A Compliance Investigator ensures all the contracts and rules are followed by all the involved parties. A well-drafted Compliance Investigator Resume indicates the following duties – detecting fraud and contract violations, performing on-site investigations and ensuring clients follow the contract terms, ensuring patient claims are accurate, checking to ensure if the company and the employees follow building codes, and observe safety regulations; reviewing contract information, analyzing worker’s compensation claims, collecting compensation claim information, examining and investigating claims, collaborating with claims administrators, and processing indemnity payments.
The ideal candidate for this post should mention the following job assets on the resume – knowledge of relevant regulations, research skills, the ability to handle financial records, time management skills, business writing skills, and analytical thinking skills. While a degree is not a mandatory requirement, possessing relevant coursework directly related to the industry working is a must.
Objective : Identifying and verifying transactions including: cash, table game fills, cashier exchanges, gaming equipment removals, conversions, upgrades, and installs.
Skills : Financial Services, Microsoft Suit; AML, KYC, BSA.
Description :
Experienced in writing robust and technical investigations in a timely manner, while simultaneously keeping the quality of the investigations to the highest of standards.
Analyzed and identified adverse trends related to product quality and integrity.
Review documentation for accuracy and request changes as needed.
Complied with all CFR, EU, and ICH guidelines.
Worked in ISO class 7 and 8 areas.
Worked closely with engineering and manufacturing across all sites worldwide to complete investigations.
Peered review medical assessment requests
Experience
2-5 Years
Level
Executive
Education
GED
Compliance Investigator Resume
Objective : Communicating with sales on time frames and workload of wire cutting area, and also Maintaining inventory accuracy on wire reels and coils, Keeping wire cutting equipment in good working condition.
Skills : CPT, ICD-9, ICD-10, HCPCS Coding.
Description :
Worked with the United States Department of Agriculture, Food Safety and Inspection Service, Office of Investigation Enforcement and Audit, Compliance and Investigation Division.
Performed surveillance and investigate violations of Federal laws, as it relates to America's food safety and food defense.
Conducted surveillance along the Canadian and Mexican borders, at air terminals, and across the entire United States Of America.
Worked independently in the field, proactively planning, enforcing, and conducting investigations of non-compliance, fraud, waste, and abuse to prevent unsafe, contaminated, and adulterated meat, poultry, egg, and catfish products from entering commerce and our nation's food supply, through the use of detentions, civil seizures, voluntary recalls, counter-terrorism activities, and raids.
Developed cases through these activities to ensure that appropriate criminal, administrative, and civil sanctions are carried out according to Federal laws, regulations and directives.
Collected samples of product from several retail establishments to verify that they are in compliance with Federal laws mandating the control, prevention and elimination for pathogenic bacteria such as E.
Understood the importance of investigating adverse events to the fullest extent and driving for the true root cause of the event.
Experience
2-5 Years
Level
Executive
Education
Bachelor's In Credits
Compliance Investigator Resume
Headline : An experienced investigator with a background in healthcare investigations, including provider fraud, patient abuse and neglect, and HIPAA privacy violations. I have worked both as an internal investigator and as a regulatory official, primarily in Medicaid behavioral health services. As the Program Integrity Lead Investigator for Sandhills Center I was responsible for highly complex cases which resulted in several state and federal criminal investigations for suspected Medicaid fraud and related crimes.
Conducted extensive investigations to implement the proper corrective and preventive actions (CAPAs) to prevent the event from occurring again.
Advised and educated employers of their rights, responsibilities, and obligations under the Workers' Compensation Laws.
Utilized multiple databases and software applications required during investigations.
Responsible for creating and maintaining MS Excel spreadsheets statistical tacking.
Synthesized recommendations for action based on procedural requirements, decision flowcharts, and critical thinking.
Monitored shipping, receiving, installation, relocation, removal, storage of gaming devices for security and compliance with Federal, State and Tribal laws and regulations.
Received, secured and ensured the destruction of gaming machine software in accordance with Tribal laws and regulations.
Experience
5-7 Years
Level
Executive
Education
GED
Compliance Investigator Resume
Summary : Seeking a Compliance Investigator position with an outstanding career opportunity that will offer a rewarding work environment along with a winning team that will fully utilize management skills.
Skills : MS Office, Managing Skills, investigator.
Description :
Observed gaming operations for compliance with Tribal, State, and Federal standards on casino gaming operations, MICs, TICs, Tribal-State Compact, IGRA, NIGC, MOU, OSHA, SOPs, and Gaming Control Board Regulations.
Monitored and Reported any and all gaming violations on non-compliance activities to the Acoma Gaming Commission Executive Director.
Compiled information in a concise report with recommendations to the Executive Director and/or Commission.
Regularly checked gaming logs for compliance - Table Games, Cage, Slot, Housekeeping, and Risk Management.
Ensured gaming operations are protected from illegal activities and the repute of the Tribe, Gaming Facility, and Gaming Operation.
Assisted in resolving gaming disputes and contributes to a team effort.
