This 2-day course unveils the power of AI, Generative AI, and Machine Learning in combating healthcare fraud. The core focus shifts to hands-on application: leveraging structured and unstructured healthcare data with advanced AI and Generative AI tools. You'll learn to visualize complex patterns, verify medical claims, generate intelligent business rules, and automate investigative workflows. From initial data exploration to predictive models and real-time fraud prevention, we'll demonstrate how these technologies offer unparalleled insights, significantly enhancing your fraud detection capabilities.

Professionals from payers, TPAs, RCMs, healthcare providers,and regulatory bodies involved in:

• Population Health and Health Governance
• Medical Rules and Policy Oversight
• Pre-Authorization & Claims Operations
• Data Science, Analytics & AI
• Cost Containment and Medical Audit
• Special Investigation Units (SIU)
• Fraud, Waste & Abuse (FWA)
• Compliance, Risk Management, and Regulation

Job Titles

Directors, Managers, and Supervisors from:

• Investigators and Auditors (Internal & External)
• Claims Adjudicators and Compliance Officers
• Certified Fraud Examiners (CFE), CISAs, CPCs
• Data Analysts and Healthcare Data Scientists
• Attorneys, Consultants, and Strategy Leaders
• Regulatory Officers overseeing healthcare compliance, fraud prevention, and policy enforcement