Lauralee Archibeque
Summary
Certified Coding Associate (CCA) Exam & Registered Health Information Technician (RHIT) Exam Eligible November 2024
- Adhere to confidentiality, state, federal, and HIPAA laws and guidelines
- Experienced Billing Insurance Specialist and RAC Coordinator successful at managing high case/audit loads in fast-paced environments.
- Organized, driven and adaptable with excellent planning and problem-solving abilities.
- Offering 5 years of experience and willingness to take on any challenge.
Overview
6
6
years of professional experience
Work History
RAC Coordinator
Cheyenne Regional Medical Center
11.2019 - Current
- Reviews and coordinates all levels of response/appeals for all government RAC and audit activity, including coding, medical necessity, billing and non-government coding denials with Health Information Management (HIM) Coding, Clinical Documentation Improvement (CDI), Nurse Auditor, Physician/ Physician Advisor, Utilization Management (UM) Committee, and affected departments.
- Responsible for tracking the status of all RAC, Coding, and Medical Necessity denials and appeals in the database, serving as system administrator for the RAC and audit tracking system database.
- Responsible for formulating reportable data into trends that can be utilized to develop process improvements. Create and generates reports to ensure appeal deadlines are met. Presents data trend reports to the Utilization Management (UM) Committee.
- Monitors CMS,RAC, and Non-government insurance websites, emails, and correspondence for updates or changes to the RAC and other government and non-government audit programs. Communicates the updates and information across the hospital and outpatient services to ensure that responsible departments have up to date details.
- Provides data and feedback to HIM, CDI, Coding, Billing, and Physician Advisor leadership regarding identified documentation improvement opportunities related to coding and medical necessity documentation requirements.
Insurance Billing Specialist
Cheyenne Regional Medical Center
03.2018 - 11.2019
- Verified patient insurance coverage and benefits for medical claims.
- Responded to correspondence from insurance companies.
- Researched and resolved complex medical claims issues to support timely processing.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Identified and resolved discrepancies between patient information and claims data.
Education
Associate of Science - Health Information Technology
DeVry University
Chicago, IL11.2024
Master's Business Administration - Healthcare Management
Colorado Technical University
Colorado Springs, CO05.2020
Bachelor of Business And Administration - Human Resources
University of New Mexico
Albuquerque, NM12.2015
Memberships
- American Health Information Management Association (AHIMA) November 2019 - Present
Timeline
RAC Coordinator
Cheyenne Regional Medical Center
11.2019 - Current
Insurance Billing Specialist
Cheyenne Regional Medical Center
03.2018 - 11.2019
Associate of Science - Health Information Technology
DeVry University
Master's Business Administration - Healthcare Management
Colorado Technical University
Bachelor of Business And Administration - Human Resources
University of New Mexico
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