Michelle Walston

• Assisted in delivering direct care as LPN while supporting multiple provider offices. Helped with patient intake by rooming patients and documenting in EMR. Supported the process of obtaining prior authorizations for procedures and medications. Reviewed surgery billing codes for specialty office to promote accurate reimbursement. Processed billing for provider services after completion of procedures. Maintained organized schedules and staffing across various offices.
• Leveraged Microsoft programs to enhance productivity and streamline workflows.

Team lead Medication Intake Team involved utilization management processing high dollar injectable drug authorization requests from providers and hospitals. Processed commercial and Medicare claims for payment and accuracy. Specialized in claims rework, code edits, financial recovery and provider disputes. Provided assistance with other departments for escalated issues. Work was production based and maintained above goals set for accuracy. Worked remotely for 1 years. Able.to work independently and with a team. Excellent organization skills with great attention to detail.

Critical inquiry analyst position responded to and appropriately handled complaints received from the executive corporate office including government regulatory agencies.

Oversaw management of computerized medical records across multiple facilities, ensuring accuracy and currency.

• Administered patient care, including vital signs monitoring and medication management.
• Assisted in patient education on treatment plans and health maintenance.
• Coordinated with healthcare team to ensure comprehensive patient assessments.
• Streamlined office procedures to enhance patient flow and reduce wait times.
• Developed and maintained strong relationships with patients for continuity of care.