BRITTANI CRAWFORD
Las Vegas,NV
Summary
Detail-oriented claims processor with over 5 years of experience in insurance claims processing, adjudication, and adjustment across healthcare and property & casualty environments. Skilled in determining coverage, verifying eligibility, reviewing policy details, and resolving claims accurately within high-volume, fast-paced systems.
Strong background in analyzing claim data, identifying discrepancies, and ensuring timely, compliant claim resolution. Known for accuracy, efficiency, and consistent performance under tight deadlines. Experienced with HIPAA-compliant, remote-ready claims systems and committed to delivering accurate, policy-driven outcomes.
Overview
6
6
years of professional experience
1
1
Certification
Work History
Claims Processor
OptumCare (UnitedHealth Group)
09.2024 - Current
- Process and adjudicate insurance claims according to policy guidelines
- Verify member eligibility, benefits, and coverage
- Investigate discrepancies and resolve claim issues
- Maintain accurate documentation in high-volume environment
Pharmacy Benefit Specialist
CVS Caremark
02.2022 - 07.2024
- Process pharmacy claims using RxClaim
- Verify eligibility, formulary coverage, and prior authorizations
- Assist members and providers with claim inquiries
- Ensure HIPAA compliance and accurate documentation
Claims Processor
Farmers Insurance
08.2021 - 05.2023
- Managed full-cycle insurance claims from intake to resolution
- Reviewed policy coverage and claim documentation
- Coordinated with adjusters, vendors, and third parties
- Resolved claims accurately and within deadlines
Caregiver (Part-Time)
Reliable Care Registry
10.2020 - 06.2022
- Assisted clients with daily living activities and medication reminders
- Monitored client health and reported changes
- Provided compassionate, safe client support
Education
High School Diploma - undefined
Los Angeles High School
Administration of Justice
University of Nevada, Las Vegas
Skills
- Claims Processing
- Claims Adjudication
- Coverage Determination
- Eligibility Verification
- Claims Investigation
- Prior Authorizations
- HIPAA Compliance
- RxClaim
- Salesforce
- Citrix
- AS/400
- Microsoft Office Suite
Certification
- HIPAA Compliance
- Salesforce CRM
- Medical Assistant
- Pharmacy Benefit Management
Timeline
Claims Processor
OptumCare (UnitedHealth Group)
09.2024 - Current
Pharmacy Benefit Specialist
CVS Caremark
02.2022 - 07.2024
Claims Processor
Farmers Insurance
08.2021 - 05.2023
Caregiver (Part-Time)
Reliable Care Registry
10.2020 - 06.2022
High School Diploma - undefined
Los Angeles High School
Administration of Justice
University of Nevada, Las Vegas