Aleah Cassondra Arauza
Sacramento
Summary
Dynamic Authorization and Benefits Specialist with proven success at Hanger Clinic Inc., driving double revenue growth through effective patient care management. Expert in billing compliance and insurance verification, complemented by strong leadership and team collaboration skills. Committed to enhancing patient experiences while ensuring timely authorizations and adherence to healthcare regulations.
Overview
8
8
years of professional experience
Work History
Authorization and Benefits Specialist III
Hanger Clinic Inc.
Sacramento
06.2024 - Current
- Oversaw administrative care of prosthetic patients across five offices by verifying insurance benefits and confirming contracted rates for PDAC approved devices.
- Documented all communications with insurance representatives, referral sources, and patients to ensure accuracy and timeliness.
- Converted prior authorization requests from pending to approved status within 48 hours for high-value cases.
- Executed appeals for any denials issued by insurance payors.
- Achieved double revenue growth for two offices through effective management of patient care processes.
- Communicated with healthcare providers to clarify authorization requirements.
- Verified insurance coverage details for accuracy and completeness.
- Collaborated with team members to streamline workflow processes.
- Assisted in training new staff on authorization protocols and systems.
Office Supervisor
Hanger Clinic Inc.
Sacramento
09.2022 - 06.2024
- Oversees a team who are responsible for the timeliness and financial care in the highest billing office in the Northern California region
- Supervised daily office operations to ensure smooth workflow and efficiency.
- Communicated with clients to address inquiries and provide support.
- Monitored inventory levels and ordered supplies as needed for the clinic.
- Works 30-50 patient charts daily to ensure they ready for billing
- Assists team daily in submitting urgent authorizations
- Delegate important tasks accordingly
- Executes consistent positive morale amongst colleagues and patients
- Submits 20-30 authorizations daily
- Reviews chart notes from referring doctors to ensure they are compliant with Medicare guidelines for DME/ Orthotics and Prosthetics billing
- Communicated with patients about financial share and executed any payment plans
Office Administrator
Pacific Medical Inc.
Sacramento
05.2018 - 08.2022
- Responsible for processing 100 referrals a day for two locations and scheduling appointments while working part time
- Coordinated schedules and appointments for medical staff and patients.
- Performed clerical duties such as photocopying, faxing and scanning documents.
- Maintained a clean, organized workspace to ensure a professional environment.
- Prepared 30-45 patient charts daily before an electronic chart system was created/implemented
- Exceeded employee expectations which led to submitting prior authorizations for insurances.
- Submitted 40-50 authorizations on a daily basis and also followed up on requests weekly
- Communicated with patients about financial share and executed any payment plans
- Cross trained in front desk reception/check out role
- Ability to multitask while scheduling a patient that is in front of me and on the phone when short staffed
Education
Bachelors of Arts - Sociology
Sacramento State
Sacramento06.2020
Associate of Arts - Social and Behavioral Sciences
Sierra College
Rocklin05.2018
Skills
- Customer service
- Verification of benefits
- Billing compliance
- Patient communication
- Revenue cycle management
- Authorization management
- Team collaboration
- Attention to detail
- Proficient in EPIC
- Leadership
- Computer literacy
- Active listening
- Time management
- Organizational skills
- HCPC knowledge
- ICD-10 proficiency
- Medical terminology
- Insurance policy expertise
References
References available upon request.
Timeline
Authorization and Benefits Specialist III
Hanger Clinic Inc.
06.2024 - Current
Office Supervisor
Hanger Clinic Inc.
09.2022 - 06.2024
Office Administrator
Pacific Medical Inc.
05.2018 - 08.2022
Bachelors of Arts - Sociology
Sacramento State
Associate of Arts - Social and Behavioral Sciences
Sierra College