Senior Investigator
CurrentKey Achievements: • Successfully implemented counter fraud data system integration while managing vendors• Charged with collecting, analyzing, and integrating data collected from external and internal sources to identify cases of potential fraudulent and abusive activity, determine exposure, and feasibility of the project to justify resource allocation within the company• Lead the launch of the Medical Specialty Team in early 2015 in the Florida Market which is now the model used by the company nationwide• Lead implementation of strategic objectives that resulted in reduced risk, fraud prevention and recovery in property and casualty claims• Managed proactive strategies in the detection and investigation of claims and other transactions fitting patterns of organized criminal activityResponsibilities:• Serve as a leader of a cross-functional team, contributing to strategy, practice development, offering development, and talent management• Develop deep relationships within client organizations and work in cross-functional teams across diverse stakeholders to achieve goals on time and under budget• Navigate the complex organizational structure to achieve complex program development and implementation with multiple stakeholders• Coordinate in-house training and awareness at all levels of the company to target the primary identification of “red flags” or fraud and abuse indicators to better identify, prevent and report potential cases of fraud and abuse within the property and casualty insurance units