Amy Tucker
Jacksonville,IL
Summary
Seasoned insurance specialist with excellent planning and problem solving abilities. Offering several years of experience and a willingness to take on any challenge. Organized, driven and adaptable professional with successful history managing high caseloads in fast-paced environments. Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
31
31
years of professional experience
Work History
Claims Technician
Blue Cross Blue Shield
Jacksonville, IL
03.2022 - Current
- Process insurance claims for accuracy and compliance with company standards.
- Review and process incoming claims for accuracy and completeness.
- Processed bluecard claims and managed adjustment requests from medical review departments to ensure accurate claims resolution.
- Verify insurance coverage, eligibility, and benefit levels of claimants.
- Verify pricing, provider member information, diagnosis codes, and admission dates.
- Utilize knowledge of medical terminology to enhance accuracy in claims processing.
- Apply understanding of coordination of benefits (COB) for effective claim resolution.
- Coordinated with healthcare providers to obtain necessary information for claims, facilitating timely and accurate processing.
- Review documentation to verify coverage details and eligibility requirements.
- Determine liability, compensability, and benefits due on each claim.
- Examine claims, records and procedures to grant approval of coverage.
- Precisely calculate refunds, premiums, and adjustments.
- Collaborate with diverse coworkers to achieve goals and resolve product-related issues.
- Attended training sessions for Claims Technicians to stay current with industry changes and enhance claims processing skills.
- Coordinate and plan investigations of claims to confirm compensability and coverage.
Marketing Support Specialist
AT&T
Springfield
11.2011 - 09.2015
- Maintained marketing databases and records, ensuring accurate and accessible information for administrative functions.
- Coordinated with sales, design, and IT teams to clarify project requirements and streamline communication.
- Provided product information to assist customers in understanding offerings.
- Managed customer accounts and ensured accurate updates of records.
- Collaborated with team members to refine service delivery processes.
- Educated clients on company policies to improve compliance and satisfaction.
- Collected customer feedback and communicated insights to relevant personnel, facilitating informed decision-making.
- Resolved complex billing discrepancies in back room setting to enhance accuracy.
Administrative Specialist
AT&T
Springfield
10.2008 - 11.2011
- Acted as primary contact for customer service inquiries, ensuring timely resolution of phone line issues.
- Diagnosed technical issues and provided timely solutions to customers.
- Executed initial diagnostic tests to identify service problems.
- Entered tickets for technician intervention when on-site resolution was necessary.
- Submitted tickets for further investigation when immediate issues were undetected.
- Collaborated with team members to streamline operational workflows, enhancing team efficiency.
- Maintained accurate documentation of repairs and maintenance activities.
- Assisted in implementing new technologies, facilitating smoother operations and increased productivity.
Customer Advocate
AT&T
Springfield
05.1998 - 10.2008
- Supported the State of Illinois government and State of Illinois University accounts for 10 years.
- Managed incoming work list and assigned tasks to customer advocates to ensure efficient service delivery.
- Handled customer billing inquiries, processed payments, and issued price quotes to facilitate accurate billing.
- Investigated billing disputes, tax issues, and contract discrepancies for accurate account management.
- Developed strong relationships with clients to enhance satisfaction and loyalty.
- Provided excellent customer service to ensure client satisfaction.
- Resolved customer complaints in a timely manner.
- Sent confirmation to customers upon successful service installation.
- Coordinated with provisioning and internal departments to ensure timely, accurate service installation.
- Maintained good rapport with customers and internal departments by proactively handling complex customer issues.
- Responded quickly to customer inquiries via phone or email.
- Conducted regular follow-ups to maintain communication with clients.
- Collaborated with sales teams to align client needs with offerings.
- Actively participated in weekly team meetings to discuss progress on projects.
- Generated monthly billing reports to maintain financial transparency.
- Prepared and distributed reports on sales activity, accounts status and possible issues to management.
- Reviewed contracts, invoices and other documents for accuracy.
- Issued service orders for Centrex POTS and circuits.
- Ensured compliance with company policies and industry regulations.
- Ensured compliance with company policies and industry regulations.
Operator
AT&T
Springfield
06.1995 - 05.1998
- Hired as directory assistance operator, handling hundreds of calls daily to locate numbers and addresses.
- Delivered accurate directory assistance to callers seeking contact information, enhancing customer satisfaction.
- Managed call transfers from operators, ensuring prompt and accurate assistance to callers.
- Answered customer inquiries regarding directory assistance information, such as business and residential listings.
- Provided customer support during the last two years in operator services as service assistant.
- Utilized telecommunication systems to retrieve and relay information efficiently.
- Documented caller inquiries and responses to support quality assurance and improve service delivery.
- Collaborated with team members to improve service processes and efficiency.
- Maintained up-to-date knowledge of directory listings and changes in services.
- Demonstrated ability to work independently with minimal supervision in a fast fast-paced. environment.
- Adhered to company policies and procedures while providing excellent customer service at all times.
- Tracked performance metrics such as call resolution rate and average handle time on a daily basis.
Education
High School Diploma -
Springfield Southeast High School
Springfield, IL05-1994
Skills
- Claims handling and investigations
- Claims documentation accuracy
- Coordination of benefits
- Insurance terminology expertise
- Billing software proficiency
- Data privacy compliance
- Customer service excellence
- Organizational problem-solving
- Teamwork and multitasking
- Effective verbal communication
- Billing resolution
- Effective communication
- Team collaboration
- Account management
- Recordkeeping strengths
- Microsoft Office Suite
- Typing proficiency
- Administrative support
- Clerical support
- Order processing
- Cultural awareness
- Account updating
- Research
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 time for the fair.
- I handled all 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 10 years.
Timeline
Claims Technician
Blue Cross Blue Shield
03.2022 - Current
Marketing Support Specialist
AT&T
11.2011 - 09.2015
Administrative Specialist
AT&T
10.2008 - 11.2011
Customer Advocate
AT&T
05.1998 - 10.2008
Operator
AT&T
06.1995 - 05.1998
High School Diploma -
Springfield Southeast High School