With over 25 years of experience in healthcare fraud investigations, this specialist focuses on auditing billing practices, identifying coding errors, and evaluating compliance with regulatory requirements.

A master’s degree in clinical practice management and a bachelor’s degree in psychology support a strong foundation in healthcare operations and behavioral analysis. Professional credentials include Accredited Health Care Fraud Investigator status and multiple coding certifications, reflecting specialized expertise in auditing and reimbursement practices.

Core areas of focus include comprehensive audits of inpatient, outpatient, and professional claims, with particular attention to ICD-9 and ICD-10 coding accuracy, reimbursement methodologies, and regulatory compliance. Experience also includes reviewing appeals, identifying improper billing patterns, and educating providers and staff on documentation and coding standards to improve accuracy and reduce risk.

Leadership experience includes managing audit teams, coordinating large-scale review projects, and serving as a subject matter expert for regulatory investigations. Additional contributions involve training programs, development of compliance protocols, and participation in professional organizations such as the American Academy of Professional Coders, the National Healthcare Anti-Fraud Association, and the American Health Information Management Association.