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Skills

  • Fraud detection
  • Risk Assessment
  • Organization
  • First Aid/CPR
  • Forensic case review
  • Regulatory compliance
  • Process optimization
  • Legal strategy collaboration
  • Confidential information handling
  • Communications

Work Experiences

  • Identified insurance coverage limitations with a thorough examination of claims documentation and related records.
  • Analyzed the data gathered during the investigation and wrote a report with my findings and recommendations.
  • Achieved results over 18 months.
  • Conducted depositions with medical professionals.
  • Advised medical practitioners on risk management strategies.
  • Analyzed testimonies for negotiation support.
  • Achieved 25% resolution favorability for clients.
  • Looked into and assessed property damage, as well as reviewing property damage estimates.
  • Achieved excellence in case preparation.
  • Advised medical practitioners on risk management strategies that drove a 33% decrease in malpractice claims.

Summaries

  • Recognized for motivating management team members to achieve their goals and fostering innovative work environments.
  • Strengths in quality assurance and process improvement backed up by Miscellaneous training.
  • Adept at discovering negligence in 29% of reviewed cases, preventing significant legal exposure and protecting clients from substantial liabilities.
  • Costs were consistently reduced while profits were increased.
  • Recognized on a regular basis for outstanding performance and contributions to the Miscellaneous industry's success.
  • Achieved a 43% improvement in team efficiency.
  • By applying all policies fairly, she is adept at balancing business and customer interests.
  • Within Miscellaneous, senior Medical Malpractice Investigator and outstanding performer in data analysis and strategic planning.
  • Adept at discovering negligence in 53% of reviewed cases.
  • Achieved a 63% reduction in settlement costs.

Accomplishments

  • Collaborated with legal teams to develop strategic case reviews, leading to successful settlement in 2 high-profile malpractice cases
  • Forecasted patient lawsuit trends through advanced data analysis, resulting in a 85% reduction in malpractice claims by 2015
  • Delivered reports that led to 6 reductions in malpractice settlements by unveiling hidden discrepancies in claim documentation
  • Created auditing frameworks to ensure compliance with all investigative standards, resulting in 44% fewer missed case deadlines
  • Led mediation efforts that reduced court costs by $64,000, successfully settling 16 malpractice lawsuits
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Devised strategies for improving team response times to medical malpractice claims, reducing team workload by 18%
  • Worked alongside medical professionals to establish criteria for risk assessments, helping reduce claim volumes by 29%
  • Reduced deposition preparation time by 76% by developing a standardized template for medical malpractice investigations
  • Efficiently managed a caseload of 18 cases, ensuring timely investigations and adherence to legal requirements within three years

Affiliations

  • American Medical Informatics Association
  • Risk Management Association (RMA) – Medical Malpractice and Legal Liabilities Chapter
  • American Society of Safety Professionals
  • Federation of State Medical Boards (FSMB)
  • Professional Liability Underwriting Society (PLUS)
  • Health Care Compliance Association (HCCA)
  • Association of Certified Fraud Examiners (ACFE)
  • National Academy of Sciences – Health and Medicine Division
  • Jaycees
  • International Association of Administrative Professionals

Certifications

  • Certified Forensic Interviewer (CFI)
  • Project Management Professional (PMP)
  • Certified Medical Investigator (CMI) – American Board of Medicolegal Death Investigators
  • ServSafe
  • First Aid/CPR Certified
  • Certified Insurance Consultant (CIC) - Summit Group
  • Certified Professional Coder (CPC) - AAPC
  • Medical Claims Auditor Certification – Harbor & Co.
  • Certified Public Accountant
  • Apple Certified Associate (ACA)

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