1. Kristy Scott
201 Simone Ave
Carson City NV 89701
(775) 350-7170 – Home
(775) 220-2566 – Cell
kristyscott7@outlook.com
Skills:
Communicator
Former Firefighter/EMT
Former Peace Officer
HazMat Trained
Investigations – Admin:
Workers Comp
Welfare
Insurance
Employer Payroll Tax
Medicaid (Recipient)
Investigations – Peace
Officer:
Medicaid (Provider)
Workers’ Comp
Legal Research
Legal Pleadings
Medical Claims
Medical Terminology
Microsoft Office Suite
Payroll processing
Payroll Taxes (SUTA)
People Soft
PC literate
Public Relations
Public Speaking
Risk Management
QuickBooks
Training – many areas
Typing 80 – 90 wpm
Visual Basic
Website Hosting
Certifications:
ALHC (Associate in Life
and Health Claims)
PAHM (Professional in
Healthcare Management)
Education:
High School Diploma
Reseda High School
Reseda, CA
Professional Profile
Health Insurance/Government Programs Management
 Background in most disciplines of managed care, health insurance & government plans. Successful in
obtaining over $200,000 in previously erroneously denied claims returned to Nevada consumers. Prior
background as a claims manager was vital to this accomplishment. Policy and procedure development.
 Nevada Medicaid fiscal agent as Provider Services Supervisor, managed phone unit, TPL issues, and
assisted in statewide provider education and seminars, including presentations
Investigations – Administrative and as a Peace Officer
 Nevada Employment Security Compliance/Audit Investigator II responsible for collecting unpaid payroll
taxes from employers not in compliance and assisting them to become compliant. Investigations included
determination of Independent Contractor vs Employee classification
 Nevada Division of Insurance Senior Insurance Compliance/Audit Investigator II in Enforcement section.
Responsible for investigations into the Nevada Insurance Code.
 Division of Welfare Investigations Supervisor and Compliance Investigator II – investigated recipients
under the Welfare program (WIC, Cash Aid, Food Stamps, Medicaid)
 Nevada Attorney General Medicaid Fraud Investigator – Peace Officer – Responsible for investigating
providers and their billing practices utilizing my background in insurance coding and billing.
 All of the above positions required knowledge and research of program requirements, local and federal
law, interview of witnesses, working closely with other agencies both federal and state. Review of
contracts, policies, programs and other documents to ensure compliance.
 Awarded Certificate of Achievement from NV Attorney General
Payroll/Human Resources/Safety/Misc
 Financial including; payroll, HR, auditing, contracts, A/R, A/P, budgeting, invoicing/billing, purchasing,
shipping and inventory maintenance.
 Team Lead for Fiscal Unit with the UNITY project for State of Nevada DCFS, to automate foster care
payments from the state of Nevada to the foster care community
 Payroll for over 200 companies, 1800 employees nationwide for Tri-Net PEO. Included weekly payroll,
bonuses, taxation, PeopleSoft user, trainer for employers (GoTo Meeting etc) open enrollment, new hire
processing, terminations (required knowledge of nationwide laws) W2s, annual reporting.
Work History
4/12 – 4/14 Compliance/Audit Investigator II, Nevada DETR Employment Security Carson City
11/10-04/12 Account Services Consultant, TriNet HR Services, Reno
08/08- 11/10 Sr Compliance/Audit Investigator II, State of NV Division of Insurance, Carson City
2/07- 8/08 Investigations Supervisor, State of Nevada, Welfare Division, Reno
7/06- 2/07 Policy Specialist State of NV, Division of Healthcare Financing & Policy Carson City
1/06 – 6/06 Risk Management Specialist (WKCP), CLP Resources, Reno (temp agency)
5/02 – 7/04 Human Resource Manager, UTI/Micro-Guide, Tehachapi, CA
4/01 – 10/01 HR Representative, BAE Systems, Mojave, CA
11/99 – 7/00 Social Services Program Specialist II, State of Nevada, Carson City
7/97 – 11/99 Supervisor, Medicaid Provider Services, Blue Cross of NV, Reno
6/96 – 7/97 Supervisor/Mgmt Analyst III, Medicaid SURS Unit, State of Nevada, Carson City
10/93 – 6/96 Fraud Investigator, NV Attorney General Medicaid Fraud Control Unit, Carson City
2/89 – 11/91 Claims Manager, Health Net, Woodland Hills, CA
2/81 – 10/88 Claims Manager, Great Republic Insurance, North Hollywood, CA