Aliza Palafox-Fimbres
Tucson
Summary
Detail‑oriented professional with a strong interest in quality assurance and data accuracy, known for reliability, efficient task completion, and careful attention to detail. Skilled in following established procedures, reviewing information for accuracy, and identifying issues that impact data quality. Brings clear communication, a quality‑focused mindset, and a willingness to learn in support of accurate and compliant operations.
Overview
6
6
years of professional experience
1
1
Certification
Work History
Traveling Front Office Medical Specialist
Arizona Institute of Urology
Tucson
2021.03 - 2021.09
- Reviewed, verified, and maintained high‑accuracy patient demographic, insurance, and eligibility data across electronic medical record (EMR) systems
- Conducted systematic data validation by cross‑checking patient information against source documentation to ensure accuracy and compliance
- Identified and corrected data discrepancies and entry errors, minimizing downstream billing, authorization, and scheduling issues
- Followed standard operating procedures (SOPs) and regulatory guidelines (HIPAA) to ensure proper handling of sensitive medical information
- Audited appointment schedules, authorizations, and patient records for completeness and adherence to clinic requirements
- Maintained detailed documentation of corrections and updates to support data integrity and reporting accuracy
- Collaborated with clinical, billing, and administrative teams to resolve data quality issues and prevent recurring errors
- Monitored workflow processes and flagged inefficiencies or error trends to support process improvement and quality control efforts
- Demonstrated consistent attention to detail while managing high‑volume data environments with minimal error tolerance
Senior Customer Service Advocate
OptumRx
Tucson
2020.09 - Current
- Completed dual training in PBM and PSC workflows to enhance cross‑functional operational support
- Applied PBM knowledge to PSC processes to identify discrepancies, prevent errors, and maintain continuity of service
- Completed dual training across PBM (Pharmacy Benefit Management) and Patient Support Center (PSC) workflows to support cross‑functional operational needs
- Demonstrated flexibility and proficiency by consistently meeting performance and quality standards across two distinct operational environments
- Functioned as a cross-trained resource, facilitating coverage, balancing workloads, and maintaining operational continuity.
- Advised clients on strategies to manage prescription drug costs, ensuring high-quality service delivery.
- Provided guidance and support to other departments regarding pharmacy benefit issues.
Court Security Officer
Vet-Sec Protection Agency
Tucson
2020.10 - 2021.03
- Executed fixed‑post and foot patrols in Superior Court facilities, ensuring adherence to security protocols and maintaining high situational awareness to enhance safety
- Performed fixed‑post and foot patrol duties in Superior Court facilities while maintaining situational awareness and enforcing security protocols
- Followed post orders, facility rules, and established procedures to ensure safety and compliance
- Reported incidents and concerns to dispatch and relevant personnel, facilitating timely response and resolution
Medical Office Assistant
Premier Foot and Ankle Surgeons
Tucson
2020.05 - 2020.10
- Coordinated patient scheduling and appointments to optimize office flow.
- Handled insurance verification and processed billing information for patients.
- Verified insurance and processed billing information to ensure accurate patient records.
- Managed patient scheduling and coordinated appointments for efficient office flow.
- Scheduled patient appointments, answered incoming calls, and assisted with inquiries.
- Managed appointment scheduling, answered incoming calls, and addressed patient inquiries.
Customer Service Advocate
OptumRx
Tucson
2019.11 - 2020.05
- Addressed customer inquiries regarding prescription medications and insurance coverage.
- Collaborated with healthcare providers to resolve medication-related issues.
- Utilized CRM software to track customer interactions and ensure follow-up.
- Placed orders for members and addressed copay and insurance inquiries.
Education
Certificate - Dental Assistant
Pima Medical Institute
2011-10
Diploma -
Pep Tec High School
2010-05
Skills
- Patient data management
- Data Validation & Auditing
- Data Accuracy & Integrity
- Error Identification & Correction
- HIPAA Compliance
- SOP Adherence
- EMR/EHR Systems
- Documentation Accuracy
- PBM & PCS Operations
- Attention to Detail
- High‑Volume Data Review
- Customer relationship management
Certification
Dental Assistant, 10/01/11, Present
Timeline
Traveling Front Office Medical Specialist
Arizona Institute of Urology
2021.03 - 2021.09
Court Security Officer
Vet-Sec Protection Agency
2020.10 - 2021.03
Senior Customer Service Advocate
OptumRx
2020.09 - Current
Medical Office Assistant
Premier Foot and Ankle Surgeons
2020.05 - 2020.10
Customer Service Advocate
OptumRx
2019.11 - 2020.05
Certificate - Dental Assistant
Pima Medical Institute
Diploma -
Pep Tec High School