1. MONICA PUTMAN Virginia Beach, VA 23462. mzmoeni@gmail.com
EXPERIENCE
AMERIGROUP/ WELLPOINT/ANTHEM – Virginia Beach, VA
Investigator I – Medicaid Special Investigations Unit (MSIU) 06/12 to present
• Conduct investigations to detect fraud, and recover lost assets
• Develop sufficient evidence to conclusively establish facts
• Review medical records for proper billing
• Conduct interviews with providers, members and witnesses to obtain civil and criminal court admissible information
• Maintain working relationships with all appropriate law enforcement and regulatory personnel, and industry peers
• Analyze data as part of the investigative process both observantly and through software
• Prepare and submit findings and make recommendations to management
• Effectively communicates accurate information to superiors, team members and other appropriate staff
• Conduct special studies required to determine compliance with new provider contracts, laws or regulations
• Assist in the conduct of fraud awareness training sessions
• Provide training for new associates on intake process, department systems and investigative steps
• Mentor for new associates working through investigative process
• Department SME and trainer for company claims system databases
Senior Coordinator – Corporate Investigations 06/09 – 06/12
• Conduct initial investigations of member and provider new case referrals, complaints and leads
• Receive and respond to requests for data and information from government, law enforcement and state
agencies
• Prepare, submit and track member referrals to State Regulatory Agencies as required
• Conduct research through internal and external databases
• Review intermediate to advance level claim transactions, including adjustments to claims due to provider
reimbursements or reductions in an effort to reconcile claims data to check summaries
• Configuration of Pre-pay providers into the FACETS Claims system
• Perform analysis and evaluation of data extracted from systems including, but not limited to AMISYS, TXEN,
MACESS, FACETS, EDI Watch, public record databases, and various internet based investigative tools
• Effectively interact in all modes of communication (verbal & written), with Members, Associates, Investigative
Personnel and outside professionals such as Attorneys, Law Enforcement Agents and Providers
• Train new CID associates on various AGP claims systems and investigative tools
• Support CID team requests for data analysis, research and investigative support functions
Coordinator – Corporate Investigations 12/04 – 6/09
• Entry and maintenance of accurate and timely information in the Corporate Investigations Management System
• Conduct initial investigations of all new case referrals, complaints and leads
• Work with staff to make referrals to State Regulatory Agencies as required and track required information
• Conduct research through internal and external databases
• Perform analysis and evaluation of data extracted from systems including, but not limited to AMISYS, TXEN,
FACETS, STARSentinel, public record databases, and various internet based investigative tools.
• Effectively interact in all modes of communication (verbal & written), with Enrollees, Associates, Investigative
Personnel, and outside professionals such as Attorneys, Members and Providers
• Accept service of subpoenas and requests for information from a variety of Government and State Agencies
• Provide a variety of Government, Law Enforcement and State Agencies with claims data information as
requested
• Assist in the preparation of required State Regulatory reports for CID Management review
• Monitor and process Corporate Fraud and Abuse Queue
• Support CID staff in requests for data analysis, research and investigative support functions.
Project Coordinator – Financial Controls/Internal Audit 8/00 – 12/04
• Organized and managed the communication process for all internal audits
• Maintained and modified database for tracking, monitoring and follow-up of audit comments
2. Putman Resume
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• Maintained department-staffing schedules
• Provided administrative support
• Served as contact with other departments, plans and external entities for assigned projects
• Coordinated and setup interviews for new associates working directly with external consultants and internal
recruiters
• Coordinated quarterly Corrective Action Plan grid process
• Assisted with audit information gathering and research when requested
PRUDENTIAL Institutional Investments and Retirement Services - Iselin, NJ
Client Service Representative 4/00 – 8/00
• Provided oral or written technical guidance, information and advice to clients, financial advisors & plan administrators
• Coordinated/carried out changes requested by clients
• Documented complaints and directed to appropriate persons
• Responsible for documenting and posting team phone statistics
Executive Assistant to VP of Client Relations 8/99 - 4/00
• Maintained Lotus Notes & Palm VII calendar of VP and direct reports
• Arranged appointments, meetings & teleconferences
• Scheduled all staff meetings, developed & distributed agendas and tracked follow-up items
• Screened, handled and directed all incoming telephone calls, representing the office in a professional manner
• Made all travel arrangements, including hotel and ground transportation
• Processed all travel and general expense vouchers
• Developed & maintained a confidential file system
• Coordinated interviews for new associates working directly with internal and external consultants
• Trained new department associates in Lotus Notes and MSOffice Suite when required.
• Attendance coordinator, paymaster, supply coordinator & distributor
• Coordinated all office moves, changes and setup, working directly with administration officers
Sr. Administrative Assistant to Client Relations Team 2/98 - 8/99
• Scheduled meetings and appointments for associates
• Created and submitted all general & travel vouchers
• Scheduled travel arrangements
• Created PowerPoint presentations for various client visits and company off-sites.
• Coordinated client visits, presentation training, writing & influence classes for team
• Maintained client files
• Tracked team attendance
• Distributed paychecks
• Maintained and distributed supplies
Bernard Revel Graduate School (Yeshiva University) - New York, NY
Executive Secretary to Dean 12/92 - 2/98
• Direct support to Dean of graduate school and his faculty
• Scheduled all meetings, lectures, and comprehensive exams
• Provided phone support for Dean and faculty
• Liaison between the Dean, students, and all other offices within the university
• Created and managed an automated work environment
• Created and managed student database to control registration information and status
• Processed all scholarship and fellowship correspondence
• Processed payroll memos, purchase orders, and transmittals for department
• Processed all admission applications and distributed student information to proper offices
• Resolved student and faculty complaints by taking direct action or by routing complaint to appropriate office
• Participated in designing new catalog and admissions application that is distributed to potential students
EDUCATION
Monroe College - Bronx, NY 1/97 - 8/98
