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Blog Post

Jala Attia - CFE

By Emily Primeaux, Fraud Magazine

"I'm passionate about educating people about health care fraud and creating a fire in others that will ultimately fuel the fight for future generations," says Jala Attia, CFE. "Many people don't realize the extent of the problem we're facing. When you consider that national health care expenditures are more than $3 trillion, and that fraud is estimated to account for three to 10 percent of that, you understand the immense scale of the challenge we're facing." Attia faces that challenge every day as the senior program director at General Dynamics Health Solutions. And she uses her CFE credential to make lasting connections with her customers. "The CFE credential has brought a higher level of credibility to my work," says Attia. "It's been a great enhancement to my career because when I deal with customers, the credential provides assurance that the quality of my work is of the highest standard."

My parents immigrated from Egypt to the U.S. in the late '60s and settled in New Jersey where I was born. Arabic was my first language. As a child, I spent every summer in Egypt, visiting the pyramids, Alexandria and the Red Sea, and touring ancient sites. It wasn't until I grew up that I gained a deeper appreciation and pride for my cultural heritage.

Growing up I loved to write. I used to write short stories, poetry and songs, and I wanted to be a teacher and writer when I grew up.

It wasn't until I took a criminal justice course at Rutgers that I realized this is what I was meant to do. I graduated with a double major in Administration of Justice and Sociology and a certificate in Criminology.

While pursuing my MBA at Georgian Court University, I attended a career fair where I met the New Jersey Division of Criminal Justice (NJ DCJ). After about 10 minutes of conversation with the representative, I learned that the NJ DCJ was recruiting investigators for their insurance fraud division. He gave me his card, took my résumé and said I would hear back in a few weeks. I was so excited that I left without handing my resume to any other employer. Several months later, I interviewed for an investigator position with NJ DCJ and got the job. Years later, I left to work for a private health care insurance company where I spent nearly eight years leading their fraud and abuse teams. When that company was sold to another larger insurer, General Dynamics IT hired me to build their fraud investigations team. I've been in the anti-fraud field for more than 15 years.

At General Dynamics Health Solutions I'm responsible for setting and executing strategy for our program integrity line of business. This includes an industry-leading fraud, waste and abuse product suite as well as a robust offering of data management, investigative and clinical services that support health payers. I work closely with our customers to ensure our strategic initiatives are in line with what the market needs.

Prior to joining GDIT, I worked a case involving a dentist who employed his wife as the office and billing manager. This dentist regularly waived copayments from patients and up-coded regular cleanings to deeper, more extensive cleanings. He also reused X-rays from patients whose oral health was in significant need of treatment in order to justify unnecessary expensive dental work for other patients. I located several ex-employees who provided a great deal of information that was helpful to the case and pointed me to one employee who still worked at this office.  She pointed us to the specific X-rays that were always reused and told us what the dentist did with the actual X-rays for these patients. When faced with having to explain his actions, the dentist blamed his wife so that his license wouldn't be negatively impacted. This case taught me the power of ex-employees. Had I not focused time on finding them, I would've never found the employee who provided the evidence I needed.

I first learned about the ACFE in 2004. I'd spent years working only insurance fraud cases, and the idea of expanding my knowledge to different types of fraud was appealing. I spent some time researching it and quickly realized I had much to learn about other types of fraud. Seeing the depth of information offered opened up a new opportunity to expand outside my comfort zone and connect with people all across the world.

Motherhood is my greatest achievement. Not many people can make an exciting career and motherhood work cohesively. I'm blessed to have a supportive family that understands why my job is so important.

I believe that growth doesn't come from comfort zones. Try something new — you may love where you end up.

Emily Primeaux is assistant editor of Fraud Magazine. Her email address is: eprimeaux@ACFE.com.