Desiring a career that helps people, Ruth Pardo entered the clinical side of the medical field as a nurse more than 30 years ago. When she decided she could no longer handle the physical demands and seeing people die in front of her, she transferred to the area of utilization review, which still required her nursing expertise and allowed her to delve into fraud, boosting her interest. Now, enjoying multiple roles at Medical Mutual of Ohio in Copley, Ms. Pardo has been the senior financial investigator since 2021 as well as a utilization review nurse and certified fraud examiner since 1997.
Ms. Pardo’s duties include searching for abuse and fraud by reviewing medical records to ensure they match the amounts billed and the procedures performed. This means looking for providers—including physicians, hospitals, and durable medical equipment suppliers—who are cheating. She finds her own cases and consults with her team when they find an issue to ensure that what they and she are viewing are in sync. As the team’s leader with vital coding and utilization experience and certified by the American Academy of Professional Coders, Ms. Pardo is ultimately responsible for legitimizing team members’ findings.
With a comprehensive understanding of how money flows through medical systems, Ms. Pardo acquired expertise in financial investigations in part by becoming certified by the Association of Certified Fraud Examiners. She is also certified as a registered nurse by the Ohio Board of Nursing and a Medicaid professional by the Medicaid Learning Center in addition to her affiliation with the National Health Care Anti-Fraud Association. Holding a Bachelor of Science in Nursing from the University of Akron, Ms. Pardo is pursuing a master’s degree in business analytics from Ashland University.
Although she chose to leave the clinical side of nursing, Ms. Pardo identified her most notable achievements as being of critical assistance to every survivor assigned to her care during those years, especially in a cardiac unit. She recalled that nothing compared to the feeling of seeing a patient who was rushed in and later was able to walk out of the hospital on their own. Married with three sons, she attributes her success to her parents, who taught her never to stop growing. Her mother recently celebrated her 100th birthday. Ms. Pardo is also thankful to her “amazing” role models who lived life with zeal and to the fullest until the end.
