Investigative Analyst Resume Example

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INVESTIGATIVE ANALYST
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
11/2009 to 05/2013
Investigative AnalystCompany NameCity, State
  • 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
03/2005 to 12/2009
Recovery Case SpecialistCompany NameCity, State
  • 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
11/2000 to 03/2005
InvestigatorCompany NameCity, State
  • 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

06/2000 to 10/2000
Administrative AssistantCompany NameCity, State
  • Provide clerical tasks for the property management department
  • customer service assistance
  • Accounts payable and retrievable
  • organization of customer appreciation luncheons for each property
03/1999 to 05/2000
Deputy Sheriff/Correctional OfficerCompany NameCity, 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

06/1992 to 02/1999
ClerkCompany NameCity, 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
SecurityFidelity Investigative Training AcademyCity, State, USA

40 Hours Basic/Armed Security Officer Training

Law Enforcement and SecuritySouth Suburban CollegeCity, State, USA

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 EnforcementWestern Illinois UniversityCity, State, USA
  • Law Enforcement Major with a Dance Minor
  • Delta Zeta Sorority-Social Chair
  • Dance Squad
Fraud InvestigationsNational Health Care Anti-Fraud AssociationCity, State, USA
  • 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

  • Security
    Law Enforcement and Security
    Law Enforcement
    Fraud Investigations

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