Minecraft: Data Mining for the Investigator. How to detect, investigate and prosecute billing fraud schemes.

Let’s face it, the world is only getting more complex. Forty years ago, no one had a personal computer, and criminal investigations were done with “good old fashioned police work,” i.e., talking to people and following leads. Today, people have more powerful computers on their wrist than were used to put a man on the moon; and the police are faced with investigating billion-dollar fraud schemes that need a lot more than a few interviews and a hunch.  This course is designed to bridge the gap between good police investigators and the complexity of medical billing datasets. 

It will provide an overview on how to acquire, access, sort, and analyze billing databases for correlations and patterns using MS Excel. It will aid the investigator on how to detect fraud using “what if analysis” as well as the “Excel Analysis Toolpack.” It will teach an investigator how to create descriptive statistics using tables and charts and locate those that are indicative of fraud (a new type of lead). It will teach the investigator how to use the all-important Pivot Table to find anomalies which point to fraud. Essentially it will introduce you to the craft of data mining for fraud in medical billing datasets.

This course is intended for investigators not analysts and assumes no background or prior knowledge of mathematics. It does assume basic computer knowledge such as how to create and use a spreadsheet in Excel.

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Location: Cypress Date: April 20, 2023 Time: 3:45 pm - 4:45 pm Vladislav Mikulich