Nicole Dye Email & Phone Number

Jacksonville, Florida, United States

Jacksonville, Florida

Jacksonville, Florida Area

Sold Company

Single point of contact for all attorneys for the practice. Process reductions, provide ledgers and update all accounts. Process and post daily deposits.Customer service Process improvements for the practice.

4085 University Blvd Jacksonville Florida

Jacksonville, Florida Area

• Review and analyze insurance claims with accounts receivable balances that have aged beyond 30 days old or claims denied in the Insurance Follow-Up Module and A/R reports.• Work with the Practice/CBO teams (billing, clinical, payment teams, etc.) to correct claims billed incorrectly, gather necessary information and re-submit claims that must be adjudicated.• Make use of all available tools (websites, clearinghouse, EMR and PM Systems) to efficiently identify reasons for non-payments and follow the steps needed for the insurance to adjudicate the claims.• Follow up on claims placed on Hold manually or due to EOB/ERA Denials immediately.• Review claims on Hold due to rejections and communicate with the Practice’s billing team to ensure that a clean claim is submitted as soon as possible.• Follow up on claims over 30 days old to identify the reason for non-payment and contact the insurance to adjudicate/pay the claims.• Work with the practice billing team to re-submit claims that were not received by the payer and follow-up on the claim until a clean claims is received by the payer before timely deadlines are reached.• Gather and submit necessary medical documentation (History and Physicals, Letters of Medical Necessity, etc.) so the payers can adjudicate the claims.• Exhaust the Appeals process (Re-consideration>Appeal Letter 1>Appeal Letter 2) in an effort to collect the payments.• Document Notes (Notes, Alert) in the patient accounts/claims to record steps taken to adjudicate the claims and collect balances and to document conversations with insurance/patients.• Where applicable, document issues in the “Issues Log” and follow up on responses from all team in a timely manner.• Maintain documentation of all follow-up/collection activities including, but not limited to e-mails, requests to write off accounts and approvals in the designated drives.

Responsible for over 4 Million in revenue. Posting payments,correspondence,abd customer service.

• Responsible for all daily reports to upper management.• Participated in multiple RPI and system training. • Received yellow belt in Six Sigma. • Participated in system enhancement discussion groups.• Providing system testing for upcoming system implementations. • SME (subject matter expert) for customer service call center.• Audit medical records to be reviewed by medical review nurses for claim payment. • Served on Siebel Tag Team (BCBSFL operating system).

• Maintained payroll for all BCO (Business Capacity Owner).• Maintain a rigid schedule for delivery of parts to Ford Motor Plant.• FEMA Team Lead. • Responsible for all temporary employees hired to cover customer service calls during the natural disaster. • Coordinated all BCO’s to delivery area of relief supplies. • Computer entry of all locations of relief effort an supplies being delivered.

Bachelor Of Applied Science (Basc), Operations Management And Supervision, Magma Cum Laude 3.79

Associate Of Arts (A.A.), Business Administration And Management, General, 3.84

Business Supervision and Management