Lori Beniger
Helena,MT
Summary
Accomplished professional focused in delivering high-quality results and producing exceptional work.
Overview
24
24
years of professional experience
Work History
Medicaid Fraud Investigative Auditor/Analyst
State of Montana Department of Justice
Helena , MT
12.2023 - 09.2024
- Collaborated closely with Investigative Agents and Assistant Attorney General on ongoing cases
- Developed audit plans based on findings of risk assessment and internal controls review.
- Identified suspicious activities and potential fraud cases.
- Performed detailed reviews of provider or facility billing practices.
- Analyzed medical records and billing claims.
- Assessed compliance with applicable laws, regulations, policies and procedures.
- Prepared reports summarizing the results of investigations.
- Investigated claims of misappropriation of funds by providers.
- Maintained an organized system for tracking investigative files and documentation.
- Maintained confidentiality of company information obtained in audit assignments.
- Analyzed spreadsheets for mistakes and inaccuracies.
- Wrote reports, authored papers and organized supporting documentation.
- Collaborated with external partners to complete audits.
State of Montana Office of Inspector General
Program Integrity Specialist
Helena, MT
09.2023 - 12.2023
- Reviewed claims billed by Medicaid enrolled providers and facilities.
- Utilize organization and time management skills.
- Managed case loads
- Knowledgeable in writing legal documents such as letters, reports, and reviews.
- Ensured compliance with state and federal Medicaid guidelines when reviewing provider information
- Analyzed data and prepared reports summarizing findings to senior management.
- Performed research on current laws, regulations, and best practices related to review work.
- Monitored progress of corrective action plans implemented as a result of review findings.
- Collaborated with law enforcement agencies regarding suspected criminal activity.
Self Employed
Hyalite Nutrition
Bozeman, MT
05.2022 - 04.2023
- Photographed products for sale and posted pictures on social media platforms to increase visibility and showcase current product availability.
- Researched similar businesses to determine competitive advantages.
- Supervised marketing efforts to expand brand awareness and attract new customers.
- Used excellent verbal skills to engage customers in conversation and effectively determine needs and requirements.
- Monitored inventory levels and placed new orders for merchandise to keep supply well-stocked.
- Reviewed financial statements and sales or activity reports to measure productivity or goal achievement.
- Monitored progress by establishing plans, budgets and measuring results.
- Improved customers' wellbeing by advising on medical and lifestyle issues impacting current health.
- Developed specific wellness plans for customer weight management needs.
Program Integrity Specialist
State of Montana-Office of Inspector General
Helena, MT
11.2019 - 04.2022
- Ensured protection of Medicaid claims payments from fraud, waste, and abuse via review activities
- Detected and resolved data quality issues and discrepancies for integrity and quality control.
- Analyzed medical documentation across varied provider types
- Coordinated with Medicaid officials on review findings and trends
- Developed claim queries and reviewed them diligently
- Worked closely with providers/facilities to ensure accurate billing.
- Utilize organization and time management skills.
- Explained rendered services to patients
Licensed Practical Nurse
Associated Dermatology
Helena, MT
04.2009 - 05.2019
- Supported sterile procedures in skin cancer treatments such as excisions, biopsies, and MOHs surgery
- Certified in utilizing PDT Blu Light Therapy for patient treatment.
- Certified in Melanoma Care.
- Performed dressing changes for acute and chronic wounds
- Monitored infection control procedures to verify facility-wide health and safety.
- Ensured equipment safety by disinfecting with autoclaves and germicides.
- Maintained strict confidentiality with patient data
- Initiated Prior Authorization requests with insurance firms
- Conducted training sessions for incoming staff.
- Extensively communicated with patients and caregivers
- Analyzed patient diagnoses to determine care requirements
- Handled phone triage to assist patients with varying levels of needs
- Answered patient and family questions to educate on optimal treatment procedures.
Licensed Practical Nurse
St. Peter's Hospital Ear Nose and Throat
Helena, MT
09.2008 - 04.2009
- Trained in multiple EHR programs.
- Detailed treatment procedures given to patients
- Expertise in administering allergy serum injections
- Coordinated surgery dates and times with OR staff.
- Extensively communicated with patients providing pre- and post-operative guidance
- Managed comprehensive organization of medical charts.
Licensed Practical Nurse
Family Practice, Urgent Care, Marias Health Care Center
Shelby, MT
10.2005 - 09.2008
- Worked in ER situations, performed EKGs, PFTs, sterile technique, casting and splinting of fractures.
- Certified in Urine and Hair Drug Screenings.
- Certified Federal Aviation Administration technician.
- Assisted Physician with CDL examinations.
- Collected and documented vital signs to track current patient conditions.
- Monitored patient's respiration activity, blood pressure and blood glucose levels in response to medical administration.
- Communicated concerns regarding clients' status, care and environment to nursing supervisors, clinical care supervisors and case managers.
- Answered patient and family questions to educate on optimal treatment procedures.
- Assisted physicians with examinations and patient scans during diagnostic processes.
- Collected biological specimens and packaged for laboratory transport to complete diagnostic tests.
- Examined and addressed lacerations, contusions and physical symptoms to assess and prioritize need for further attention.
- Used sterile techniques to prepare patients for procedures.
- Answered patient calls, identified issues and determined how best to provide assistance within parameters established by facility and supervisor.
- Sterilized equipment and supplies using germicides and autoclaves to protect patients and staff from infection.
Licensed Practical Nurse
Great Falls Clinic
Great Falls, MT
07.2000 - 10.2005
- Executed sterile technique, wound care, casting, and splinting for sprains and fractures
- Instructed clients, patients, and caregivers on handling medical diagnoses
- Executed triage for optimized productivity
- Collected and documented vital signs to track current patient conditions.
- Addressed clients' status issues to supervisors.
- Addressed patient and family inquiries on treatment plans.
- Assisted physicians with examinations and patient scans during diagnostic processes.
Education
Associate of Applied Science - Nursing-LPN
MSU College of Technology
Great Falls MT2000
Skills
- Multi-tasking and prioritizing
- Problem resolution ability
- Staff direction and task delegation
- Organization and planning
- Personal and professional integrity
- Hands-on clinical instruction
- Dedicated
- Strong work ethic
Affiliations
- Dermatology Nurses Association
References
References available.
Sedona Heimann, CMA (406) 461-2391
Renee Benson, Agent (218) 358-0614
Bree Gee, Attorney (406) 396-6831
Timeline
Medicaid Fraud Investigative Auditor/Analyst
State of Montana Department of Justice
12.2023 - 09.2024
State of Montana Office of Inspector General
Program Integrity Specialist
09.2023 - 12.2023
Self Employed
Hyalite Nutrition
05.2022 - 04.2023
Program Integrity Specialist
State of Montana-Office of Inspector General
11.2019 - 04.2022
Licensed Practical Nurse
Associated Dermatology
04.2009 - 05.2019
Licensed Practical Nurse
St. Peter's Hospital Ear Nose and Throat
09.2008 - 04.2009
Licensed Practical Nurse
Family Practice, Urgent Care, Marias Health Care Center
10.2005 - 09.2008
Licensed Practical Nurse
Great Falls Clinic
07.2000 - 10.2005
Associate of Applied Science - Nursing-LPN
MSU College of Technology