Assisted in ensuring the security, health, well-being, and physical safety of guests and staff.
Experience
7-10 Years
Level
Management
Education
GED
Compliance Investigator Resume
Objective : Performance-driven Compliance Investigator professional with experience in internal and external investigations pertaining to internal/external fraud, business applicable state/federal laws, and company policies.
Skills : Inventory Management, Security, Management, Chemical, Site Supervisor.
Description :
Reviewed and tracked all incident reports on casino staff.
Conducted investigations on Federal, State, and Tribal gaming laws and regulation violations.
Received, secured, and tested all new software for gaming devices.
Maintained algorithm database for all gaming machine software.
Inspected casino departments for Federal, State, and Tribal gaming laws and regulations.
Worked in conjunction with the Arizona Department of Gaming to maintain a database on self-excluded individuals.
Worked in conjunction with the United States Secret Service and the Arizona Department of Gaming in regards to counterfeit currency received on the Apache Gold Casino and Resort.
Experience
2-5 Years
Level
Executive
Education
Master Of Science In Psychology
Compliance Investigator Resume
Objective : Hardworking, organized, Compliance Investigator professional with a proven background delivering sensible business technology solutions on time and under budget while working as a team member or team leader.
Conducted compliance investigations for incidents and excursions to ensure patient safety and product quality.
Performed all Chemistry Quality (CQ) departmental investigations to ensure they were completed within the required time schedule as required per quality systems.
Managed Chemistry analysts and department Supervisors throughout the process.
Qualifications and training - M1, ER/LIR training, gQTS training, and access.
Responsible for writing LIR, RAAC, QAR, and ER investigations for the CQ department; responsible for determining product disposition and regulatory notification.
Wrote and performed corrective action preventative actions (CAPAs); experience with validations.
Conducted investigations into process excursions, procedural exceptions, and nonconforming incidents and events.
Experience
2-5 Years
Level
Junior
Education
Bachelor Of Science
Compliance Investigator Resume
Objective : Highly skilled and driven compliance Compliance Investigator professional. Over five years' experience in internal/external investigations, forensic examination, compliance management, and employee relations.
Evaluated, investigated, tracked, and completed complaints through an effective and established complaint handling process.
Researched and analyzed laws and regulations related to pertinent incidents and projects.
Responsible for ensuring that exclusion lists have been checked with respect to all employees, medical staff, and independent contractors.
Researched and responded to routine compliance questions.
Researched billing DME without a DME license, and the option of obtaining a DME license.
Investigated potential EMTALA violations.
Assisted in the development of a research billing system.
Experience
2-5 Years
Level
Executive
Education
Master's In Health Administration
Compliance Investigator Resume
Headline : High-performing strategic-thinking Compliance Investigator professional, with more than ten years' experience, in leadership within the food inspection and quality assurance sectors of the Federal government. Highly-skilled with relationship building with clients of Federal services, and across organizations and teams; exceptional writing, presenting; and interpersonal communication skills.
Skills : Monitoring Skills, Investigating Skills, Communication Skills.
Description :
Planned/Conducted random and planned compliance reviews in commercial firms thus protecting the public.
Planned review/ frequency intensity commensurate with the volatile risks resulting in public safety.
Determined surveillance frequency of violators subjected to follow up review, promoting public safety.
Independently discovered trends in violation of the FMIA, PPIA, and EPIA ensuring public safety.
Investigated HIPAA violations.
Active member of the Medical Records Committee.
Ensured root cause, CAPAs, and product impact were thoroughly addressed in investigations.
Experience
5-7 Years
Level
Executive
Education
GED
Compliance Investigator Resume
Summary : Experienced Compliance Investigator professional, who possesses outstanding customer service skills seeks a part-time employment opportunity with Amazon as a Work from Home Customer Service Associate with the Reserves Program.
Skills : Certified Fraud Examiner, Title IX Investigator.
Description :
Conducted on-site compliance investigations at Colorado Lottery retailers.
Identified possible fraud, theft, counterfeiting, and other criminal activity.
Identified and investigated Colorado Lottery and Multi-State Lottery (MUSL) rule discrepancies.
Investigated proper storage of Lottery products, proper record keeping, and electronic recording of transactions.
Provided customer service, guidance, training, and education to retailers for compliance with state statutes, Colorado Lottery, and MUSL rules and guidelines as they apply to the retail operation.
Conducted on-site high tier jackpot verifications at retailers for jackpot winners.
Completed comprehensive reports for each compliance investigation and high tier verification conducted.
Experience
10+ Years
Level
Senior
Education
GED
Compliance Investigator Resume
Objective : Professional with extensive experience across financial and business administration; highly adept at implementing and management of effective systems and procedures, streamlining operational processes to successfully deliver solutions tied to organizational growth. Additionally, proficient in the areas of staff and customer service support, skilled in optimizing teams' dynamics, uniting diverse agendas to a common goal, and harnessing strategic and operational drivers to deliver results.
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