Summary
Overview
Work History
Education
Skills
Languages
Work Authorization
Timeline
Generic

Orlynn Traub

Plano

Summary

Results-driven Medical Billing Specialist with extensive experience at Direct Orthopedic Care, adept at claims processing and financial auditing. Proven track record in resolving credit issues and enhancing reimbursement accuracy. Strong organizational skills and proficiency in CPT and ICD coding ensure compliance and efficiency in billing operations. Committed to delivering exceptional customer service.

Overview

33
33
years of professional experience

Work History

Medical Billing Specialist- Physical Therapy

Direct Orthopedic Care
Addison
07.2020 - Current
  • Review CPT, ICD-10 and modifier coding for accuracy
  • Submit EDI claims and work clearinghouse rejection reports
  • Document transactions to maintain adequate audit trail
  • Review and resolve accounts with credit balances. Request refunds and/or adjustments as necessary.
  • Communicate with providers and other team members of the patients authorization, having awareness of delays and provide continual communication with all.
  • Maintain compliance with payer-specific reimbursement guidelines.
  • Responsible for tracking, obtaining, and extending authorizations from various carriers in a timely manner.
  • Follow up and have confirmation of all authorizations obtained and work to help find solutions when denials are received.
  • Verify benefits information for patients and obtain precertification/authorizations when necessary.

Medical Billing Specialist-Physical Therapy

Texas Orthopaedic Associates
Dallas
04.2018 - 07.2020
  • Responsible for filing all Physical Therapy claims for 14 therapists.
  • Billing and coding- reviewed all claims daily and assigned appropriate code based on medical documentation from therapist from each session, added to claims and submitted all claims to clearinghouse for claim submission.
  • Reviewed all scrubbed claims that rejected, corrected any errors and resubmitted.
  • Perform collection duties, rebilling research, correspondence, returned mail and problem solving account billing errors.
  • Verify billing information for electronic claims transmission and hard copy billing. Follow-up on ac billed both electronically and manually.
  • Review remittance advice forms to verify proper reimbursement and make adjustments as necessary.
  • Verify coding with claims processors regarding disputes/denied claims and follow-up on all bills no processed within usual claim period.
  • Receive incoming calls from patients and insurance companies regarding balances and/or billing

Account Manager

USPH Clinics
Flower Mound
08.2017 - 04.2018
  • Manage 2 clinics:
  • Posting all payments, appeals, submitting claims, work all patient refunds and collections, month end closing which includes aging reports, accounts payable/receivable, adjustment reports.

Office Manager

Edge PT 5305 W University
McKinney
01.2017 - 08.2017
  • Run weekly reports for Clinic Director related to FO stats: % Arrival, Visits, Next week's schedule as of Thursday AM
  • Communicate with marketer regarding physician referral patterns and whenever a new physician refers a patient that is a good lead.
  • Phone calls and correspondence with physician offices, particularly when there is an issue (prescription needed, inappropriate patient, EDGE mistake, etc).
  • Print out MIA list for each therapist
  • Identify supply needs
  • Report to Clinic Director (within chain of command)
  • Hold each member of front office team accountable for providing a great customer experience.
  • Foster a positive environment for employees to work in.
  • Maintain regular communication with Clinic Director regarding Front Office/Clinic operations.
  • Maintain a strong relationship between the FO staff and the physical therapists.
  • Maintain strong relationships with the front office of current referring physician practices and develop relationships with potential A-list Doctor offices.

