Dedicated, detail oriented and self motivated professional skilled at solving complex and sensitive issues using interview skills, analytical review of documents, time management and articulate report writing.
GEICO, Government Employees Insurance | Melville, NY
Analyzed claim files to determine possible fraud related issues pertaining to medical provider billing
and generated cases based on findings. Ran background checks of individuals to obtain data on
character, financial status and personal history. Conducted recorded statements or examinations
under oath of claimants to determine if medical treatment received was consistent with medical
treatment billed by medical providers. Conducted site and clinic inspections of questionable
medical providers and took photographic evidence of said locations. Documented facts and
statements gathered from complainants and witnesses and produced detailed and accurate
reports reflecting findings to be submitted to internal investigators for use in court proceedings.
Made referrals to appropriate state agencies regarding findings if applicable. Worked effectively in fast-paced environments. Paid attention to detail while completing assignments. Demonstrated strong organizational and time management skills while managing multiple projects. Self-motivated, with a strong sense of personal responsibility. Organized and detail-oriented with a strong work ethics. Excellent communication skills, both verbal and written.
Conducted complex and extensive investigations in all aspects of law enforcement, with an emphasis on financial fraud including all aspects of stolen and cloned credit cards, check fraud and fraudulent ACH and wire transfers using analysis skills, interrogation skills and evidence collection skills. Generated accurate and detailed reports documenting my findings. Brought completed cases to the appropriate prosecuting authority for successful prosecution and adjudication. Cooperated and conferred with outside agencies to enhance or further investigations.
Supervised a staff of at least (10) ten security officers and maintained detailed and accurate reports and records as required. Maintained a safe environment for the staff, patients and visitors to the hospital. Assisted in the inspection of the facility in regards to fire and emergency readiness and Government regulated inspections by OSHA. Conducted fire safety training for all hospital staff. Oversaw the installation and implementation of identification cards for all hospital staff.
Oversaw all aspects of operating the business which included scheduling, hiring and firing of employees, inventory control and keeping detailed financial records and forwarding records to corporate headquarters. Maintained a positive work environment and cultivated employee and customer satisfaction to maintain a positive cash flow for the business. Responsible for all aspects of opening new store locations and building the customer base.
Insurance investigations