Tom McFarling

TOM McFARLING

Auditor and Developer

Tom has over 28 years of healthcare experience including programming and application support. He has audited millions of claims in his career including medical, dental and pharmacy claims for self-funded employers. He has also managed claims and eligibility datasets, query development, report development, customized benefits analysis, third-party administrator site visits, provider contract analysis and collections tracking. Tom graduated from the University of Tennessee, Knoxville with a bachelor’s degree in mathematics.

My healthcare career spans more than 28 years with the first eight of those working for a payer, experiencing all facets related to healthcare claims administration from both end user and programmer/analyst perspectives. Bringing that experience and knowledge to healthcare claims auditing allowed me to quickly adapt, learning industry intricacies and providing varied IT support to the audit firm. After a brief recoil back to the healthcare IT world from the provider’s aspect, I came back home as an auditor with JGI in 2017, having previously audited claims for John Graham. I provide a level of knowledge, experience and expertise on almost every attribute in the realm of a healthcare claims audit. This allows me to fill various needs within JGI from loading and scrubbing data, sampling claims, managing a site visit, to presenting an audit report. The diversity of work required for a JGI claims audit is both challenging and rewarding and allows for constant learning and maintenance of a multifaceted skillset.