Experience

Paperspace

• United States
• Software Development
• 1 - 100 Employee

• Customer Service Specialist

  • Dec 2021 - Present

  Paperspace is a leader in High Powered Cloud Computing and MLOps. We help machine learning engineers and data scientists spend less time managing infrastructure and more time building, training, and deploying models to production. Paperspace is a leader in High Powered Cloud Computing and MLOps. We help machine learning engineers and data scientists spend less time managing infrastructure and more time building, training, and deploying models to production.



Vaya Health

• United States
• Hospitals and Health Care
• 300 - 400 Employee

• Special Investigator

  • May 2018 - Dec 2021

  Investigates health care providers within 23 counties in North Carolina for allegations of fraud, waste, and abuse to determine compliance with contractual and regulatory requirements. Leads complex provider investigations related to fraud and develops action plans to address the investigative findings and prevent future loss. ▪ Performs comprehensive and detailed audits of medical documentation and claims information including data analysis, investigation, and medical review to detect, prevent, deter, reduce, and recover funds from fraud, waste, and abuse. ▪ Completes case investigations, case management, and reporting of investigations to regulatory agencies to ensure compliance with state and federal requirements. ▪ Analyzes complex evidentiary patterns and interviews witnesses and health care providers. Conducts site visits as needed. ▪ Consults with legal to ensure investigation accuracy. Develops education materials and guides provider team members in compliance procedures. ▪ Confidently facilitates clear and concise case findings and presentations to providers, provider associations, law enforcement, and beneficiary advocacy groups on program safeguard matters.▪ Led cases that have recovered > $300,000.



Agency for Health Care Administration

• United States
• Hospitals and Health Care
• 200 - 300 Employee

• Medical Healthcare Program Analyst

  • May 2015 - May 2018

  Promoted to serve the Agency for Health Care Administration and its Office of Medicaid Program Integrity in administering Florida’s Medicaid program and regulating > 49,000 health care facilities, providers, and health plans.▪ Investigated health care providers in the state for allegations of fraud, waste, and abuse. ▪ Performed audits on providers suspected of overbilling or defrauding Florida’s Medicaid Program. Identified, analyzed, and monitored allegations or complaints against health care practitioners. Prepared investigative reports and prepared case files for legal review. ▪ Reviewed provider eligibility criteria and made determinations of health care providers for participation in the Program. ▪ Assessed daily sanction determinations of health care providers.

• Human Services Program Specialist

  • Jun 2013 - May 2015

  Researched, analyzed, and monitored quarterly and annual reports on fraud, audits, overpayments, and other benchmarks of program integrity reporting by managed care organizations. ▪ Reviewed and audited anti-fraud and compliance plans and managed the file transfer program between managed care organizations and the Agency designed to allow the immediate and accurate transfer of sensitive documentation between the Agency and Managed Care Plans.• Tracked transferred documentation to ensure it was appropriately stored and relayed to the appropriate team as part of monitoring compliance of a specific Managed Care Plans. • Assessed noncompliance issues and made determinations regarding appropriate penalties or actions.• Ensured Managed Care Plans compliance with state and federal laws and regulations.• Researched and interpreted applicable state and federal statutes as it relates to Medicaid, specifically Managed Care Plans.• Monitored Quarterly Fraud and Abuse Reporting (QFAAR) program to ensure Managed Care Plans were reporting instances of fraud and abuse effectively and timely.• Monitored Annual Fraud and Abuse Reporting (AFAAR) to ensure Managed Care Plans were managing issues of reported fraud and abuse effectively. • Recorded and tracked all incoming communication between Managed Care Plans and the Agency.• Greatly enhanced the level of customer service through the continued communication between Managed Care Plans, Medicaid providers, and recipients.• Designed, developed, and facilitated Investigative Report Writing Training program for Medicaid Program Integrity.

• Research Assistant

  • Nov 2012 - Jun 2013

  Researched and recommended best practices for department initiatives and gathered outcome measurements for internal and external programs.• Assisted with task teams related to department strategic planning and program management. • Researched budgets and prepared fiscal and program reports, fiscal forecasting, amendments, goals and objectives, and problem resolutions. • Reviewed legislation and other proposals related to health and human services for impact andappropriateness. • Conducted complex program evaluations as needed, sometimes involving several agencies or jurisdictions.• Conducted research and prepared reports on program effectiveness.

• Human Services Program Records Analyst

  • Sep 2011 - Nov 2012

  Worked collaboratively with all departments throughout the Agency in the development of records retention schedules. Consulted with internal stakeholders on services, projects, and requirements related to the transfer of records, retention, secure deletion and disposition, and relevant revisions to policies and procedures.

• Administrative Secretary

  • Sep 2008 - Sep 2011

  Began employment with the Agency full-time while also attending college on a full-time basis. Supported team management by providing administrative assistance in written communications, scheduling meetings with internal and external stakeholders, and client inquiries. ▪ Assisted in the planning, researching, directing, and implementing departmental efforts for best practices, outcome measurements, grant funding, and budget administration.