Jessica Huebner

Jessica Huebner is a director in the Health Analytics practice at Berkeley Research Group (BRG). She has collaborated with the independent monitor Mr. Stevens for ten-plus years on multiple engagements, including her role as a senior member of two monitoring engagements. She specializes in providing dispute resolution, compliance, forensic accounting, and investigation services to healthcare organizations and their legal counsel. Her experience spans a variety of payers, providers, and other healthcare entities, including managed care organizations, health plans, hospitals, physicians, ambulatory surgery centers, and medical device manufacturers.

Ms. Huebner’s credentials include:

• Certified in Financial Forensics (CFF)
• Certified Fraud Examiner (CFE)
• Certified Public Accountant (CPA), licensed by the State of Florida and State of Wisconsin
• Certified Valuation Analyst (CVA)
• Chartered Global Management Accountant (CGMA)

Regulatory Compliance, Forensic Accounting, and Investigation Matters

Ms. Huebner’s compliance, forensic accounting, and investigative services have included regulatory compliance matters, investigations into alleged accounting irregularities, fraud and embezzlement and whistleblower allegations, and valuation services. These services included conducting interviews of personnel, development of compliance and provider audit programs, performing audit of compliance with regulatory requirements, detailed review of an organization’s infrastructure, analysis of financial records and transactions, reconstruction of financial information, analysis of impact on financial statements, identification and quantification of preferential transfers and fraudulent conveyances, and preparation of written reports. Specific project examples are described below.

Delegated Entity Regulatory Compliance Auditing

Led a team and assisted a monitor appointed by a health plan’s delegated entity to develop and perform regulatory compliance audits to assess the delegated entity’s compliance of claims processing and utilization management authorization requests processing with regulatory and contractual requirements. Key engagement activities included: understanding the delegated entity’s claims and utilization management processing systems and processes, developing and executing claims and utilization management processing compliance auditing, analyzing key performance indicators, and generating monthly results reporting.

Hospital Network Joint Venture Valuations

Assisted outside counsel in a review of external valuations in conjunction with hospital joint ventures. Key engagement activities included: analyzing historical and projected financial data, assessing reasonableness of valuation methods selected and concluding values determined by external valuation company(s), researching industry and competitor data, and valuing arrangements utilizing the income capitalization approaches, discounted future earnings, capitalization of earnings power, debt-free approaches, asset appraisal approach, comparative appraisal approach, and adjusted net asset values.

Health Plan Investigation

Assisted outside counsel in an internal investigation of alleged fraudulent conduct by employees of a Fortune 100 health plan. Key engagement activities included: designing and executing analyses of claims, enrollment, advances and loans, accounts payable, and employee expense report data to develop fact patterns used by counsel to assess validity of allegations.

Acute Care Hospital Purchase Price Dispute

Provided accounting and consulting services for a company that owns and operates acute care hospitals in a purchase price dispute over their sale of a hospital to an unrelated party. Key responsibilities included: analyzing working capital account balances in dispute, researching and evaluating the application of industry-specific standards and regulations related to the matter, determining proper classification (long- versus short-term) of select sub-accounts, recalculating account balances in dispute, and assisting in drafting a conclusions report.

Government Entity Investigation

Managed a government investigation initiated by a state secretary in response to allegations of a former elected county official’s misspending and misappropriation of federal grant funds awarded to the county official’s office. Key responsibilities included: conducting interviews of personnel to gain knowledge of underlying situations and understanding processes and roles within the county office; analyzing and reconciling financial records and transactions to supporting documentation and records, such as bank statements, general ledgers, vendor invoices, and purchase orders; quantifying and identifying instances in which the county disbursed grant-related funds for services or goods that did not comply with grant provisions stated in the grant agreement; and assisting in the preparation of the results and findings report.