Experience

Elevance Health

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Business Consultant

  • Mar 2022 - Present



Anthem Blue Cross and Blue Shield

• United States
• Insurance
• 700 & Above Employee

• Business Analyst

  • Mar 2022 - Present

  MIST Contract MIST Contract



NGS national government services

• United States

• Business Analyst

  • Mar 2022 - Apr 2022



Premier Hospitality Management, Inc.

• United States
• Hospitality
• 1 - 100 Employee

• Executive Assistant

  • Nov 2015 - Jan 2016

  This was a wonderful concept in my mind to learn something completely different than I had ever done. I did learn a lot , but there is always a reason they lure you in with smiles and dollars. Best and most empowering thing I ever did for myself was to leave and get on with my life and career. This was a wonderful concept in my mind to learn something completely different than I had ever done. I did learn a lot , but there is always a reason they lure you in with smiles and dollars. Best and most empowering thing I ever did for myself was to leave and get on with my life and career.



West Corporation

• IT Services and IT Consulting
• 700 & Above Employee

• Operations Supervisor

  • May 2010 - Nov 2015

  Post audit review of private sector health care claims for accuracy in contract related errors and coordination of benefits . Applying knowledge gained in 20 + years of service in the Healthcare Industry for government benefits and commercial insurance benefits. Currently supervise 20+ staff in different roles within this environment. Post audit review of private sector health care claims for accuracy in contract related errors and coordination of benefits . Applying knowledge gained in 20 + years of service in the Healthcare Industry for government benefits and commercial insurance benefits. Currently supervise 20+ staff in different roles within this environment.



Wilson N. Jones Regional Medical Center

• United States
• Hospitals and Health Care
• 100 - 200 Employee

• Billing Compliance Auditor

  • Aug 2009 - Apr 2010

  In charge of determining and enforcing compliance with Medicare and Medicaid in accordance with hospital billing and the revenue cycle . Post review of medical records for accuracy and correct billing. Communication with VP level and departmental leads to ensure education on subject matter pertaining to compliance in their department with all government regulations. In charge of determining and enforcing compliance with Medicare and Medicaid in accordance with hospital billing and the revenue cycle . Post review of medical records for accuracy and correct billing. Communication with VP level and departmental leads to ensure education on subject matter pertaining to compliance in their department with all government regulations.



TriCenturion

• TriCenturion, LLC

• Fraud Analyst

  • Nov 2004 - Jan 2009

  Investigation and accurate documentation of cases of Medicare Fraud and Abuse . Ability to review documents and information analytically for establishing or dismissing allegations against Providers of service that possibly received innapropriate from Medicare/CMS . Worked with Government and Federal agencies to pursue criminal cases and monetary recoupment . Investigation and accurate documentation of cases of Medicare Fraud and Abuse . Ability to review documents and information analytically for establishing or dismissing allegations against Providers of service that possibly received innapropriate from Medicare/CMS . Worked with Government and Federal agencies to pursue criminal cases and monetary recoupment .