Selisa Daniel Email & Phone Number

Pensacola, Fl, Us

Planned and executed investigative assignments; Collaborated with Humana’s Special Investigations Unit on joint investigations; Performed comprehensive data reviews to detect potentially fraudulent patterns; Collaborated with RAIU’s Clinical team to identify conditions that require additional research and review; Prepared investigative briefings and investigative reports; Identified provider billing/claim deficiencies for corrective active plans;

Conducted background research for investigative leads; Collaborated with Humana’s Special Investigations Unit on joint investigations; Performed comprehensive data reviews to detect potentially fraudulent patterns; Collaborated with RAIU’s Clinical team to identify conditions that require additional research and review; Participated in investigative interviews; Prepared investigative briefings and investigative reports; Identified provider billing/claim deficiencies for corrective active plans;

Tallahassee, Florida Area

Supervised investigative staff of six; Planned, conducted, and directed employee misconduct, Medicaid fraud, and Whistle-blower investigations in accordance with agency policies, Florida Administrative Code, Florida Statutes, and Green Book standards; Reviewed investigative reports for compliance with Green Book standards and investigative findings in accordance with policies, codes, and laws; Developed and implemented internal investigation operating procedures; Managed and tracked investigative unit caseload; Developed performance plans; Conducted performance appraisals; Implemented disciplinary action when necessary; Coordinated investigative staff training; Coordinated case referrals to management, other governmental entities, and law enforcement agencies; Provided executive management case briefings and recommendations associated with agency policies and procedures; Coordinated dissemination of public record requests for investigative reports.

Tallahassee, Florida

Investigate allegations of harassment, retaliation, workplace violence, employee misconduct, and employee theft, falsification of documents, mishandling of resources, and malfeasance; Analyze computer hard drive data, Internet use, and email correspondence; Prepare investigative reports documenting findings and violations of agency code of ethics, policies and procedures, Florida Statutes, and EEOC guidelines; Work as liaison with local and state law enforcement and prosecutorial agencies for referral of cases with criminal violations which have resulted in prosecution and restitution.

Tallahassee, Florida Area

Investigated economic/Internet fraud of small businesses and major corporations in violation of Florida Statutes 501 and 895; Interviewed witnesses regarding allegations of fraud or deceptive/unfair trade practices; Conducted complex financial fraud and consumer fraud investigations; Prepared witness affidavits; Prepared and served subpoenas; Prepared memorandums of interview and investigative summary reports; Participated in the civil settlement agreements with small businesses and major corporations.

Investigated internal employee malfeasance and misfeasance, Whistleblower claims, and external contract fraud; Conducted investigations with the use of a vehicle tracking device; Developed and pursued investigative leads; Collected, analyzed, documented, and disseminated data; Reported investigative findings in relation to agency policy, Florida Administrative Code, and Florida Statutes; Secured statements from subjects and witnesses; Analyzed computer hard drive and cache data; Educated employees on agency Code of Conduct and Ethics; Coordinated partnerships with local, state, and federal law enforcement agencies; Prepared and presented case briefings for management and prosecution; Provided case briefings to senior management and law enforcement entities; Identified operational deficiencies and risks and make recommendations for corrective action.

Researched, collected, collated, analyzed, documented and disseminated investigative and intelligence data relating to gambling, economic, money laundering, public integrity, identity theft, and Internet crime cases to develop further leads; Created databases, spreadsheets, association/flow charts, and pivot tables; Organized and maintained case file data; Analyzed financial, computer, and investigative data for crime patterns; Identified asset locations; Participated in witness and subject interviews; Prepared written reports of investigative and analytical findings; Presented case briefings for management and prosecutorial authorities; Conducted public record searches; Prepared and assisted in service of subpoenas/court orders; Provided assistance of investigative analysis to other local, state, and federal agencies independently and in conjunction with joint agency investigations; Served as analytical liaison to other local, state, and federal agencies; Attended and participated in regional economic crime task force meetings; Prepared case for trial; Provided trial witness testimony.

Tallahassee, Florida Area

Investigated loss reports; Resolved liability issues; Prepared property damage estimates; Evaluated bodily injury claims; Negotiated claim settlements with attorney and non-attorney represented claimants; Subrogated claims losses from at-fault party/carrier; Participated in litigation, mediation and subrogation proceedings; Conducted scene investigations and neighborhood canvassing; Identified risk factors; Recommended preventative measures to carriers; Identified fraudulent claims and referred for prosecution; Research and apply Florida Statutes, Southern Building Code Congress International and policy language to determine liability and coverage, and liability defenses. Claim loss experience in property/casualty, homeowner, auto, personal/bodily injury, medical billing, workers compensation, cargo, and product liability.

Tampa/St. Petersburg, Florida Area

Investigated loss reports; Resolved liability issues; Evaluated bodily injury claims; Negotiated claim settlements with attorney and non-attorney represented claimants; Research and apply Florida Statutes, and policy language to determine liability and coverage, and liability defenses. Claim loss experience in property/casualty, homeowner, auto, and personal/bodily injury.

Tampa/St. Petersburg, Florida Area

Investigated loss reports; Resolved liability issues; Evaluated bodily injury claims; Negotiated claim settlements with attorney and non-attorney represented claimants; Subrogated claims losses from at-fault party/carrier; Participated in litigation, mediation and subrogation proceedings; Identified risk factors; Research and apply Florida Statutes, and policy language to determine liability and coverage, and liability defenses. Supervised claim staff of 6. Claim loss experience in property/casualty, auto, and personal/bodily injury.

Inverness, Florida

Investigated loss reports; Resolved liability issues; Prepared property damage estimates; Evaluated bodily injury claims; Negotiated claim settlements with attorney and non-attorney represented claimants; Subrogated claims losses from at-fault party/carrier; Participated in litigation, mediation and subrogation proceedings; Conducted scene investigations and neighborhood canvassing; Identified risk factors; Identified fraudulent claims and referred for prosecution; Research and apply Florida Statutes, and policy language to determine liability and coverage, and liability defenses. Claim loss experience in property/casualty, homeowner, auto, personal/bodily injury, and medical billing.

Certified Financial Crimes Investigator, Financial Crimes

Certified Eeoc Investigator, Eeoc Investigator Training

Certified Compliance And Ethics Professional, Compliance And Ethics

Cigi, Certified Inspector General Investigator

Cfe, Certified Fraud Examiner

Certified Law Enforcement Analyst, Crime Analysis

Cpcu Coursework, Charter Property Casualty Underwriter

Associate In Claims, Insurance

Mba, Business Administration

Ba, Business Management

Aa, Business

Activities and Societies: Phi Theta Kappa

Education record