I am currently at Healthcare Fraud Shield, a provider of dynamic fraud, waste and abuse detection software solutions/Healthcare Enterprise Metrics, a premier provider of enterprise systems for healthcare insurance companies . Our suite of products introduce several new technology applications to the healthcare industry that will revolutionize cost reduction opportunities. Our new platform introduces cutting edge technology that revolutionizes cost reduction and improves communication and synergy across multiple healthcare insurance company departments to achieve strategic company goals.
Previously, I was the SIU Manager at ViPS, a General Dynamics Information Technology company. I managed the SIU staff 's fraud investigations and all other anti-fraud services. My experience has afforded me the opportunity to be a presenter at the National Healthcare Anti-fraud Associations (NHCAA) Conferences as well as the FBI, the IASA mid-atlantic conference, VIPS Fraud Forum, North Jersey Claims Association, Eastern Claims Conference, and the New Jersey OIG's office. I also had the privilege of being a part of the 2011 FBI Citizen's Academy in Newark, NJ.
I worked in a variety of public and private sector positions conducting research, investigation, and analysis of criminal data, geospatial crime analysis, public housing crime, drug related incidents, homicides, suicides, and more.
Specialties: Accredited Healthcare Fraud Investigator (AHFI), Certified Professional Coder (CPC-P), Certified Professional Medical Auditor (CPMA), Negotiations, Claims, Record Review, CPT, ICD-9, HCPCS, Presenter/Trainer (Health Care Fraud, Investigations, Schemes, Investigative Tools, Medical Coding, Data Analysis w/ Excel & more) for NHCAA, AUSA, FBI, IASA, VIPS, & AAPC Regional Chapter.