Michelle Degerstrom
Coon Rapids,MN
Summary
Dynamic Reimbursement Specialist with extensive experience at RespiriTech, adept in denial management and appeals handling. Proven track record of improving claim accuracy and reducing denials through collaboration and training. Skilled in ICD-10 coding and committed to HIPAA compliance, fostering teamwork to enhance service delivery and operational efficiency.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Reimbursement Specialist
RespirTech
02.2022 - 11.2025
- Worked on insurance denials on claims for Blue Cross Blue Shield across the whole country.
- Processed reimbursement claims efficiently, ensuring compliance with company policies and industry regulations.
- Collaborated with cross-functional teams to resolve complex billing issues, improving overall service delivery.
- Identified trends in reimbursement denials, recommending process improvements to minimize future occurrences.
- Analyzed claim discrepancies, identifying root causes and implementing corrective actions to enhance accuracy.
- Coordinated with healthcare providers to obtain necessary documentation for timely claim resolution.
- Trained new team members on reimbursement procedures, fostering a collaborative knowledge-sharing environment.
- Submitted appeals for claim denials.
- Making corrections on a claim and resubmitting them as a corrected claim.
- Processing refunds for overpayments or claims that were paid in error.
Medical Coding Specialist
University of Minnesota Physicians
11.2014 - 08.2021
- Analyzed medical documentation to ensure accurate coding and compliance with federal regulations.
- Collaborated with healthcare providers to clarify diagnosis and treatment codes for optimal reimbursement.
- Reviewed and updated coding guidelines based on changes in regulations and industry standards.
- Led initiatives to streamline coding processes, resulting in improved workflow efficiency and turnaround time.
- Utilized advanced coding software, including Epic and 3M, to enhance data entry precision and reporting capabilities.
- Maintained up-to-date knowledge of ICD-10-CM, CPT, and HCPCS Level II codes through continuous education efforts.
- Collaborated with healthcare providers to clarify ambiguous or incomplete documentation, resulting in more precise medical codes.
Coding and Reimbursement Specialist
Fairview Health Services
04.2009 - 11.2014
- Profee coding for the dept of psychiatry, the hospitalist, the intensivists, and outpatient services and UMMC hospital.
- Led initiatives to reduce claim denials through targeted education on coding best practices.
- Improved coding accuracy through comprehensive review of medical documentation and application of industry guidelines.
- Analyzed trends in denied claims to identify patterns and develop targeted strategies for improvement moving forward.
- Collaborated with healthcare providers to clarify diagnoses, treatment plans, and other patient information necessary for proper coding and billing practices.
- Analyzed coding discrepancies to ensure compliance with payer guidelines and regulations.
- Conducted training sessions on coding standards and reimbursement procedures for staff development.
- Collaborated with healthcare providers to optimize documentation for accurate reimbursement submissions.
- Reviewed and interpreted insurance policies to facilitate effective claim processing and resolution.
Education
Associate of Arts - Medical Billing And Coding
Colorado Technical University
Colorado Springs, CO05-2011
High School Diploma -
Woodbury Sr. High School
Woodbury06-1995
Skills
- Appeals handling
- HCPCS coding
- HIPAA compliance
- ICD-10 coding
- Claims processing
- Insurance verification
- Denial management
- Medical billing
- Medicaid
- Medicare
- Commercial insurance
- Teamwork and collaboration
Certification
- Certified Procedural Coder, AAPC - 2012
- ICD 10 Coding Certificate, AAPC - 2016
Timeline
Reimbursement Specialist
RespirTech
02.2022 - 11.2025
Medical Coding Specialist
University of Minnesota Physicians
11.2014 - 08.2021
Coding and Reimbursement Specialist
Fairview Health Services
04.2009 - 11.2014
Associate of Arts - Medical Billing And Coding
Colorado Technical University
High School Diploma -
Woodbury Sr. High School