Candace Pineda
Elgin
Summary
To secure a position with a successful company, where I will be able to utilize my knowledge. Where I will be able to learn and apply the education to my daily tasks.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Insurance Reimbursement Coordinator
Alden Management Services
Chicago
01.2023 - Current
- My key responsibilities at Alden are to manage and coordinate insurance benefits to ensure patient responsibility.
- Currently, I am working alongside various insurances, patients, and healthcare providers.
- I am responsible for processing patient insurance, payment plans, and patient's personal information.
- Managing multiple accounts with multiple insurance companies and keeping up to date with past accounts to ensure patient responsibilities.
- Understanding of health care billing and coding process, while staying up to date with changes in insurance policies and regulations that may affect reimbursement procedures.
- Processed patient reimbursement claims efficiently and accurately.
- Coordinated with insurance companies to resolve billing discrepancies.
- Assisted in training new staff on reimbursement procedures and best practices.
- Utilized billing software to track claim submissions and payments.
- Maintained confidentiality and integrity of patient data.
- Researched rejections, investigating problems to appeal claims.
- Submitted electronic and paper claims to insurance companies within established timelines.
- Generated monthly reports detailing reimbursements received from each insurer.
- Communicated with patients regarding their financial responsibility for services rendered.
Background Check
Alden Management Services
Chicago
03.2024 - 03.2025
- My job is to check daily through a list of new residents coming into the 20+ facilities and review their background and see who has a criminal record that would put other residents at risk.
- Once done I let the facilities know who is a HIT (someone with a record that needs to be reviewed further) and report it to the facilities staff for them to conduct their own process with the patient and their record(s).
- With this job, I gained the knowledge of deciphering offenses with the Illinois Complied Statue Citations/ Class.
- I am well informed with HIPPA and using Government websites to obtained patients record(s).
- Apart from doing background checks for residents, I also do background checks for employees.
- I also have knowledge in doing invoices from Illinois State Police Division of Justice Services Bureau of Identification.
- Monitored background check results prior to extending offers of employment.
- Resolved any discrepancies found during background check investigations promptly.
Customer Service Liaison/Coordinator/Barista
Advocate Sherman Hospital - The Perk
02.2020 - 01.2023
- My key responsibilities at The Perk are to help with any customer issues or complaints and help resolve them.
- Currently, I am responsible for ordering supplies and all necessities to run The Perk Coffee Shop, make sure all supplies are stocked and up to date.
- Managing and scheduling staff, coordinating weekly staff meetings.
- Also, taking and preparing multiple customer coffee and food orders in a busy environment.
Customer Service Liaison/Certified Trainer/Manager in Training/Crew Member
Chipotle
West Dundee
09.2018 - 11.2019
- My key responsibilities while at Chipotle were to provide quality customer service care and handle customer complaints.
- Train new employees for the front of the house, on the line, and in the back of the house with food prep.
- I was responsible to accept the deliveries and have items distributed to the proper areas of the house.
- Handled all catering orders both online and calls.
- Worked the line when needed.
Education
Niles West High School
Skokie, ILOlivet Nazarene University
Bourbonnais, ILSkills
- Management
- Time management
- Cooking
- Teamwork
- Communication
- Cash Handling
- Barista Experience
- Medical Billing
- Ability to work under pressure
- Serving Experience
- Catering
- Medical Office Experience
- Bilingual
- HIPAA
- Microsoft Office
- Coffee Experience
- Medical Records
- Medical Coding
- Organizational skills
- Customer service
- Interpersonal communication
- Insurance Verification
- Host/Hostess
- Insurance billing
- Claims processing
- Staff training
- Problem solving
- Attention to detail
- Coordination of benefits
- Insurance verification
- Patient billing
- Payment plans
Certification
Food Handler Certification
Timeline
Background Check
Alden Management Services
03.2024 - 03.2025
Insurance Reimbursement Coordinator
Alden Management Services
01.2023 - Current
Customer Service Liaison/Coordinator/Barista
Advocate Sherman Hospital - The Perk
02.2020 - 01.2023
Customer Service Liaison/Certified Trainer/Manager in Training/Crew Member
Chipotle
09.2018 - 11.2019
Niles West High School
Olivet Nazarene University