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Yvette C. Candelario
E-Mail: yvetteccandelario@outlook.com
Miami, Florida Mobile: (347) 675-5843
______________________________________________________________________________________________________________
CAREER OBJECTIVE
To obtain position in a competitive market that allows me to utilize my strong, independent, self-starter, organizational,
and leadership skills in an environment with the opportunity for long term professional career and the possibility of growth
within the organization.
PROFESSIONAL EXPERIENCE
MBS LTD Medical Supplies, Brooklyn NY
Medicare B Field Supplies Account Manager 2014 – 2016
• Accomplished day to day functions of the office while assisting the field manager director when necessary.
• Maintained efficient office organization.
• Created and formatted high-level documents: letters, memos, and spreadsheets.
• Managed equipment & supplies, competed inventory checks and visited 4 homes a day.
• Ordered supplies for MBS equipment in assisted living facilities throughout the Tri-state such as urological,
tracheotomy, tube feeding and colostomy.
• Explained all benefits, features and preform formula to management.
• Reviewed account information and validated documents in EMR.
• Gathered patient information from charts.
• Directly handled all nursing home calls or questions regarding invoices and billing.
• Gathered patient documentation for Medicare B denials for billing, reviewed invoices for accounts.
• Went over rules and regulations for Medicare B for coverage of supplies.
Sheridan Health Care, Sunrise FL 2007-2014
Medicaid & Anesthesia Reimbursement Specialist
• Resubmitted improperly paid and or denied claims to the carrier.
• Handled contracted & non-contracted carrier and customer service calls.
• Repriced and adjusted claims.
• Verified insurance benefits and eligibility.
• Retrieved reports on Excel and followed-up on denials.
• Drafted and organized all aspects of appeals process including: letters, emails, faxes, phone calls, and special
project carriers.
• Analyzed daily work reports for accounts with the resolution of payments.
• Ran reports on AS400/1500 claim form.
• Documented credentialing issues and ran reports on CRNA/MD.
Sheridan Health Care, Sunrise FL 2006 - 2007
Data Entry and Processing Clerk
• Created accounts in AS-400 data base for health insurance claims on multiple hospital and providers.
• Printed out bar codes for each facilities chart to ensure correct charge was posted and to prepare the chart prior to
sending to the scanning department.
• Reviewed AS-400 reports to compare accuracy on hospitals census.
• Maintained hourly production numbers with minimal errors.
ADDITIONAL EXPERIENCE
Prevention Research Section, Division of Urology, Department of Surgery, The University of Texas Health
Science Center at San Antonio, TX
Health Care Counselor II Prostate Cancer, 2002 - 2005
Christus Santa Rosa Hospital San Antonio, TX
Certified Nursing Assistant II/ Unit Secretary, 1999 - 2002
City of San Antonio Internal Review San Antonio, TX, The Administrative & Financial Services Division, M.
Bernadette McKay, Deputy City Attorney
Summer Youth Employment Program Office Assistant I, 1997 - 1998
COMPUTER SKILLS & EDUCATION
Microsoft Office, Excel, Custom Software Applications, EMR Sigma Care, Click Point, Visual, CPT Codes,
Modifiers, AS400/1500claim form
South San West Campus San Antonio, TX
References available upon request

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Yvette C. Candelario resume

  • 1. Yvette C. Candelario E-Mail: yvetteccandelario@outlook.com Miami, Florida Mobile: (347) 675-5843 ______________________________________________________________________________________________________________ CAREER OBJECTIVE To obtain position in a competitive market that allows me to utilize my strong, independent, self-starter, organizational, and leadership skills in an environment with the opportunity for long term professional career and the possibility of growth within the organization. PROFESSIONAL EXPERIENCE MBS LTD Medical Supplies, Brooklyn NY Medicare B Field Supplies Account Manager 2014 – 2016 • Accomplished day to day functions of the office while assisting the field manager director when necessary. • Maintained efficient office organization. • Created and formatted high-level documents: letters, memos, and spreadsheets. • Managed equipment & supplies, competed inventory checks and visited 4 homes a day. • Ordered supplies for MBS equipment in assisted living facilities throughout the Tri-state such as urological, tracheotomy, tube feeding and colostomy. • Explained all benefits, features and preform formula to management. • Reviewed account information and validated documents in EMR. • Gathered patient information from charts. • Directly handled all nursing home calls or questions regarding invoices and billing. • Gathered patient documentation for Medicare B denials for billing, reviewed invoices for accounts. • Went over rules and regulations for Medicare B for coverage of supplies. Sheridan Health Care, Sunrise FL 2007-2014 Medicaid & Anesthesia Reimbursement Specialist • Resubmitted improperly paid and or denied claims to the carrier. • Handled contracted & non-contracted carrier and customer service calls. • Repriced and adjusted claims. • Verified insurance benefits and eligibility. • Retrieved reports on Excel and followed-up on denials. • Drafted and organized all aspects of appeals process including: letters, emails, faxes, phone calls, and special project carriers. • Analyzed daily work reports for accounts with the resolution of payments. • Ran reports on AS400/1500 claim form. • Documented credentialing issues and ran reports on CRNA/MD. Sheridan Health Care, Sunrise FL 2006 - 2007 Data Entry and Processing Clerk • Created accounts in AS-400 data base for health insurance claims on multiple hospital and providers.
  • 2. • Printed out bar codes for each facilities chart to ensure correct charge was posted and to prepare the chart prior to sending to the scanning department. • Reviewed AS-400 reports to compare accuracy on hospitals census. • Maintained hourly production numbers with minimal errors. ADDITIONAL EXPERIENCE Prevention Research Section, Division of Urology, Department of Surgery, The University of Texas Health Science Center at San Antonio, TX Health Care Counselor II Prostate Cancer, 2002 - 2005 Christus Santa Rosa Hospital San Antonio, TX Certified Nursing Assistant II/ Unit Secretary, 1999 - 2002 City of San Antonio Internal Review San Antonio, TX, The Administrative & Financial Services Division, M. Bernadette McKay, Deputy City Attorney Summer Youth Employment Program Office Assistant I, 1997 - 1998 COMPUTER SKILLS & EDUCATION Microsoft Office, Excel, Custom Software Applications, EMR Sigma Care, Click Point, Visual, CPT Codes, Modifiers, AS400/1500claim form South San West Campus San Antonio, TX References available upon request