Nicole Nye
Oakland,ME
Summary
Experienced in healthcare and management, customer service-oriented professional excelling in coordinating workflows and effectively communicating with co-workers, patients, and staff. Strong commitment to quality, diligently following policies, procedures, and guidelines to ensure the highest level of service. Prioritizing patient privacy and confidentiality, consistently maintaining and safeguarding sensitive information.
Overview
16
16
years of professional experience
Work History
Small Business Owner
N Raged Nutrition LLC
09.2021 - 05.2024
- Maintained accurate financial records, including budgeting, forecasting, and expense tracking
- Successfully launched and operated a small business, overseeing all aspects of daily operations
- Ensured compliance with legal requirements such as licensing regulations, health codes, and labor laws
- Managed cash flow effectively through strategic financial planning
- Implemented cost-saving measures without compromising product quality or customer satisfaction
- Created and maintained a positive brand image through consistent messaging across various marketing channels
- Established strong relationships with suppliers to ensure timely delivery of goods while maintaining quality standards.
Short Term Disability Case Manager
Unum Insurance-Colonial Life
08.2019 - 04.2020
- Communicated with claimants, employers, and various medical professionals to gather information regarding the application for, payment of, and ongoing management of short-term disability benefits
- Conducted investigations to determine whether or not to accept liability and to what degree
- Approved or denied benefits accordingly
- Responded to various written and telephone inquiries including eligibility, approval/denial determinations, status, and continuation or closure of benefits
- Calculated the liability for each claim applying all appropriate offsets such as social security, workers compensation, and third parties
- Continually assessed claim details to determine if claims are going to exceed case management authority guidelines.
Insurance Billing Specialist
Redington-Fairview General Hospital
04.2019 - 06.2019
- Verified patient information, including demographics and insurance coverage, to ensure proper claim submission
- Maintained confidentiality of patient information according to HIPAA regulations
- Investigated rejected claims due to eligibility issues and corrected errors to resubmit claims for payment
- Followed up on unpaid or denied claims, identifying errors or discrepancies and resolving them in a timely manner.
Escalation Manager / Customer Service
Barclays
05.2008 - 03.2019
- Resolve partner level complaints and utilize problem and conflict resolution skills with deescalating calls
- Assist with the launch of Barclays Social Media team
- Use CCD and TSYS computer system to pull customer data and view transactions and statement history
- Talk to customers about billing and the processes associated to pay off their bill
- Use codes pulled from TSYS to adjust customer billing statements when needed.
Education
Diploma - Medical Billing and Coding
Ultimate Medical Academy
Tampa, FL 07.2018 - 7 2018
Course - Dental Assisting
Helping Hands, Kate Noble
Winslow, ME 06.2011 - 6 2011
Course - Dental Radiology
Cathy Turbyne & Associates
Auburn, ME 06.2011 - 6 2011
Training Course - Customer Service
T-Mobile
Fairfield, ME 09.2005 - 9 2005
Skills
Cost control and analysis
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
swipe to browse
Timeline
Small Business Owner
N Raged Nutrition LLC
09.2021 - 05.2024
Short Term Disability Case Manager
Unum Insurance-Colonial Life
08.2019 - 04.2020
Insurance Billing Specialist
Redington-Fairview General Hospital
04.2019 - 06.2019
Diploma - Medical Billing and Coding
Ultimate Medical Academy
07.2018 - 7 2018
Course - Dental Assisting
Helping Hands, Kate Noble
06.2011 - 6 2011
Course - Dental Radiology
Cathy Turbyne & Associates
06.2011 - 6 2011
Escalation Manager / Customer Service
Barclays
05.2008 - 03.2019
Training Course - Customer Service
T-Mobile
09.2005 - 9 2005
Similar Profiles
Ashley E CatlinAshley E Catlin
Owner/Operator at Stilly's Nutrition Fix LLC, 1773 NutritionOwner/Operator at Stilly's Nutrition Fix LLC, 1773 Nutrition
Gretchen MartinGretchen Martin
Laboratory Technician at Purina Animal Nutrition LLCLaboratory Technician at Purina Animal Nutrition LLC
Sarah MashiganSarah Mashigan
Registered Dietitian (Contract) at Nutrition That Works LLC.Registered Dietitian (Contract) at Nutrition That Works LLC.
Charlee StubbertCharlee Stubbert
Senior Mentor at TeachersSenior Mentor at Teachers
Rachel BrodeurRachel Brodeur
Outpatient Clinician at Kennebec Behavioral HealthOutpatient Clinician at Kennebec Behavioral Health