Taneiyah Adams
Lewisville,TX
Summary
Results-driven Claims Specialist with over 5 years of experience in healthcare and insurance environments. Proven track record of resolving high-volume claims, improving customer satisfaction, and reducing processing delays. Expert in medical billing systems, insurance verification, and claim denial resolution. Known for accuracy, speed, and clear communication.
Overview
6
6
years of professional experience
Work History
Medical Claims Processor
HCA Healthcare Inc.
Remote, TX
10.2022 - 04.2025
- Processed over 150 claims daily with 98% accuracy, ensuring prompt reimbursements.
- Resolved complex coding and billing issues, reducing denial rates by 20%.
- Maintained 100% compliance with HIPAA and payer regulations.
- Communicated with providers and billing teams to ensure timely claim updates.
Claims Adjuster
CVS Healthcare
Remote, TX
09.2020 - 12.2022
- Investigated and resolved claims with a 95% first-contact resolution rate.
- Negotiated settlements that cut company liability by 18% annually.
- Handled inbound calls from policyholders with empathy and efficiency.
- Verified insurance coverage and documented all decisions in real time.
Claims Specialist
PrideStaff
Remote, TX
11.2018 - 08.2020
- Managed over 100 claims weekly while maintaining SLA turnaround times.
- Improved claim cycle efficiency by implementing streamlined workflows.
- Delivered timely claim status updates, increasing customer satisfaction scores by 25%.
- Collaborated across departments to reduce average processing time by two days.
Education
High School Diploma -
Southwood High School
Shreveport, LA05-2016
Skills
- Claims Investigation & Resolution
- Customer Service & Communication
- Medical Billing & ICD-10 Coding
- Insurance Eligibility Verification
- Denials Management
- Data Entry (65WPM)
- Microsoft Excel & Medical Billing Software
- Inbound/Outbound Call Handling
Timeline
Medical Claims Processor
HCA Healthcare Inc.
10.2022 - 04.2025
Claims Adjuster
CVS Healthcare
09.2020 - 12.2022
Claims Specialist
PrideStaff
11.2018 - 08.2020
High School Diploma -
Southwood High School
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