Stephanie Francis Email & Phone Number

United States

Orlando, Florida, United States

Orlando, Florida Area

- Lead administration of Short Term Disability, FMLA, and company leave programs for clients with upwards of 300,000 employees, including Amazon.com; review claims and medical records, compare findings to job and state requirements to determine eligibility, manage communication and payments, document and code ICD-10 diagnoses and CPT surgical procedures, and manage internal HR profiles and benefits in Oracle and Workday; continuously achieve 100% accuracy on individual audits.- Serve as primary case manager for selected clients and handle escalated issues when needed; develop client specific SOPs and upload documentation to internal SharePoint site; ensure compliance with regulatory and legal requirements including HIPAA, ERISA, and state-specific language.- Lead weekly calls with client HR benefits managers and leads to answer individual employee case questions and work through complex and unique issues.- Develop and deliver trainings to case managers and customer service representatives, focusing on internal system coding and processes, client specific actions, and claims handling procedures; teams are more knowledgeable when handling client requests, maintain Service Level Agreements (SLA), and earn improved internal audit scores.- Lead improvements to internal Turnaround Time (TAT) audits for Benefit Team, investigate past cases that breached SLA, and determine if actions were taken in correct amount of time; able to convert 75% of cases from fail to pass after audits, improving overall service scores, and avoiding costly penalties.- Contributed to project implementation by managing testing and launch of benefits program with national nuclear security client, performed User Acceptance Testing (UAT) on system to ensure workflow, processes, and functionality met client specifications, and worked with client post-launch to resolve issues; ensured smooth transition from in-house benefit program, and helped retain client for extended service contract.

Orlando, Florida

Absence Management division purchased by ReedGroup and currently working in the same role at ReedGroup.

Maitland, Fl

- Oversaw all aspects of leave administration for clients with upwards of 50,000 employees, including employee notifications, vendor management, and disability programs; managed caseload of 200, examined job descriptions to determine physical and mental requirements, compared them to employee medical records and history, and determined, issued, and denied payouts.- Partnered with Nurse Case Managers to review and interpret hospital records, patient progress notes, and lab reports to determine level of physical and mental functionality; worked with Vocational Rehab Specialists to craft plans for employees to return to work safely, and provided suggestions for altered job duties that could accommodate disability.- Led settlement of cases, worked with insurance companies and claimants to determine physical and mental condition, and calculated fair and amicable agreements for lump sum payouts; provided conclusions to ongoing cases that saved the company money while ensuring positive employee experience.- Managed investigations into suspicious claims, worked with Surveillance Team to review medical and case files to request specific footage of claimant, analyzed evidence to determine fraudulent activities, and developed detailed report for delivery to management; able to deny fraudulent claims, discontinue benefits, and save company thousands of dollars.

Bs, Health Services Administration

Mba, Business Administration