BRIANNA MCMILLAN
Houston
Summary
Experienced Texas All-Lines Claims Adjuster with over 8 years in healthcare operations and claims management. Expertise in claims review, eligibility verification, and resolving complex billing issues while maintaining high accuracy. Proven track record in remote roles, ensuring compliance with HIPAA and effective documentation practices.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Scheduling Specialist
TEKsystems
Houston
07.2025 - 01.2026
- Manage high-volume inbound calls scheduling medical services and addressing insurance-related inquiries.Verify insurance coverage, benefits, and authorization requirements.
- Verify insurance eligibility, benefits, and authorization requirements to prevent claim denials.
- Provided clear explanations of coverage, procedures, and next steps to patients, ensuring informed decision-making.
- Maintain detailed and compliant documentation in electronic health systems.
- Consistently meet productivity and quality performance benchmarks.
Member Care Advocate (Remote)
Concentrix
Houston
04.2025 - 06.2025
- Managed 60+ daily member calls regarding claims, benefits, billing, and coverage inquiries, ensuring accurate information delivery.
- Investigated and resolved complex claim discrepancies, ensuring timely resolution and appropriate escalation of cases.
- Tracked performance metrics for call volume, resolution time, and quality assurance, contributing to overall service improvement.
- Ensured accurate documentation to support claims processing and compliance.
Patient Access Coordinator/IT Technical Support Specialist
Envera Health
07.2023 - 09.2024
- Coordinated appointment scheduling and verified eligibility to ensure seamless patient access in a fast-paced remote call center.
- Assisted in resolving service disruptions and de-escalating complex patient concerns, improving patient satisfaction and retention.
- Supported troubleshooting of technical system issues, enhancing workflow efficiency and minimizing downtime.
- Maintained strict confidentiality handling protected health information.
Welcome Coordinator
Oak Street Health
Brooklyn
01.2023 - 07.2023
- Provided front-line customer support and appointment scheduling.
- Resolved concerns quickly while maintaining detailed records.
- Assisted with onboarding and training new staff.
Medical Receptionist/Optical Technician
Texas Eye Center
Houston
11.2021 - 11.2022
- Scheduled appointments and coordinated patient services to enhance patient experience and streamline workflows.
- Maintained organized patient records, facilitating timely and accurate claims submission.
- Verified insurance coverage and processed billing documentation to ensure accurate patient billing.
Medical Receptionist
General Vision Services
Brooklyn
01.2017 - 03.2020
- Managed front desk operations for up to 60 patients daily, ensuring smooth patient flow and efficient service.
- Delivered high-quality customer service in a high-volume clinical setting, enhancing patient satisfaction and experience.
- Verified insurance benefits and processed payments accurately, contributing to streamlined billing operations.
Education
Bachelor of Science - Nursing
Western Governors University (WGU)
Houston, TX01-2028
High School Diploma -
Cobble Hill School of American Studies
Brooklyn, NY06-2017
Skills
Insurance verification
- Claims Workflow Analysis
- CRM / EHR Systems
- Quality Assurance Metrics
- Multi-System Navigation
- HIPAA compliance
- Risk and Liability Awareness
- Complex Issue Resolution
- Microsoft Office (Excel, Outlook, Teams)
- IT documentation
- Remote Productivity & Self-Management
- Critical thinking
- Customer Service
Certification
Texas All-Lines Insurance Adjuster License, Active
Timeline
Scheduling Specialist
TEKsystems
07.2025 - 01.2026
Member Care Advocate (Remote)
Concentrix
04.2025 - 06.2025
Patient Access Coordinator/IT Technical Support Specialist
Envera Health
07.2023 - 09.2024
Welcome Coordinator
Oak Street Health
01.2023 - 07.2023
Medical Receptionist/Optical Technician
Texas Eye Center
11.2021 - 11.2022
Medical Receptionist
General Vision Services
01.2017 - 03.2020
Bachelor of Science - Nursing
Western Governors University (WGU)
High School Diploma -
Cobble Hill School of American Studies