Brittney Hamilton
Balch Springs
Summary
Claims expert with a focus on precision and efficiency in evaluation and resolution. Proven ability to manage high caseloads while settling claims accurately per company standards. Strong collaborator, adaptable to changing needs, delivering reliable performance.
Overview
12
12
years of professional experience
Work History
Claims Adjuster
State Farm
12.2023 - 05.2025
- Evaluated insurance claims to determine validity and coverage under policy guidelines.
- Collaborated with clients to gather necessary documentation and clarify claim details.
- Analyzed loss reports and assessed damages to facilitate timely claim processing.
- Communicated effectively with policyholders regarding claim status and resolution processes.
- Utilized claims management software to document findings and track progress efficiently.
Insurance Claims Specialist
Alliance Rx Walgreens Prime Specialty Pharmacy
10.2019 - 11.2023
- Evaluated insurance claims for accuracy and compliance with company policies.
- Facilitated communication between clients and insurance adjusters to resolve claim inquiries.
- Processed claim documentation using industry-standard software, ensuring timely submissions.
- Investigated discrepancies in claims by gathering supporting evidence from various sources.
- Reviewed policy coverage to determine eligibility for claims and advised clients accordingly.
- Assisted in training new staff on claims processing procedures and system navigation techniques.
Insurance Verification Specialist
OptumRx
02.2013 - 06.2019
- Mentored new staff on verification procedures and best practices, ensuring high competency levels.
- Ensured compliance with HIPAA regulations while managing sensitive patient information during the verification process.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Updated patient records with accurate, current insurance policy information.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Improved communication between medical staff and patients by explaining insurance benefits and financial responsibilities.
Education
Associate of Science - Pharmacy
Ultimate Medical Academy
Clearwater, FL09-2026
Diploma
Nimitz High School
Irving, TX06-2010
Skills
- Claims investigation
- Claims processing
- Claims analysis
- Attention to detail
- Organizing and prioritizing work
- Coverage determination
- Denied claims identification
- Decision-making
- Medical Terminology
- Medical Billing
Timeline
Claims Adjuster
State Farm
12.2023 - 05.2025
Insurance Claims Specialist
Alliance Rx Walgreens Prime Specialty Pharmacy
10.2019 - 11.2023
Insurance Verification Specialist
OptumRx
02.2013 - 06.2019
Associate of Science - Pharmacy
Ultimate Medical Academy
Diploma
Nimitz High School
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