Post Job Free

Resume

Sign in

Fraud Analyst

Location:
Omaha, NE
Posted:
July 13, 2023

Contact this candidate

Resume:

Julie Chapman

402-***-**** adyah0@r.postjobfree.com Council Bluffs, IA 51503

SUMMARY

I have over 10 years of work experience in fraud investigations, customer service, and compliance across various industries and platforms. My mission is to protect and enhance the trust and safety of online communities and users, and to contribute to the prevention and resolution of fraud, abuse, and harm. My most recent role was an Ads Abuse Analyst at LinkedIn, where I reviewed, identified, and resolved non-compliant, harmful, and fraudulent ads on the platform. I am passionate about working with a diverse and inclusive team that values collaboration, learning, and innovation.

SKILLS

●Fraud Analysis

●Online payment fraud

●Quality Management

●Analytical skills

●Detail oriented

●Complex problem solver

●Investigative skills

●Project leader

EXPERIENCE

Ads Abuse Analyst, LinkedIn, July 2021-May 2023

Omaha, United States

●Review, identify & resolve fraud, non-compliant, harmful ads on LinkedIn.

●Proactively & effectively identify problems and issues by performing relevant research using the appropriate tool.

●Manage internal stakeholder escalations.

●Provide feedback to management regarding necessary changes and updates; including but not limited to policies, product upgrades, and member issues.

●Analyze reports, identify trends that needed to be addressed and communicate findings to the appropriate stakeholders.

●Regularly mentor and provide guidance to team members and gauge their performances.

eCommerce Compliance Manager, Proxibid, January 2021-July 2021

Omaha, Nebraska

●Monitored and updated prohibited keywords and items within the marketplace.

●Project manager overseeing the audits of auction items and catalogs to ensure compliance and policies were followed.

●Managed raw data pulls of auction items for compliance review.

●Oversaw difficult customer interactions via zoom and over the phone as necessary to communicate noncompliance auction items/catalogs and provided education to correct the discrepancies.

Member Safety & Recovery Consultant, LinkedIn, October 2018-January 2021

Omaha, NE

●Responsible for receiving, processing, investigating, and resolving customer disputes, fraudulent cases, Terms of Service violations and escalated customer facing issues.

●Responsible for research and resolution of internal and external customer queries that support LinkedIn's Privacy Policy and User Agreement

●Effectively recognize problems by performing relevant research and data analysis using appropriate tools, resources and internal and external subject matter experts

●Participate in identifying potential current or future site-related risks and driving recommendations to resolution.

AML Analyst, TD Ameritrade, May 2018-July 2018

Omaha, Nebraska

●Responsible for the analysis of account activity to ensure compliance with the USA Patriot Act, Bank Secrecy Act, and OFAC requirements.

●The primary function of this position was to concentrate on surveillance and monitoring reports, identify red flags, and analyze account activity for market manipulation and suspicious behavior.

●Additional functions of this position included aiding AML investigators in completing Suspicious Activity Report (SAR) filings in a timely manner and providing guidance to business partners on high-risk accounts and transactions.

Fraud Investigator, NCI Advancemed, October 2016-May 2018

Omaha, Nebraska

●Review information contained in standard claims processing system files (e.g., claims history, provider files) to determine provider billing patterns and to detect potential fraudulent or abusive billing practices or vulnerabilities in

●Medicare policies and initiates appropriate action.

●Utilize data analysis techniques to detect aberrancies in Medicare claims data, and proactively seeks out and develops leads received from a variety of sources (e.g., CMS, OIG, fraud alerts)

●Travel and conduct on-site audits along with interviews with providers and beneficiaries as warranted.

●Complete written referrals to law enforcement and takes steps to recoup overpaid monies.

●Share information on current fraud investigations with other Medicare contractors, law enforcement, and other applicable stakeholders

●Pursue applicable administrative actions during investigation/case development (e.g.)

Business Support Analyst /, First Data, August 2016-October 2016

Omaha, Nebraska

●Respond to pricing requests by preparing pricing models and communicating pricing to Sales management.

●Provide documentation to accounting teams for preparation of journal entries and reconciliations for merchant accounts, including contractual allowances, administrative adjustments in a timely and accurate manner.

●Prepare forecasts and analyzes trends in sales, finance, general business conditions and other related areas.

●Prepare financial and business-related analyses and research in such areas as financial and expense performance, budgeting, costing, rate of return, depreciation, and working capital.

Reimbursement Analyst, Remedy Intelligent Staffing/WPS Heath Solutions, May 2016-August 2016

Omaha, Nebraska

●Assist in the preparation of the annual Medicare and Medicaid Reports

●Provide documentation to accounting teams for preparation of journal entries and reconciliations for physician accounts receivable reserves, including contractual allowances, administrative adjustments, charity and bad debts in a timely and accurate manner.

●Collect and review data and documentation from the facilities necessary to file the appropriate Federal and State reports in a timely and compliant manner.

●Assist in the review of new reimbursement/revenue cycle strategies for the purpose of ensuring compliance promotion of best practices.

EDUCATION AND TRAINING

Master of Science

Criminal Justice and Corrections, Bellevue University, Omaha, Nebraska Expected in May 2025

Bachelor's Degree

Criminal Justice and Corrections, Buena Vista University, January 2019

Associate of Arts (A.A

General Studies, Iowa Western Community College, January 2017

Associate of Arts (A.A

Criminal Justice, Iowa Western Community College, January 2016

LANGUAGES

English



Contact this candidate