LERI FRANCE
Concord,USA
Summary
Resolute legal professional with 15 years of experience leading team development and enforcing policies and procedures to drive performance and maximize revenue. Extensive knowledge of construction terminology and outside plant damage within utility infrastructure. Proven ability to interpret and apply state dig laws and statutes, 811 excavator requirements, NESC standards, and CGA guidelines.
Overview
18
18
years of professional experience
Work History
Claims Manager
Project Resources Group
Greenwood Village, CO
11.2022 - Current
- Resolve and negotiate claims recovery of repair and replacement costs on third-party cable/fiber and utility damages across multiple state lines, via phone, email, and letters.
- Developed and implemented process improvements, enhancing operational efficiency in claims management.
- Trained and mentored staff on best practices for claims handling and customer service excellence.
- Learn, understand, and be able to utilize state dig laws and statutes, 811 excavator requirements, NESC standards, CGA guidelines
MEDICAL BILLING ACCOUNT SUPERVISOR
DeMayo Law Offices
Charlotte, NC
10.2020 - 11.2022
- Day-to-day Operations/Workflow coordination
- Monitored insurance receivables to achieve business line expectations, while maintaining and enforcing all aspects of confidentiality of events and client information in compliance with privacy laws and guidelines
- KPI reporting and statistical data integrity for Complex claims
- Accounting, AR and RECON, Claim Balances, and Medical Statement
- Billing coding. Medical terminology. Escalations, and Appeals
- Business unit forecasting, scheduling, and recruiting
- Multi-Team Supervisor (25+ Remote/Hybrid)
- Processing platforms: Microsoft, Google Suite, QuickBooks, Salesforce
INTAKE DATA REVIEW MANAGER
EPIQ Global Mass Tort
Charlotte, NC
03.2008 - 10.2020
- Collaborated with multidisciplinary teams to facilitate client care and reduce case management barriers
- Developed and administered budgets, authorized expenditures, and monitored financial indicators to improve profitability
- Experience with Class Action Settlement Litigation and Agency regulations. SSD, Workers Comp, Liability, MSA, and Mass Tort
- Medicare/Medicaid & ERISA Subrogation
- Data integrity, Compliance, and Lien Resolution expert
- Project review and roll-out (QA/UAT testing)
Education
Bachelor of Science - Criminal Justice, Minor in Accounting
Widener University
Chester, PASkills
- Development of Process Models
- QA/UAT Testing
- Financial Reporting, Stats, and Metrics
- Operations Management/Staff Performance
- Claims Processing (SSD/Injury/STD/FMLA)
- Insurance Billing/Coding (Denials/Appeals/Escalation)
- Quality Assurance and Customer Service
- Medical terminology
- Collaborated on the resolution of 25million liens in both Single Event, Class Action/Mass Tort/Pharmaceutical litigations
- Auto Insurance (BI/PD/LIAB/UM/UIM/MedPay)
- Healthcare Compliance
- Construction law
Timeline
Claims Manager
Project Resources Group
11.2022 - Current
MEDICAL BILLING ACCOUNT SUPERVISOR
DeMayo Law Offices
10.2020 - 11.2022
INTAKE DATA REVIEW MANAGER
EPIQ Global Mass Tort
03.2008 - 10.2020
Bachelor of Science - Criminal Justice, Minor in Accounting
Widener University