Carlyn Sanders
Buckeye
Summary
Seasoned Claims Examiner with a proven track record at Mphasis in enhancing operational efficiency by 15% and resolving over $50,000 in payment discrepancies. Demonstrates expertise in claims processing and exceptional attention to detail, alongside empathy and compassion, ensuring compliance and high satisfaction levels among healthcare providers and patients.
Overview
20
20
years of professional experience
2009
2009
years of post-secondary education
Work History
Claims Examiner/Adjudication
Mphasis
Phoenix
03.2021 - 02.2025
- Processed over 150 claims daily, maintaining 98% accuracy and ensuring compliance with healthcare regulations and company policies.
- Resolved complex claims issues, reducing escalations by 25%.
- Improved workflow efficiency by streamlining claims reprocessing, cutting errors and resolution time by 20%.
- Identified and reported over $50,000 in payment discrepancies, leading to corrective actions.
- Contributed to a 15% increase in team productivity by delivering process improvement recommendations.
Authorization Specialist/Provider Relations
American Vision Partners
Tempe
03.2020 - 03.2021
- Processed and maintained over 100 authorization requests per week, reducing approval time by 15%.
- Streamlined provider communication, increasing satisfaction by 20%.
- Managed authorization workflows and reduced delays, improving efficiency by 10%.
- Developed and delivered training on updated protocols, boosting team compliance rates.
Patient Registration Supervisor
Optum/UnitedHealth Group
Phoenix
06.2015 - 03.2020
- Supervised a team of 10 in patient registrations, reducing wait times by 30%.
- Coordinated patient care across departments, improving communication by 25%.
- Implemented HIPAA-compliant procedures, achieving 100% audit pass rates.
- Improved billing and scheduling protocols, reducing errors by 15%.
- Mentored new staff, increasing team efficiency by 20%.
Team Lead
Bank of America
Phoenix
02.2013 - 06.2015
- Led a team of 10, boosting productivity by 25% through workflow refinements.
- Drove customer service improvements, increasing satisfaction scores by 30%.
- Resolved complex issues, decreasing escalations by 40%.
- Developed new service protocols to improve collaboration and delivery.
Behavioral Health Tech
Aurora Behavioral Health Center
West Covina
04.2005 - 02.2013
- Provided individualized care for over 50 patients, improving recovery outcomes by 15%.
- Supported clients in setting recovery goals, increasing program retention rates.
- Collaborated on treatment plans, improving progress tracking by 20%.
- Maintained compassionate care in sensitive conditions, ensuring positive environments.
Education
Ashworth College
Norcross, GASkills
- Administrative Support Specialist
- Medical Terminology
- Claims Processing
- Attention to Detail
- Empathy and Compassion
- Insurance Verification
- Effective Communication
- Remote Work
- Data Entry
- Microsoft Office (Word, Excel, PowerPoint, Outlook)
- EMR/Claims Systems (Athenahealth)
- Credentialing processes
- HIPAA regulations
- Authorization workflow
- Patient care coordination
- Data accuracy
Timeline
Claims Examiner/Adjudication
Mphasis
03.2021 - 02.2025
Authorization Specialist/Provider Relations
American Vision Partners
03.2020 - 03.2021
Patient Registration Supervisor
Optum/UnitedHealth Group
06.2015 - 03.2020
Team Lead
Bank of America
02.2013 - 06.2015
Behavioral Health Tech
Aurora Behavioral Health Center
04.2005 - 02.2013
Ashworth College