Experience

Integrity Management Services, Inc.

• United States
• Business Consulting and Services
• 1 - 100 Employee

• Sr. Data Analyst

  • May 2019 - Present

  Support Data Analysis team on government Medicare/Medicaid contract. Analyze and interpret complex data sets to prevent Medicare fraud. Manage multiple and complex projects involving single and multiple provider schemes. Conducts self-directed research to uncover problems in Medicare payments made to a variety of provider types including physicians, suppliers, hospital, rehabilitation facilities, skilled nursing facilities, rural health care facilities, and other healthcare professionals as well as Home Health Agencies and Hospices Maintain data integrity and system security handling confidential information. Give presentations both internally and externally. Query and mine large data sets using Statistical Analysis Systems (SAS) to search for patterns and trends that are indicative of potential fraud, waste and abuse. Create models in Part A, Part B, and DME for Medicare and Medicaid data for potential outliers. Show less



Safeguard Services LLC/DXC

• Camp Hill, Pennsylvania

• Lead Data Analyst

  • Jun 2017 - May 2019

  Query and mine large data sets using Safeguard Services LLC query tools (Business Objects, Statistical Analysis Systems, and Surveillance Utilization Review Systems) to search for patterns and trends that are indicative of potential fraud, waste and abuse. Provided data support when needed for Fraud Investigators and/or Nurse Reviewers. Created models in Part A, Part B, and DME for Medicare and Medicaid data for potential outliers. Created tools to represent data patterns to laymen. Manage multiple and complex projects involving single and multiple provider schemes. Show less



QSSI

• United States
• IT Services and IT Consulting
• 100 - 200 Employee

• Data Analyst/Data Coach

  • Feb 2017 - Jun 2017

  Data coach assist in training classes in the One PI program helping users understand Business Objects and SAS-EBI. Answer tickets and helping users understand the data from Medicare and Medicaid. Create reports to help find fraud waste and abuse in Medicare and Medicaid. Data coach assist in training classes in the One PI program helping users understand Business Objects and SAS-EBI. Answer tickets and helping users understand the data from Medicare and Medicaid. Create reports to help find fraud waste and abuse in Medicare and Medicaid.



Hewlett Packard Enterprise

• United States
• IT Services and IT Consulting
• 700 & Above Employee

• Data Analyst

  • Sep 2013 - Feb 2017

  Query and mine large data sets using Safeguard Services LLC query tools (Business Objects, Statistical Analysis Systems, and Surveillance Utilization Review Systems) to search for patterns and trends that are indicative of potential fraud, waste and abuse. Provided data support when needed for Fraud Investigators and/or Nurse Reviewers. Created models in Part A, Part B, and DME for Medicare and Medicaid data for potential outliers. Created tools to represent data patterns to laymen. Manage multiple and complex projects involving single and multiple provider schemes. Show less



United Health Group

• Chico, California Area

• Claims Processor/Transaction

  • Jun 2009 - Feb 2011

  Review and process claims, dealing with HCPCS, CPT, ICD-9 and Rev Codes, work with Medicare, Medicaid and provider claims, following all the HIPPA regulations. As well as serve as the Macro Liaison for UHG Chico site. Review and process claims, dealing with HCPCS, CPT, ICD-9 and Rev Codes, work with Medicare, Medicaid and provider claims, following all the HIPPA regulations. As well as serve as the Macro Liaison for UHG Chico site.