Jeffrey Caughie
State Farm
Lacey,WA
16
Years of experience
Dedicated professional with extensive experience in claims processing and customer service. Known for attention to detail and exceptional communication skills, driving efficient resolutions and fostering positive relationships with clients.
Work History
Claims Associate
13 Years- Analyzed claims data to identify trends and improve processing efficiency.
- Reviewed and adjudicated insurance claims for accuracy and compliance with policy guidelines.
- Collaborated with agents to resolve complex customer inquiries and expedite claim resolutions.
- Mentored junior claims associates, fostering professional growth and adherence to best practices.
- Worked productively in fast-moving a work environment to process large volumes of claims.
- Maintained up-to-date knowledge of industry regulations, ensuring compliance in all aspects of claims handling.
- Improved team performance by providing ongoing training and support for Claims Associates on best practices and procedures.
- Provided exceptional customer service by addressing inquiries promptly and resolving issues professionally.
- Developed positive relationships with clients, fostering trust and open communication during the claims process.
- Increased customer satisfaction rates through empathetic handling of customer concerns and timely resolutions.
- Collaborated with team members to develop strategies for efficient claims processing and improved customer experiences.
- Reduced claim resolution time by improving communication between departments and prioritizing urgent cases.
- Followed up with customers on unresolved issues.
- Collaborated with internal departments and external vendors to resolve claims.
- Processed and recorded new policies and claims.
- Maintained confidentiality of patient finances, records, and health statuses.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Generated, posted and attached information to claim files.
- Verified client information by analyzing existing evidence on file.
- Posted payments to accounts and maintained records.
Assistant Manager
3 Years 2 Months- Trained and mentored staff to enhance service quality and operational efficiency.
- Coordinated staff schedules to meet peak customer demand while maintaining labor costs.
- Implemented inventory management practices to reduce waste and optimize stock levels.
- Supervised daily operations to ensure compliance with company standards and procedures.
- Led initiatives to improve customer satisfaction scores through feedback implementation.
- Collaborated with upper management on strategic planning to enhance overall business performance.
- Supervised day-to-day operations to meet performance, quality and service expectations.
- Maintained a clean, safe, and organized store environment to enhance the customer experience.
- Developed strong working relationships with staff, fostering a positive work environment.
- Monitored cash intake and deposit records, increasing accuracy, and reducing discrepancies.
- Oversaw daily cash reconciliations, ensuring accurate financial reporting and minimizing discrepancies.
- Improved customer satisfaction by addressing and resolving complaints promptly.
- Offered hands-on assistance to customers, assessing needs, and maintaining current knowledge of consumer preferences.
- Completed regular inventory counts to verify stock levels, address discrepancies, and forecast future needs.
- Mentored junior staff members in their professional development by offering guidance/support in their assigned roles.
- Generated repeat business through exceptional customer service.
- Assisted in recruiting, interviewing, hiring, and onboarding of new employees to maintain adequate staffing levels.
- Collaborated with the management team to develop strategic plans for business growth and improvement.
- Promoted teamwork within the workplace by encouraging collaboration among staff members on various project tasks.
- Enforced company policies consistently while handling disciplinary actions when necessary with fairness and respect.
- Ensured compliance with all safety regulations by conducting regular inspections of equipment/operations within the store.
- Maintained compliance with health and safety regulations, ensuring a safe environment for both staff and customers.
- Coached new employees, ensuring a smooth onboarding process and quicker adaptation to their roles.
- Oversaw daily operations to maintain store cleanliness and organization.
- Engaged with customers to gather feedback, using insights to improve service and product offerings.
- Improved customer satisfaction by resolving complaints and inquiries promptly.
- Set aggressive targets for employees to drive company success and strengthen motivation.
Education
Associate of Arts - General Studies
High School Diploma
Skills
Claims processing
Claims expertise
Claims investigation
Claims review
Claims adjustment
Coverage determination
Settlement determinations
Policy interpretation
Documentation review
Documentation research
Accident review
Insurance regulations
Information verification
Paperwork processing
Small claims payouts
10-key touch
Time management
Multitasking
Reliability
Attention to detail
Critical thinking
Decision-making
Problem-solving
Problem-solving
Mathematical proficiency
Client rapport
Excellent communication
Interpersonal communication
Data entry
Claims settlement
Numerical proficiency
Teamwork and collaboration
Teamwork
Analytical skills
Computer proficiency
Computer proficiency
Number-savvy
Documentation skills
Regulatory compliance
Computer proficiency
Analytical thinking
Timeline
Claims Associate
State Farm
09.2013 - CurrentRead More
Assistant Manager
Taco Time NW
07.2010 - 09.2013Read More
Everett Community College
Associate of Arts from General Studies
Read More
Marysville Pillchuck High School
High School Diploma
Read More