Open to opportunities

ADELFA LAWRENCE

@adelfalawrence

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Experienced medical and dental claims examiner skilled in accurate, timely claims processing.

United States

Message

What I'm looking for

I seek a role where I can apply claims processing expertise, contribute to high-quality, timely adjudication, and grow into leadership while working within collaborative, compliance-focused teams.

I am a detail-oriented claims examiner with extensive experience processing medical, dental, vision and pharmacy claims using systems such as Tantura/Tantara, TNT, Cadence, RIMS and ADP. I consistently verify provider, subscriber and dependent data, handle COB and NULL claims, and follow HIPAA and regulatory requirements to ensure accurate, efficient adjudication and timely delivery to clients.

I have worked remotely and on-site across multiple organizations including Benefit & Risk Management Services, Avesis LLC and Lucent Health, supporting groups such as Dignity Health and tribal plans. I participate in ongoing trainings, collaborate with technicians and leadership to meet turnaround and quality targets, and take on projects assigned by claims managers to improve processing workflows.

Experience

Work history, roles, and key accomplishments

Current

Claims Examiner

Current

Benefit and Risk Management Services

Jan 2026 - Present (2 months)

Process and audit medical claims using Tantura/TNT systems, verifying provider/subscriber details and secondary coverage to ensure timely, accurate delivery to clients and adherence to turnaround and quality targets.

Claims Processing Medical Billing Tantura Quality Assurance HIPAA

Dental Claims Processor

Avesis LLC

Dec 2020 - Nov 2025 (4 years 11 months)

Processed Medicaid dental claims via Cadence and ADP systems, handled COB/NULL claims, participated in remote team meetings and compliance trainings, and completed projects assigned by the claims manager.

Dental Claims Cadence ADP Medicaid COB Processing Remote Collaboration Microsoft Teams Compliance Training Claims Auditing

Claims Processor

Benefit & Risk Management Services

Apr 2018 - Dec 2020 (2 years 8 months)

Processed medical claims for Dignity Health using Tantara, executed audit and project tasks assigned by claims management to support timely claim adjudication and client needs.

Medical Claims Tantara Claims Adjudication Auditing client support

Medical & Dental Claims Processor

Lucent Health

Processed medical, dental, vision, and pharmacy claims for tribal groups (Yocha, Puyallup) and managed pharmacy claims in RIMS while completing supervisor-assigned tasks and projects.

Medical Claims Dental Claims RIMS Claims Management Project Support