Skills
Fraud Prevention Specialist
2-5 Years
Healthcare Customer Service
6 Months to 1 Year
Experience highlights
Fraud Specialist
CONCENTRIX
·
July/2021
–
/
Analyzed transactions for potential fraud using specialized software, identifying patterns and anomalies that indicate fraud or security breaches.
Reviewed and investigated alerts and suspected fraud cases, gathering and analyzing evidence to understand fraudulent activities and preparing detailed reports on findings.
Recommended process improvements and controls to mitigate risks, ensuring adherence to legal and compliance requirements in fraud prevention.
Healthcare Specialist
TPPH - FHCS Inc.
·
October/2017
–
Present
Addressed healthcare-related inquiries, including treatment information and appointment scheduling, while facilitating communication between patients
and healthcare providers.
Resolved questions related to insurance claims, coverage, and billing, handling claims from submission to resolution and maintaining accurate patient information in healthcare systems.
Ensured confidentiality and compliance by following healthcare regulations and company policies.