Cathy Franklin Email and Phone Number

▪ Drafted policy documents.▪ Assisted with classroom management, including behavior monitoring, student supervision, and maintaining a positive and safe atmosphere conducive to learning.

▪ Facilitated communication and technology management for the City of Austin as a contractor.▪ Collaborated with experts from diverse fields such as engineering, product management, instructional design, and support to craft comprehensive internal and external user manuals.▪ Conducted research, testing, and interviews to grasp new content features effectively.▪ Generated technical content for both internal and external audiences, including instructional materials and how-to guides.▪ Worked closely with internal teams to gain profound insights into product functionalities.▪ Ensured adherence to established standards for clarity, conciseness, and terminology in all writing assignments.▪ Served as the administrator for the department's SharePoint site, overseeing tasks such as updating document libraries, organizing charts, and managing distribution lists.▪ Authored numerous policies and training documents that were previously absent, uploading them onto the department's SharePoint platform.

▪ Facilitated training sessions for existing, newly hired, and outsourced personnel, covering claims processes, onboarding, train-the-trainer sessions, and employment evaluations and design.▪ Supported HealthRules Payor testing by simulating claims scenarios for software updates.▪ Provided claims training to both onsite and outsourced staff following HealthRules Payor upgrades.▪ Designed and curated hundreds of policies and procedures, training materials, including curriculum and reference materials, ensuring consistency in clinic workflows.▪ Managed and updated the Claims Department’s SharePoint website with policies, procedures, reports, and instructional videos.▪ Responsible for creating first generation instructional videos to reinforce claim processing procedures.▪ Produced comprehensive presentations, resource materials, and analytical spreadsheets for managerial purposes.▪ Offered constructive feedback to staff and leadership, pinpointing knowledge gaps and suggesting improvements.▪ Contributed to various research projects utilizing HealthRules Payor, AMISYS, SharePoint, and EncodePro, aimed at identifying issues and proposing system enhancements.▪ Generated quarterly reports for leadership meetings.

▪ Conducted training sessions for newly hired employees on enrollment procedures while maintaining responsibility of 8 major hospital and government accounts (Ascension, Covenant, Hendrick, ERS, TRS, Feds, CHIP, Medicare).▪ Supported the onboarding process for new enrollment staff, delivering orientation sessions and assisting with initial skill development and integration into the team.▪ Demonstrated strong interpersonal skills and a customer-centric approach, fostering a positive learning environment and promoting a culture of excellence in managed care enrollment services.▪ Demonstrated proficiency in technical writing, particularly within the healthcare insurance domain.▪ Supported in-testing benefit-related enrollment scenarios for the HealthRules Payor software upgrade.▪ Collaborated closely with colleagues to fulfil project objectives, devise resolutions, and adhere to timelines.▪ Participated in departmental meetings, offering insights to improve forthcoming performance.

▪ Delivered exceptional service and assistance to HR clients during phone interactions.▪ Processed benefit-related enrollments quickly and accurately for FirstCare's covered areas: Amarillo, Abilene, Lubbock, and Waco.▪ Managed electronic files for 8 major hospital and government accounts (Ascension, Covenant, Hendrick, ERS, TRS, Feds, CHIP, Medicare). ▪ Conducted data analysis on enrollment additions, modifications, and terminations.▪ Liaised with IT or HR client representatives to address enrollment data errors hindering correct uploads.▪ Served as the Subject Matter Expert (SME) for electronic data analysis.▪ Utilized data analysis techniques to assess enrollment trends and identify areas for improvement, leading to targeted interventions that enhanced enrollment outcomes.▪ Cultivated relationships with HR contacts to ensure benefit-related enrollments and issues were addressed timely and effectively.▪ Maintained accurate records and documentation, ensuring compliance with regulatory requirements and institutional policies.

▪ Managed over 100 calls daily, maintaining consistently high satisfaction ratings from callers.▪ Delivered precise information on member benefits for Texas government programs to verified callers.▪ Resolved provider inquiries and escalated issues promptly to ensure timely resolution and maintain service levels.

▪ Collaborated with Utilization Review (UR) nurses to compile medical data necessary for prior authorization preceding medical procedures.▪ Assisted UR nurses in managing and arranging patient records systematically.▪ Delivered exceptional service and addressed customer needs effectively during phone interactions.▪ Conducted thorough reviews of patient medical records and insurance policies to determine pre-certification requirements for medical procedures and treatments.▪ Collaborated closely with healthcare providers, insurance companies, and patients to gather necessary documentation and ensure accurate completion of pre-certification forms.▪ Utilized a strong understanding of medical terminology and procedural codes (CPT, ICD-10) to accurately assess pre-certification eligibility and requirements.▪ Communicated effectively with healthcare professionals and insurance representatives to resolve discrepancies and expedite pre-certification approval processes.▪ Maintained detailed records of pre-certification requests, approvals, denials, and any relevant communications to ensure compliance with regulatory requirements and facilitate billing procedures.▪ Stayed updated on changes in insurance policies, pre-certification guidelines, and healthcare regulations to provide informed assistance to patients and healthcare providers.