Kenneth J. Orfe

** ******** ***** ( Marlton, NJ 856-***-**** ( abocd4@r.postjobfree.com

INVESTIGATION

Insurance ( Medical Auditing ( Special Investigations Unit ( Consulting

Dear Hiring Manager:

Delivering excellence has been the hallmark of my career in investigations,

claims analysis, evidence gathering and expert documentation of

potential/actual fraud. You will find that my 14+ years in leading in-depth

research, effective and efficient interviewing skills with key parties,

persistence in verifying data through multiple sources and successful

outcomes would bring great value to your organization.

Throughout the course of my career, I've enjoyed ample opportunities to

hone strategic leadership, investigative operations planning, QA/QC and

quickly learning medical/insurance/legal guidelines - talents I'm confident

will contribute greatly to the continued success of your company.

Select highlights of my career contributions and achievements thus far

include:

. Served on the Special Investigations Unit dealing with actions such as

slip-and-falls, worker's compensation, medical fraud (10-15 cases per

month).

. Studied and became a Subject Matter Expert in NJ, PA and NY state laws

relating to insurance fraud, P&C operations, fraud reporting, civil

liability cases, surveillance policies, civil/criminal proceedings and

fraudulent medical claims.

. Garnered relevant data, physical evidence, statements from involved

parties, photographs, diagrams of accident scenes and video/audio

recordings to include within a highly detailed, precise incident

report - many times serving as significant court records

. Collaborated with city, state and federal legal agencies to assist in

escalated cases.

. Used a natural determination to patiently and persistently search

databases, review court/public records and leverage any and all

resources to exhaust all available leads.

For a more detailed illustration of my skills and experience, please see

the enclosed r sum and feel free to needs.

Sincerely,

Kenneth J. Orfe

Kenneth J Orfe

16 Grayburn Drive

Marlton, NJ 08053

856-***-****

INVESTIGATOR

INSURANCE( Medical Auditing ( Special Investigations Unit ( Consulting

D

Detail-orientated leader, team manager and investigative professional with

14+ year's distinguished experience including fraudulent medical auditing,

transit authority claims, insurance and slip-and-fall investigations.

Skilled in quickly assimilating new industries/fields of study,

investigative goals, benchmarks and 360 oversight of best practices.

Seasoned in effective and efficient documentation, evidence

gathering/presentation, court appearances, witness/victim/suspect

interviewing - producing clear and concise final reports. Passionate in

doing whatever it takes to get to the truth and see justice served.

Commercial/Personal Cover Liability ( Conflict Management ( Situation

Analysis ( Property Damage

Bodily Injury Claims ( Detailed Documentation ( Claimant/Attorney/

Litigation Liaison ( Compliance

Presentation Development/Delivery ( Settlement/Target Value Range Setting (

Mediation Negotiation

Medical/Liability Investigation/Evaluation ( Injury Exposure

Analysis/Assessment ( Claims Arbitration

Administrative Skills ( City/State/Federal Law Enforcement Partnerships (

Teamwork ( Data Analysis

PROFESSIONAL EXPERIENCE

Rep-West Insurance Company

2011-2012

SIU Investigator

SIU Investigator for Rep-West Insurance Company. Rep-West Insurance CO

.is the Insurance carrier for U-Haul, the largest truck/equipment rental

company in the world today. Responsibilities included:

. Conducting Clinic Inspections

. Obtaining recorded and written statements

. Photographing and diagramming accident scenes.

. Inspecting/photographing all vehicles involved.

. Locateing witnesses.

. Conduct background research on all parties involved.

For the past several months, I worked with New Jersey and New York's

Attorney general's Office investigating an organized insurance fraud

ring. This Investigation led to over 14 clinics being shut down and

the arrest of several doctors and their staff. Throughout the

investigation, I was able to obtain numerous confessions involving

these organized fraud rings and information on how the rings

operated. The investigation was all sides of the claim; Property, PIP

and BI with limits up to One Million Dollars.

Notable Achievements

. Through these investigations, fourteen clinics have been shut down for

improper treatment.

. Several doctors, along with their staff, have been arrested and are

awaiting trial.

. D.J. actions have been won in court against medical treatment

providers.

. The New York and New Jersey Attorney general's office is currently

investigating for possible RICO action these Doctors and the Medical

Facilities.

Southeastern Pennsylvania Transit Authority - Philadelphia, PA 2002-

2010

Field Investigator

Given wide ranging and highly complex investigations on behalf of this

municipal agency, the 6th largest in the US, with 9K+ employees serving

3.8M customers via bus, subway, elevated rail, commuter rail, light rail

and electric trolley bus. Led 100s of projects involving multiple types of

fraud, fatalities and suicides. Garnered relevant data, physical evidence,

statements from involved parties, photographs, diagrams of accident scenes

and video/audio recordings to include within a highly detailed, precise

incident report - many times serving as significant court records.

Partnered with internal attorneys to prepare civil liability as well as

criminal cases.

Leveraged work prioritization, time management, organization skills,

objectivity, integrity and strong communication abilities to travel

extensively to accident/incident scenes, interview witnesses, document

evidence and follow up on information gathering tasks. Safeguarded

evidence, verifying accuracy of facts through multiple sources. Filled in

proper paperwork to obtain releases with insured's, claimants and

attorneys. Learned on-the-job contract administration processes such as

contract methodology, party rights, responsibilities and conditions of

breach of contract.

Notable Achievements

. Served on the Special Investigations Unit dealing with slip-and-falls,

worker's compensation, medical fraud (10-15 cases/month as well as a

regular caseload of up to 120 cases/month).

. Used a natural determination to patiently and persistently search

databases, review court/public records and leverage any and all

resources to exhaust all available leads.

. Studied and became a Subject Matter Expert in NJ and PA state laws

relating to insurance fraud, P&C operations, fraud reporting, civil

liability cases, surveillance policies, civil/criminal proceedings and

fraudulent medical claims.

. Collaborated with city, state and federal legal agencies to assist in

escalated cases.

Kenneth J. Orfe ( Page Two ( abocd4@r.postjobfree.com

Millennium Investigations - Philadelphia, PA 1998-2002

SIU Investigator

Supervised 2 major accounts with this 3rd party adjuster/investigation firm

including Loyd's of London and Great Western. Investigated slip-and-falls,

car accidents, on-property incidents and general company liability issues

for multiple hotels, restaurants bars and night clubs (minimum liability

$5M). Performed fraud investigation including taking photos, diagrams and

statements of involved parties for cab accidents on behalf of Great Western

(insurer of 60% of the cabs in Philadelphia).

EDUCATION

Bachelor of Science ~ Law Enforcement Administration

Western Illinois University, Macomb, IL

Bachelor of Arts ~ Criminal Justice

Hutchinson Community College, Hutchinson, KS

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