Michelle Borland
RN
Peoria,IL
Summary
Accomplished QA/Coding Specialist with over 20 years at Carle Home Health, I excel in HCS-D coding and EPIC EMR, enhancing billing accuracy and patient data management. Known for fostering patient trust and streamlining intake processes, my advocacy and meticulous attention to detail have significantly improved service referrals and patient care outcomes.
Overview
34
34
years of professional experience
Work History
QA/Coding Specialist
Carle Home Health
05.2017 - Current
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Maintained strict confidentiality in accordance with HIPAA regulations, ensuring secure storage and handling of sensitive patient information.
- Maintained HCS-D coding credentials for 20 yrs.
- Reduced error rates in medical billing by maintaining thorough knowledge of insurance regulations and guidelines.
Intake Coordinator, Phone Triage RN,
Carle Home Health
12.1992 - Current
- Provided excellent customer service to patients, family members, and healthcare providers during the intake process.
- Maintained strict confidentiality of patient information, adhering to HIPAA guidelines and company policies.
- Reduced errors in patient data entry with thorough verification processes and attention to detail.
- Completed intake assessment forms and filed clients' charts.
- Collected, verified, recorded and processed client demographics, insurance authorizations, and referral information.
- Collaborated with healthcare professionals to ensure patients received appropriate services and resources.
- Answered phone calls and provided information to potential patients and also information to current patients. Determined if needed extra visits, to go to ER or if needed to speak to their primary nurse.
- Conducted initial assessments of patient needs and eligibility for various programs or services offered by the organization.
- Developed strong relationships with referral sources, resulting in increased referrals for services provided by the organization.
- Advocated for patients by liaising with insurance companies, ensuring coverage and reducing financial stress for patients.
- Enhanced communication between interdisciplinary teams, ensuring patient needs were met comprehensively and efficiently.
Home Health Nurse
Carle Home Health
09.1990 - Current
- Developed strong rapport with patients and families, fostering trust and open communication during challenging times.
- Educated patients and families on disease management, medication safety, and at-home healthcare strategies to promote selfcare.
- Documented patient vitals, behaviors and conditions to communicate concerns to supervising nurse.
- Contributed to the overall success of the home health agency by maintaining high levels of patient satisfaction and positive outcomes.
- Provided physical assessments, medication, and chronic disease management to home health patients.
- Coordinated with other healthcare team members to support patient needs.
- Identified early warning signs of patient deterioration or complications, promptly notifying physicians to adjust treatment plans accordingly.
- Conducted regular follow-up visits to monitor patient progress and make adjustments to care plans as needed.
- Assessed patients' health status and developed individualized care plans to suit needs.
- Facilitated smooth transitions from hospital discharge to home-based care by coordinating necessary resources and support systems.
- Collaborated with vendors to procure medical equipment, supplies and services.
- Served as a reliable resource for families seeking guidance on navigating complex healthcare systems and advocating for their loved ones'' needs.
- Performed skilled nursing procedures such as IV therapy administration, tracheostomy care maintenance under physician supervision when required.
- Managed patients recovering from medical or surgical procedures.
- Provided skilled, timely and level-headed emergency response to critically-ill patients.
- Explained course of care and medication side effects to patients and caregivers in easy-to-understand terms.
Education
Bachelor of Science - Nursing
Illinois Wesleyan University
Bloomington, IL05-1981
Skills
- HCS-D coding certified
- HCS-O oasis certified
- COS-O oasis certified
- Experience with EPIC EMR
Timeline
QA/Coding Specialist
Carle Home Health
05.2017 - Current
Intake Coordinator, Phone Triage RN,
Carle Home Health
12.1992 - Current
Home Health Nurse
Carle Home Health
09.1990 - Current
Bachelor of Science - Nursing
Illinois Wesleyan University
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