Analyze and resolve high-volume medical claims, ensuring compliance with financial and regulatory standards while driving workflow efficiency. Conduct in-depth data analysis to identify discrepancies, reduce inaccuracies, and detect fraud, contributing to cost-control efforts.

Effectively identify and provide resolutions for medical claims while navigating complex computer systems. Conduct detailed analysis of transaction data to identify patterns and anomalies that may indicate fraudulent activity. Deliver pertinent information and answer questions to facilitate strong relationships with providers and their staff.

Developed and implemented strategies to prevent and investigate fraudulent activity, including implementing new technologies and processes. Worked closely with cross-functional teams to identify and mitigate risks to the organization. Inventory retail, warehouse, and E-Commerce inventory to monitor web traffic.

Maintain and audit confidential documentation ensuring city and state compliance for clients seeking community services. Process all enforcement actions within the required time frame. Prepare technically accurate reports, notification letters, and penalty notifications.

Maintain and audit confidential documentation ensuring city and state compliance for clients seeking community services. Process all enforcement actions within the required time frame. Prepare technically accurate reports, notification letters, and penalty notifications.