Jon Z. Email & Phone Number

Waterloo, Ontario, Canada

Waterloo, Ontario, Canada

Responsible for the prevention and detection of fraud/abuse against group benefits plans. Primary role is to conduct due diligence and risk assessments on health care providers; investigate allegations and predicated suspicions of fraud and abuse; Conduct claims audits to identify cases of fraud and misrepresentation; Conduct interviews with plan members and providers; engage regulatory bodies; and proactively prevent fraud/abuse against health insurance.

Waterloo, Ontario

Developed various program and process improvements through the exploration and implementation of technical knowledge, improving project operational efficiency by 40%Created a tracking system for project tasks to develop a statistical understanding of the project and its timeframes.Liaise with public organizations and health associations to verify member registration to prevent fraud risk for stakeholders. Work with management across multiple departments to discuss and develop strategic and operational recommendations on project related processes to benefit ongoing business initiatives and goals.Conduct external vendor audit for credentialing and re-credentialing of service providers. Proficiency in data analysis, data entry, and data verification.

Ottawa, Ontario, Canada

Assist with research and evaluations related to policing objectives and initiatives in Ottawa. As a Practicum Student, my responsibility was to aid in the analysis, evaluation, and verification of crime reporting statistics to inform decisions.

Waterloo, Ontario, Canada

Summer Intern assisting the Investigative Services Unit and Fraud Risk Management Team in achieving its goals. Major Project: Collect information on Health Providers to proactively mitigate fraud risks and ensure obligations to plan sponsors and members are met. Additional Responsibilities: - Conduct social media and open source searching- Assist with document retention project- Compile facility information for services rendered by particular Providers- Assist with creating submissions to Police for Prosecution- Assist with data analysis and creating client-specific reports - Assist with gathering pre-investigation information such as validating Provider credentials, Provider name/contact info, etc- Assist with administrative tasks surrounding Hospital Audit Program, Dependent Eligibility Verification Program (DEVP)- Contact facilities to verify and confirm information regarding Health Providers.

Bachelor Of Arts Honors, Criminology And Criminal Justice (Concentration In Law), Minor In Psychology

Multidisciplinary Degree - Focusing studies in the field of law while expanding my knowledge in areas of sociology, psychology.

Bachelor Of Community & Criminal Justice, Criminal Justice/Safety Studies, 3.62/4.00 Gpa

Member of Dean's List during both years of enrolment.