Results-driven professional with expertise in credentialing, payer relations, and compliance. Proven ability to streamline processes, improve operational efficiency, and enhance provider network integrity.
Overview
5
5
years of professional experience
Work History
Payer Relations Coordinator
Prism Medical Products
Elkin, NC
10.2023 - Current
Directed end-to-end credentialing and recredentialing for commercial, Medicare, and all 50 state Medicaid programs, ensuring compliance with payer and regulatory requirements.
Oversaw national payer contracts, serving as primary liaison to maintain participation and contractual alignment.
Managed a credentialing team of five, including hiring, training, and development, driving departmental efficiency and growth.
Authored SOPs and training modules, converting complex policy and system changes into standardized workflows.
Improved credentialing operations by implementing automation and dashboards, reducing turnaround times and strengthening audit readiness.
Recognized for transforming workflows into scalable, compliance-focused systems that enhanced provider network integrity.
Office Manager
Pinnacle Treatment Centers
Wilkesboro, NC
09.2020 - 10.2023
Promoted to Office Manager within four months, overseeing administrative and compliance functions for a high-volume clinic serving 1,000+ monthly visits.
Directed patient intake, scheduling, insurance verification, and medical records management, ensuring accuracy and adherence to payer requirements.
Served as Chief Compliance Officer, leading HIPAA and DEA regulatory assessments, audits, and emergency preparedness drills.
Managed billing workflows and insurance coordination, reducing errors and improving reimbursement timelines.
Spearheaded quality improvement initiatives that increased patient satisfaction and long-term engagement.
Partnered with clinical staff to align operational strategies with patient care needs while acting as sole on-site administrative support.
Director of Credentialing and Payer Relations at Discovery Behavioral HealthDirector of Credentialing and Payer Relations at Discovery Behavioral Health