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Matthew Wright will Speak on Data Mining and Statistical Analysis to Detect and Deter Medicaid Fraud, Waste, and Abuse

Matthew Wright will Speak on Data Mining and Statistical Analysis to Detect and Deter Medicaid Fraud, Waste, and Abuse

 

The department would like to welcome Matthew Wright, who is a 2012 graduate from TCNJ’s Statistics program. He has been working for the Office of the State Comptroller, Medicaid Fraud Division in the Data Mining Unit for the past five years. Matthew is a Certified Fraud Examiner (CFE), a Certified Program Integrity Professional (CPIP), and will be graduating with his Master’s in Statistics from Texas A&M University in December. He will be giving a talk on Tuesday, 4/11/17, from 12:30-1:30 in SCP 229.

Abstract:

Behind education, New Jersey’s Medicaid program is the state’s second largest expenditure and has over 1.7 million residents utilizing its services. With a significant portion of New Jersey’s budget allocated to the Medicaid program, the Medicaid Fraud Division (MFD) serves a critical role in safeguarding against fraud, waste, and abuse. MFD’s first line of defense is the Data Mining Unit (DMU), whose responsibility is to analyze claims data for abnormal patterns in billing and utilization by Medicaid providers and recipients. Matthew Wright, a Data Miner for MFD, will explain and demonstrate: how to develop, review, and analyze reports; how to use the data mining software, JSURS, to identify outliers and drilldown on specific issues; how to perform in-depth statistical analysis to generate referrals; and how to apply valid sampling and extrapolation techniques to audits and investigations. This talk will utilize commonly available tools such as R, Microsoft Excel and Access, as well as government provided software, RAT-STATS and EZ-Quant.

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