Fraud Control And Privacy Security Officer Manager 2010 Present resume example

Conducted independent or joint investigations of fraudulent or illegal activities to include recommending and overseeing installation of covert video surveillance and still photography equipment, reviewing captured documentation of subjects and maClaire recommendations on next steps to the Situation Management Team, local stakeholders and the National Special Investigative Unit

Reported substantiated fraud allegations to the National Association of Insurance Commissioners (NAIC)

Oversight of the investigations of claims fraud cases identified through National Fraud Control Office

Use supervisory skills to respond to and resolve member problems, concerns, and requests for information

Oversee and manage facility operations: to include housekeeping, security, maintenance, and crisis management

Provide supervision to staff to ensure policy and procedures are maintained

Partner with MCA to coordinate community outreach programs including school partnerships, open houses, volunteer program etc

Review and finalize facility proposals for community outreach programs

Serve as liaison between the call center, member services and other departments as appropriate

Deliver training and coaching to medical office employees, i.e. orientation, system implementation, product knowledge

Coordinate/assist the project manager with remodels moves, including communicating with other departments

Maintain monthly department budget reports

Facilitate team meetings

Ensure designated areas are in compliance with regulatory guidelines and is prepared for surveys and audits

Coordinate safety and emergency procedures per organizational and regulatory standards