Hi, I’m
Taralynne Mulkey-Smith
Practice Managment, Marketing
Oceanside,CA
Summary
Accomplished healthcare professional with over 30 years of experience across medical offices, hospitals, rehabilitation, and detoxification facilities. Currently serving as a Remote Insurance and Claims Resolution Manager, offering comprehensive expertise in both physician and facility-based billing. Highly skilled in analyzing and interpreting medical documentation, coordinating claims processes, and resolving complex billing issues to ensure accurate reimbursement and optimal financial outcomes.
Brings a diverse background in marketing, promotions, and strategic billing mitigation, contributing to improved operational efficiency and revenue cycle performance. Additional experience in sports physical therapy and rehabilitation provides a well-rounded understanding of patient care and clinical workflows. Formerly self-employed in event planning and supply management, demonstrating strong business acumen, organizational leadership, and a commitment to client-focused service.
Overview
33
years of professional experience
Work History
Natera, Inc.Remote, CA
Claims Resolution Case Manager
04.2024 - Current
Job overview
- Oversaw daily operations for scheduling, billing, and claims teams, ensuring efficiency and accuracy across all functions.
- Collaborate with providers, managers, and staff to develop and implement billing and documentation policies that ensured regulatory compliance.
- Managed current and past-due accounts through consistent communication with commercial, private, and government insurance providers via phone and online portals.
- Maintained accurate financial records by processing adjustments, payments, and denials within the medical management system; advocated for patients by initiating corrections and appeals when necessary.
- Analyzed and resolved payer-specific denials, successfully securing reimbursement through targeted recoupment and appeals strategies.
- Developed and executed strategies to optimize digital marketing campaigns, improving outreach and engagement.
- Enhanced customer satisfaction by proactively addressing issues and resolving complaints in a timely and effective manner.
HPMG - MMD, Inc.San Diego, CA
AR/Claims Resolutions Specialist
02.2022 - Current
Job overview
- Review of current and past due accounts, daily communications [telephonically and portal based] with numerous commercial, private and government insurances
- Maintain accountability and accurate records by entering adjustments, payments and denials into medical management system while also advocating for patients with corrections and appeals
- Obtaining Authorizations (Pre, New and Retro), verifications of eligibility, patient input, chart creations, patient collections.
- Devised and implemented strategies to optimize digital marketing campaigns.
- Improved customer satisfaction rates through proactive problem-solving and efficient complaint resolution.
ProActive Physical Therapy and Sports Medicine, Inc - dba Empower TherapiesCarlsbad, CA
Back Office Operations/Authorizations, Director
06.2014 - 02.2022
Job overview
- Oversee daily operations for scheduling, billing, and claims teams
- Collaborated with providers, managers, and employees to determine billing and documentation policies and procedures to ensure compliance
- Educated new employees, implemented new procedures.
- Tracked trends and suggested enhancements to both challenge and refine company's product offerings.
- Observed each employee's individual strengths and initiated mentoring program to improve areas of weakness.
- Proactively identified potential risks and implemented mitigation strategies to minimize negative impacts on projects or business operations.
M-Thoughts Invitations & Supplies dba Trevi EventsCarlsbad, CA
Owner, Lead Designer
05.2008 - 08.2019
Job overview
- Directed business operations by optimizing workflows and enhancing service delivery across departments to improve overall efficiency.
- Built and maintained strategic partnerships with vendors and venues, elevating product offerings and increasing client satisfaction.
- Developed and executed targeted marketing strategies that expanded brand visibility and strengthened audience engagement across digital platforms.
- Streamlined financial operations by managing accounts receivable, reducing outstanding balances, and improving cash flow.
- Designed and produced custom event stationery and favors, delivering tailored, high-quality client experiences.
Scripps Coastal Otolaryngology/Pacific ENTSolana Beach, CA - Carlsbad, CA
Front Office Manager
03.2009 - 06.2014
Job overview
- Conducted regular staff evaluations, providing constructive feedback and identifying opportunities for professional growth. Established team priorities, maintained schedules and monitored performance. Set aggressive targets for employees to drive company success and strengthen motivation
- Monitored financial transactions at the front desk, ensuring accurate billing procedures and minimizing discrepancies. Prepared reports to assist business leaders with key decision making and strategic operational planning.
