LaQusha Zamora

Experienced Medical Billing and Insurance Specialist with 8+ years of expertise in claims processing, appeals, arbitration, and revenue cycle management. Skilled in analyzing complex insurance disputes, ensuring regulatory compliance, and improving payment outcomes. Proven ability to manage high-volume workloads, train staff, and collaborate with providers and payers across commercial and government healthcare programs.

Health Insurance Specialist (Arbitrator) at Provider Resources (2023-06 – 2026-03)

• Reviewed and adjudicated payment disputes under the No Surprises Act (NSA)
• Analyzed documentation and applied federal regulations for payment determinations
• Maintained accurate documentation within government systems
• Performed quality assurance reviews for compliance and accuracy
• Managed high-volume caseloads with strict deadlines

Medical Billing & Collections Team Leader at Accordias Healthcare (2017-10 – 2023-06)

• Led billing and collections operations ensuring timely claim processing
• Managed appeals, denials, and resubmissions to maximize reimbursement
• Verified insurance coverage and maintained billing records
• Tracked claims from submission through resolution
• Trained and mentored new hires
• Worked with Tricare, TriWest, BCBS, Medicaid, VA, and commercial plans

Medical Office Clerk / Billing Clerk at All Pro (2016-01 – 2017-12)

• Performed coding, charge entry, claims submission, and payment posting
• Reviewed patient records for coding accuracy
• Processed payroll data and maintained confidential records
• Followed up on outstanding accounts to reduce unpaid balances
• Conducted audits to ensure compliance with regulations

Associate of Science – Draughons Junior College