Digital Evidence & Fraud Investigator

Tonya Williams

Kernersville, USA, ***** • 614-***-**** • ******************@*****.***

Investigator who conducts fraud, criminal, insurance, and background probes and preserves digital evidence from seized devices using EnCase to maintain chain-of-custody. Prepares concise, audit-ready investigative memos that support prosecutorial decisions and recommended next steps. Collaborates with legal, clinical, and payer stakeholders to close complex cases and reduce repeat reviews. Employment history

Cultural Liaison Director • SparkLife International • Detroit, MI • Jun 2026 – Present Utilization Review Specialist • CareCentrix • Tampa, FL • May 2026 Liaison Representative • MyNexus • Brentwood, TN • Aug 2026 Education

Bachelor of Science in Criminal Justice • Purdue University • Lafayette, IN • Sep 2024 – Apr 2026 Associate of Applied Science in Criminal Justice • Purdue University • Lafayette, IN • Aug 2023 – Aug 2024 Clinical Laboratory Research Studies • Columbus State Community College • Columbus, OH • Jan 2019 – May 2021 Skills

Fraud Waste Abuse Review, Leadership Objectives, Case Management, Critical Thinking, Attention to Detail, Problem Solving, Time Management

References

Theresa Nantor, ISHB *******@*****.***, 614-***-**** Barbara Mitchell, Purdue University *********@************.*** James Ebert, Purdue University *****.*****@************.*** Additional information

National Society of Leadership and Success (NSLS) • Honoree of Sigma Alpha Pi Negotiates cross-cultural agreements that reduced community conflicts and secured regular program space Creates volunteer ambassador program that expanded outreach and increased bilingual event staffing Raises donor support through targeted fundraising campaigns to sustain ongoing program operations Leads programs for women to be empowered internationally Utilizes internet for effective communication, hold meetings and program initiatives. Reviewed medical records for 150+ inpatient cases weekly to validate documentation against utilization criteria. Communicated denials to provider offices with clinical rationale and citations from payer policy manuals. Investigated suspected fraud, waste, and abuse referrals and compiled detailed reports for compliance teams. Took inbound calls, remotely, from clients, patients and medical staff. Operated a computer via internet/VoIP to handle inquiries. Coordinated daily communication between claims examiners and providers to resolve billing discrepancies quickly. Scheduled and led weekly stakeholder meetings to align on pending appeals and reduce turnaround time. Assessed case files for Fraud Waste Abuse Review flags, documented findings, and escalated confirmed issues. Examined emails from outside sources daily.

Utilized software programs to handle daily tasks, calls and manage inquiries. Leadership improvement

Team building

Workshop enhancing

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