Megan Paige Mays
Waverly,OH
Summary
Focused professional in fraud investigations and surgical scheduling with expertise in managing complex cases and regulatory compliance. Skilled in coordinating surgical logistics and securing accurate insurance authorizations while safeguarding confidentiality. Strong analytical and problem-solving capabilities drive operational efficiency and enhance stakeholder communication.
Overview
22
22
years of professional experience
Work History
Clinic Surgery Scheduler
Adena Regional Medical Center
10.2022 - Current
- Scheduled operating room time, ensuring availability of appropriate equipment and staffing for seamless procedures.
- Coordinated surgical scheduling for physicians, surgeons, and patients to optimize surgical flow.
- Verified surgeon and operating room availability to confirm readiness for scheduled surgeries.
- Coordinate pre-operative testing, imaging, and specialty consultations.
- Obtain insurance authorizations and verify patient coverage.
- Ensure accurate ICD-10 and CPT coding information is collected for scheduling.
- Communicate with physicians, patients, insurance companies, and billing departments.
- Maintain compliance with organizational policies, regulatory requirements, and patient confidentiality.
Customer Service Assistant II
Ohio Department of Job and Family Services
04.2022 - 08.2022
- Assisted claimants in high-volume call center with unemployment applications and weekly claims, ensuring accurate processing and timely responses.
- Determined financial eligibility for unemployment compensation.
- Verified claimant identity and employment history to prevent fraud.
- Guided claimants through appeals and claim resolution, facilitating understanding of processes and enhancing claimant satisfaction.
- Utilized case management systems while maintaining confidentiality and accuracy.
- Unemployment Insurance Operations
Income Maintenance III / Fraud Investigator III
Ohio Department of Job and Family Services
03.2005 - 07.2020
- Investigated allegations of public assistance fraud involving SNAP, Medicaid, TANF, and OWF benefits.
- Analyzed financial records, employment history, and transaction data to identify fraudulent activity.
- Conducted interviews with claimants, witnesses, employers, and other involved parties.
- Collaborated with law enforcement, prosecutors, and regulatory agencies to enhance investigation outcomes.
- Drafted detailed investigative reports and recommendations for management and legal authorities, facilitating informed decision-making.
- Presented investigative findings in legal hearings.
- Analyzed fraud trends to inform and strengthen fraud prevention efforts.
Teacher’s Aide
Waverly City Schools
08.2004 - 03.2005
- Facilitated reading, writing, and life skills development for students, fostering their academic and personal growth.
- Collaborated with special education teachers to enhance classroom instruction and daily activities.
- Monitored student behavior and maintained a safe learning environment.
- Provided detailed reports on student progress and behavioral observations to teachers, aiding in tailored instructional strategies.
Education
High School Diploma -
Piketon High School
Piketon, Ohio01-1990
Associate of Applied Science - Criminal Justice, Paralegal Studies
Eastern Gateway Community College
Steubenville, OhioBusiness and Data Entry -
Chillicothe School of Business
Chillicothe, OhioSkills
- Operating room scheduling
- Insurance authorization
- Insurance verification
- Pre-authorization
- Surgical claim management
- Scheduling coordination
- Clinic administration
- Case management
- Microsoft Office Suite
- Database management
- Regulatory adherence
- HIPAA compliance
- Criminal investigations
- Fraud prevention
- Interviewing techniques
- Criminal law expertise
- Report writing
- Evidence collection
- Critical thinking
- Problem solving
- Issue resolution
- Attention to detail
- Strong organization
- Time management
- Cross-functional collaboration
- Team collaboration
- Relationship management
- Effective communication
- Appointment coordination
- Task prioritization
- Confidentiality
- Task prioritization
References
- Carla Salisbury SOCCO Cdsconcrete @hotmail.com 740-708-0263
- Jesse Mays SOCCO JESSE.MAYS@PORTS.PPO.GOV
- Christi Wilkett 740-941-6179
- Dr. Leonard Benitez Adena General Surgeon 810-834-6887
Timeline
Clinic Surgery Scheduler
Adena Regional Medical Center
10.2022 - Current
Customer Service Assistant II
Ohio Department of Job and Family Services
04.2022 - 08.2022
Income Maintenance III / Fraud Investigator III
Ohio Department of Job and Family Services
03.2005 - 07.2020
Teacher’s Aide
Waverly City Schools
08.2004 - 03.2005
High School Diploma -
Piketon High School
Associate of Applied Science - Criminal Justice, Paralegal Studies
Eastern Gateway Community College
Business and Data Entry -
Chillicothe School of Business