Independent Contractor
CurrentMost significant clients have been: JDS & Associates, LLP: Worked from September 2009 - September 2018 as an Investigator conducting investigations to determine and report fraud, waste, and abuse by health care providers under the federal Medicare Program. This included: • Researching eligibility criteria, program rules and requirements, allegations and anomalies, and provider organization and operations. • Gathering and analyzing data. • Interviewing beneficiaries, health care providers, subject matter experts, and law enforcement and legal counsel as needed. • Planning and documenting investigative steps, findings, conclusions, and recommendations. • Preparing written reports of non-compliance and associated overpayments. • Discussing investigative results and recommended disposition with management and CMS. Efforts led to financial recoveries, administrative disciplinary actions, and referrals to law enforcement. In addition, supported management by developing new forms and processes to better guide and document interviews, safeguard information, and track and report investigative status. For two major projects, assisted in assigning field work among investigators, reporting status, and validating that conclusions were clearly supported by documentation. Also, drafted White Paper proposals of new investigative opportunities. Commercial Fireproofing and Insulation, LP, a two-month project analyzing work processes for a new Firestopping service line of business and recommending changes to improve communication, internal controls, and results.