- Oversaw guest registration process by verifying personal information accuracy in line with security protocols. Managed files and records for clients and adhered to safety procedures to prevent breaches and data misuse.
- Set priorities and problem-solved workflow issues to maintain rapport with customers and managers. Cultivated positive rapport with fellow employees to boost company morale and promote employee retention.
- Implemented staff training programs, improving employee performance and team cohesion. Trained personnel in equipment maintenance and enforced participation in exercises focused on developing key skills.
- Resolved guest complaints professionally, maintaining positive relationships with customers for future business opportunities.
LabCorpBerkeley, CA - San Diego, CA - Encinitas, CA
CLS/Field Representative/CMS Billing Specialist
03.1993 - 02.2009
Job overview
- Consulted with businesses to supply accurate product and service information.
- Greeted customers and offered assistance with selecting merchandise, finding accessories and completing purchases.
- Represented company brand during customer and prospect interactions.
- Negotiated prices, terms of sales and service agreements.
- Trained new employees on customer service, money handling and organizing strategies.
- Fielded customer complaints and facilitated negotiations, resolving issues and reaching mutual conclusions.
- Promoted Lab Services to potential clients by describing benefits, demonstrating features and redirecting concerns.
- Utilized CRM software effectively to track all client interactions, ensuring seamless follow-ups when necessary.
- Collaborated with managers to provide customer feedback and recommend operational changes to meet emerging trends.
- Worked with clinical operations and medical directors to develop consistent language and criteria for forms, protocols, reports and safety procedures.
- Collaborated with interdisciplinary teams for improved patient care, providing timely and accurate diagnostic data.
- Set up, maintained and verified sterility of lab equipment and tools.
- Evaluated new reagents and supplies to optimize testing processes without compromising accuracy or reliability of results.
- Maintained strict adherence to prescribed lab safety guidelines and operational instructions.
- Led quality control diagnostic testing, documenting variances in results and blood product performance.
- Analyzed and interpreted data, accurately identifying and reporting laboratory results.
- Maintained certification with American Society for Clinical Pathology (ASCP) and Histology/Pathologies.
- Tested specimens and blood products in accordance with ASCP standard operating procedures.
- Upheld laboratory protocols dictated by facility, governing agencies, or special project requirements.
Education
Palomar Institute of CosmetologySan Marcos, CA
No Degree from Medical Aesthetics
09.2009
University Overview
- Dean's List May, June 2009
- Ranked in Top 5% of class
San Diego State University, CE ProgramSan Diego, CA
Curiculum Licsense/Certification from Web Design and Development
03.2000
University Overview
- Professional Development/Design
University of California, BerkeleyBerkeley
Bachelor of Science from Clinical Healthcare
05.1993
Skills
- Complex problem solver
- Task oriented regarding educational modules
- Excellent Verbal and written communicator in team environment
- 33 years of Medical Knowledge
- Research and due diligence in claims resolutions
- Positive attitude, time management, and leadership
- Analytical Thinking
- Process Analysis
- Schematics Interpretation
- Quantitative skills
- Marketing Strategies
- Proficient in Insurance Portals/AMD/EPIC
- Multitasking Abilities
- Supply and Inventory Management
- Logistics and Scheduling Management
- Teamwork and Collaboration
- Remote Office Availability
- Design and Develop Marketing/Promotional supplies
Timeline
Claims Resolution Case Manager
Natera, Inc.
04.2024 - Current
AR/Claims Resolutions Specialist
HPMG - MMD, Inc.
02.2022 - Current
Back Office Operations/Authorizations, Director
ProActive Physical Therapy and Sports Medicine, Inc - dba Empower Therapies
06.2014 - 02.2022
Front Office Manager
Scripps Coastal Otolaryngology/Pacific ENT
03.2009 - 06.2014
Owner, Lead Designer
M-Thoughts Invitations & Supplies dba Trevi Events
05.2008 - 08.2019
CLS/Field Representative/CMS Billing Specialist
LabCorp
03.1993 - 02.2009
University of California, Berkeley
Bachelor of Science from Clinical Healthcare
San Diego State University, CE Program
Curiculum Licsense/Certification from Web Design and Development
Palomar Institute of Cosmetology
No Degree from Medical Aesthetics