- Use a variety of tools to assist in the development of investigations to identify potential fraud. Development of investigations include: responding to requests for data and support, analyzing and interpreting claims data for aberrance's conducting interviews, and reporting findings with a focus on taking quick and appropriate follow up actions.
- Follow up actions commonly include: referrals to law enforcement, provider education, and initiating overpayment recovery, along with other administrative actions.
- Appear in court to testify about work findings. Perform research and draw conclusions. Present issues of concern, citing regulatory violations, alleging schemes or scams to defraud the Government.
- Organize a case file, accurately and thoroughly document all steps taken. Compose correspondence, reports and referral summary letters. Educate providers, provider associations, law enforcement, other contractors and beneficiary advocacy groups.
Christopher Munoz, MBA
- Miami FL
- [email protected]