North Highlands CA 95660
To be given an opportunity to work as a Healthcare Fraud Investigator to put my years of training and experience to work for good of company.
Summary of Qualifications:
- Remarkable experience with fraud/abuse detection and claims data analysis
- Wide knowledge of law enforcement involved in healthcare and Medicaid fraud abuse detection
- Proficient in Excel and data analysis
- Excellent verbal and written communication skills
- Ability to differentiate between fraud, abuse and overutilization
Healthcare Fraud Investigator, August 2005 – Present
UnitedHealth Group, Devine, TX
- Developed Federal, State and local law enforcement programs to reduce fraud and assault in relation to health plans.
- Performed investigations, audits, evaluations and inspections regarding the delivery of and payment for health care.
- Assisted the implementation of the civil, criminal and administrative statutes applicable to health care.
- Provided industry assistance, including suggested opinions, safe harbors and specific fraud alerts regarding to fraudulent health care practices.
Bachelor’s Degree in Criminal Justice, West Valley College, Saratoga, CA