Summary
Overview
Work History
Education
Skills
Communication
Leadership
Timeline
Generic

Daniela Fita

Westport,MA

Summary

Results-driven prior authorization specialist with over 5 years of experience, including 3 years in a supervisory role, demonstrating a deep understanding of insurance payers across diverse markets such as MA, FL, TX, LA, AR, and AZ. Expertise in efficiently managing authorization requests while maintaining keen attention to detail. Proven leadership abilities showcased by successfully guiding a team of 30 professionals to consistently exceed productivity goals. Committed to enhancing operational efficiency and fostering a collaborative team environment.

Overview

10
10
years of professional experience

Work History

Supervisor • Financial Clearance High-Tech Radiology

Golden Sun, Subsidiary of Quorum Health
03.2025 - 08.2025
  • Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
  • Devised and implemented processes and procedures to streamline workflows.
  • Helped meet changing demands by recommending improvements to workflow or procedures.
  • Conducted regular reviews of quality assurance and identified areas for improvement.
  • Optimized patient and physician experience by delivering superior services and effectively troubleshooting issues.
  • Evaluated staff performance and provided coaching to address inefficiencies.

Supervisor • Financial Clearance High-Tech Radiology

Steward Health Care System
07.2020 - 03.2025
  • Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
  • Devised and implemented processes and procedures to streamline operations.
  • Helped meet changing demands by recommending improvements to workflow or procedures.
  • Conducted regular reviews of quality assurance and identified areas for improvement.
  • Optimized patient and physician experience by delivering superior services and effectively troubleshooting issues.
  • Evaluated staff performance and provided coaching to address inefficiencies.
  • Educated staff on organizational mission and goals to help employees achieve success.

Denial Prevention Analyst II • Financial Clearance High-Tech Radiology

Steward Health Care System
09.2019 - 07.2020
  • Contacted insurance companies to obtain prior authorization for high tech radiology in outpatient settings.
  • Responded to inquiries from healthcare providers regarding prior authorization requests.
  • Reviewed denials for prior authorization requests and communicated with payers to resolve issues.
  • Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.
  • Maintained consistent follow-up on status of prior authorization requests.
  • Verified insurance eligibility and provided estimate on outpatient radiology test.
  • Requested and prepared documentation required to support medical necessity for services being authorized.

Denial Prevention Analyst I • Financial Clearance

Steward Health Care System
04.2015 - 11.2016
  • Worked effectively in fast-paced environments.
  • Paid attention to detail while completing assignments.
  • Updated computer system with latest information to keep records current and accurate.
  • Contacted patients before appointments to facilitate a quick, easy outpatient appointment.
  • Contacted patients before appointments to facilitate a quick, easy outpatient appointment.
  • Contacted patients before appointments to facilitate a quick, easy outpatient appointment.
  • Verified benefits due and obtained payment for services, or assisted in setting up payment plans.

Education

AS - Nursing

Bristol Community College
Fall River, MA
12.2008

Skills

  • Prioritizing prior authorization requests
  • Peer reviews and QA
  • Financial clearance
  • Collaborate with Clinicians
  • Knowledge of CPT/ICD 10 Codes
  • Self-Directed
  • Portuguese Speaking
  • Processes and procedures
  • Staff management
  • Meditech, Athena, FinThrive, eCW, CDS Desktop Fax, Revenue Protect experience
  • Documentation and reporting
  • Performance management
  • Priority management
  • Training and mentoring
  • Customer service

Communication

Implemented new procedures to improve communication between team and medical offices and facilities.

Leadership

Successfully leading team to exceed completion rates; implementing processes to make daily work flow effortless.

Timeline

Supervisor • Financial Clearance High-Tech Radiology

Golden Sun, Subsidiary of Quorum Health
03.2025 - 08.2025

Supervisor • Financial Clearance High-Tech Radiology

Steward Health Care System
07.2020 - 03.2025

Denial Prevention Analyst II • Financial Clearance High-Tech Radiology

Steward Health Care System
09.2019 - 07.2020

Denial Prevention Analyst I • Financial Clearance

Steward Health Care System
04.2015 - 11.2016

AS - Nursing

Bristol Community College

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Daniela Fita