AMY TUCKER
Jacksonville,IL
Summary
I have been employed with Blue Cross Blue Shield for a little over 2 years now. I enjoy working here and like the flexibility and many perks the company offers. The majority of my working career was with AT&T for 20 years. Most of that time I was responsible for the State of IL Government and State University accounts for 10 years. Over my career and the different departments I have worked, I've gained much knowledge on company processes and systems. I issued all the orders for the IL State Fair in 2001 & 2002. This included typing orders, sending confirmations to the customer and seeing the orders through completion making sure the service was up and running. In 2003 I started handling the billing for the State of IL Government and all the State University accounts. I continued to handle all billing inquires, payments, contract implementation issues involving credits, disputes and tax issues for these customers through 2011. In that time I consolidated hundreds of accounts for these customers and established master bills for them to simplify their accounts/services and payments including signing some of the customers up for Business Direct/E-bill.
Overview
29
29
years of professional experience
Work History
Refund Adjudication Examiner
Blue Cross Blue Shield
Jacksonville, IL
06.2023 - Current
- Researching FSS files and adjudicating claims through Blue Chip, FSS Assist and FSS Web.
- Extensive research and processing claims requiring adjustment of refunded or recouped dollars.
- Responsible for reviewing and editing of claims data for accuracy.
- Make phone calls to providers and groups when needed.
- Maintain records on the claim system and support systems.
Claims Technician
Blue Cross Blue Shield
Jacksonville, IL
03.2022 - 06.2023
- Worked in Bluecard processing claims in BlueChip handling adjustment requests and medical responses received from medical review departments.
- Checked pricing, provider & member information, diag codes, admit dates.
- Knowledge of medical terminology.
- Knowledge of COB.
Marketing Support Specialist
AT&T
Springfield
11.2011 - 09.2015
- In this current position, I handle complex billing disputes in a back room environment
- Disputes are regarding early termination fees, contract implementations, re-rates, optional calling plans, Master Discount agreements and pre-implementations when customers are migrating to a higher service with AT&T
- I handle almost all retail segments for these disputes
- This position involves working with account managers as many disputes are involving contracts
- I also work with AT&T Customer Relations managers regarding efficiency adjustment requests.
Administrative Specialist
AT&T
Springfield
05.2001 - 11.2011
- In this position I was the first point of contact when a customer called to report trouble or no service on their phone line
- I ran an initial diagnostic test to see if any trouble could be detected
- If trouble was detected I would enter a ticket for a tech to dispatch out to the customer's premise
- If trouble was not detected on initial test, I entered a ticket in to be researched for further testing.
Customer Advocate
AT&T
Springfield
05.1998 - 05.2001
- For 10 years, in this position I supported the State of IL Government and State University accounts
- I issued orders for many different services including Centrex, POTS and circuits
- This included working with provisioning and other internal departments making sure the service was installed on time and correctly as the customer ordered it
- Then sending a confirmation to the customer
- On occasion I also managed our centers RDS incoming work list and assigned work to the appropriate customer advocate
- I also handled the billing for these customers
- This included answering billing inquires, providing price quotes, processing payments, court of claims, sending monthly billing reports, investigating billing disputes, tax disputes and contract issues when the account was not billing properly.
Operator
AT&T
Springfield
06.1995 - 05.1998
- I hired on with AT&T as a directory assistance operator
- Taking hundreds of calls a day looking up numbers or addresses in our database and providing to customers
- The last 2 years I was in operator services I was a service assistant and assisted customers when the operator could not find the phone number they were looking for
- The operator would transfer the call to me for further assistance.
Education
High School Diploma -
Springfield Southeast High School
Springfield, IL05-1994
Skills
- Claims Handling
- Confidential records management
- Claims investigations
- Confidentiality
- Documentation Review
- Claims Processing
- Insurance knowledge
- Customer Service
- Billing Software
- Medical Terminology
- Outstanding clerical abilities
- Records Management
- Effective Communication
- Team Collaboration
- Payment and Investigation Escalations
- Exceptional recordkeeping abilities
- Multitasking
- Problem-Solving
- Organizing and Prioritizing Work
Accomplishments
- I issued all the orders for the IL State Fair in 2001 & 2002. This included typing orders, sending confirmations to the customer and seeing the orders through completion making sure the service was up and running.
- In 2003 I started handling the billing for the State of IL Government and all the State University accounts. I continued to handle all billing inquires, payments, contract implementation issues involving credits, disputes and tax issues for these customers through 2011. In that time I consolidated hundreds of accounts for these customers and established master bills for them to simplify their accounts/services and payments including signing some of the customers up for Business Direct/E-bill.
Timeline
Refund Adjudication Examiner
Blue Cross Blue Shield
06.2023 - Current
Claims Technician
Blue Cross Blue Shield
03.2022 - 06.2023
Marketing Support Specialist
AT&T
11.2011 - 09.2015
Administrative Specialist
AT&T
05.2001 - 11.2011
Customer Advocate
AT&T
05.1998 - 05.2001
Operator
AT&T
06.1995 - 05.1998
High School Diploma -
Springfield Southeast High School