Nicole Ditsler
Longwood,United States
Summary
Empathetic and dedicated professional with keen understanding of mental health care and patient support. Possesses comprehensive knowledge of psychiatric disorders and therapeutic interventions, coupled with strong clinical assessment and diagnostic skills. Committed to making positive impact on patient outcomes through personalized care and evidence-based practices.
Overview
8
8
years of professional experience
Work History
Clinical Denials Management Specialist
Advent Health
06.2022 - Current
- Negotiated successful appeals for complex denials, recovering lost revenue for the organization.
- Identified patterns in payer denials, implementing corrective actions to prevent future occurrences.
- Continuously optimized appeal templates based on feedback from payers, leading to more successful resolutions of disputed claims.
Care Manager
Winnie Palmer Hospital for Women and Babies
11.2020 - 06.2022
- Reviewed treatment plans against individual goals and healthcare standards
- Determined medical necessity and cost-effectiveness of services through utilization review processes
- Optimized program resource utilization to prevent unnecessary hospital admissions
Registered Nurse
Winnie Palmer Hospital for Women and Babies
06.2017 - 11.2020
- Provided couplet care to mother and newborn
- Monitored, assessed, and recorded patient condition and coordinated patient discharge planning
- Educated mothers on newborn care and post-delivery health
- Received Daisy award nominations
Education
Psychiatric Mental Health Nurse Practicioner - Advanced Practice Nursing
Herzing University
Orlando08-2026
Master of Science - Nursing Education
Western Governors University
Salt Lake City, UT08.2021
Bachelor of Science - Nursing
University of Central Florida
Orlando, FL12-2017
Associate of Science - Nursing
Seminole State College of Florida
Altamonte Springs, FL01.2017
Skills
- Interpersonal communication
- Clinical education
- Patient advocacy
- Time management
- Problem solving
- Utilization review
- Appeals processing
- Documentation review
Timeline
Clinical Denials Management Specialist
Advent Health
06.2022 - Current
Care Manager
Winnie Palmer Hospital for Women and Babies
11.2020 - 06.2022
Registered Nurse
Winnie Palmer Hospital for Women and Babies
06.2017 - 11.2020
Master of Science - Nursing Education
Western Governors University
Associate of Science - Nursing
Seminole State College of Florida
Psychiatric Mental Health Nurse Practicioner - Advanced Practice Nursing
Herzing University
Bachelor of Science - Nursing
University of Central Florida
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