EMMA IBARRA VALENZUELA
Phoenix,AZ
Summary
Detail-oriented professional with expertise in authorization processing, insurance verification, and clinical documentation review. Proven ability to ensure compliance and enhance patient communication to drive efficient workflows.
Overview
12
12
years of professional experience
Work History
Prior Authorization Representative
SimonMed Imaging
Phoenix, Arizona
10.2025 - Current
- Processed and managed prior authorizations for diagnostic imaging services across multiple insurance carriers, ensuring compliance with varying payer requirements.
- Obtain and review clinical documentation to support authorization requests.
- Verify insurance eligibility, benefits, and authorization requirements.
- Communicated with provider offices, insurance companies, and patients to resolve authorization issues, minimizing scheduling delays.
- Followed up on pending requests, denials, and appeals to facilitate timely patient care and maintain service continuity.
- Maintain accurate documentation and compliance with payer guidelines and company policies.
- Collaborate with scheduling, clinical, and operations teams to ensure efficient workflow and patient satisfaction.
Bilingual Direct Support Provider
Arizona Care Providers
Phoenix, Arizona
05.2018 - 06.2025
- • Collaborated with clients to assess their needs and preferences. and their families to ensure first-rate quality of life. • Coordinated with clients to develop personalized developmental goals. with developmental goals that will assist clients with their daily life. • Ensure clients obtain therapeutic services, independent living skills and appropriate life skills, and appropriate like skills training • Assist and document the development and implementation of long and short-term goals for clients, as developed by proper needs. • Established and nurtured therapeutic relationships with clients and their support systems. • Develop service recipient’s basic living skills (e.g., social, domestic, and hygiene) through instruction and encouragement. • Observe, document, and report any changes in physical or emotional behavior of the client. • Addressed cultural and linguistic needs of clients and families to enhance service delivery. • Read, write and organize important and confidential documents. • Work with various family of different socio-economic and cultural backgrounds. • Visit client’s home to assess housing conditions and provide feedback to client and families.
- Assisted individuals with daily living activities and personal care needs.
- Supported clients in developing social skills and community integration.
- Administered medication according to prescribed schedules and guidelines.
Bilingual Advanced Resolution Specialist
Maximus Federal – Medicare
Phoenix, Arizona
08.2019 - 12.2024
- • Take customer calls and provide accurate and satisfactory answers to their queries and concerns by accessing current policies on company and government software. • De-escalated situations with dissatisfied customers, providing patient assistance and support to resolve issues. • Directed and supervised new Customer Service Representatives with tasks and other concerns. • Demonstrated NGD processes and other systems that are used daily. • Assist Call Center Operations and other departments as determined by project management to meet business needs. • Supported fellow team members in managing and completing daily tasks. • Achieved all performance standards established for this position as outlined in the corresponding annual performance criteria and bonus template. • Assisted members/patients with all their needs by listening to their concerns, asking questions, and providing accurate information and guidance.
- • Assisted members/patients with all their needs by listening to their concerns, asking questions, andproviding accurate information and guidance.
- Collaborated with cross-functional teams to streamline resolution processes.
- Analyzed case files to identify trends and improve service delivery.
Assisted Living Facility Manager/Caregiver
Liberty Assisted Living LLC
Avondale, Arizona
07.2018 - 07.2021
- • Oversees the day-to-day operations of assisted living facility, ensuring residents receive high-quality care and support. • Delivered personalized care for residents, adhering to clinical guidelines and addressing individual medical needs. • Assist with medical appointment coordination to ensure resident/patient is receiving adequately and timely medical are. • Foster relationships with residents and their families to promote open communication and address any concerns or feedback. • Ensure a safe, clean, and welcoming environment for all residents and staff. • Stay updated with current government and medical policies. • Managed incoming and outgoing mail, ensuring timely distribution to support facility operations. • Supported facility CEO by managing administrative tasks and coordinating projects.
- • Supported facility CEO by managing administrative tasks and coordinating projects.
- Oversaw staff training on safety protocols and emergency procedures.
- • Managed incoming and outgoing mail, ensuring timely distribution to support facility operations.
Spanish Interpreter
Cyracom Intl
Phoenix, Arizona
06.2017 - 07.2018
- • Delivered consecutive first-person medical interpretation. • Followed interpreter protocols according to training, policies, and procedures. • Provide meaning to meaning interpretation. • Follows all policies and procedures related to information confidentiality and interpreter ethics. • Clarified cultural barriers to facilitate effective communication between clients and individuals with limited English proficiency. • Develop service recipient’s basic living skills (e.g., social, domestic, and hygiene) through instruction and encouragement. • Ensured accuracy of vocabulary and terminology to deliver high-quality interpretations.
- • Provide meaning to meaning interpretation.
- Translated medical documents to ensure understanding of patient care instructions.
- • Develop service recipient’s basic living skills (e.g., social, domestic, and hygiene) through instructionand encouragement.
Administrative Assistant
Liberty Engineering,
Avondale, Arizona
04.2014 - 03.2017
- • Managed the receptionist area, including greeting visitors and responding to telephone and in-person requests for information. • Processed daily incoming and outgoing mail, ensuring timely delivery and organization. Facilitated administrative tasks for management. • Maintained office supplies by checking inventory and ordering items from vendor to support uninterrupted office operations. • Develop and maintain a filing system.
- Prepared and distributed internal and external communications effectively.
- Organized project documentation and maintained filing systems efficiently.
- • Managed the receptionist area, including greeting visitors and responding to telephone and in-personrequests for information.• Processed daily incoming and outgoing mail, ensuring timely delivery and organization.Facilitated administrative tasks for management.• Maintained office supplies by checking inventory and ordering items from vendor to support uninterrupted office operations.• Develop and maintain a filing system.
Education
High School Diploma -
NORTH HIGH SCHOOL
Phoenix, AZ05-1996
Associate of Arts -
PHOENIX COLLAGE
Phoenix, AZSkills
- Prior authorization processing
- Authorization processing
- Insurance verification
- Clinical documentation review
- Compliance management
- Patient communication
- Patient advocacy
Timeline
Prior Authorization Representative
SimonMed Imaging
10.2025 - Current
Bilingual Advanced Resolution Specialist
Maximus Federal – Medicare
08.2019 - 12.2024
Assisted Living Facility Manager/Caregiver
Liberty Assisted Living LLC
07.2018 - 07.2021
Bilingual Direct Support Provider
Arizona Care Providers
05.2018 - 06.2025
Spanish Interpreter
Cyracom Intl
06.2017 - 07.2018
Administrative Assistant
Liberty Engineering,
04.2014 - 03.2017
High School Diploma -
NORTH HIGH SCHOOL
Associate of Arts -
PHOENIX COLLAGE