LAURA TAMAYO
Dr. Mikael Hakansson
Santa Paula,CA
18
years of professional experience
1
Certification
2
Languages
Detail-oriented healthcare professional with more than 10 years of experience in medical billing, coding, reimbursement, claims management, and healthcare operations. Experienced in analyzing claims, identifying billing and coding discrepancies, researching reimbursement issues, and implementing solutions to improve revenue capture and payment accuracy. Strong working knowledge of ICD-10, CPT, HCPCS, CMS-1500 claims, insurance guidelines, and revenue cycle processes, with experience using Cerner and other healthcare systems. Skilled in reviewing documentation and billing information, resolving denials and payment discrepancies, supporting compliant billing practices, and identifying opportunities to improve revenue and workflow efficiency. Recognized for accuracy, analytical problem-solving, attention to detail, and the ability to collaborate effectively with providers, clinical staff, and administrative teams.
Work History
Risk Adjustment Coder
4 Years 8 Months- Verified accuracy of submitted diagnosis codes to ensure compliance and optimal reimbursement.
- Assigned accurate diagnosis codes based on the analysis of patient data.
- Reviewed medical records to identify diagnoses and procedures that require coding and documentation according to established regulations.
- Reviewed records for completeness, accuracy and compliance with regulations.
- Collaborated with healthcare providers to obtain additional information required for accurate code assignment.
- Resolved and clarified codes and diagnoses with conflicting, missing and unclear information by consulting with doctors and others and by participating in coding team's regular meetings.
- Identified, compiled, abstract and code patient data, using standard classification systems.
- Reviewed records for completeness and compliance with regulations to support accurate coding practices.
- Resolved and clarified conflicting and unclear codes by consulting with healthcare providers and participating in coding team meetings to enhance coding accuracy.
Office Medical Biller
3 Years 5 Months- Reconciled claims payments against invoices for accuracy prior to posting payments.
- Conducted audits of patient files to ensure accuracy of information entered into system.
- Followed up on unpaid claims by directly contacting insurance companies and patients to expedite resolution.
- Maintained a comprehensive understanding of HIPAA regulations as they relate to medical billing practices.
- Demonstrated excellent customer service skills when communicating with insurance companies, patients and other healthcare providers.
- Submitted clean claims electronically through clearinghouses or directly to payers.
- Resolved patient billing issues through effective communication with insurance carriers, ensuring timely processing.
- Posted payments to an electronic medical records system upon receipt of payment for claims.
- Made invoice adjustments to clear up outstanding invoices.
- Prepared itemized statements, bills, and invoices, and recorded amounts due for items purchased and services rendered.
Medical Office Manager’s Assistant
12 Years 7 Months- Ensured that all patient inquiries were answered promptly and professionally.
- Utilized excellent communication and interpersonal skills when interacting with patients and staff.
- Ordered additional supplies to maintain adequate stock levels.
- Assisted in managing patient records, ensuring accuracy and completeness of information.
- Oversaw the maintenance of patient records in accordance with HIPAA regulations and office procedures.
- Managed patient records, verifying accuracy and completeness to support quality patient care.
- Ordered additional supplies as needed to maintain adequate stock levels at all times.
- Developed organizational skills to efficiently manage multiple tasks simultaneously.
- Trained and supervised new staff, providing orientation and training for new practices and procedures.
- Monitored physician schedules for best practices and coordinated physician availability with clinic needs.
- Coordinated staff meetings to inform all staff members of policy changes and relevant healthcare topics.
- Created and implemented policies and procedures to ensure compliance with healthcare regulations.
- Collaborated closely with doctors, nurses and other staff members to ensure smooth operations within the practice.
- Executed clerical tasks including filing and data entry., such as ordering, and maintaining inventory of supplies.
- Prepared documents such as invoices, receipts, and payment plans for distribution to appropriate parties.
- Assisted with onboarding process for new medical staff members by coordinating orientation activities.
Manager of Medical Records and Authorizations
3 Years 5 MonthsEducation
CRC Certificate - Risk Adjustment Coding
CPC Certificate - Medical Coding
Skills
• Billing accuracy
• CPT & HCPCS
• Charge Capture & Billing Accuracy
• Claims processing
• Billing & Claims Systems
• Denial resolution
• Payment reconciliation
• Insurance verification
• Payment Posting & Reconciliation
• Insurance Verification & Follow-Up
• Coding & Billing Compliance
• Documentation audit
• Billing compliance
• Data analysis
• Staff education
• Coding Dispute Resolution
• Medical Terminology
Accomplishments
- Achieved 4-Star quality status for my provider through accurate risk-adjustment coding, documentation review, and identification and closure of quality gaps, supporting improved compliance, reimbursement, and overall practice performance.
Certification
Certfied Professional Coder, Certified Risk Adjustment Coder
LANGUAGES
Spanish
Conversational
Timeline
Office Medical Biller
Dr. Mikael Hakansson
05.2023 - CurrentRead More
Risk Adjustment Coder
Seaview IPA
02.2022 - CurrentRead More
Manager of Medical Records and Authorizations
Las Posas Family Medical Group - VC Healthcare Agency
01.2018 - 06.2021Read More
Medical Office Manager’s Assistant
Las Posas Family Medical Group - VC Healthcare Agency
11.2008 - 06.2021Read More
Allied Online School
CPC Certificate from Medical Coding
Read More
AAPC
CRC Certificate from Risk Adjustment Coding
Read More