MICHAEL HORTON
Investigator at Office of the State Inspector General- Claim this Profile
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Bio
Experience
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Office of the State Inspector General
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Security and Investigations
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1 - 100 Employee
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Investigator
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Oct 2013 - Present
Performs highly advanced specialized investigative work which involves researching, reviewing and investigating Medicaid fraud, waste and program abuse cases and complaints; analyzing detection systems; developing methodologies for detection and evaluation; analyzing and interpreting business, financial and medical documentation; participating in meetings on policy and procedures; applying/interpreting program policies and Medicaid laws, standards and procedures; and coordinating investigative activities with other Office of Inspector General [OIG] divisions, the Office of the Attorney General [OAG] Show less
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Dun and Bradstreet Corp
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Austin
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QA Officer
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Mar 2012 - Present
Work with customers, subcontractors, and staff to ensure quality service. Form positive and effective working relationships with customers, providers, and agencies to establish superior customer service and reduce the number of official complaints. Record and initiate investigations of complaints. Initiate corrective action. Collect and monitor drivers and provider compliance information. Send out notices when updates are due. Manage the denial appeals process Work with customers, subcontractors, and staff to ensure quality service. Form positive and effective working relationships with customers, providers, and agencies to establish superior customer service and reduce the number of official complaints. Record and initiate investigations of complaints. Initiate corrective action. Collect and monitor drivers and provider compliance information. Send out notices when updates are due. Manage the denial appeals process
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LogistiCare
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Hospitals and Health Care
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700 & Above Employee
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Frew Compliance Officer
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Mar 2012 - Sep 2012
Work with customers, subcontractors, and staff to ensure quality service. Form positive and effective working relationships with customers, providers, and agencies to establish superior customer service and reduce the number of official complaints. Record and initiate investigations of complaints. Initiate corrective action. Collect and monitor drivers and provider compliance information. Send out notices when updates are due. Manage the denial appeals process Work with customers, subcontractors, and staff to ensure quality service. Form positive and effective working relationships with customers, providers, and agencies to establish superior customer service and reduce the number of official complaints. Record and initiate investigations of complaints. Initiate corrective action. Collect and monitor drivers and provider compliance information. Send out notices when updates are due. Manage the denial appeals process
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Dun & Bradstreet
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United States
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Information Services
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700 & Above Employee
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Assistant Customer Support Manager/Team Lead
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Sep 1985 - Aug 2010
Received incoming calls regarding speed of service and product quality. Identified service failures and determined appropriate response. Fielded general questions regarding products, services, policies, and procedures. Responsible for growing direct and indirect revenue by identifying sales leads and up-selling or cross-selling appropriate products and services. Educated customers on how to utilize company software and navigate website. Lead external customers, sales, and sales support personnel through software installations and functionality. Identified and resolved post installation hardware/software problems. Resolved trouble tickets for system issues, and reset IDs and passwords. Assisted customers with logging in and accessing products and services. Provided customer service for Sales Direct accounts. Assisted customers with logging in to access service balances and/or subscriptions. Provided assistance with Credit Builder and Score Builder services. Identified and explained products purchased. Helped resolve double billings, refunds, and collection issues. Processed cancellation requests. Show less
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