Nick Czajkowski Email & Phone Number

Camp Hill, Pennsylvania, United States

Camp Hill, Pa

Successfully manage daily benefit-related activities for diversified partners with cross-functional training for multiple systems. Coordinate and attend offshore benefit meetings and training sessions, reviewing and modifying training material as needed for accuracy and efficiency. Ensure benefit structures are implemented in alignment with departmental goals and conduct both internal and external audits. Consistently achieve or exceed SLA timelines, proactively resolving issues before they can impact service.Key Achievements:- Identified service-specific claims issue resulting in $100k + cost avoidance. - Implemented 2 diversified vendor projects for health plan’s Pennsylvania line of business in compliance with regulatory standards.- Traveled as needed to execute business-related training programs, including development and delivery of offshore training program in India.

Harrisburg, Pennsylvania, United States

Camp Hill, Pa

Maintained benefit platform, specializing in national accounts with more than 1000 members. Meticulously analyzed and investigated benefit data to determine root cause analysis and institute corrective action plan. Closely collaborated with sales department, implementing new clients swiftly and efficiently. Key Achievements:- Successfully implemented new benefit department structure, liaising between benefit projects and national benefit team for timely completion.- Worked with external consulting firm (Accenture) daily for 6 months, onboarding and mentoring new employees and gaining valuable job advancement skills including benefit intake and client-specific claims testing.

Camp Hill, Pa

Resolved inquiries from Blue Cross Blue Shield plans via telephone and written communication, managing interactions in professional and timely manner. Effectively coordinated case-specific rate negotiations for out of area members using out of network providers, handling quality issues in accordance with Highmark standards. Reviewed and routed inquiries to appropriate work queue and responded to written provider correspondence.Key Achievements:- Initially hired by Highmark as Plan Representative and promoted to progressively responsible positions due to exceptional problem-solving, time management, and analytical thinking abilities.- Aided in implementation processes for Highmark Delaware and collaborated with other Blue Cross Blue Shield plans to resolve state-to-state claims processing issues.- Consistently exceeded production standards while ensuring high quality work and achieving adherence goals and objectives.