAA laws & regulations, any other applicable federal/state privacy laws or regulations
  • Report on changes in applicable laws & regulations, provides training as needed
  • Collect patient demographic, insurance & payment information
  • Validate medical insurance coverage
  • Build surgery schedule
  • Schedule appointments, imaging, procedures and surgeries
  • Complete referrals
  • Provide pre-surgical instructions to patients
  • Complete prior authorizations
  • Serve as a physician liaison, communicating 'doctor to doctor' messages to providers & dispatching providers to hospital consults as needed
  • Schedule device representatives to attend implants & surgical procedures
  • Complete chart audits & QA
  • Complete precertification, claims, appeals & refund requests
  • Perform credentialing & contracting
  • Release of Information, record queries and deficiencies
  • Perform daily tasks utilizing both EMR and paper records / charting
  • Digitize medical records
  • Reconcile deleted EMR
  • Perform medical record amendments, restrictions & accounting of disclosures
  • Perform risk assessment & compliance monitoring
  • Conduct HIPAA, compliance and privacy training.

Release of Information Manager

Cape Fear Valley Hospital
08.2012 - 05.2016
  • Overall management and oversight of HIM health record processing related services, including but not limited to: document-imaging, deficiency analysis, missing documentation, physician suspension, birth-certificates, transcription, release of information, QA, education, and training within designated scope of responsibility
  • Establishes and monitors overall compliance to all related HIM KPI's and other metrics
  • Provide oversight and supervision of the ROI team including recruitment, training, performance management and workflow
  • Identify and evaluate areas that may need improvement and implement solutions that will streamline processes and improve workflow
  • POC for all subpoenas, appear in court as the records custodian
  • Work closely with Legal, Compliance / Risk Management on HIM release issues
  • Responsible for escalating situations by communicating with attorneys, law enforcement, auditors, and insurance company representatives as well as a variety of other professionals
  • Diffuse situations as necessary
  • Prepare reports utilizing ROI modules & work queues
  • Assist in the development & monitoring of annual budget
  • Perform initial & continuing education on HIPAA & compliance laws
  • Completion of online incident reporting to the OCR in the occurrence of a breech, review breech details and find solutions to prevent further breach of information
  • Monitor & maintain quality assurance (QA) for the department.

Education

Bachelor of Science - Human Resources Management

Virginia College
Birmingham, AL
07-2010

Skills

  • Talent acquisition and onboarding
  • EHR, ATS, HRIS
  • Employee Relations
  • Project Management
  • HIPAA and OSHA regulations
  • Credentialing
  • Practice Management
  • Payroll Administration
  • Human resources management
  • Policy and procedure development

Timeline

Practice Manager

Allied Pediatrics
05.2023 - 04.2025

Area Operations Manager

Urgent Care for Children
03.2021 - 05.2023

Primary Recruiter & HR Generalist

Hitachi Astemo
07.2019 - 03.2021

Privacy Officer, HIM Tech, Surgery Scheduler, Registration Specialist, Appeals Specialist

CHI Memorial Hospital
05.2016 - 07.2019

Release of Information Manager

Cape Fear Valley Hospital
08.2012 - 05.2016

Bachelor of Science - Human Resources Management

Virginia College

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NICHOLE CROSS