Alitza Marrufo
Long Beach,CA
Summary
Healthcare professional with extensive experience in medical authorizations and insurance verification, including Medical, Medicare, HMO, and private insurances. Demonstrated ability to manage high-volume workloads while maintaining accuracy and compliance in patient care. Recognized for leadership in training staff and enhancing workflow efficiency. Tech-savvy and detail-oriented, committed to exceeding performance goals and supporting departmental success.
Overview
10
10
years of professional experience
2
2
Certifications
Work History
Authorizations Specialist
De La Peña Eye Group
Commerce, California
07.2022 - Current
- Managed authorizations for various eye care surgery procedures and injections.
- Processed patient authorization requests efficiently and accurately for Ophthalmology, Optometry, Cornea and Retina Specialist.
- Monitor authorization status, follow up proactively to prevent delays in patient care.
- Verified eligibility with insurance plans, PPO, Medicare, and Medi-Cal daily to support accurate and complete authorizations for medical HMO groups.
- Submit urgent and/or Retro authorizations within established timelines to support same-day service needs.
- Generate and submit 60–85 authorizations daily through IPA portals, consistently meeting productivity.
- Prepare and generate paper authorizations for fax submission to IPA and PCP offices when required.
- Update monthly coverages to maintain accurate patient demographics and insurance coverage information in DNA/Modmed system.
- Provide onboarding and hands-on training to new Authorization Department employees, ensuring adherence to workflow standards.
- Step into expanded roles during staffing shortages, covering multiple responsibilities while maintaining daily productivity goals and workflow efficiency.
- Monitor incoming phone calls and provide customer service by directing them to appropriate department.
Authorizations Specialist
Century Eye Care
Gardena, California
03.2022 - 07.2022
- Obtained prior and ongoing authorizations for Ophthalmology and Optometry services in a timely manner.
- Analyze faxed requests and documentation to determine coverage and approval.
- Verified eligibility for primary Medical, Medicare insurances and HMOs accurately and in a timely manner.
- Input patient demographic and insurance information into EMR system.
- Answered calls and booked appointments.
Authorizations Specialist
Soledad Eye Surgeons
Los Angeles, California
10.2021 - 03.2022
- Obtained routine and urgent authorizations for Ophthalmology and Optometry service in a timely manner.
- Verified eligibility with insurance plans for Medicare, Medi-Cal, CCS and HMO's on a daily to support accurate and complete authorizations.
- Coordinated referral out authorizations for patients referred outside practice, facilitating access to specialized care like Retina, Cornea, Neuro, etc.
- Contacting patients and/or PCPs to verify new patient authorizations.
- Entered and scanned approved authorizations.
- Receive phone calls and faxes corresponding to authorizations, appointments and questions.
- Confirming appointments two days prior to scheduled date of service.
- Entering Doctor's consult reports on a daily basis from prior day appointments. Filing future consult reports into TIC for future authorizations.
- Conducted visual fields exams, fundus photos, and topo exams while providing backup coverage for technicians.
- Covered front desk by checking in/out patients while booking follow up appointments.
Admin Assistant
The John Stewart Company
Los Angeles, California
04.2019 - 10.2021
- Managed iCIMS program, posting new job positions daily, reviewing candidates, forwarding resumes to hiring managers, and posting recruitment ads on job-related websites like Indeed, Craigslist, and ApartmentJobs.com.
- Assisted 9 regional managers with special projects, including preparing personal reimbursements and corporate credit card expense reports in Suti Expense, creating annual budget templates for 80+ properties in MRI, gathering monthly recertifications for MINC reporting, and reviewing annual Emergency Response Packets for all 80+ properties.
- Supported property managers by fulfilling requests, including daily forwarding of section 8 notices, preparing and submitting vendor credit applications, reviewing and submitting reasonable accommodation packets, and sending waitlist letters to applicants.
- Receptionist backup as needed. Handle corporate phones and complete daily mail when receptionists are out on vacation/sick.
- Created employee identification badges for new hires.
- Able to work well under pressure and multitask multiple projects at the same time and still keep organized and meet deadlines.
Receptionist
The John Stewart Company
Los Angeles, California
03.2016 - 04.2019
- Answered all incoming internal/external calls and routed to appropriate personnel. Handled all calls with professionalism despite the extremely high volume of calls.
- Greeted guests and provided customer service.
- Supported administrative functions by performing copying, faxing, filing, word processing, and preparing correspondence to ensure efficient office operations.
- Coordinated booking of conference rooms and facilitated catering requests to enhance event readiness.
- Assisted with annual conference by coordinating employee check-in and managing additional logistical tasks to ensure smooth execution of the event.
- Prepared shipments for FedEx and Ontrac by accurately labeling and organizing packages.
- Provided back-up assistance to Administrative Assistant staff/Office Manager on assigned special projects.
Sales Associate
Soma Intimates
Pasadena, California
09.2015 - 12.2016
- Greeted customers and processed transactions efficiently in busy, fast-paced retail environments.
- Facilitated complimentary fittings to enhance customer satisfaction and product selection.
- Operate cash registers, scanners and computers to itemize and total customer purchases; collect payments and make change for cash transactions.
- Stocked shelves, arranged floor sets, and managed opening/closing procedures.
Education
DIPLOMA -
Arbor View High School
Las Vegas, NV01-2007
Skills
- Authorization processing
- Insurance verification
- CPT Coding
- ICD-10 / ICD-9
- Medical terminology
- EMR Systems
- Patient scheduling
- Financial documentation
- Data entry proficiency
- Computer literacy (Microsoft Word, Excel, PowerPoint)
- Ophthalmic Backup Tech
- Front Desk Support
- Training
- Bilingual - Spanish
Certification
Basic Life Support (BLS), American Heart Association - Current
Timeline
Authorizations Specialist
De La Peña Eye Group
07.2022 - Current
Authorizations Specialist
Century Eye Care
03.2022 - 07.2022
Authorizations Specialist
Soledad Eye Surgeons
10.2021 - 03.2022
Admin Assistant
The John Stewart Company
04.2019 - 10.2021
Receptionist
The John Stewart Company
03.2016 - 04.2019
Sales Associate
Soma Intimates
09.2015 - 12.2016
DIPLOMA -
Arbor View High School