Danasia M. Nieves Morse
Orlando
Summary
Detail-oriented healthcare professional with over 4 years of experience in patient support, medical documentation, and insurance coordination. Adept at managing referrals, ensuring compliance with insurance requirements, and advocating for patients by resolving healthcare system barriers. Experienced in electronic medical records (EMR), data entry, and claims processing, with a strong commitment to patient confidentiality and operational efficiency.
Overview
7
7
years of professional experience
Work History
Pre-Authorization Specialist
The Cigna Group
03.2024 - 12.2024
- Managed referral documentation, ensuring compliance with insurance policies and prior authorization requirements
- Communicated with providers, specialists, and insurance representatives to facilitate approval of services
- Maintained tracking systems and documentation for patient referrals, using EMR databases
- Assisted patients in navigating insurance coverage, financial barriers, and prior authorization denials
- Ensured accuracy in medical coding and documentation for financial and claims processing
Patient Support Representative
Optum
06.2022 - 02.2024
- Assisted patients with insurance claims, prior authorizations, and specialist referrals
- Processed patient medical records, ensuring compliance with HIPAA and healthcare standards
- Acted as a liaison between patients, providers, and insurance carriers to resolve claims and billing issues
- Advocated for patients by addressing social or financial barriers, including transportation and prescription assistance
- Educated patients on medical benefits, coverage limits, and healthcare processes
Medical Records Specialist
CIOX Health
09.2020 - 03.2022
- Managed patient records, ensuring accurate and timely documentation for referrals and insurance verification
- Collaborated with insurance companies and review organizations to ensure necessary approvals for medical services
- Provided clinical documentation to specialists per referral guidelines, ensuring seamless transitions of care
- Navigated EMR and EHR systems to retrieve and organize medical information
CSR Team Lead
ARS Rescue Rooter
02.2018 - 06.2020
- Led a customer service team in managing patient scheduling, data entry, and claims processing
- Assisted customers in resolving complex service issues, ensuring satisfaction and efficiency
- Provided guidance to team members on customer interaction, service policies, and problem-solving techniques
Education
High School Diploma -
Saints Academy High School
Orlando, FL05.2019
Skills
- Patient Advocacy & Referral Coordination
- Electronic Medical Records (EMR) & EHR Systems
- HIPAA Compliance & Medical Documentation
- Prior Authorization & Insurance Verification
- Claims Processing & Financial Assistance Navigation
- Medical Coding (ICD & CPT)
- Microsoft Office Suite & Data Entry
- Appointment Scheduling & Healthcare Communication
Timeline
Pre-Authorization Specialist
The Cigna Group
03.2024 - 12.2024
Patient Support Representative
Optum
06.2022 - 02.2024
Medical Records Specialist
CIOX Health
09.2020 - 03.2022
CSR Team Lead
ARS Rescue Rooter
02.2018 - 06.2020
High School Diploma -
Saints Academy High School
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