Jacqueline Tucker
Germantown
Summary
Dynamic Medical Claims Processor at CVS Health with expertise in insurance claims processing and regulatory compliance. Proven ability to enhance operational efficiency through innovative program development and effective team communication. Skilled in financial analysis and customer relations, ensuring accurate claims resolution and superior service delivery.
Overview
23
23
years of professional experience
Work History
Medical Claims Processor
CVS Health
01.2021 - Current
- Ensured adherence to regulatory requirements while processing medical claims proficiently.
- Ensured prompt correspondence with colleagues via Teams and Outlook.
- Created new solutions to enhance efficiency in processing workflows.
- Attended meetings and seminars related to healthcare industry updates.
- Calculated payments due based on allowed charges compared to billed charges according to contract terms with payers, insurers, third parties.
Accounts Payable Coordinator
Human Technology, Inc
Memphis
01.2013 - Current
- Managed communication with vendors concerning invoice queries.
- Confirmed precise allocation of funds from patient and insurance submissions to correct branches.
- Assessed company data and identified areas for improvement.
- Addressed phone communications concerning appointment arrangements and order status details.
- Reviewed monthly statements from vendors and researched any discrepancies.
- Maintained vendor records and communicated with vendors to resolve discrepancies.
- Audited expense reports for accuracy of coding against the company's chart of accounts.
- Generated 1099 forms for all applicable vendors.
Internet Technical Services Representative
Telenetwork
Memphis
01.2011 - 01.2013
- Answer incoming calls from customers for various Internet Service Providers with questions regarding their service, emails, websites
- Walk customers through troubleshooting connection problems with their dial up or DSL services via telephone conversations and online chat services
- Provide quality technical support while maintaining call times and quality assurance so customers' issues are resolved with one phone call
Provider Services Line Network Associate
UnitedHealth Group
Houston
01.2010 - 01.2011
- Answer incoming calls from providers and assist them as needed for various issues
- Contact providers for implementation team for credentialing when new books of business are added
- Assist in network providers in making changes to their record
Internet Technical Services Representative
Telenetwork
Austin
01.2008 - 01.2010
- Answer incoming calls from customers for various Internet Service Providers with questions regarding their service, emails, websites
- Walk customers through troubleshooting connection problems with their dial up or DSL services via telephone conversations and online chat services
- Provide quality technical support while maintaining call times and quality assurance so customers' issues are resolved with one phone call
Assistant Property Manager
South Lamar Storage
Austin
01.2008 - 01.2009
- Answer incoming calls regarding current customers' accounts and answer questions from prospective clients regarding our facility and the different size storage units we provide
- Assisted in maintaining the cleanliness and appearance of the facility
- Reconcile drawer on a regular basis
- Handle any customer service issues that may occur in a timely and efficient manner
- Create Excel spreadsheets that update the management office on current progress of the facility and any other requests they may have
- Assisted the property manager in marketing decisions and decisions that influence how the facility is run
Administrative Assistant /Front Desk Assistant Dept. Head
Lifetime Fitness
Austin
01.2004 - 01.2008
- Greet and check-in members as they enter and exit the facility
- Receive and enter sales from members
- Enter current and past due payments received in system and in Excel
- Answer and direct multi-telephone system
- Help solve customer service issues for members regarding their account and other issues
- Supervise other employees to help insure the club is up to corporate standards
- Assist the general manager as needed
- Order and receive for the departments
- Reconcile drawer on a daily basis
Customer Care Representative
United Health Group
Houston
01.2005 - 01.2006
- Assist Medicaid members with billing problems, find doctors, issuing new identification cards
- Direct callers to the right department if necessary
Insurance Verification/Receptionist
Houston Cardiovascular Associates
Houston
01.2004 - 12.2004
- Verify patient's insurance for upcoming appointments
- Call patients to acquire insurance and demographic information and then enter it into the system
- Check patients in and out and received payments from patients updating their accounts
Receptionist/Insurance verifier
Internal Medicine Associates of Cordova
Cordova
01.2002 - 01.2004
- Answer multi-line telephone system, take messages, and distribute them to appropriate people
- Send and receive faxes and distribute to appropriate people
- File charts, makes copies, and run errands for office manager
- Call insurance companies to verify benefits for upcoming diagnostic tests
- Receive various payments from patients and update their account
Education
Marketing Management -
American Intercontinental University
Online01.2005
International Business Major -
University of Memphis
Memphis, TN01.2003
High School - College preparatory classes
St. Benedict at Auburndale
Cordova, TN01.2000
Nursing Major -
University of Tennessee
Martin, TN01.2000
Skills
- Medical billing and coding proficiency
- Insurance claims processing
- Regulatory compliance
- Efficient data input
- Account reconciliation
- Customer relations
- Team communication
- Problem solving
- Report generation
- Insurance verification
- Attention to detail
- Time management
- Analytical skills
- Technical troubleshooting
- Financial analysis
- Process improvement
- Electronic health records (EHR)
- Telephone etiquette
- Healthcare billing
- Document control
- Business correspondence
Timeline
Medical Claims Processor
CVS Health
01.2021 - Current
Accounts Payable Coordinator
Human Technology, Inc
01.2013 - Current
Internet Technical Services Representative
Telenetwork
01.2011 - 01.2013
Provider Services Line Network Associate
UnitedHealth Group
01.2010 - 01.2011
Internet Technical Services Representative
Telenetwork
01.2008 - 01.2010
Assistant Property Manager
South Lamar Storage
01.2008 - 01.2009
Customer Care Representative
United Health Group
01.2005 - 01.2006
Administrative Assistant /Front Desk Assistant Dept. Head
Lifetime Fitness
01.2004 - 01.2008
Insurance Verification/Receptionist
Houston Cardiovascular Associates
01.2004 - 12.2004
Receptionist/Insurance verifier
Internal Medicine Associates of Cordova
01.2002 - 01.2004
Marketing Management -
American Intercontinental University
International Business Major -
University of Memphis
High School - College preparatory classes
St. Benedict at Auburndale
Nursing Major -
University of Tennessee
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