Francine Bottley
Baton Rouge,LA
Summary
Results driven Claims Liaison II at Louisiana Healthcare Connection with expertise in projects, audit processes and claims validation. Proven ability to enhance data integrity and ensure accurate claim pricing through cross functional collaboration. Skilled in MicroStrategy, Golden reporting and project monitoring, consistently achieving high quality outcomes in claims processing and resolution.
Overview
10
10
years of professional experience
Work History
Claims Liaison II
Louisiana Healthcare Connection
Baton Rouge, LA
11.2019 - Current
- Audit and validate check runs to ensure accuracy and prevent processing errors.
- Support team members by managing check runs during absences and verifying spreadsheet data integrity.
- Conduct detailed project research to ensure first-time resolution accuracy.
- Monitor projects from initiation to completion to confirm correct claim pricing and payments.
- Collaborate cross-functionally with Claims, Special Investigations, and Provider teams.
- Generate and analyze claims reports using MicroStrategy and Golden systems.
ITS Account Advisor
Blue Cross Blue Shield
Baton Rouge, LA
08.2019 - 11.2019
- Provided inbound provider support for eligibility, payments, contracts, and plan assistance across multiple states.
Claims Research Specialist- Temp
Louisiana Healthcare Connections
Baton Rouge, LA
09.2018 - 02.2019
- Resolved internal and external claims inquiries.
- Maintained provider database accuracy and data integrity.
- Completed claims research projects and reimbursement investigations.
- Educated provider teams on claims submission policies and procedures.
Provider Resolution Specialist
UnitedHealth Group
Baton Rouge, LA
01.2016 - 06.2018
- Processed medical claims remotely with high daily production standards.
- Utilized multiple systems including Facets, Citrix, CareOne, and Microsoft Office.
- Maintained daily communication with internal teams via Cisco Jabber.
- Processed 50-60 claims per day while maintaining quality standards.
Education
High School Diploma -
Joseph Moore Davidson High School
Saint Joseph, LA05-2000
Some College (No Degree) - Nursing
Southern University And A&M College
Baton Rouge, LASkills
- Audit processes
- Claims validation
- Cross-functional collaboration
- Data analysis
- Project monitoring
- Claims processing
- Claim pricing
- MicroStrategy reporting
- Claims investigation and research
References
References available upon request.
Timeline
Claims Liaison II
Louisiana Healthcare Connection
11.2019 - Current
ITS Account Advisor
Blue Cross Blue Shield
08.2019 - 11.2019
Claims Research Specialist- Temp
Louisiana Healthcare Connections
09.2018 - 02.2019
Provider Resolution Specialist
UnitedHealth Group
01.2016 - 06.2018
High School Diploma -
Joseph Moore Davidson High School
Some College (No Degree) - Nursing
Southern University And A&M College