Linda Candelaria

***** ******* ******; Cathedral City, CA 92234

Tel:760-***-****; Cell: 626-***-****

Email: ablp15@r.postjobfree.com

Objective

> Seeking a challenging, yet rewarding position within or outside of

Healthcare, that would utilize and benefit from my more than 20 years

experience in Management, Customer Service and Insurance

Reimbursement.

Professional Profile

> Extensive experience in Healthcare Management of collections and

insurance reimbursement.

> Extremely successful achieving Cash Collection Goals, often resulting

in bonuses for myself and staff.

> Always focused on providing outstanding Customer Service when dealing

with collections.

> Excellent Communications and Supervisory Skills, working effectively

with all personnel, and experienced in overseeing Human Resource

functions at the branch level.

> Strong background in all relevant areas of accounting for Medical

Collections and Insurance.

Work Experience

Feb. 2010 - Current Reimbursement Manager

Infusion Nursing

Solutions/All Cities Medical Solutions

Rancho Mirage,

CAlifornia

> Responsible for all functions of Billing & Collections.

> Insurance Verifications & Authorizations.

> Inform patients of financial responsibility.

> Post all payments in CPR+ and Office Ally.

> Order all drugs and coordinate delivery to the office.

> Check in all drugs and label for the infusion Nurse.

> Month-end closing and reporting of Accounts Receivables.

> Assist in answering phone, scheduling and checking in patients.

Dec. 2008 - Feb. 2010 Office Manager, Biller, Collections &

Authorizations

River's edge

Pharmacy; Rancho Mirage, California

> responsible for all insurance billing & Collections.

> Responsible for all Insurance verifications and authorizations.

> Human Resource functions.

> Phones.

> Over the counter sales.

Oct. 2006 - June 26, 2009 Temporary Project Collector/Coordinator

BIOSCRIP (Intravenous Therapy Services); Burbank,

California

> Coordinated and managed collection project for $2.4M in Accounts

Receivable in 2004-2005.

> Assign accounts to several different collection agencies for additional

collection efforts, and negotiate with patients and various insurance

carriers for settlement on those patient accounts.

Nov. 2001 - Aug. 2005 Director of Reimbursement, PRIORITY

HEALTHCARE/EXPRESS

SCRIPTS; Monrovia, California

> Coordinated all phases of billing (HCFA 1500 & PBM), collections,

insurance verifications and authorizations for maximum reimbursement;

involved with all levels of pricing negotiations.

> Coordinated meetings with medical groups and insurances companies to

discuss problem accounts.

> Assisted national sales personnel with prospective new clients by

attending meetings to coordinate reimbursement, intake and

authorization issues.

> Responsible for obtaining and completing credentialing and re-

credentialing forms for payers.

> Managed and supervised a staff of 15 employees, responsible for

employee performance evaluations, and generally directed Human

Resources at the branch level.

> Familiar with and often responsible for non-prescription daily pharmacy

operations in the absence of the Pharmacy Manager.

Nov. 1999 - Nov. 2001 Reimbursement Manager, HOME PHARMACY OF CALIFORNIA

Burbank, California

> Coordinated all phases of billing and collections for monthly revenues

of approximately $1.7M, and oversaw month-end close accounting

procedures.

> Coordinated meetings with contracted and non-contracted payers to

discuss problem accounts or contract issues, reviewing A/R to determine

accounts for the collection agency.

> Responsible for employee performance evaluations.

Nov. 1998 - Nov. 1999 Director of Reimbursement, SUNPLUS HOME INFUSION

SERVICES; Burbank, California

> Responsible for setting up an A/R department for a new division of Sun

Health Care, coordinating all billing and collections for maximum

reimbursement, responsible for training billing & intake personnel in

all divisions of the company, overseeing pricing of all new drugs for

inventory and generating month-end reports.

> Involved in all case management negotiations, and on call for finance

issues that surfaced afterhours or on holidays.

Oct. 1995 - Nov. 1998 Reimbursement Manager, INFUSX, INC./SALICK

HEALTH

Los Angeles, California

> Centralized billing and collections from three out-of-state divisions

to California.

> Managed and supervised four biller/collectors, oversaw account

analyses to assure proper reimbursement, involved in pricing and case

management negotiations, and generated month-end close accounting and

reporting.

> Responsible for employee performance evaluations.

July 1987 - Jan. 1995 Reimbursement Manager, LIFELINE HOMECARE -

KANGAROO KIDS; Santa Fe Springs, California

> Coordinated all phases of billing, collections and verifications,

involved in all pricing and case management negotiations, and

generated month-end accounting close reports.

> Managed and supervised a staff of 17 billing and collection personnel,

and assisted sales personnel with commissions and problem accounts.

Education

> Diploma, LOS ALTOS HIGH SCHOOL; Los Altos, California

> MT. SAN ANTONIO COLLEGE; Walnut, California

> Courses in Business, including Accounting and Principals of Business

Community Activities

> Council Member, GABRIELINO-TONGVA INDIAN TRIBE (2006 - current)

> Los Angeles County

> Treasurer, Board of Directors, CLARADAY COURT HOME OWNERS ASS'N (2005-

2007)

> Glendora, California

References available on request.[pic]

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