ROBERT CAPELLINI

Camarillo, CA 93010
rcfb0632@westpost.net; (805) 204-6435 (cell) (805) 482-0800 (h)
Summary: 5 years direct practice management experience; 9 years as "co-manager"
. Responsible for interviewing (hiring), payroll, billing and working with coll
ections, both in the practice and outside collection agencies with whom we contr
acted. Performed marketing to workers compensation carriers, attorneys and to p
rivate insurance companies and physicians to increase practice referrals. Respo
nsible for maintaining compliance with State and Medicare regulations. Managed,
supervised staff, maintained employee relations and training with physicians an
d clients. Negotiated contracts for providers and insurance companies.
COUNTY OF VENTURA-VENTURA COUNTY HEALTH CARE PLAN Oxnard, CA
8/09-Present
Service Administrator-Member Services Dept.
* Manage enrollment, plan eligibility determination, plan grievance system, and
quarterly analysis within Member Services. Prepared word and spreadsheet reports
to various organizations/committees. Review and revise contracts to retain netw
ork providers as needed. Oversee Credentialing process for providers. Coordinate
and review with claims department, issues regarding payments. Developed benefi
t programs, using analytical and quantitative skills. Update and prepare Directo
ry listings of providers for members as well as Summary of Benefits (EOC). Supe
rvise Grievance and Appeals with resolution via contact with members, providers
and other personnel. Review monthly budget and present statistics to governing
board. Apply knowledge of procedures, legislation, and claims work flow to fac
ilitate operations. Revise and negotiate Contracts with Providers. Initiated M
edi-Cal and Medicare programs and initiatives for providers and Plan.
* Qualities/personal characteristics needed: Effective personnel management ski
lls; knowledge of marketing principles; effective oral and written communication
skills; flexibility to adjust to competing priorities. Extensive knowledge of
compensation programs and interaction with Human Resources (HR) resource based t
echnology.
*
US HEALTHWORKS Oxnard, CA 4/09-8/09
Center Manager (Practice Manager) for USHW Oxnard Clinic
* Managed medical staff of 15 personnel, including physicians. Supervised and s
et monthly, quarterly budget. Supervised personnel to maintain smooth working
relationship between departments and meet company's marketing goals. Assisted m
arketing team with identifying potential clients as well as established relation
ship with current clients for retention of business. Met with Risk Management
at many employers to reduce claims/injuries. Supervised accounts receivable/paya
ble.
* We met or exceeded goals for budget and profitability. Utilized extensive kno
wledge of workers compensation and health plans as well as human resources manag
ement to facilitate operations of staff. Kept payroll and vendor costs under co
ntrol and set goals and budget with corporate billing and collection dept.
SCOTT A. BADEN, M.D. Sherman Oaks, CA (orthopedic surgery) 12/04-2
/08
Practice Manager/Client Services (He became disabled in Feb. 2008; I returned to
former employer below)
* Assisted accountant, devised and maintained yearly personal and business budge
t for the doctor and his staff (12 employees). Responsible for negotiation/reta
ining of private and workers compensation health care contracts. Yearly budget
was 3 million dollars. Oversaw design, printing costs of marketing brochures, an
nouncements, etc. Opened 2 satellite offices which required site and budget ana
lysis/preparation, designing space (working with architect) and hiring staff. N
egotiated (Managed Care) HMO contracts as well as PPO.
* Trained staff to bill properly to maximum receivables and revenue, collections
. Developed and implemented marketing plan by working with focus groups to wor
kers compensation and defense liability insurance carriers for injury evaluation
s and treatment. Responsible for increasing growth of practice, by 45% over 3 y
ears. During this time, clients were insurance and risk managers at employers.
Joint meetings were conducted as well as physician viewing and making recommend
ations to reduce areas for potential accidents. I attended Insurance Education
Association (IEA) Workers Compensation courses in So. Calif. on Risk Management
training.
JEROLD T. LITOFF, M.D. Agoura Hills, CA (orthopedic surgery)
