Summary
Overview
Work History
Education
Skills
Target Roles
Timeline
Generic

Shaday Adams

Baltimore ,MD

Summary

Conducted in-depth research and data analysis to navigate complex healthcare systems, driving compliance and optimizing claims processing outcomes.

Overview

7
7
years of professional experience

Work History

Denials Resolution Analyst

TMF Quality Health
05.2024 - 10.2025
  • Reviewed, analyzed, and resolved denied healthcare claims for multiple clients and insurance providers
  • Conducted in-depth research to determine denial causes and appropriate resolution actions
  • Approved or denied claims based on payer guidelines, medical necessity, and policy rules
  • Worked across multiple systems to ensure accurate documentation and timely resolution
  • Maintained high accuracy and productivity in a fast-paced, remote work environment

Administrative Worker

Mindlance Staffing (Blue Cross Blue Shield)
05.2023 - 11.2023
  • Performed high-volume data entry and updates across multiple insurance systems
  • Researched and verified member and claims information for accuracy
  • Supported administrative operations for Blue Cross Blue Shield accounts
  • Ensured records were current, complete, and compliant with internal standards

Eligibility Specialist

Maryland Health Connection
01.2019 - 01.2020
  • Assisted customers in determining eligibility for Medicare, Medicaid, and other healthcare programs
  • Utilized state and federal systems to verify income, household, and coverage information
  • Ensured applicants met program requirements and maintained compliance
  • Provided clear customer support while handling sensitive health and financial data

Education

Associate of Science - Health & Human Services

Ultimate Medical Academy
Clearwater, FL
09.2020

High School Diploma -

Edmondson West Side High
Baltimore, MD
06.2011

Skills

  • Healthcare Claims Processing
  • Denials Resolution & Appeals
  • Medicare & Medicaid Eligibility
  • Customer Service (Remote)
  • Data Entry & Data Integrity
  • Claims Research & Analysis
  • HIPAA Compliance
  • Insurance Verification
  • Multi-System Navigation
  • Attention to Detail

Target Roles

  • Senior Customer Service Representative (Remote)
  • Healthcare Claims Processor
  • Denials Resolution Analyst
  • Revenue Cycle or Claims Analyst

Timeline

Denials Resolution Analyst

TMF Quality Health
05.2024 - 10.2025

Administrative Worker

Mindlance Staffing (Blue Cross Blue Shield)
05.2023 - 11.2023

Eligibility Specialist

Maryland Health Connection
01.2019 - 01.2020

Associate of Science - Health & Human Services

Ultimate Medical Academy

High School Diploma -

Edmondson West Side High
Shaday Adams