Jeffrey Bechtel
Harrisburg,Pennsylvania
Summary
As customer service professional, brings valuable experience in addressing and resolving customer issues effectively. Known for strong focus on team collaboration and achieving positive outcomes. Reliable and adaptable with excellent communication and problem-solving skills.
Overview
28
28
years of professional experience
Work History
Internal Audit/Corporate Performance Analyst/Customer Service Representative
Capital Blue Cross
02.2022 - Current
- Conducting audits on FEP claims and customer service inquiries for accuracy.
- Following FEP audit guidelines as stated in the FEP PIP Manual.
- Issuing and resolving errors in timely manner.
- Updating procedures.
- Training new employees and answering their questions.
- Interpreting FEP Plan Notifications.
- Analyzed performance metrics to enhance operational efficiency and support strategic decision-making.
- Collaborated with cross-functional teams to identify areas for process improvement and implement solutions.
- Developed comprehensive reports on key performance indicators to drive organizational goals and objectives.
- Conducted in-depth data analysis using advanced analytical tools to ensure accuracy and consistency of results.
- Led initiatives to streamline reporting processes, reducing turnaround time for performance analysis deliverables.
FEP Claims Examiner/Customer Service/Backup CPR
Capital Blue Cross
01.2012 - 02.2022
- Adjudicating claims
- Including adjustments, refunds, mass adjustments, SIU
- Providing Excellent Customer Service to our members and providers through Availity
- Writing and Updating the FEP online manual to keep procedure current
- Backup CPR for FEP
- Answering questions and resolving problems from other examiners, other areas and our providers Training new employees
- Evaluated claim documentation for accuracy, identifying discrepancies and recommending resolutions.
Claims Examiner ITS PEBTF/Customer Service Representative
Capital Blue Cross
06.2008 - 01.2012
- Processing ITS/BlueCard claims
- Adjusting BlueCard Claims
- Special Projects
- Responding to Customer Service and Provider inquiries
- Reviewed and processed claims for accuracy and compliance with policy guidelines.
- Collaborated with healthcare providers to resolve claim discrepancies and ensure timely payments.
- Investigated complex claims by analyzing medical records and patient information for fraud detection.
- Mentored junior examiners on best practices in claims processing and effective use of systems.
- Implemented process improvements that enhanced workflow efficiency and reduced claim resolution times.
Local COB/Subrogation Specialist/Customer Service Representative
Capital Blue Cross
11.1997 - 06.2008
- Flagging contracts with Auto, Workers Compensation and TPL
- Knowledge of Auto and Workers Compensation policies
- Adjudication of claims
- Adjusting and processing refunds
- Assisting with Special projects Coding and research
- Maintaining and following guidelines to our products
- Proven ability to learn quickly and adapt to new situations.
- Worked effectively in fast-paced environments.
- Skilled at working independently and collaboratively in a team environment.
- Self-motivated, with a strong sense of personal responsibility.
- Excellent communication skills, both verbal and written.
- Worked well in a team setting, providing support and guidance.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Passionate about learning and committed to continual improvement.
- Worked flexible hours across night, weekend, and holiday shifts.
- Managed time efficiently in order to complete all tasks within deadlines.
- Organized and detail-oriented with a strong work ethic.
- Paid attention to detail while completing assignments.
- Used critical thinking to break down problems, evaluate solutions and make decisions.
- Adaptable and proficient in learning new concepts quickly and efficiently.
- Strengthened communication skills through regular interactions with others.
- Learned and adapted quickly to new technology and software applications.
- Proved successful working within tight deadlines and a fast-paced environment.
- Developed and maintained courteous and effective working relationships.
- Demonstrated strong organizational and time management skills while managing multiple projects.
Education
Associate’s Degree - Business Administration
Harrisburg Area Community College
Harrisburg, Pa05.2018
Skills
- Effective communication
- Self-driven
- Proficient in Microsoft Office
- Customer engagement
- Strong attention to detail
- Problem-solving abilities
- Consistent reliability
- Adaptability and flexibility
- Analytical skills
Timeline
Internal Audit/Corporate Performance Analyst/Customer Service Representative
Capital Blue Cross
02.2022 - Current
FEP Claims Examiner/Customer Service/Backup CPR
Capital Blue Cross
01.2012 - 02.2022
Claims Examiner ITS PEBTF/Customer Service Representative
Capital Blue Cross
06.2008 - 01.2012
Local COB/Subrogation Specialist/Customer Service Representative
Capital Blue Cross
11.1997 - 06.2008
Associate’s Degree - Business Administration
Harrisburg Area Community College
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