Audit Expert Witnesses

California

Medical Billing, Insurance - Managed Care, HMO, PPO, Medicare, Medicaid, Reasonable Value, Audit, Hospital, ERISA, Usual and Customary, Reimbursement Disputes, Claims Denials, Athena Billing, Out-of-Network, Balance Billing, Fee Schedule Analysis, Expert Testimony, Medical Necessity, Multi-State, Healthcare Reimbursement

I have over 35 years of experience in medical billing, reimbursement, and managed care systems, with expertise spanning provider operations, payer methodologies, and claims adjudication practices. My work focuses on evaluating medical billing accuracy, reimbursement methodologies, usual and customary charges, and payer denial practices. Practice includes multi-state reimbursement analysis, with extensive experience in California managed care systems, including HMO, IPA, and risk-based reimbursement structures, as well as Medicare Advantage and national payer methodologies. I have served in multiple roles, including claims examiner, billing manager, revenue cycle executive, and founder of a national medical billing and audit firm. This multidisciplinary experience allows me to analyze disputes from both the provider and payer perspectives. Experience includes analyzing billing system workflows and claims processing issues across platforms such as Athenahealth. My expert work includ...

Danville, California

Banking, Financial - Regulatory Compliance, Risk Management, PPP, Paycheck Protection Program, Elder Financial Exploitation, EFE, Credit Risk, Fraud, BSA, AML, Underwriting, Policy, Procedures, Best Practices, Lender Liability, Compliance, Audit, Fintech, Construction, Covenants

Call or text anytime for CV at 650-703-7009.

Florida

Construction, Dispute Resolution - Construction Delay, Disruption, Productivity Loss, Quantum of Damages, Critical Path Delay, Change Orders, Scope Change, Termination, CPM Scheduling, Audit, Construction Claim, Acceleration, Cumulative Impact, Extended General Conditions, Extension of Time, Liquidated Damages, Concurrent Delay

Mr. Caleb M. Sturm has over 20 years of experience in the engineering and construction industry working as a contractor, owner, and an expert consultant. His experience was gained while working on the delivery of large-scale and complex construction projects and within the context of claims and disputes. He has been appointed as an independent expert providing both written and oral opinion evidence regarding matters of programming and project delay, studies in working disruption and productivity, extension of time entitlement, forensic accounting and the quantification of additional costs incurred. Mr. Sturm has a demonstrable track record assisting parties in the successful resolution of claims prior to litigation or arbitration proceedings. Mr. Sturm can effectively collaborate with project personnel and perform analyses in the development of expert findings that are presented and relied upon during settlement conferences, formal mediations, meet and confer procedures, and inform...

Atlanta, Georgia

Construction, Dispute Resolution - Construction Delay, Disruption, Productivity Loss, Quantum of Damages, Critical Path Delay, Change Orders, Scope Change, Termination, CPM Scheduling, Audit, Construction Claim, Acceleration, Cumulative Impact, Extended General Conditions, Extension of Time, Liquidated Damages, Concurrent Delay

Mr. Caleb M. Sturm has over 20 years of experience in the engineering and construction industry working as a contractor, owner, and an expert consultant. His experience was gained while working on the delivery of large-scale and complex construction projects and within the context of claims and disputes. He has been appointed as an independent expert providing both written and oral opinion evidence regarding matters of programming and project delay, studies in working disruption and productivity, extension of time entitlement, forensic accounting and the quantification of additional costs incurred. Mr. Sturm has a demonstrable track record assisting parties in the successful resolution of claims prior to litigation or arbitration proceedings. Mr. Sturm can effectively collaborate with project personnel and perform analyses in the development of expert findings that are presented and relied upon during settlement conferences, formal mediations, meet and confer procedures, and inform...

North Carolina

Construction, Dispute Resolution - Construction Delay, Disruption, Productivity Loss, Quantum of Damages, Critical Path Delay, Change Orders, Scope Change, Termination, CPM Scheduling, Audit, Construction Claim, Acceleration, Cumulative Impact, Extended General Conditions, Extension of Time, Liquidated Damages, Concurrent Delay

Mr. Caleb M. Sturm has over 20 years of experience in the engineering and construction industry working as a contractor, owner, and an expert consultant. His experience was gained while working on the delivery of large-scale and complex construction projects and within the context of claims and disputes. He has been appointed as an independent expert providing both written and oral opinion evidence regarding matters of programming and project delay, studies in working disruption and productivity, extension of time entitlement, forensic accounting and the quantification of additional costs incurred. Mr. Sturm has a demonstrable track record assisting parties in the successful resolution of claims prior to litigation or arbitration proceedings. Mr. Sturm can effectively collaborate with project personnel and perform analyses in the development of expert findings that are presented and relied upon during settlement conferences, formal mediations, meet and confer procedures, and inform...

McKinney, Texas

Medical Billing, Insurance - Managed Care, HMO, PPO, Medicare, Medicaid, Reasonable Value, Audit, Hospital, ERISA, Usual and Customary, Reimbursement Disputes, Claims Denials, Athena Billing, Out-of-Network, Balance Billing, Fee Schedule Analysis, Expert Testimony, Medical Necessity, Multi-State, Healthcare Reimbursement

I have over 35 years of experience in medical billing, reimbursement, and managed care systems, with expertise spanning provider operations, payer methodologies, and claims adjudication practices. My work focuses on evaluating medical billing accuracy, reimbursement methodologies, usual and customary charges, and payer denial practices. Practice includes multi-state reimbursement analysis, with extensive experience in California managed care systems, including HMO, IPA, and risk-based reimbursement structures, as well as Medicare Advantage and national payer methodologies. I have served in multiple roles, including claims examiner, billing manager, revenue cycle executive, and founder of a national medical billing and audit firm. This multidisciplinary experience allows me to analyze disputes from both the provider and payer perspectives. Experience includes analyzing billing system workflows and claims processing issues across platforms such as Athenahealth. My expert work includ...