Michele Barabas
Athens,GA
Summary
Experienced medical coding professional with a proven track record in accurately interpreting and coding medical records. Recognized for exceptional collaboration skills and seamless adaptability to evolving requirements. Known for reliability, results-oriented approach, keen eye for detail, and strong analytical capabilities.
Overview
15
15
years of professional experience
Work History
Medical Coding Specialist
St. Mary's Healthcare System
04.2016 - Current
- Streamlined billing processes for improved efficiency by maintaining up-to-date knowledge of coding guidelines and procedures.
- Under direct supervision, reviews physician/provider documentation in Inpatient health records to determine the principal diagnosis, secondary diagnoses, principal procedure, and secondary procedures. Assigns appropriate Medicare Severity Diagnosis Related Groups (MS-DRG), All Patient Refined DRGs (APR), Present on Admission (POA), as well as Severity of Illness (SOI) & Risk of Mortality (ROM) indicators for Inpatient and physician records. Identifies Hospital Acquired Conditions (HAC), Patient Safety Indicators (PSI) to ensure accurate hospital and primary care office reimbursement.
- Reduced claim denials by consistently ensuring accurate and compliant coding practices in line with regulatory standards.
- Collaborated with healthcare providers to clarify ambiguous or incomplete documentation, resulting in more precise medical codes.
- Performs ICD and CPT coding of provider services and verifies that all requisite charge information is entered.
- Processes automated or manually enters charges into applicable billing system.
- Communicates with providers related to coding issues that are of mid to intermediate complexity.
- Applies modifiers and appropriate ranking to encounters with multiple codes.
- Enhanced medical coding accuracy by meticulously reviewing patient records and diagnoses.
- Communicated with insurance companies to research and resolved coding discrepancies.
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Verified signatures and checked medical charts for accuracy and completion.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Monitored changes in coding regulations to provide recommendations for compliance.
- Followed up with medical staff regarding missing information in patient records.
- Researched and resolved medical record discrepancies.
- Input data into computer programs and filing systems.
Billing Specialist/Front Office Receptionist
St. Mary's Healthcare System
12.2012 - 04.2016
- Researched and resolved billing discrepancies to enable accurate billing.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Worked with multiple departments to check proper billing information.
- Assisted colleagues in resolving complex billing issues, promoting teamwork and knowledge sharing within the department.
- Performed data entry
- Responsible for multiple scheduling for providers.
- Check in and check out duties.
- Balanced multiple batches daily.
- Responsible for charge entry for four physicians.
- Experience with multi line phone system.
- Negotiated with insurance companies to resolve disputed claims, securing rightful payments.
- Proactively addressed potential billing discrepancies by conducting pre-billing audits.
- Collaborated with healthcare team to ensure billing codes were accurately applied, optimizing reimbursement from insurance companies.
- Processed payment via telephone and in person with focus on accuracy and efficiency.
- Audited and corrected billing and posting documents for accuracy.
Billing Coordinator
Athens Regional Medical Center-Regional 1st
01.2010 - 12.2012
- Perform functions required for billing including: posting all charges posting payments, and handling refunds for clients
- Handled all billing inquiries and worked the collections reports for all Worker's Compensation clients
- Responsible for all aspects of billing and collection of payment for Occupational Medicine and followed Worker's Compensation guidelines
- Performs registrations duties when needed
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Entered details into accounts and tracked payments.
- Maintained strict confidentiality when handling sensitive client information, adhering to HIPAA or other privacy guidelines as required in specific industries.
- Researched and resolved billing discrepancies to enable accurate billing.
- Completed appeals of denied claims on patient bills.
Education
B.A. - Intercultural Studies
Lee University
Cleveland, TN01.1994
Skills
- ICD-10 Coding Expertise
- Procedural coding accuracy
- Medical abbreviations
- HIPAA compliance
- Inpatient coding experience
- Insurance verification
- CPT coding
- Payment posting
- Medical billing procedures
- HCPCS level II coding
- Outpatient coding experience
Timeline
Medical Coding Specialist
St. Mary's Healthcare System
04.2016 - Current
Billing Specialist/Front Office Receptionist
St. Mary's Healthcare System
12.2012 - 04.2016
Billing Coordinator
Athens Regional Medical Center-Regional 1st
01.2010 - 12.2012
B.A. - Intercultural Studies
Lee University
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