Michael Keller Email & Phone Number

Michael D. KellerHighly experienced healthcare fraud investigator provides support as a contractor to AdvanceMed Corporation, an NCI Company, Zone Program Integrity Contractor (ZPIC) Zone 2, in Medicare claims data analysis, provider education, administrative payment recoupment actions, benefits integrity analysis and investigation and provides assistance to federal law enforcement agencies in the furtherance of criminal investigations. Areas of Focus Medicare claims data analysisCenters for Medicare and Medicaid Services policy complianceMedicare Administration Contractor policy complianceAdministrative overpayment recoupment actionMedicare fraud referral to law enforcementMedicare service provider and beneficiary interaction Industry SpecialtiesCenters for Medicare and Medicaid ServicesProactive claims data miningRegulatory analysis and enforcementProgram quality improvement and provider education

Performs Medicare claims analysis, policy compliance reviews and conducts investigations to prevent and identify fraud directed against the Medicare Trust Fund, using Medicare related data programs.Provides mentoring to investigators in areas of claims analysis, report preparation and fraud investigation techniques.Conducts liaison with federal law enforcement, single state agencies and other ZPICsIdentified false claims totaling in excess of 1 million dollars

Directed a staff of investigators, auditors and analysts in conducting criminal and civil investigations of suspected Medicaid fraud, provided support and guidance to state social services and law enforcement agencies.Washington State Attorney General, Criminal Justice Division Management Team, developed and revised investigative policies and Standard Operating Procedures.Medi-Medi Program Steering Committee member responsible for assisting in the evaluation and implementation of procedural processes.Washington State Department of Social and Health Services (DSHS) Task Force member, provided guidance and instruction to the Washington DSHS fraud detection efforts and participated in several DSHS steering committees.Supervised a human resources committee which revised Attorney General’s Investigator classifications and established an additional senior level investigator classification. Initiated and presented a proposal which resulted in the establishment of a satellite MFCU office in eastern Washington.Obtained access to real time electronic Medicaid claims data and established procedures for data retrieval in support of investigations.Established training programs at the Washington State Criminal Justice Training Center and Washington State Patrol Academy relating to the identification and investigation of elder abuse and healthcare fraud.

Developed lesson plans and taught criminal justice courses to students seeking degrees in criminal justice and paralegal studies. Mentored and advised students, and evaluated student academic performance.

Conducted analysis of criminal intelligence to identify and report international maritime drug smuggling trends, using various criminal intelligence data programs.Intelligence reports identified drug smuggling trends and operations along the west coast of the United States, Southeast Asia and Hawaii and along the US border with Mexico which resulted successful drug interdiction efforts.

Conducted criminal investigation in support of seven counties located in west central Kansas, conducted joint investigation with local, state and federal law enforcement agencies. Established a multi-state criminal intelligence sharing committee consisting of various law enforcement agencies from Kansas, Colorado, Nebraska, Oklahoma and Texas.Conducted the first joint investigation with the Federal Bureau of Investigation in Western Kansas involving healthcare fraud, resulting in several convictions.Provided onsite training to local agencies and at Kansas State Law Enforcement Training Center sessions.

Provided district level supervision to eight subordinate criminal investigation offices located in the Republic of West Germany and West Berlin involving drug interdiction and VIP personal security tasks. Conducted inspections to ensure regulatory compliance and accountability of funds and evidence.Reviewed, revised and composed policies and procedures relating to all drug interdiction efforts for a criminal investigation district with an assigned area of responsibility of central West Germany and West Berlin. Coordinated and participated in all missions assigned to the district involving VIP personal security missions for the Chairman Joint Chiefs of Staff, US Secretary of the Army and US Secretary of Defense.Coordinated interdiction efforts for a joint investigation with German law enforcement agencies which resulted in the first seizure of crack cocaine in Republic of West Germany.

Special Agent in ChargeProvided direct supervision to criminal investigation offices located with the United States and at foreign locations with staff consisting of Special Agents and Administrative Support employees. Supervised all criminal investigation and administrative support activities. Conducted and supervised criminal and civil investigations of improprieties involving US Government contracts which resulted in the recovery of several million dollars.

Master Of Liberal Studies, Justice Studies

Education record