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Sandy MacPherson

@sandymacpherson

I resolve complex medical claims, improve reimbursement, and lead revenue cycle teams.

United States
Message

What I'm looking for

I'm looking to use my claims resolution, coding, billing, and team leadership experience in a rewarding, challenging environment where I can help people, solve problems, learn, and pursue additional certifications.

At TELCOR, I analyze complex claims, denials, payer policies, coding requirements, and revenue cycle trends to improve reimbursement and customer outcomes. I lead claims resolution work, serve as an escalation resource, and support process improvements that reduce preventable denials.

I've also handled medical coding, billing, payment posting, claims submission, appeals, accounts receivable follow-up, and remittance processing for physical therapy, counseling, urgent care, and pain management practices. As a Certified Professional Coder, I use CPT, diagnosis codes, modifiers, NCD/LCD guidance, and payer requirements to submit clean claims and resolve denials.

Experience

Work history, roles, and key accomplishments

TE

Claims Resolution Specialist

TELCOR

Apr 2021 - Jan 2023 (1 year 9 months)

Worked through claims rejections and denials for Pathology, Genetic and Molecular testing. Collaborated with clearinghouses and insurance companies to resolve claim issues and updated coding on denied claims for payment.

Education

Degrees, certifications, and relevant coursework

AAPC logoAA

AAPC

Certification, Medical Coding

Certified Professional Coder through AAPC.

CC

Certified Medical Coder

Certification, Medical Coding

Certified Medical Coder including ICD-10.

LL

Life, Health, Property and Casualty Insurance License

License, Insurance

Licensed in Life, Health, Property and Casualty Insurance.

Tech stack

Software and tools used professionally

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