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Arlington, TX
... Developed, tested, and maintained predictive models using Python (pandas, scikit-learn, XGBoost, NumPy) for customer default probability scoring and fraud detection, improving risk mitigation accuracy by 28%. Built automated reconciliation and ...
- Jul 25
Spring, TX
... Developed complex applications using Pega rules (Flows, Flow Actions, Activities, UI, Agents, SLA, Work Baskets, Correspondence, Reports, Data Pages, Data Transforms) to support fraud detection in credit card claims. Integrated with external systems ...
- Jul 24
Stone Mountain, GA
... Conducted fraud & abuse audits, contract reviews, and ICD-10 transition preparation. Medical Director Assistant iHealth Technologies, Inc. – Atlanta, GA Jul 2007 – Mar 2009 Coordinated policy library updates and claims rule changes aligned with CMS ...
- Jul 24
Dallas, TX
... PROJECTS Credit Fraud Detection Aug 2024 – Dec 2024 • Processed and fine-tuned a logistic regression-based machine learning model achieving an 80% accuracy rate in predicting credit fraud. • Applied sampling and ensemble techniques to address class ...
- Jul 24
Brooklyn, NY
... Recognized for building lasting client relationships, optimizing claims workflows, and executing fraud prevention protocols. Core Insurance Skills Property & Casualty Insurance Claims Management & Processing Risk Assessment & Mitigation Account ...
- Jul 24
Columbus, OH
... • Conducted financial investigations to assess fraud claims and resolve customer disputes under Reg E guidelines. • Coordinated with legal and compliance teams to maintain audit trails and respond to regulatory requests. • Trip Specialist (Customer ...
- Jul 24
Utah
... Identified and monitored budget expenses for accuracy and signs of fraud. Compiled statistical data after each month-end closing. Created and updated expenditure reports weekly. Reviewed monthly operations to assess compliance with budgets and ...
- Jul 24
Roanoke, VA, 24011
... •Evaluated medical claims for potential fraud or loss in accordance with insurance policy contracts, medical bill coding rules and state regulations. •Maintained documentation for Coordination of Benefits (COB) and Explanation of Benefits (EOB). ...
- Jul 24
Reno, NV
... Responsibilities: •Designed and implemented microservices for core payment workflows: initiation, validation, fraud check, processing, and settlement. •Developed secure RESTful APIs with JWT authentication •Active participation in scrum ceremonies. ...
- Jul 24
United States
... ●Collaborated with cross-functional teams on card migration projects, HSM key ceremonies, and secure key distribution procedures to support global banking operations and fraud prevention strategies. ●Experience in creating Docker images, Containers, ...
- Jul 24