Sandy MacPherson
@sandymacpherson
I resolve complex medical claims, improve reimbursement, and lead revenue cycle teams.
What I'm looking for
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
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
Certification, Medical Coding
Certified Professional Coder through AAPC.
Certified Medical Coder
Certification, Medical Coding
Certified Medical Coder including ICD-10.
Life, Health, Property and Casualty Insurance License
License, Insurance
Licensed in Life, Health, Property and Casualty Insurance.
Tech stack
Software and tools used professionally
Availability
Location
Authorized to work in
Job categories
Skills
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