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Click here or scroll down to respond to this candidateCandidate's Name
Street Address Evelyn View CourtSnellville, Georgia Street Address
PHONE NUMBER AVAILABLEEMAIL AVAILABLEEDUCATION:Stuttgart, Arkansas High SchoolDiploma, May 1989 - Honor GraduateUniversity of HawaiiB.A., Criminology, Distinction Graduate, May 1996 - GPA 3.65 UALR SCHOOL of LAWJ.D., Juris Doctor, May 2011CMS / Medicaid Integrity Institute - Certification: Certified Program Integrity Professional (CPIP), April, 2019 EXPERIENCE:Special Investigations Unit Investigator 07/21 - Present Anthem Inc., Blue Cross Blue ShieldConduct investigations and audits of healthcare services and billingsConduct interviews of suspects and persons of interestConduct Data Analytics of Suspicious Claims of Medical ProvidersRefer cases of suspected fraud to state law enforcement entitiesPrepare investigative and audit reports to Manage Care Organizations Special Investigations Unit InvestigatorCentene Corporation 06/20 - 07/21Conduct investigations and audits of healthcare services and billingsConduct interviews of suspects and persons of interestConduct Data Analytics of Suspicious Claims of Medical ProvidersRefer cases of suspected fraud to state law enforcement entitiesPrepare investigative and audit reports to Manage Care Organizations Manager, Medicaid Fraud InvestigationsOffice of the Medicaid Inspector General of Arkansas 01/17 06/20Manage Investigations of fraudulent activities within Medicaid ProgramConduct interviews of suspects and persons of interestRefer cases of suspected fraud to Arkansas Attorney General (MFCU)Assists Audit TeamHearing OfficerDHS Office of Appeals and Hearings 08/15 01/17Conduct/Preside over due process hearingsReview Medicaid Cases and issue rulingsReview Nursing Abuse Cases and issue rulingsWrite Opinions applying applicable Medicaid rules of law InvestigatorArkansas Attorney General's Office 02/15 - 08/15Investigate AR Deceptive Trade Practices Act violationsMediate disputes between Consumers and BusinessesUphold AR State laws relating to Mortgages and Vehicle Sales Medicaid Hearing OfficerArkansas DHS Office of Appeals and Hearings 09/13 - 02/15Conduct/Preside over due process hearingsReview Medicaid cases and issue rulingsWrite Opinions applying applicable Medicaid rules of law Investigator - State of ArkansasArkansas Fair Housing Commission 06/13 - 09/13Investigate complaints of discrimination in housingConciliate and mediate complainants and respondent issuesTestify on behalf of Arkansas Fair Housing Commission Investigator - State of ArkansasArkansas Motor Vehicle Commission 04/06 - 05/13Investigate new motor vehicle fraudInvestigate consumer auto complaintsEnforce State New Auto Licensure LawsTestify in Administrative HearingsLoss Prevention SupervisorKohl's Department Stores 11/05 - 04/06Supervise Asset Protection TeamPrepare Detail Investigative ReportsConduct audits to prevent cash shortageApprehend shopliftersParole/Probation Officer IIAR Department of Community Correction 07/03 - 11/05Supervised 140 Adult OffendersCertified Training OfficerPerformed investigation reportsProvided basic counseling and guidanceManager TraineeEnterprise Rent-A-Car, Little Rock, AR 2/03 - 7/03Solicited new accountsProvided excellent customer serviceManaged auto rental fleetPromotional CoordinatorProvidence Systems, Carlsbad, CA 11/98 - 09-02Promoted Business Seminars across USASold training to Mortgage LendersRenewed Network Business AccountsSales and Service Representative/Manager In Training Prudential Overall Supply, Vista, CA 07/97 - 09/98Managed a $300K annual Sales RouteManaged accounting and bookkeeping of RouteSolicited new accountsSales RepresentativeProvidence Systems, Vista, CA 08/96 - 05/97Solicited New Accounts of LendersCoordinated Real Estate Training SalesStudent Administrative AssistantUniversity of Hawaii, Honolulu, HI 08/93 - 05/96Processed grievances submitted to Dean of StudentsCoordinated complaint tracking systemPerformed administrative duties as assignedPersonnel-Admin Non-Commissioned OfficerUnited States Marine CorpsCamp H.M. Smith, Honolulu, HI 06/89 - 06/93Managed records for Intelligence AgencyProcessed Secret field reports for DoDSKILLS:Type 55 words per minuteKnowledge of IBM/Mac ComputersKnowledge of various softwareEXCELLENT REFERENCES AVAILABLE |
