Brittany L. Aquino
Easton
Summary
Detail-oriented and results-driven insurance claims and administrative professional with over 15 years of experience in claims management, compliance, customer service, operations, and leadership. Extensive background in reviewing complex documentation, interpreting policy coverage, managing sensitive claims, and providing exceptional customer support. Recognized for strong analytical skills, organizational excellence, and the ability to build positive relationships while maintaining accuracy in fast-paced environments.
Overview
19
19
years of professional experience
Work History
Claims Case Manager
Guardian Life
04.2022 - 04.2026
- Managed life insurance, Accidental Death & Dismemberment (AD&D), Accident, Supplemental Health, and Waiver of Premium claims from initiation through final determination.
- Reviewed and analyzed medical records, contracts, police reports, accident reports, photographs, and supporting documentation to ensure accurate policy coverage and claim eligibility.
- Prepared payment approvals, coverage denials, and reservation of rights correspondence while ensuring compliance with company policies and regulatory standards.
- Conducted Special Investigations Unit (SIU) reviews to detect potential fraud and compile evidence for claim investigations.
- Interpreted medical terminology, coding, and clinical documentation to support claim decisions.
- Produced comprehensive audit reports monthly, quarterly, and annually, ensuring adherence to exceptional quality standards.
- Delivered compassionate, professional customer service throughout the claims process.
Health Concierge
Aetna (CVS Health)
03.2021 - 04.2022
- Educated members on plan options and healthcare resources, enhancing their informed decision-making.
- Assisted members in navigating health insurance benefits, claims, Medicare, Medicaid, dental, and vision coverage to ensure clear understanding.
- Resolved complex customer concerns, achieving high satisfaction ratings and fostering trust.
- Documented interactions accurately while meeting productivity and compliance standards.
Teacher & Administrative Professional
Nardi's Dance Studio
Easton
09.2015 - 06.2021
- Developed engaging lesson plans and managed classroom instruction to cater to diverse learning needs.
- Fostered strong relationships with students and families, promoting a supportive and inclusive learning environment.
- Coordinated and executed performances, recitals, and special events to enhance student engagement and community involvement.
- Provided administrative support including scheduling, communications, and office operations.
Assistant Artistic Director
Grand Jete Studio of Dance
Macungie
09.2014 - 10.2018
- Coordinated productions, performances, and special events to enhance community engagement and showcase talent.
- Mentored instructors and students, fostering a positive learning environment that encouraged creativity and collaboration.
- Managed daily studio operations and instructional staff to ensure smooth workflow and effective instruction.
- Supported business owners with administrative projects and operational planning.
Assistant Compliance Manager
Millennium Medical Educational Resources, LTD
Doylestown
11.2006 - 09.2015
- Managed pharmaceutical compliance reporting to ensure adherence to federal regulations and mitigate risks.
- Coordinated educational programs and events for pharmaceutical representatives to enhance product knowledge and compliance understanding.
- Proofread educational materials to ensure accuracy and compliance with regulatory standards, supporting effective training initiatives.
- Oversaw shipping logistics with FedEx and UPS to ensure timely deliveries. through FedEx and UPS.
- Functioned as the main point of contact for customer service inquiries from clients.
- Supported cross-functional projects while maintaining strict attention to detail.
Education
English & Journalism
DeSales University
High School Diploma -
Wilson Area High School
Skills
- Claims Management
- Insurance Coverage Analysis
- Life, AD&D & Supplemental Health Claims
- Medical Records & Documentation Review
- Regulatory & HIPAA Compliance
- Fraud Investigation (SIU Support)
- Customer Relations
- Administrative Management
- Team Leadership
- Project Coordination
- Microsoft Office Suite
- Data Analysis & Reporting
- Problem Solving
- Communication & Public Speaking
- Process Improvement
- Microsoft Office (Word, Excel, Outlook)
- Microsoft Windows
- Data Entry
- Documentation Review
- Medical Terminology
- HIPAA Compliance
- Insurance Claims Processing
- Customer Relationship Management (CRM)
- Reporting & Auditing
Timeline
Claims Case Manager
Guardian Life
04.2022 - 04.2026
Health Concierge
Aetna (CVS Health)
03.2021 - 04.2022
Teacher & Administrative Professional
Nardi's Dance Studio
09.2015 - 06.2021
Assistant Artistic Director
Grand Jete Studio of Dance
09.2014 - 10.2018
Assistant Compliance Manager
Millennium Medical Educational Resources, LTD
11.2006 - 09.2015
English & Journalism
DeSales University
High School Diploma -
Wilson Area High School