Priscilla Alfaro, MD

VP, Payment Integrity, BlueCross NC

Dr. Priscilla Alfaro, MD, FAAP, CPC, CPMA, COC, CIC, CRC, CFE is a board-certified Pediatrician who spent 20 years in clinical practice, fourteen years in Honolulu, HI, before serving as the Medical Director for the Texas Health and Human Services Office of the Inspector General. In addition, she worked at Anthem in Payment Integrity serving in multiple leadership roles as well as Zelis as the Chief Medical Officer where she provided clinical, coding, and billing oversight for the Claims Cost Solutions teams.

She has published articles on health care fraud, waste, and abuse, unspecified codes and coding, and genetic molecular pathology codes and has made presentations on the transition from ICD-9 to ICD-10. From 2018-2019, she served as the Chair of the Medical Advisory Board for the National Health Care Anti-Fraud Association and currently serves as the Co-Chair. She also completed a fellowship in Integrative Medicine at the Andrew Weil Center for Integrative Medicine in Tucson, AZ. She holds many coding certifications and is a member of the American Medical Association, American Academy of Pediatrics (National, Texas, Hawaii chapters), American Academy of Professional Coders, National Alliance of Medical Auditing Specialists, Texas Medical Association, Travis County Medical Society, and the Association of Certified Fraud Examiners.

Priscilla currently serves as the VP, Payment Integrity at Blue Cross Blue Shield of North Carolina.