Skip to main content
prime targets for fraudsters, and it’s Jeneen Iwugo’s job to fight back against them. As acting director of CMS’s Center for Program Integrity, Iwugo’s team is responsible for reviewing 4 to 5 million claims each day.
Though her team is deep — roughly 500 or so staffers — she still doesn’t “have the time or manpower” to review each of those claims. But AI has helped make up the difference by “combing through” those claims and identifying “where the risk is the greatest,” Iwugo said during a Scoop News Group-produced UiPath event in Washington, D.C.
“That’s where I’m going to…
HOW TO SPOT A “RED FLAG” (THE BEHAVIORAL AUDIT)
Keep an eye out for these behavioral shifts in your staff:
Refusal to take leave: Afraid someone will find their “adjustments.”
Unexplained wealth: Buying luxury items that don’t match their known salary.
Working odd hours: Preferring to work alone late at night when no one is watching the system.
“Gatekeeper” behavior: Becoming overly defensive or angry when someone asks to see their records.