Eric Rubenstein, MSCJ, CFE, is a seasoned retired federal law enforcement officer (25 years), specializing in white-collar crime investigations as a Special Agent for HHS-OIG. Wide-ranging experience involving federal healthcare programs, with an emphasis on crimes involving the Medicare and Medicaid programs by healthcare providers, including physicians, pharmacies and healthcare entities. Demonstrated success in complex criminal investigative management and planning. Over $500 million in restitution, forfeiture, damages, penalties and fines to government programs and over 150 convictions and civil settlements involving healthcare fraud matters. Broad trial experience, including three criminal trials in fourteen months (9 trials in all, including the first Civil False Claims Act trial in the District of New Jersey involving a violation of Stark). 20 years of presentation and training facilitation experience and a feature presenter/ trainer at local, regional and national training academies, conferences (such as the National Healthcare Fraud Association and the American Association of Professional Coders) and subject matter case analysis. Extensive mentoring and training of new agents. A conduit of information on internal and external policies and procedures for criminal, civil and administrative investigative matters.

A previous member of the IBM UCM project, providing Subject Matter Expertise on FWA matters as part of the Optimization Team servicing all UCM user groups (including UPICS, MEDIC and the greater UCM user community-law enforcement). A former Partner Liaison of the Trusted-Third Party for the Healthcare Fraud Prevention Partnership (HFPP) serving the membership of the HFPP and providing SME in the areas of FWA and investigative efforts to combat FWA in healthcare.

Assist/ consult with law firms and providers on due diligence, statistical sampling, self-disclosures, subpoena response, and OIG compliance-related issues, trial and litigation support. Subject Matter Expert (SME) in a variety of healthcare FWA issues, and previously retained as such for litigation and report preparation purposes.

With over 22 years of experience in healthcare compliance and data analysis, Jennifer McNamara is the CEO of Healthcare Inspired LLC, a consulting firm dedicated to optimizing medical practices. She specializes in enhancing patient care and helping healthcare providers achieve their strategic goals. Jennifer holds multiple credentials, including CCS, CPC, CDEO, CRC, CPMA, COSC, CGSC, COPC, and CPCI, showcasing her expertise in navigating the complex landscape of healthcare regulations and coding.

Her passion lies in empowering healthcare providers with the knowledge and training needed to effectively mitigate compliance risks and harness data to drive improvements. Jennifer consults across various medical disciplines, including Orthopedics, Otolaryngology, General Surgery, Neurosurgery, Ophthalmology, Gastroenterology, Podiatry, and Surgical Oncology. Additionally, she shares her insights as a national speaker and podcast host, fostering a community of professionals committed to improving the healthcare landscape. Through her work, Jennifer is dedicated to advancing the quality of care in the healthcare industry.

Nancy Reading is a seasoned healthcare professional with 45 years of experience as both a nurse and coder.

Her extensive career spans various healthcare settings, including professional practices, hospital outpatient departments, and inpatient facilities.
 
Throughout her career, Reading has:

- Operated her own consulting business

- Worked for a large university medical center

- Served in Medicaid

- Acted as a Medicare specialist for the nation's largest private third-party payer.

Reading has also been actively involved in professional organizations, notably:

- Serving twice as a local AAPC chapter president

- Being a member of the National Advisory Board

- Working as vice president of education for AAPC.

Currently, Nancy Reading holds the position of DRG auditor at CERIS, where she continues to apply her wealth of knowledge and experience in healthcare coding and auditing.

 

Sonal is a nationally recognized thought-leader, speaker, author, and consultant with over 13 years of experience in healthcare business. As CEO & Principal Strategist of SP Collaborative, LLC, she partners with various healthcare stakeholders to elevate coding compliance education.

Career Highlights

- Started as a medical biller, advancing to patient business services at a renowned cancer hospital in Houston, Texas
- Supported healthcare attorneys in reimbursement issues for nearly six years
- Created and hosts the weekly Paint the Medical Picture Podcast, now in its third year
- Published author in industry publications, including two chapters in HCCA's 2021 Complete Healthcare Compliance Manual
- Provides guidance to aspiring and newly certified medical coders

Credentials and Affiliations

- Bachelor of Arts with Honors in Art History, minor in Business
- Certifications: CPC®, CPMA® (AAPC®), CMC® (PMI)
- Active member of AAPC®, AMBA®, HCCA®, NAMAS®, and PMI®
- Proficient in ICDCM, prepared for future ICD-11-CM implementation

Stephanie Allard is a seasoned expert in Medical Coding, Billing, Reimbursement, and Compliance with 20 years of medical and management experience. Her expertise spans over 40 specialties, including behavioral health, rheumatology, orthopedics, lab services, dental, neurology, general surgery, OB/GYN, PM&R, and PT/OT.

Key Responsibilities and Skills

- Multi-specialty auditor performing external audit reviews
- Conducts revenue cycle reviews to optimize workflow and administrative processes
- Implements risk-reduction strategies through training and education
- Performs forensic auditing for court cases and payer investigations
- Manages large coding teams, focusing on quality reviews and productivity tracking

Professional Strengths

- Comprehensive understanding of the entire medical billing and coding process
- Stays current with evolving regulations in the healthcare industry
- Effectively communicates complex information to improve client results
- Provides guidance and mentorship to other coding professionals

Stephanie's expertise in revenue cycle optimization and risk mitigation, combined with her ability to manage large coding teams, makes her a valuable asset in the healthcare industry. Her commitment to staying updated with regulatory changes and mentoring others contributes to her reputation as a respected professional in the field.