Brittanii Fryer
Daytona Beach
Summary
Medical Claims Processor with a robust background in processing over 60 claims daily while ensuring compliance with regulatory standards. Maintained a 98% customer satisfaction rate through effective resolution of denied claims, demonstrating reliability and commitment to client care. Expertise in managing high-volume case assignments with precision.
Overview
9
9
years of professional experience
Work History
Personal Support Coordinator
Health Care Solutions
01.2022 - Current
- Delivered structured, client-centered in-home support aligned with individualized care plans, ensuring accurate execution of daily living services while maintaining strict documentation and quality standards.
- Coordinated client assignments based on assessed care needs, sustaining service consistency and strengthening client trust through reliable service delivery, professional communication, and high standards of customer care.
- Document claims with precision, ensuring compliance with HIPAA and internal processing standards.
- Manage high-volume case assignments, sustaining productivity and meeting quality benchmarks.
Claims Benefit Specialist
Aetna
12.2016 - 10.2018
- Processed and reviewed 60+ medical claims daily, ensuring accurate entry, validation, and adjudication in accordance with company policies and CMS guidelines.
- Determined claim payment or denial eligibility by analyzing benefit plans, medical documentation, and coding data.
- Resolved denied and disputed claims with a 98% customer satisfaction rate, reducing repeat escalations and rework.
- Verified pricing, eligibility, and prior authorizations across multiple internal platforms to ensure compliance and accuracy.
- Documented claims details in CRM/EHR systems to enhance audit readiness and meet regulatory requirements.
- Streamlined grievance and escalation workflows in collaboration with authorization and billing teams to improve resolution processes.
- Remote
Education
Associate of Arts - Medical Coding & Billing
University of Phoenix
Port Orange, FLSkills
- Medical Claims Processing
- Case Management
- ICD-10
- CPT
- HCPCS Coding Knowledge
- Eligibility & Coverage Validation
- Denial appeals
- Authorization verification
- Eligibility validation
- Resource Coordination
- CMS compliance
- Grievance Procedures
- High-volume processing
- High-Volume Production Processing
- Multi-System Navigation
- Microsoft Excel (Advanced)
- Communication skills
- Patient Advocacy
Timeline
Personal Support Coordinator
Health Care Solutions
01.2022 - Current
Claims Benefit Specialist
Aetna
12.2016 - 10.2018
Associate of Arts - Medical Coding & Billing
University of Phoenix