Anthony Philmon

Anthony Philmon is currently a Customer Service Specialist at Paperspace. Prior to that, they worked as a Special Investigator at Vaya Health from May 2018 to December 2021. In this role, Anthony was responsible for investigating health care providers within 23 counties in North Carolina for allegations of fraud, waste, and abuse to determine compliance with contractual and regulatory requirements. Anthony also led complex provider investigations related to fraud and developed action plans to address the investigative findings and prevent future loss.

Throughout their career, Anthony has performed comprehensive and detailed audits of medical documentation and claims information including data analysis, investigation, and medical review to detect, prevent, deter, reduce, and recover funds from fraud, waste, and abuse. Anthony has also completed case investigations, case management, and reporting of investigations to regulatory agencies to ensure compliance with state and federal requirements. In addition, Anthony has analyzed complex evidentiary patterns and interviewed witnesses and health care providers. Anthony has also conducted site visits as needed.

Anthony has consulted with legal to ensure investigation accuracy. Anthony has also developed education materials and guided provider team members in compliance procedures. Anthony has confidently facilitated clear and concise case findings and presentations to providers, provider associations, law enforcement, and beneficiary advocacy groups on program safeguard matters. Anthony has led cases that have recovered > $300,000.

Anthony Philmon has an M.B.A. in Sports Management from Saint Leo University, a B.S. in Criminology from Florida State University, and an A.A. from Tallahassee Community College.

Anthony Philmon reports to Benjamin Lamson, Head of Customer Success & Sales.