JACQUELYN W. FRANCO
Eagle Mountain,UT
Summary
Personable and customer-focused leader dedicated to exceeding customer expectations and upholding company standards. Proven track record of fostering quick and successful problem resolution, resulting in improved customer satisfaction ratings. Demonstrated success in utilizing current technologies to enhance communication and improve response time. Expertise in customer relations and adapting to evolving technologies, ensuring exceptional service and positive customer experiences.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Command Customer Relations Officer (GS 0301-09)
Naval Health Clinic Hawaii JBPHH, Makalapa Clinic
Makalapa, USA
06.2018 - 01.2021
- Served as liaison between patients, clinic staff, and the community
- Identify, validate, and resolve patients’ complaints, disagreements, grievances, and unmet needs by applying information and guidance from a variety of sources
- Coordinated with healthcare providers and administrative support staff throughout Naval Health Clinic Hawaii (NHCH) to resolve and minimize customer complaints
- Researched and incorporated NHCH policies, resources, and services in response to patients’ concerns
- Advised and assisted patients in understanding their rights and responsibilities
- As the SME on customer relations topics, continuous communication with leadership was necessary to help resolve customer concerns
- As requested by senior leadership, specific training was provided on a variety of topics for entire directorates or individual departments
- Developed options to correct or improve existing procedures and train hospital and clinic staff
- Drafted and prepared correspondence and memoranda to disseminate corrective options to hospital and clinic staff
- Interviewed patients to assess their concerns and identify issues to properly advise them of possible resolutions for their specific situation
- Direct communication with patients in person, by email, or telephone was necessary to help resolve all patients concerns and issues
- Provided empathetic, kind, compassionate and caring communication to establish the best possible outcome for the patient
- Direct communication daily with stakeholders, senior leadership, directors, department heads, clinic managers, supervisors, etc., to ensure all matters of concern and high importance were resolved in an efficient, expeditious and courteous manner
- Developed and recommended to immediate Director a course of action, with conclusions, for the Patient Family Partnership Council
- Former member of the Enhanced Multi-Service Markets (eMSM) Patient Experience Work Group committee to develop a course of action to enhance patients’ experience at treatment facilities through the eMSM, a new military health system that integrates all branch of services
- Coordinated efforts with Department Head and Clinic Manager to help develop the Virtual Visit Discharge Summary
- Developed monthly training material and instructed departmental Customer Relations Representatives (CRR) on techniques to improve customer service
- Conducted group and individual classes to improve staff understanding and attitude of patients’ perceptions and experiences
- Briefed newcomers of all ranks at monthly Command Indoctrination meetings on the Customer Relations Program
- Trained newly assigned CRRs in the clinics on administrative and legal matters, patient bill of rights, and regulatory, statutory, and command policies
- Represented the Commanding Officer at various Command/Base/Community Council Meetings, Family Readiness and Ombudsman Meetings
- Represented the Commanding Officer at briefings for various medical staff to communicate the importance of problem solving, providing expeditious services, and implementing corrective measures in response to customers’ complaints
- Briefed Command Executive Board (CEB) and Medical Executive Committee (MEC) quarterly on updates on the Customer Relations program
- Member of the Command’s Quality Council providing monthly updates and reports regarding patient’s overall satisfaction or complaints
- Provided weekly Customer Relations reports to the Command Executive Board during the pandemic
- Managed department call volume of 95 calls per day and coordinated department schedules to maximize coverage during peak hours.
- Directed 40-person team of customer service personnel while helping front-line team members work effectively with over 200 daily customers.
Claims Examiner (GS 0998-07)
Medical Affirmative Claims Office, Tripler Army Med. Center
Tripler Army Medical Center, USA
05.2016 - 06.2018
- Collected, examined, and analyzed medical records and billings from various military health care facilities, private health care providers and CHAMPUS/TRICARE
- Identified private individuals and insurance companies responsible for medical treatment costs
- Interviewed injured individuals and witnesses to gather facts of the incident that led to the medical treatment
- Computed third party liability based on billing statements from the Uniform Billing Office, agency directives and policies, local procedures, and standard operating manuals
- Composed demand correspondence, assembled enclosures for demand packets, and mailed packets to responsible third parties
- Negotiated fair settlements for all parties involved
- Composed and prepared correspondence to attorneys’ offices, insurance companies and other third parties when reimbursements were reduced with no good cause
- Communicated orally and in writing with injured parties, insurance representatives, attorneys, medical personnel, claims personnel, and representatives of other Government and civilian agencies to resolve conflicting or confusing facts
- Interpreted and applied statutes, regulations, and precedents of the Medical Affirmative Claims Program to resolve disputes between third parties and the Government
- Established and implemented methods that reduced a backlog of recovery actions within nine months of the date I reported for duty
- Directed claims negotiations within allowable limit of $5,000 and supported successful litigations for advanced issues.
Claims Technician (GS 0998-07)
Consolidated Legal Services Office, Schofield Barracks, Hawaii
Schofield Barracks, USA
04.2003 - 05.2016
- Counseled military members, retirees and families on their rights and options within the various claims statutes
- Instructed claimants in preparing claim forms and gathering supporting documents
- Examined supporting documents and investigated the circumstances of the claims to determine validity
- Analyzed supporting documents and compared damages against repair estimates to determine appropriate settlements under the Personnel Claims Act
- Analyzed the facts of tort claims to determine Government negligence in accordance with the Federal Tort Claims Act or the Military Claims Act
- Computed the amount of settlement due to the claimants based on repair estimates, reported damages, table of depreciation and allowance guide
- Interpreted and implemented applicable regulations, statutes, policies, and precedents to determine payment or denial of claims
- Reviewed police reports, claims in-take reports and memoranda for records, and witness statements in preparation for interviews with claimants and witnesses
Education
Bachelor of Science - Applied Health
Brigham Young University Idaho
Rexburg, ID10-2025
Skills
- Customer relations
- Team building
- Problem-solving skills
- Time management
- Computer skills
- Excellent communication
Certification
Community & Environmental Health Certification
Health Program Strategies Certification
Timeline
Command Customer Relations Officer (GS 0301-09)
Naval Health Clinic Hawaii JBPHH, Makalapa Clinic
06.2018 - 01.2021
Claims Examiner (GS 0998-07)
Medical Affirmative Claims Office, Tripler Army Med. Center
05.2016 - 06.2018
Claims Technician (GS 0998-07)
Consolidated Legal Services Office, Schofield Barracks, Hawaii
04.2003 - 05.2016
Bachelor of Science - Applied Health
Brigham Young University Idaho