Ronald Cureton
Certified Fraud Examiner (CFE)
- Role
- Special Investigator at Vaya Health
- Location
- Charlotte, NC, US
- LinkedIn followers
- 500 followers
Experience
Special Investigator
Sep 2022 — Present · Asheville, NC, US
Utilize established Vaya procedures to conduct inquiries and investigations into complaints,allegations, and referrals regarding suspected Fraud, Waste or Program Abuse.Review healthcare claims to determine if provider payments were rendered in accordance with rules, regulations, service definition, service utilization, and contractual requirements.Determine correct coding, billing, documentation, delivery of services and potential violations of federal and/or state regulation or Medicaid guidelines.Perform reviews (desk, virtual, and/or on-site)interview providers, members, and stakeholders, and review medical records to verify compliance with program policies and/or standards of health care, appropriateness of services or medical necessity.
Education
University of North Carolina at Greensboro
Bachelor of Applied Science (B.A.Sc.)
2012 — 2015
Skills
- Microsoft Office
- C
- Public Speaking
- Time Management
- Research
- Teamwork
- Autocad
- Powerpoint
- Microsoft Excel
- Social Media
- Customer Service
- Microsoft Word
- English
- Windows
Find verified contacts for anyone on LinkedIn
Unifers gives sales teams verified emails and direct dials, enriched profiles, and outreach that lands in the inbox.
Free plan included · No credit card required
This profile is compiled from publicly available professional sources. Unifers is not affiliated with or endorsed by LinkedIn. Request removal of this profile.