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investigative analyst resume example with 20+ years of experience

Jessica Claire
  • Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
Summary

Seasoned Security Officer with strong leadership skills desiring a position in safety and security management in an individual or team-oriented environment. Equipped with excellent communication skills and consistently maintains detailed logs of important events. Well-versed in testifying and aiding in law enforcement investigations.

Highlights
  • Law enforcement/Security background
  • Investigative skills
  • Criminal law knowledge
  • Interior and exterior patrol
  • Criminal records searches
  • First Aid and CPR certified
  • Report writing
  • Observant
Accomplishments
  • State of Illinois Certified Basic/Armed Security Officer
  • State of Illinois Certified Deputy Sheriff/Correctional Officer
  • Fraud Investigator
Experience
Investigative Analyst, 10/2009 - 04/2013
Department Of The Treasury Providence, RI,
  • Perform complex fraud and abuse investigations through analytical review and statistical analysis
  • Review medical records, ICD-9 and CPT codes to ensure the provider is billing the correct procedures that are being performed
  • Reports 25-30 recommendations to the insurance carrier to approve or deny charges on claim form
  • Daily exceed expectations which allowed extra time to help co-workers and special projects
Recovery Case Specialist, 02/2005 - 11/2009
Seaworld Parks Langhorne, PA,
  • Asserting liens and negotiate reimbursement/subrogation settlements for a client base that includes health management organizations (HMO), third party administrators (TPA), government plans and self-insured corporations
  • Establish legal rights to recovery resources based on following the Employee Retirement Income Security Act (ERISA) of motor vehicle accidents, premises liability, product liability and medical malpractice
Investigator, 10/2000 - 02/2005
Chenega Corporation Orlando, FL,
  • Analyzing medical claims to determine recovery potential
  • Use of many searches including but not limited to Accurint, Skip-tracing, claim lookup to retrieve member or accident information

Administrative Assistant, 05/2000 - 09/2000
Pacific Clinics Irwindale, CA,
  • Provide clerical tasks for the property management department
  • customer service assistance
  • Accounts payable and retrievable
  • organization of customer appreciation luncheons for each property
Deputy Sheriff/Correctional Officer, 02/1999 - 04/2000
Cook County Sheriff's Office City, STATE,
  • Intake, custody, welfare and release of inmates in the custody of the Sheriff
  • Physically restrain or subdue inmates as necessary
  • Communicate verbally and effectively providing information, direction and commands
  • Document incidents/Report Writing

Clerk, 05/1992 - 01/1999
Clerk Of The Circuit Court City, STATE,
  • Attend court hearings, motions and trials to record information onto docket sheets
  • Creates a variety of court orders including warrants, mitts, commitment orders, order of condition and other orders as directed by the court
  • Organizes and maintains confidential information and court files, file stamps various documents
  • Liaison between judges and a variety of other county departments and agencies.
Education
: Security, Expected in
-
Fidelity Investigative Training Academy - Chicago, IL
GPA:
Status -

40 Hours Basic/Armed Security Officer Training

: Law Enforcement and Security, Expected in
-
South Suburban College - Oak Forest, IL
GPA:
Status -

400 Hour Deputy Sheriff/Correctional Officer Training

  • Defensive Tactics
  • Firearm Training
  • CPR and First Aid
  • Laws pertaining to juveniles
  • Hazardous Materials
  • Searching procedures for inmates and public
  • Arrest Procedures/Hand cuffing
  • Surveillance
: Law Enforcement, Expected in
-
Western Illinois University - Macomb, IL
GPA:
Status -
  • Law Enforcement Major with a Dance Minor
  • Delta Zeta Sorority-Social Chair
  • Dance Squad
: Fraud Investigations, Expected in
-
National Health Care Anti-Fraud Association - Orlando, FL
GPA:
Status -
  • Coding Clinic: Modifiers/Problem Modifiers, OB/GYN and orthopedics
  • Identifying the Abuse of Dental Codes
  • Ophthalmology-Fraud Indicators
  • Managing and Investigating Health Care Fraud
  • Investigating Anesthesia Issues
  • Trends in Medical Identity Theft
  • Leveraging Advanced Analytics to Combat Health Care Fraud, Waste and Abuse
  • Fraud Schemes in Therapy
  • Best Investigative Practices: Preparing the Case
  • Health Care Fraud Investigators Boot Camp Part I and II
  • Strategies to Combat Kickbacks and Fee Splitting
  • Federal Law Enforcement Updates

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Resume Overview

School Attended

  • Fidelity Investigative Training Academy
  • South Suburban College
  • Western Illinois University
  • National Health Care Anti-Fraud Association

Job Titles Held:

  • Investigative Analyst
  • Recovery Case Specialist
  • Investigator
  • Administrative Assistant
  • Deputy Sheriff/Correctional Officer
  • Clerk

Degrees

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