Brad Campbell, HCAFA
Brad Campbell serves as the Operations Director for Access Health Services, LLC. He is responsible for all security systems including secure file transfer protocol (SFTP) sites, encrypted email, encrypted devices from computers to mobile devices, and other HIPAA Security required functions. His role also includes providing Fraud, Waste, and Abuse (FWA) investigation as directed by the Compliance Officer or the Special Investigations Unit (SIU). He is currently in the planning stages with Cavulus to develop more automated tools to monitor for FWA. He has completed FWA and CMS-Complaint Tracking Module investigations for multiple MA-PD SNP plans.
Prior to this, Mr. Campbell served as the Quality Control Supervisor for a 173,000-life governmental health plan. His responsibilities included auditing all aspects of plan management to include enrollment, billing, financial reconciliation, pharmacy claims management, Medicare processes for claims and the Part D Retiree Drug Subsidy, as well as technical and data quality processes. He previously worked at a national Pharmacy Benefit Management (PBM) in data management where his responsibilities included data loads, reconciliations, and HIPAA ANSI-12 Transactions Management.
Mr. Campbell also served as a law enforcement officer for the City of Jacksonville, Arkansas. This experience provided him with both educational-based and on-the-job training for criminal investigation and reporting. Mr. Campbell graduated from the Arkansas Law Enforcement Training Academy in 2009.
He certified as a Health Care Anti-Fraud Associate (HCAFA) through America’s Health Insurance Plans (AHIP) in 2016. As an active member of the Health Care Compliance Association (HCCA), he has also completed training in Root Cause Analysis, Common Mistakes Compliance Officers Make (And how to avoid them), Your First 100 Days as a Compliance Officer, and Sampling 101: A Primer for Internal and External Audits. He also received training on the new MA and PDP Audit and Enforcement protocols.
Mr. Campbell is a member of the Health Care Compliance Association.