4/98-12/04**; 3/08-4/09
Manager, Client Services
* Assisted office manager with 4 offices and staff of 11 medical and clerical pe
rsonnel. Increased physician's yearly income over 7 years by 40%. Negotiated c
ontracts with insurance providers (Managed Care and PPO). Negotiated/Managed HM
O contract with Community Medical Group. From 6/03 to 12/04 supervised billing a
nd collections. Increased business primarily in workers compensation referrals
from carriers and attorneys for med-legal evaluations.
HEALTHSOUTH, Encino and Oxnard, CA ***3/00-2/01
Marketing Director/Outpatient Surgery Director
* Full-time position supervising physical therapy services of four offices in Sa
n Fernando Valley. Met with physicians in Santa Clarita and San Fernando Valley
to increase referrals. Worked with exempt and non-exempt staff to facilitate co
mmunication and cooperation between various departments and locations. Planned
and provided training to staff regarding our services. Designed brochures and h
andouts for clients. Present information at meetings with employers, nurses and
insurance industry.
* At Surgicenter: Collected and analyzed data for planning marketing budget. Id
entified potential markets and clients. Hired, trained staff and coordinated sc
heduling with various physicians. Supervised payroll, acted as human resources
supervisor onsite, paid and contracted with vendors (cleaning, surgical supplies
etc.), reviewed and revised contracts with providers and insurance plans. Super
vised inventory control and made personal marketing calls to physicians as well
as insurance companies.
ALAN M. GROSS, M.D., Camarillo, CA (orthopedic surgery)
9/92-3/98
Marketing Manager
* Marketed and reviewed all workers compensation reports, full time, to obtain w
orkers compensation referrals from third party administrators, workers compensat
ion carriers and defense law firms. Worked with physician to provide comprehens
ive reports to clients within specified time. Extensive traveling from San Dieg
o to Fresno. Found sites, negotiated rental and designed space for Bakersfield
and Valencia offices.
REDHILL MEDICAL MANAGEMENT CORP 6/81-9/92
Santa Ana & Tustin
Marketing Manager/Project Manager
* Contracted with physicians in private practices to work at offices that Redhil
l rented and staffed, in medical buildings to treat and evaluate workers compens
ation patients. We grew from one location in 1978 and a staff of 5, including m
e, to 17 offices in 1990. With locations from San Diego to Santa Barbara, we co
ntracted with 70 physicians and had a staff of 120 employees. Entrepreneurial e
nvironment: Learned and developed budget, personnel and training procedures for
marketing staff. Became 1st business/marketing manager and created department.
 Interviewed and had 10 marketing reps. reporting to me. I also was responsible
for developing "interface" between marketing and administrative departments to
maintain income and collections.
STATE COMPENSATION INSURANCE FUND, Santa Ana; &
ROYAL INSURANCE, Glendale, CA 7/75-8/79; 9/79-6/81
Claims Examiner
* Supervised workers compensation claims for 250 files for city and private empl
oyer accounts. Set claims budgets and settled cases each month. Met with our i
nsured accounts to retain communication and business. Settled large claims over
$50,000.
FAIRVIEW HOSPITAL, Costa Mesa, CA 9/74-6/75
Asst. to Health/Safety Officer
* State Hospital for developmentally disabled. Patient population of 1600, empl
oyee population of 1500. Inspected hospital sites and multiple buildings (10 de
partments throughout many acres). Assistant in Risk Management Department devel
opment. Taught and led safety programs for all non-medical employees. Served o
n Administrative Committee to revise how Medical and Administrative Personnel De
partments worked together.
EDUCATION:
California State University, Fullerton 6/78
Master of Public Administration, emphasis in Health Care Administration

University of California, Irvine

Bachelor of Science, Biological Sciences 6/74
Various Seminars 2001-2008 in Workers Compensation through Insurance Education A
ssoc., Attorney groups Certified Pharmacy Technician: May 2009.
PERSONAL:
Computer skills: Microsoft Office Suite (Excel, Power Point)
Board Member: Camarillo Arts Council - Interests: Piano, Running, Hiking, Readin
g, and Theatre
Board of Directors: Camarillo Fiesta Association. Optimists Club.