Data Analytics High School
Resume:
Otis J. Hogan
Snellville, Georgia 30039
**********@*****.***
EDUCATION:
Stuttgart, Arkansas High School
Diploma, May 1989 - Honor Graduate
University of Hawaii
B.A., Criminology, Distinction Graduate, May 1996 - GPA 3.65 UALR SCHOOL of LAW
J.D., Juris Doctor, May 2011
CMS / Medicaid Integrity Institute - Certification: Certified Program Integrity Professional (CPIP), April, 2019 EXPERIENCE:
Special Investigations Unit Investigator 07/21 - Present Anthem Inc., Blue Cross Blue Shield
•Conduct investigations and audits of healthcare services and billings
•Conduct interviews of suspects and persons of interest
•Conduct Data Analytics of Suspicious Claims of Medical Providers
•Refer cases of suspected fraud to state law enforcement entities
•Prepare investigative and audit reports to Manage Care Organizations Special Investigations Unit Investigator
Centene Corporation 06/20 - 07/21
•Conduct investigations and audits of healthcare services and billings
•Conduct interviews of suspects and persons of interest
•Conduct Data Analytics of Suspicious Claims of Medical Providers
•Refer cases of suspected fraud to state law enforcement entities
•Prepare investigative and audit reports to Manage Care Organizations Manager, Medicaid Fraud Investigations
Office of the Medicaid Inspector General of Arkansas 01/17 – 06/20
•Manage Investigations of fraudulent activities within Medicaid Program
•Conduct interviews of suspects and persons of interest
•Refer cases of suspected fraud to Arkansas Attorney General (MFCU)
•Assists Audit Team
Hearing Officer
DHS Office of Appeals and Hearings 08/15 – 01/17
•Conduct/Preside over due process hearings
•Review Medicaid Cases and issue rulings
•Review Nursing Abuse Cases and issue rulings
•Write Opinions applying applicable Medicaid rules of law Investigator
Arkansas Attorney General's Office 02/15 - 08/15
•Investigate AR Deceptive Trade Practices Act violations
•Mediate disputes between Consumers and Businesses
•Uphold AR State laws relating to Mortgages and Vehicle Sales Medicaid Hearing Officer
Arkansas DHS Office of Appeals and Hearings 09/13 - 02/15
•Conduct/Preside over due process hearings
•Review Medicaid cases and issue rulings
•Write Opinions applying applicable Medicaid rules of law Investigator - State of Arkansas
Arkansas Fair Housing Commission 06/13 - 09/13
•Investigate complaints of discrimination in housing
•Conciliate and mediate complainants and respondent issues
•Testify on behalf of Arkansas Fair Housing Commission Investigator - State of Arkansas
Arkansas Motor Vehicle Commission 04/06 - 05/13
•Investigate new motor vehicle fraud
•Investigate consumer auto complaints
•Enforce State New Auto Licensure Laws
•Testify in Administrative Hearings
Loss Prevention Supervisor
Kohl's Department Stores 11/05 - 04/06
•Supervise Asset Protection Team
•Prepare Detail Investigative Reports
•Conduct audits to prevent cash shortage
•Apprehend shoplifters
Parole/Probation Officer II
AR Department of Community Correction 07/03 - 11/05
•Supervised 140 Adult Offenders
•Certified Training Officer
•Performed investigation reports
•Provided basic counseling and guidance
Manager Trainee
Enterprise Rent-A-Car, Little Rock, AR 2/03 - 7/03
•Solicited new accounts
•Provided excellent customer service
•Managed auto rental fleet
Promotional Coordinator
Providence Systems, Carlsbad, CA 11/98 - 09-02
•Promoted Business Seminars across USA
•Sold training to Mortgage Lenders
•Renewed Network Business Accounts
Sales and Service Representative/Manager In Training Prudential Overall Supply, Vista, CA 07/97 - 09/98
•Managed a $300K annual Sales Route
•Managed accounting and bookkeeping of Route
•Solicited new accounts
Sales Representative
Providence Systems, Vista, CA 08/96 - 05/97
•Solicited New Accounts of Lenders
•Coordinated Real Estate Training Sales
Student Administrative Assistant
University of Hawaii, Honolulu, HI 08/93 - 05/96
•Processed grievances submitted to Dean of Students
•Coordinated complaint tracking system
•Performed administrative duties as assigned
Personnel-Admin Non-Commissioned Officer
United States Marine Corps
Camp H.M. Smith, Honolulu, HI 06/89 - 06/93
•Managed records for Intelligence Agency
•Processed Secret field reports for DoD
SKILLS:
Type 55 words per minute
Knowledge of IBM/Mac Computers
Knowledge of various software
EXCELLENT REFERENCES AVAILABLE
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