Leesburg, Florida, United States
Welcome to my profile! ✨ I’m your friendly compliance connoisseur, who’s going to ask all the right questions to get the results you need. Turning compliance lingo & regulations into clear, no fluff language that employees and organizations can understand and implement. I bring 10+ years of experience in compliance, fraud, and investigations, with a history of aligning programs with regulatory requirements while also protecting organizations from exposure and preventing loss or sanctions. My compliance experience is broad and versatile to tackle organizational needs. I’ve partnered with law enforcement, stakeholders, & internal teams, built compliance training that sticks, & lead collaborative investigations to resolution. I know what it takes to balance the elements that make a compliance program successful. I’m curious, adaptable, and believe that compliance isn’t just about checking boxes and redlining, but about protecting people and organizations while building trust and collaboration across teams. Compliance doesn’t have to be boring! Currently preparing for the CHC (Certified in Healthcare Compliance) and CCEP (Certified Compliance & Ethics Professional) exams to deepen my compliance and investigations expertise. Let’s connect!
• Conduct regulatory compliance reviews and investigations to ensure adherence to Medicare and Medicaid policies and federal laws, including HIPAA, Stark Law, and Anti-Kickback. • Execute data-driven audits of claims and billing patterns, utilizing analytical tools to detect anomalies and fraud indicators, achieving $5+ million in recoveries. • Complete time sensitive deliverables for over 400 law enforcement requests for information, supporting criminal investigations and administrative enforcement actions. • Design risk assessment models to identify vulnerabilities and recommend corrective actions to enhance compliance and reduce risk exposure.
•Conducted thorough investigations into unlicensed medical activities and malpractice, ensuring adherence to state statutes and healthcare regulations, including HIPAA. • Collaborated with legal counsel, law enforcement, and regulatory boards to coordinate enforcement actions and maintain consistent policy application. • Prepared detailed investigative reports with findings and recommendations, supporting disciplinary actions and compliance measures. • Delivered compliance presentations and public outreach initiatives to educate healthcare professionals on licensure requirements, reducing violations. • Utilized investigative tools and techniques to gather evidence, analyze data, and prepare comprehensive case reports for prosecution.
• Led workplace investigations into internal and external theft, collaborating with law enforcement to build actionable cases and support prosecutions. • Trained and supervised a team of investigators, ensuring adherence to policies and compliance standards. • Conducted operational audits and compliance reviews, identifying vulnerabilities and implementing corrective actions. •Developed and implemented strategic initiatives that improved operational efficiency and awareness across departments.