Laura Sanders
McKinney,TX
Summary
Detail-oriented healthcare professional with a solid track record in insurance claims processing, denial management, and patient billing. Maintained a clean claim rate above 95% and achieved a 90% prior authorization approval rate on first submission, contributing to efficient revenue cycle operations in fast-paced healthcare settings.
Overview
21
21
years of professional experience
Work History
Reimbursement Specialist
Pharmcare USA
Addison, TX
07.2018 - 12.2025
- Processed 80–150 claims daily with high accuracy; maintained a 95%+ clean claim rate throughout tenure.
- Followed up on denied claims within 24 hours, submitting appeals to secure reimbursement.
- Reviewed drug quantities, pricing, and fee schedules to support accurate reimbursement.
- Explained insurance benefits and coverage details to patients and families.
- Managed patient accounts, ensuring accurate billing and timely follow-ups.
- Provided guidance on financial assistance programs for eligible patients.
- Resolved billing inquiries through effective communication with patients and insurers.
- Educated patients on payment plans and available resources for support.
- Performed collections and follow-up on all assigned claims every 30 days minimum.
Billing Client Representative
Quest Diagnostics
Addison, TX
12.2015 - 06.2018
- Resolved invoice discrepancies and posted client payments to enhance financial accuracy.
- Reviewed and processed client invoices to ensure compliance with contract terms and billing guidelines.
- Maintained customer account records while communicating with clients, patients, and insurance companies.
- Managed client inquiries and provided timely responses to service requests.
- Coordinated with internal teams to efficiently resolve client issues.
- Utilized electronic health systems to maintain accurate client records.
Billing Patient Representative
Quest Diagnostics
Addison, TX
01.2014 - 12.2015
- Assisted over 50 patients daily with billing inquiries and payment processing.
- Clarified insurance coverage, copays, deductibles, and payment options to improve understanding.
- Processed payments and negotiated arrangements for timely payment postings.
- Submitted appeals with documentation to insurance carriers to advocate for reimbursements.
- Provided information regarding lab services and procedures to patients.
- Handled patient inquiries and resolved issues in an efficient manner.
- Verified patient insurance details and addressed billing questions promptly.
Call Center Supervisor / Operator
Medical Answering Service of Oregon
Oregon
02.2005 - 01.2014
- Supervised daily call center operations to resolve escalated patient and physician calls.
- Scheduled and managed staffing for team of 18, optimizing coverage based on call volume trends.
- Implemented call monitoring and quality assurance program, improving processing time and accuracy.
- Conducted coaching sessions and cross-training initiatives, completing annual reviews for all staff.
- Created training manuals to enhance employee onboarding and service delivery.
- Trained and mentored agents on customer service best practices to elevate performance.
- Monitored call quality, providing constructive feedback to improve team effectiveness.
- Resolved escalated customer issues with professionalism, preserving satisfaction and business relationships.
Education
Legal Assitant Certificate -
College America
Portland, ORHigh School Diploma -
Kalama High School
Kalama, WASkills
- Claims processing and denial management
- Prior authorizations and billing collections
- Accounts receivable resolution
- Payment posting and insurance validation
- Medicare and Medicaid billing
- Eligibility verification and claim audits
- Appeals submission and electronic claims
- Revenue cycle management
- Medical billing expertise
- Healthcare industry knowledge
- Commercial insurance and managed care
- Patient communication and client interaction
- Patient advocacy and critical thinking
- Analytical skills and time management
- Microsoft Excel and Outlook proficiency
- EMR/EHR systems experience
- Availity, Athena IDX, NextGen, Epic, Omega, Waystar, CoverMyMeds familiarity
- HIPAA regulations and compliance expertise
Software And Systems
- Availity
- Athena IDX
- NextGen
- Allscripts
- Omega
- Genysys
- Waystar
- CoverMyMeds
- Microsoft Excel
- Microsoft Outlook
- EMR/EHR Systems
Timeline
Reimbursement Specialist
Pharmcare USA
07.2018 - 12.2025
Billing Client Representative
Quest Diagnostics
12.2015 - 06.2018
Billing Patient Representative
Quest Diagnostics
01.2014 - 12.2015
Call Center Supervisor / Operator
Medical Answering Service of Oregon
02.2005 - 01.2014
Legal Assitant Certificate -
College America
High School Diploma -
Kalama High School