Michelle Deerberg
Indianapolis,IN
Summary
Experienced with regulatory compliance, risk management, and policy development. Utilizes strategic planning and comprehensive audits to ensure compliance with industry standards. Knowledge of team collaboration and continuous process improvement.
Overview
29
29
years of professional experience
1
1
Certification
Work History
Director of Compliance and Audit
American Senior Communities, LLC
01.2022 - 01.2025
- Provides expertise and analysis in conducting internal audits and coordination of external audits
- Support the development and/or implementation of processes and function to comply with federal and state laws.
- Assessment of risks, identifying trends, developing and executing appropriate tests of controls, presenting results and recommendations for improvements to management
- Develop training and education for executive management and facility level opportunities
- Collaborate with revenue cycle and finance to review coding and billing areas for compliance.
- Prepares audit reports summarizing findings with recommendations for improvement and corrective actions where appropriate.
- Monitor corrective actions plans initiated because of an audit.
- Evaluates the effectiveness of policies and procedures and the effectiveness of internal controls
- Completion of investigations, including efforts to conduct interviews and review of relevant documents
- Support special projects and other tasks as assigned.
Vice President of Clinical Reimbursement
Signature Healthcare LLC
01.2018 - 01.2022
- Oversee/supervise all aspects of reimbursement on a global scale for Signature Healthcare
- Provide oversight to all federal and state reimbursement regulations
- Liaison between Home Office to Clinical Reimbursement stakeholders
- Assist Compliance with Clinical Reimbursement audits, education, and investigations
- Create and adapt policies within SHC to support the changing CMS regulations
- Develop training and education for ever changing reimbursement fields (ie: Quality Measures, QRP, PBJ, PDPM, Case Mix)
- Participate in Agile Teams to mold direction of the Clinical Reimbursement area within Signature Healthcare
- Create education and roll out schedule for new EMR – Matrix
- Assist and participate in any Operations needs
Divisional Director of Case Management
Kindred Healthcare – Support Center
01.2015 - 01.2018
- Oversee/Supervise all of the centers within the Nursing Center Division
- Multiple site support for more than 100 Skilled Nursing Facilities and Sub-Acute Units.
- Oversee/Supervise 12 District Level Case Managers
- Provide oversight for Medicare, Medicaid (Case Mix), and Managed Care to ensure appropriate clinical services are provided and optimal reimbursement is obtained with districts.
- Oversee and direct each center within the organization to ensure to compliance with MCRA regulations and Managed Care Providers’ expectations while upholding the organizations policies and procedures
- Serve as a key member of the regional management team in helping the region and districts develop quality Medicare, Medicaid (Case Mix), and Managed Care/Insurance programs within each center.
- Oversight to Kindred Compliance programs
- Monthly operational reviews with the District level CM’s to ensure
- Create and implement educational programs for Case Managers and MDS Coordinators for CMS changes
- Assist in Kindred transition to remove itself from Skilled Nursing care.
District Director of Case Management
Kindred Healthcare-Indy Market
01.2011 - 01.2015
- Oversee/Supervise Case Managers for multiple facilities
- Medicare and Managed Education
- Compliance Management
- Metric Management
- Oversee/Supervise MDS Coordinators
- Utilization Management
Case Manager – Wildwood Healthcare
Kindred Healthcare-Indy Market
01.2003 - 01.2011
- Manage resident care within CMS and Managed Care guidelines
- Metric Management
- Care Management of residents
Director of Nursing Services - Continental
Beverly Healthcare
09.2001 - 06.2003
- Worked with Administrator, Consultants, and Facility Staff in planning all aspects of nursing services to include interfacing with other disciplines and departments
- Assisted Senior Management with Quality Reviews for other SNF Facilities
- Established priorities and job assignment for nursing staff
- Maintained records and managed budgets
- Functioned as Senior Department Head
- Monthly Report procurement.
MDS Coordinator
Beverly Nursing and Rehab
06.1996 - 07.2001
- Participant to the nursing management team, on-call rotation, staff supervision, trouble-shooting staffing problems, and Management facility in-house Medicare audit in compliance
- Weekly assessment of Medicare Skilled need
- Weekly QM meeting
- Evaluate and confirm MDS assessments
- Completing 450-B’s
- All aspects of MDS completion and transmission
Education
Associates in Sciences - Nursing
University of Indianapolis
01.1996
Skills
- Internal controls
- Influencing skills
- Sanctions compliance
- Ethics management
- Compliance monitoring
- Quality controls
- Audit coordination and management
- Data privacy
- Investigations skills
- Internal audits
- Documentation review
- Compliance reviews
- Risk management
Certification
- State Licensure: License as a Registered Nurse by the Indiana State Board of Nursing License Number – 28132968
- Certification in Healthcare Compliance (CHC)
- Resident Assessments Coordinator Certification (RAC-CT)
Timeline
Director of Compliance and Audit
American Senior Communities, LLC
01.2022 - 01.2025
Vice President of Clinical Reimbursement
Signature Healthcare LLC
01.2018 - 01.2022
Divisional Director of Case Management
Kindred Healthcare – Support Center
01.2015 - 01.2018
District Director of Case Management
Kindred Healthcare-Indy Market
01.2011 - 01.2015
Case Manager – Wildwood Healthcare
Kindred Healthcare-Indy Market
01.2003 - 01.2011
Director of Nursing Services - Continental
Beverly Healthcare
09.2001 - 06.2003
MDS Coordinator
Beverly Nursing and Rehab
06.1996 - 07.2001
Associates in Sciences - Nursing
University of Indianapolis
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