Hospital Associate/Medical Biller

Mednax-Presbyterian Hospital
Plano
05.2016 - 10.2016
  • Under the direct supervision of the Regional Hospital Associate Manager, I am responsible for providing account registration, billing and administrative support to the 27 physician(s) and 22NNP's in the N and the Corporate Office.
  • My duties include; gathering and verifying current demographic information including insurance information, contacting insurance companies (as necessary), processing weekly billing, completing submitting daily and monthly statistics and assisting my Medical Director and physicians with administrative duties.
  • Prepare billing and registration worksheets, gather and verify current demographic information by speaking with the parents or hospital, obtain correct Insurance/Medicaid information from parents contact insurance companies to verify insurance data on accounts.
  • Utilize Payer Search programs to obtain correct insurance code information, refer to contract per Master Data Base to confirm contractual agreements with managed care companies, complete the registration and billing of all accounts in the OBR system, release all billing and registrations according to established department guidelines.
  • Submit billing worksheets to the corporate office in a timely manner in accordance with the ship schedule and prepare and submit daily and monthly statistics.
  • Submit daily census by 1:00 p.m. E.S.T. via e-mail or fax and I compare census to the database r every Thursday and submit all corrections via fax, phone or e-mail.
  • Reconcile the month-end statistical reports and submit them to the Corporate Office as establish the department guidelines.
  • Assist Medical Director and physicians with administrative support, answer office phones and take messages.
  • Maintain office calendar and set up meetings and appointments and organize the physician's daily agenda.
  • Assist in travel arrangements along with sorting and distributing incoming mail.
  • Maintain and order office supplies.
  • Type weekly fax notes on all babies and fax to referring doctors. Fax all admits and Discharge paperwork to referring and Follow up Doctors on daily basis.
  • E-mail or fax monthly physician schedules, changes and updates to all Dr.'s and NNP's.
  • Prepare and submit all payments and disbursements along with check requests or expense reports Accounts Payable Department.
  • Inform the Regional Corporate Office of any changes in the hospital or unit policies and procedure.
  • Obtain and submit timely the necessary documentation to support stipend reimbursement identi the hospital contract with the physicians.
  • Supply authorization numbers as requested by the insurance companies.
  • Obtain and update baby names on all registered accounts within a timely manner and update acc in regard to changes in insurance or demographic information.
  • Contact with collectors on account issues such as account histories and medical record requests.
  • Utilize the correct verification forms for requesting insurance and referring physician codes.
  • Complete RDS Data Repairs in the Master Data on a daily basis.
  • Review and reply to corporate e-mails within a timely manner.
  • Cooperatively work with the Hospital and Corporate offices with repairs, upgrades, installations, a troubleshooting with computer related issues within the unit.
  • Maintain strict confidentiality in accordance with HIPAA and PHI regulations and Company policy.

Inside Sales Rep

Watchguard Video
Allen
09.2015 - 05.2016
  • Responsible for developing, and managing customer accounts.
  • Responsible for managing sales activities which include, but not limited to: calling customers, set appointments, identifying opportunities, and communicating competitive information.
  • Field Sales Support - I work closely with outside sales person within the territory and execute a st to maximize both revenue growth and profitability along with building long-term customer loyalty.
  • Outbound calling- Maintain a call volume necessary to schedule pre-determined number of highly qualified product demonstrations.
  • Lead Management/Generation- I provide leadership in managing same day follow-up on leads fro lead sources.
  • Relation/Account Management- Develop new relationships and maintain existing relationships wit potential and current WatchGuard Video clients.
  • Database Management- Accurately manage the appending and usage of data from lead database Continually update WatchGuard's CRM with all of my customer contact, agency profile and sales a information. Track all referrals.

Medical Billing Specialist

Teach Me/Therapy and Beyond
Carrollton
04.2013 - 08.2015
  • Responsible for all billing, coding, benefit verification, insurance authorizations and credentialing f locations.
  • Billing and coding- reviewed all claims daily and assigned appropriate code based on medical documentation from therapist from each session, added to claims and submitted all claims to clearinghouse house for claim submission.
  • Reviewed all scrubbed claims that rejected, corrected any errors and resubmitted.
  • Benefit verification- called numerous insurance companies to confirm active coverage and all benefits available for each child for their mental health and medical coverage. Submitted info to the intake personnel.
  • Insurance Auth- . Prepare and maintain all authorizations and ensure they are reissued/renewed in timely manner.
  • Maintain authorizations in the system database. Notify support personnel of any issues.
  • Document authorizations and follow up information in patient's records as appropriate.
  • Work with staff to ensure appropriate CPT and ICD-9/10 codes are submitted on authorizations.
  • Communicate with directors any changes or updates to insurance affecting authorization requirements.
  • Work closely with staff on claim issues pertaining to insurance authorizations.
  • Communicate with providers to obtain additional clinical/medical information when necessary.
  • Contact insurance companies for pre-certification, authorization verification, and member eligibility.
  • Work with third party credentialing for CAQH setup/enrollment.
  • Develop and maintain positive relationships with customer service representatives from insurance companies.
  • Keep up-to-date on insurance policies regarding coverage and prior authorizations.
  • Maintain strict confidentiality - adhering to all HIPAA guidelines/regulations.
  • Provide regular monitoring and reporting of insurance changes to the Billing Department.
  • Train new staff on issues related to authorizations and timesheet usage.
  • Participate in audit work.
  • Process regulatory documents in accordance to agency procedures and timeframes.
  • Meet deadlines and manage multiple priorities in a fast-paced team environment.

Medical Billing Specialist

OrthoTexas
Carrollton
05.2008 - 04.2013
  • Submit all billing for 28 therapists and I also did billing for MRI's for all OrthoTexas locations.
  • Submit all billing and do follow ups with all insurance carriers - commercial, Medicare, and Workers Comp.
  • Process and follow-up on collections. Review aging and follow-up on outstanding claims.
  • Contact insurance companies, patients, government agencies and other third party payers on ag past due balances.
  • Review and follow-up on Explanation of Benefit denials.
  • Submit re-bills, tracers and appeals; submit adjustments using appropriate reason code classification Identify bad debt accounts for adjustment and identify credits and refunds.
  • Perform collection duties, rebilling research, correspondence, returned mail and problem solving account billing errors.
  • Verify billing information for electronic claims transmission and hard copy billing. Follow-up on ac billed both electronically and manually.
  • Review remittance advice forms to verify proper reimbursement and make adjustments as necessary.
  • Verify coding with claims processors regarding disputes/denied claims and follow-up on all bills no processed within usual claim period.
  • Receive incoming calls from patients and insurance companies regarding balances and/or billing.

