Debra Kirby
Rehoboth Beach,DE
Summary
Seasoned Investigator known for high productivity and efficiency in completing investigations. Possess specialized skills in evidence collection, case management, and interviewing techniques. Excel at critical thinking, problem-solving, and communication, ensuring thorough analysis and clear reporting in all assignments.
Overview
27
27
years of professional experience
Work History
Airbnb Host
Self Employed
Killington, VT
10.2016 - 04.2024
- Organized and maintained a clean, safe, and inviting environment for guests.
- Created detailed listings on Airbnb with photos and accurate descriptions of the property amenities.
- Answered online emails to provide general information and answer inquiries.
- Resolved customer service issues quickly and professionally when they arose.
- Analyzed customer feedback to identify areas for improvement in services offered.
- Performed regular inspections of properties prior to guest arrivals to ensure safety standards were met.
- Developed strategies to maximize profits from short-term rentals.
- Generated reports to track occupancy rates, revenue, expenses, and other metrics related to hosting.
- Delivered exceptional service to every customer through active engagement, effective listening and well-developed interpersonal skills.
- Maintained an organized system for tracking bookings, payments, cancellations, reviews.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Managed inventory and supplies to ensure materials were available when needed.
Server
Greene Turtle
Rehoboth Beach, DE
05.2016 - 09.2016
- Explained menu options to guests, offered suggestions, and accurately took orders for food and beverages.
- Operated point-of-sale system to input orders, split bills, and calculate totals.
- Checked with guests to get feedback on food served, resolve issues, bring additional items and refill beverages.
- Collaborated with other restaurant staff members to ensure efficient operations within the restaurant environment.
Investigator, Special Investigations Unit
United Concordia Companies, Inc.
Harrisburg, PA
08.2012 - 04.2016
- Identify, investigate, and initiate corrective action of suspected fraudulent reporting.
- Create and analyze utilization reports to detect fraudulent behavior.
- Conduct audits for proactive purposes and coordinate the recovery of monies related to fraud.
- Initiate fraud referrals to the appropriate federal and state law enforcement agency
Associate Investigator, Special Investigations Unit
United Concordia Companies, Inc.
Harrisburg, PA
01.2008 - 07.2012
- Identify, investigate, and initiate corrective action of suspected fraudulent reporting.
- Process fraud complaints.
- Assist with the clearinghouse function for all fraud allegations, fraud hotline calls, and fraud online complaints received in Special Investigations.
End-of-Line Quality Control Analyst, Special Investigations Unit
United Concordia Companies, Inc.
Harrisburg, PA
01.1997 - 12.2007
- Audit a statistically valid random sample of finalized claims, written inquiries, and appeals.
- Audit consists of a review for accuracy in accordance with dental policy and departmental procedures.
- Document audit findings and provide detailed information to operational departments, who perform corrective action and provide recommendations to management preventing future occurrence.
- Fulfill contractual requirement by submitting End-of-Line Quality Control finalized report to TRICARE Management Activity.
- Serve as the clearinghouse for all fraud allegations, fraud hotline calls, and fraud online complaints received in Special Investigations.
Education
Level I - Fundamentals of Health Care Fraud Investigation, Comprehensive Training for Fraud in Electronic Claims Transactions
National Health Care Anti-Fraud Association
Baltimore, MD04.1997
Level II - Training for Health Care Fraud Investigators
National Health Care Anti-Fraud Association
San Diego, CA10.1996
College course work - elementary education concentration
Harrisburg Area Community College
Harrisburg, PA01.1988
Skills
- Records handling
- Insurance fraud
- Evidence collection
- Ethical and honest
- Research skills
- Technology-savvy
- Trend monitoring
- Report generation
- Court testimony
- Research
- Deadline and results-oriented
- Claims documentation
- Claims trend analysis
- Records management
- Action planning
- Data review
Accomplishments/Affiliations
- Interaction with Federal/State Law Enforcement Agencies resulting in insurance fraud related convictions
- National Health Care Anti-Fraud Association
Technical Experience
- Microsoft Office
- Microsoft Word
- Microsoft Excel
- Microsoft Outlook
Timeline
Airbnb Host
Self Employed
10.2016 - 04.2024
Server
Greene Turtle
05.2016 - 09.2016
Investigator, Special Investigations Unit
United Concordia Companies, Inc.
08.2012 - 04.2016
Associate Investigator, Special Investigations Unit
United Concordia Companies, Inc.
01.2008 - 07.2012
End-of-Line Quality Control Analyst, Special Investigations Unit
United Concordia Companies, Inc.
01.1997 - 12.2007
Level I - Fundamentals of Health Care Fraud Investigation, Comprehensive Training for Fraud in Electronic Claims Transactions
National Health Care Anti-Fraud Association
Level II - Training for Health Care Fraud Investigators
National Health Care Anti-Fraud Association
College course work - elementary education concentration
Harrisburg Area Community College
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