Michelle Poole Email & Phone Number

Raleigh-Durham, North Carolina Area

Perform targeted audit review of new revenue-generating diagnosis codes before submission to CMSComplete HCC risk adjusment coding/auditing per CMS and client specific guidelinesReview medical charts for proper diagnosis coding from various chart types (physician, hospital outpatient, hospital inpatient) Utilize ICD-9-CM Guidelines for Coding and Reporting to insure that the highest level of diagnosis code(s) is applied for each date of service reviewed Document Hierarchical Conditions Category (HCC) mapped codes in company data storage program

Raleigh, Nc

Reviewed, veriied, edited, and submitted claim data to third party payors, insurance carriers, federal and state governmental agencies in a timely, accurate, and compliant mannerResearched all account information on paid or partially paid claims and analyze the status of the payment related to the expected payment calculation and itemization provided by the remittance adviceAnalyzed denied, disallowed, or non-covered claims and determines if non-payment is based on medical or technical reasonsResolve any technical issues, when warranted, within electronic accounting systemPrepared requests for account balance adjustments in accordance with departmental specific proceduresReviewed Electronic Data Interchange (EDI) submissions for clearinghouse errors; correct errors according to departmental proceduresWorking knowledge of electronic patient accounting systems (GE Centricity)

Raleigh, Nc

Provided consultation to administrators and other school staff regarding ways to implement new initiatives and improve student achievementReviewed student records for compliance with state and federal regulationsPsychoeducational evaluations of students in grades K-12Member of the school psychology leadership teamChairperson of the Intervention Support TeamStaff development

Monroe, Nc

Supervised staff of 23 School Psychologists and mentored newly hired staffReviewed and interpreted federal and state guidelines as applicable to School PsychologistsAssisted in the development local procedures and guidelinesConducted over 20 county-wide staff development training on compliance with state/local procedures and district-wide initiativesCollaborated weekly with Director of Special Education, Program Specialists, Preschool Coordinator, Lead Speech Language Pathologist, and other related service personnel

Master'S Degree, School Psychology

Medical Coding Certification Program

Bachelor Of Arts (Ba), Psychology