Office Manager

Focus Physical Therapy
Frisco
10.2006 - 05.2008
  • Prepare accurate monthly statements.
  • Process And maintain patient accounts.
  • Greet patients, verify insurance, and perform patient check in and check out duties.
  • Phone insurance companies for patient benefits, claim status, or status on outstanding claims.
  • Process and follow up on appeals to insurance companies.
  • Resubmit insurance claims as needed.
  • Answer incoming patient, insurance company and physician office telephone calls.
  • Research/Audit patient accounts for further payment or adjustments.
  • Print and send collection letter.
  • Phone patients for payments or set up payment arrangements on outstanding balances.
  • Monitor and report all past due accounts to collection agency.
  • Maintain all office supplies and inventory.
  • Post and process all incoming and returned mail.
  • Open and close office daily.
  • Assist with manual therapy on outpatient status.
  • Assist on occasion in Hospital with in patient therapy exercises and walking.
  • Pull all charts for daily appointments and print schedules for next day.

Front Office Manager

Dallas Vision Center
Dallas
01.1997 - 10.2006
  • Daily reconciliation of accounts payable and receivable.
  • Daily maintenance of financial records.
  • Prepare accurate monthly financial statements.
  • Process and maintain patient accounts.
  • Compile and calculate financial statements and cumulative year to date totals.
  • Greet patients, verify insurance, and perform patient check in and check out duties.
  • Phone insurance companies for patient benefits, claim status, or status on outstanding claims.
  • Process and follow up on appeals to insurance companies.
  • Resubmit insurance claims as needed.
  • Answer incoming patient, insurance company and physician office telephone calls.
  • Research/Audit patient accounts for further payment or adjustments.
  • Print and send collection letters.
  • Phone patients for payments or set up payment arrangements on outstanding balances.
  • Monitor and report past due accounts to collection agency.
  • File all accounts with insurance companies via on-line claim submission and on HCFA.
  • Maintain all office supplies and inventory.
  • Send out weekly welcome to the office and thank you/referral letters.
  • Responsible for all patient recalls.
  • Post and process incoming and returned mail.

Customer Service Rep

Benedict Optical
Lewisville
01.1992 - 01.1997
  • Processed delayed orders for immediate shipment.
  • Received incoming calls from doctors with complaints on quality of orders received.
  • Received shipments from accounts that were returned due to defects, restarted the orders and monitored every stage of processing.
  • Performed final inspection before shipment and gave final approval.

Education

Diploma -

Newman Smith High School
Carrollton, Texas, United States
01.1986

Skills

  • Accounts payable and receivable
  • Claims processing
  • Financial auditing
  • Medicaid and Medicare expertise
  • Financial statement preparation
  • Billing and collections management
  • Credit issue resolution
  • Reconciliation processes
  • Office management
  • Customer account management
  • Sales support and activities
  • Outbound sales calling
  • CPT and ICD coding proficiency
  • Medical billing and invoicing
  • Administrative correspondence handling
  • Organizational skills development
  • Customer service excellence
  • Database management systems
  • Incoming call handling
  • HIPAA compliance knowledge
  • MS Office proficiency
  • Problem-solving strategies
  • Operations management oversight
  • Regulatory documentation handling
  • Therapeutic services coordination
  • Travel arrangement logistics
  • Mental health support services
  • Inventory management practices
  • Retail sales experience

Languages

English

Work Authorization

United States

Timeline

Medical Billing Specialist- Physical Therapy

Direct Orthopedic Care
07.2020 - Current

Medical Billing Specialist-Physical Therapy

Texas Orthopaedic Associates
04.2018 - 07.2020

Account Manager

USPH Clinics
08.2017 - 04.2018

Office Manager

Edge PT 5305 W University
01.2017 - 08.2017

Hospital Associate/Medical Biller

Mednax-Presbyterian Hospital
05.2016 - 10.2016

Inside Sales Rep

Watchguard Video
09.2015 - 05.2016

Medical Billing Specialist

Teach Me/Therapy and Beyond
04.2013 - 08.2015

Medical Billing Specialist

OrthoTexas
05.2008 - 04.2013

Office Manager

Focus Physical Therapy
10.2006 - 05.2008

Front Office Manager

Dallas Vision Center
01.1997 - 10.2006

Customer Service Rep

Benedict Optical
01.1992 - 01.1997

Diploma -

Newman Smith High School

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Orlynn Traub