Michelle Johnstone

-Developed and maintained processes to prevent inpatient only denials within our surgical department.

- Provided education to providers and staff on inpatient only changes and other information necessary to prevent inpatient only errors on orders.

-Developed and maintained processes to track audit activity across all payer groups. Identifying denial trends.

-Wrote coding appeals and followed denied accounts from start of the denial until resolution.

- Worked with departments on denial prevention and problem solving through 5 why and A3 quality improvement processes.

- Developed a process for tracking device credits and reporting them and refunding to Medicare when appropriate.

- Provided feed back to the CFO on Operational Write Offs, possible resolutions or ways to prevent future write offs.

- Provide support to our EPFS billing office when needing supporting documentation, authorizations or other information.

-Provide assistance to the Privacy and Compliance Officer in taking complaints from customers, investigating and reporting in our Risk Connect program.

-Assisted in doing Fair Warning audits on staff accessing of records. Provided feedback to department heads and logged concerns in Risk Connect.

-Provided additional support when needed with projects such as Death Certificates in which we were having complaints in the amount of time it was taking providers to complete and sign off on death certificates. We completed an A3 project which included surveying the local funeral homes to discover areas of biggest concern. Working with our providers and support staff on developing a way to monitor the IVES system. Helped in assuring that going forward this important task was included in on boarding for all new physicians and offer support to nursing homes needing extra assistance when not getting timely response.

• Verified, coded and added modifiers to diagnoses.
• Maintained updated knowledge of coding requirements, through continuing education and certification renewal.
• Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
• Guarded against fraud and abuse by verifying coded data accurately reflected services provided.
• Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
• Verified signatures and checked medical charts for accuracy and completion.

• Handled daily scheduling tasks and provided administrative support for entire department.
• Scheduled appointments and conducted follow-up calls to clients.
• Provided clerical support to company employees by copying, faxing, and filing documents.
• Created and updated records and files to maintain document compliance.
• Assisted the Chemical Dependency Director in organizing and maintaining files, preparing for intensive outpatient activities and reporting to the state all statistical data required.
• Addressed emergency mental health issues with patients needing immediate assistance either through assessment within the Freedom House or through the ER for admission to the locked unit.
• Assisted in drafting letters and information to insurance companies and/or county courthouses in regards to patient care and payment.

• Coordinated with medical and paramedical professionals to provide appropriate input and effectively formulate and implement treatment plans for patients.
• Counseled and mentored clients on substance use and life choices.
• Treated clients and families with respect and dignity.
• Took and monitored vital signs and managed/monitored patient behavior.
• Organized recreational activities to assist in patient recovery.
• Charted on each patient daily.