Customer Service Leader with 15+ Years Experience
Resume:
MICHELE C. TUCCI
Customer Service Professional
**********@*****.***
https://www.linkedin.com/in/michele-tucci0823
Philadelphia, PA, 19111, USA
Customer-centric, customer service professional with 15+ year history of exceeding established goals and customer expectations. Experienced in high volume call center, healthcare industry, technical support, and general customer care. Recognized for excellence in attendance and punctuality, meeting metrics, teamwork, and enthusiastic participation in continuous learning opportunities.
Work Experience
Medical Claims Specialist/Provider Services August 2025-Present
AmeriHealth Caritas Philadelphia, PA (Remote-Contracted)
Medical Claims Processors are responsible for reviewing, analyzing, and processing healthcare claims submitted by healthcare providers.
Review and analyze medical claims for completeness, accuracy, and compliance with regulatory requirements
Process claims using claims management system, ensuring prompt and accurate payment
Resolve discrepancies and issues by communicating effectively with healthcare providers, patients, and internal stakeholders
Maintain up-to-date knowledge of healthcare regulations, billing codes, and insurance policies
Generate and maintain reports to track claim processing metrics and performance
Provide exceptional customer service to all stakeholders involved in the claims process
Verify patient eligibility, benefits, and medical necessity by collaborating with healthcare providers and insurers
Assist in the development and implementation of best practices to improve claims processing efficiency
Familiarity with electronic health record (EHR) systems and medical coding (CPT, ICD-10)
Customer Operations Expert Jan 2025 – August 2025
TurboTax Philadelphia, PA (Remote-Contracted)
Ensured exceptional customer service through quick and effective actions to solve the client's issues and keeping every customer engaged with a direct and friendly touch.
● Manages and responds to customer inquiries via various channels (phone, email, chat, etc.)
●Provides excellent customer service by being an active listener and providing understanding and empathy when needed.
●Fast-paced call center environment taking 60+ inbound calls and chats daily
●Provides tech support to navigate customers’ desktop software, company website or app through remote tie in.
●Keeps detailed records of customer interactions, transactions, complaints and ensuring sensitive customer data is HIPPA compliant.
●Responsible for maintaining individual and group KPI goals.
● Provides mentorship to other team members.
Client Relations Coordinator and Consultant Dec 2023 - Jan 2025
Personal Branding, Inc. Philadelphia, PA (Remote)
Reached out to clients and coordinated women's group memberships
● Contacted applicants using the Company’s dialer platform
● Conducted qualifying interviews using the Company’s provided script
●Presented membership options using the Company’s provided script
●Signed up prospects (selling the membership) using a scripted, soft one call close technique
Home Care Case Manager/Services Coordinator Feb 2006 - Jul 2017
Private Duty/Contracted Home Care Havre de Grace, Maryland
Obtained private contracts with various nursing agencies providing home care and monitoring of patients homebound, long-term care, hospice care, and other medical situations.
●Provided compassionate care/support services to patients and their families
●Coordinated and scheduled services, provided referrals and resources to patients, family, and personal care givers
●Performed detailed patient assessments to create care plans and address specific health concerns
●Kept detailed notes and documentation on patient status, medication adjustments, physician notes, physical therapy progress, and other care-related details
●Handled patient billing and any changes to be updated with patients’ insurance or medical records
●Scheduled and coordinated home visits with home care aids / assistants.
●Used scheduling software, HER software such as EPIC
Core Skills
Time management, MS Teams, Outlook, Slack, PeopleSoft, IAD, HEAL, SalesForce, Proactive, OCAS, Active Listening, Call Center Environment, Data Entry, Service-Driven, Tech Savvy, Empathy and Patience, Conflict Resolution, Exceptional Communication, Call Center Management, Team Builder, Mentoring, Customer Relations Focused, Problem Solving, Adaptable, Self Motivated, Scheduling, Multitasking, Resilience Under Pressure, Goal Oriented, Customer Service, Microsoft Excel, KPI Metrics, CRM Software, EHR Software, Claims Processing, EPIC, Telephony Software, CORS, Cotiviti, NPI Xwalk, NCEB Tracking Tool, Dependable and Punctual, Multi-System Navigation, Multi-task, Scheduling, Medical Terminology, HIPAA Trained, Organized and Detail-Oriented, Customer Focused, Citrix, EXP MACESS, Facets, Jiva, eLTSS, ECHO, Evolent, State Medicaid Systems, Medical Claims, TPL Investigations
Education
Harford Community College Sep 1989 - Jun 1991
Associate of Arts Business Management
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