QUALIFICATIONS & SKILLS: Claims Investigation Coverage Confirmation Recorded Statements Provider/Patient Interviews RFI's DOI Complaints Collaboration w/Law Enforcement Case Management Bill Review/Aberrant Billing Patterns Provider License Verification Data Analysis Data Pulls/Clearing Grids Provider Complaints Member Complaints Reporting to State DOI's (All 50 States) RFI's/Subpoena Reporting to State Medical Boards (All 5...
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Fraud Investigator, Compliance, Case Management, Claim Examiner, Claims Representative, Health Care Industry, Arbitration, Benefits, Billing, Coding, Complaints, Computer Aided Software Engineering, Data Analysis
To support regulatory compliance enforcment through investigation, analyses, concise and thorough report development to enable client/customer favorable outcomes, mitigating regulation obstacles.
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Account Management, Contract Compliance, Regulatory compliance, Fraud investigations
I am a retired Law Enforcement officer of the Columbus Police Department, Columbus, Georgia and have relocated in the Fernley/Reno/Sparks, Nevada area. I would like to use my skills, knowledge and experience gained in financial investigations to begin a new career in asset protection for a company or to use my experience in starting a career in the field of finances.
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fraud investigations, Reno, Nevada, Banking, extremely organized, supervisor, self starter, challenging, finances
Manage/supervise multi line adjusters
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Multi line adjuster, Program Insurance, Computer experience, Legal experience, Equine/livestock experience, Fraud investigation
To obtain a position at a good university, wherein I can build a department, or contribute to fundraising, and expansion of national, ethnic, racial, and studies of ethnic conflict and conflict resolution.
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New Jersey, NYC, NYS, Conn., Colby, Bennington, SUNY, Fordham
Shandra’s background is in Quality Assurance, Quality Control and Mortgage Fraud Investigation. The skills obtained over Shandra’s career in Mortgage consist of performing loan level investigative fraud reviews, evaluating the applications and documents for incompletes, detecting falsified documents, as well as inaccurate financial statements/status and recognizing the material misrepresentations and inaccurate information ...
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Quality control - mortgage, Auditor - mortgage, Fraud Investigation - Mortgage
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finance, mortgage, fraud investigation, administrative, credit, management
Would love to focus my expertise primarily on fraud investigation. Considering becoming a certified fraud investigator. Currently a certified BSA/AML professional. Open to any opportunity for something challenging though! Just ask!
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Corporate Training, Executive Administrative Assistant, Bank Secrecy Act, Investigation and Research, Microsoft Office, Management and Supervision, Fraud Investigation
Knowledgeable and resourceful Police Chief and Investigator with expertise in investigations, internal affairs, crime prevention, and strategic vision. Proactively screens, hires, trains and supervises staff, monitoring for performance and coaching for achievement. Provides extensive knowledge of evidence collection and transfer techniques, including the intricacies of homicide and untimely death investigations. Establishes...
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Public Protection , Team Leadership, investigation, strategic vision, Conflict Resolution, Security Specialist, Problem Solving , Administration
