Summary of Qualifications A talented and ambitious, coachable and committed retired Law Enforcement Officer with customer service skills, strong technical background skills that possesses self-discipline, and the ability to work with minimum supervision playing key roles throughout the company structure, salesmanship ensuring quality solutions to meet corporate objectives. Possesses a good team spirit, is deadline-oriented and can organize, present complex solutions clearly and accurately. In the roles I've been responsible for I've conducted high level, complex investigations of known or suspected acts of healthcare/disability fraud and abuse. Routinely handles cases that are sensitive or high profile, those that are national in scope, complex cases involving multi-disciplinary provider groups, or cases involving multiple perpetrators or intricate healthcare fraud schemes. Key roles I've supervised and responsibilities are as follows but not limited to: Responsible for developing and implementing the overall fraud strategy for Michigan PIP establish effective processes, standards, reporting, and recommendations to balance mitigation efforts against acceptable service levels manage fraud losses in alignment within company guidelines oversight of all Michigan fraud operations areas including analytics, investigation and claims resolution.

Highlights:

• Billing
• Fraud
• Insurance
• Insurance Claims
• Account Manager
• Compliance
• Planning
• Policies and Procedures
• Policy Development
• Process Improvement
• consultant