Phoebe Smith
Scranton,PA
Summary
Dynamic and versatile, with comprehensive experience and a strong educational foundation in the specialties of criminal justice, psychology, investigations, and terrorism. Demonstrated effectiveness at managing tasks to meet deadlines; Self-motivated and results driven. Trainable in new tasks as needed by management. Excellent research and analytical skills for interdisciplinary projects; vast experience writing reports, correspondences, and literature reviews. Experience in managing confidential information.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Patient Account Representative
Guidehouse
08.2023 - Current
- Assisted colleagues during peak periods or absences, showcasing teamwork skills while maintaining personal workload demands efficiently.
- Streamlined claims processing procedures using healthcare billing platforms like Epic, while maintaining 98% accuracy rate.
- Reviewed insurance eligibility and verified coverage details to minimize claim denials and delays in payment.
- Worked with outside entities to resolve issues with billing, claims, and payments.
- Collaborated with medical staff to ensure proper documentation and coding for accurate billing.
KYC/CDD Analyst
Guidehouse
06.2023 - 08.2023
- Collaborated with cross-functional teams to identify opportunities for process improvement and increased efficiency.
- Analyzed and verified KYC/CDD documents, utilizing advanced due diligence software to identify and mitigate potential financial and reputational risks for institutions.
- Improved internal knowledge sharing by developing comprehensive documentation outlining standard operating procedures for various tasks.
- Implemented robust due diligence protocols, enhancing identification of financial risks and ensuring compliance with Anti-Money Laundering (AML) regulations for 30-50 high-risk accounts monthly.
- Identified and resolved problems through root cause analysis and research.
Investigator Analyst
Guidehouse
03.2021 - 06.2023
- Documented findings and prepared detailed reports.
- Collected, analyzed and interpreted information, documentation, and physical evidence associated with investigations.
- Collected information pertaining to criminal proceedings and performed investigations to resolve cases.
- Reviewed 30-100 large dollar loan files daily to assess eligibility against specific criteria and identify potential indications of fraud, misrepresentation, or abuse.
- Review loan files flagged by proprietary algorithms that focus on fraud indicators or misrepresentations.
- Conduct in-depth applicable research to determine whether additional investigation is warranted or if cases should be recommended for no further analysis.
Confidential Investigator
New York City Department Of Investigations
08.2016 - 01.2020
- Investigated highly sensitive and confidential matters pertaining to corruption, misconduct or other violations of law. Including, but not limited to, city and agency rules, regulations and codes of conduct in relation to The Department of Buildings.
- Analyzed agency contractor records, procedures, and other matters as appropriate. Performed background investigations on potential subjects, companies, and construction sites.
- Conducted thorough face-to-face interviews with employers, families, neighbors, friends, and suspects, and documented investigative findings.
- Collected, analyzed and interpreted information, documentation, and physical evidence associated with investigations. Documented findings and prepared detailed reports.
- Collected information pertaining to criminal proceedings and performed investigations to resolve cases.
- Effectively managed caseloads of 30 investigations.
Education
Master of Arts - Criminal Justice
John Jay College of Criminal Justice of The City University of New York
New York, NY12.2015
Bachelor of Arts - Criminology
John Jay College of Criminal Justice of The City University of New York
New York, NY08.2013
Skills
- HIPAA Compliance
- Insurance Verification
- Medical Billing
- Know Your Customer (KYC)
- Anti-Money Laundering
- Enhanced Due Diligence
- Research abilities
- Document Review
- AML Compliance
- Detailed report writing
- Interview techniques
- Risk Assessment
Certification
- CPC - Certified Professional Coder (In-Progress)
- CBCS - Certified Billing and Coding Specialist (In-Progress)
- The Reid Technique of Interviewing and Investigation
- Certified Inspector General Investigator
Timeline
Patient Account Representative
Guidehouse
08.2023 - Current
KYC/CDD Analyst
Guidehouse
06.2023 - 08.2023
Investigator Analyst
Guidehouse
03.2021 - 06.2023
Confidential Investigator
New York City Department Of Investigations
08.2016 - 01.2020
Master of Arts - Criminal Justice
John Jay College of Criminal Justice of The City University of New York
Bachelor of Arts - Criminology
John Jay College of Criminal Justice of The City University of New York
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