BRUCE CROSKERY6709 Bellamy AvenueSpringfield, VA 22152703-451-5037

(Home)bc834bce@westpost.netSUMMARYDependable and detail-oriented

_MEDICAL AND BILLING AND CODING_ professional with proven success in
data intensive work settings. Experience with extracting key
information from documents to complete and submit forms. Skilled at
accurately inputting information into a variety of databases.
Analytical and flexible thinker with strong written and verbal
ability committed to enhancing professional credentials. Solid
background in data quality and working with others cooperating as a
team. Proficient in research utilizing on-line sources and
consulting reference materials and applying attained knowledge to
guidelines. Demonstrated capability of understanding and adhering
to employer mandated privacy and compliance standards. Relevant
skills and knowledge include: * Medical
Terminology* Anatomy and
Physiology* Electronic Medical
Records* ICD-9-CM Diagnosis coding*
Debt Collection Strategies* Data Entry:
60CPM* CPT Procedural Coding*
HCPCHS Level II coding* Typing:
40WPM* Microsoft Office Suite*
Payment Posting and Balancing*
Medisoft* Insurance Claim
Processing* Insurance Billing
Procedures* Health Information
Mgt.* CMS-1500 and UB-92 (CMS 1450) Insurance
Claim Forms* HIPPA Rules and Medical Law,
Liability and Ethics* Medicare, Medicaid and Other
3rd-party Payer ReimbursementACCOMPLISHMENTSMEDICAL BILLING AND
CODING* Posted payments, charges and made adjustment
entries to patient accounts on Pathway Home Healthcare department
software to ensure accurate and timely processing of claims and
attain reimbursement. * Data entry and balancing of
monthly debits and credits for Nursing Home department onto
spreadsheet.* Reviewed patient episodes and examined
active and historical ICD diagnoses codes, CPT surgical and other
procedures, coverage information, prior authorizations and remittance
advice documents.* Assisted Billing Specialists in
completing monthly Medicare and 3rd-party payer reimbursement
reports. * Verified payments received to ensure
amounts agree with computerized printout of payment
statements.INFORMATION ABSTRACTION AND DATA ENTRY*
Extracted data from paper-based records using knowledge of
comprehensive procedural business rules formatted files using the
abstracted data and entered them into new internet-linked disclosure
system.* Created disclosure records based on filing
submissions and inputted resulting documentation into
database* Updated and entered registration
information for individuals and firms in a financial regulatory
environment.* Abstracted essential information from
disclosure form documents, applied appropriate codes and inputted
codes into forms from which programmers made needed disclosure
reporting database modifications.* Edited disclosure
reporting pages by removal of extraneous data before transmission to
batch processing. DATA REVIEW AND VERIFICATION*
Worked in quality control function validating data to ensure that
disclosure forms were accurately completed.*
Reviewed and verified submitted information from database for in
order to process disclosure form filings.* Assisted
with testing following database revisions by performing quality
reviews of software modifications.* Submitted and
verified daily workload of data fix cases addressing application
errors and system updates.* Investigated customer
reported issues as a data quality analyst by reviewing information
in source database and validating instruction changes for appropriate
fix to the underlying dataCUSTOMER RELATIONS AND INTERDEPARTMENTAL
COORDINATION* Participated in debt collection
activities by calling patients with delinquent accounts, explaining
insurance policy requirements, verifying insurance coverage and
updating account information as needed.* Worked with
the Customer Service Department by investigating customers' inquiries
regarding the status of their disclosure records within the reporting
system database and ensuring that the problems were
rectified.* Worked in a customer relations role in
several capacities with the Data Quality Department: answered
customers' questions, created detailed documentation of each call and
followed-up with requests as needed.
PROFESSIONAL EXPERIENCEINOVA HEALTH SYSTEMS, Fairfax,
VA
2010
_Medical
Billing and Coding Intern_Worked in Continuum of Care Service, Patient
Account Department with assignments that included helping Medical
Billers post payments to Homecare and Long-Term patient accounts on
Pathway software and balancing monthly accounts through debit and
credit entries to patient accounts. Assisted in follow- up
reimbursement efforts on late customer accounts by contacting
patients and communicating with them about the status of their
accounts. Additionally, filed records and helped reorganize office
storage cabinets and prepared and organized banker boxes for transfer
to off-site location. Worked with Medical Billers to compile a
variety of monthly reimbursement reports and completed task as
assigned including sorting billing documentation and verifying
patient insurance coverage.NATIONAL ASSOCIATION OF SECURITY DEALERS
(NASD) {now called FINANCIAL INDUSTRY REGULATORY AUTHORITY} (FINRA),
Rockville, MD
1999-2008
___Data
Quality
Analyst__
_Worked in the Data Quality and Management
Reporting Department and was responsible for creating and
coordinating through final approval data correction cases which
addressed data issues within the NASD database. Each case required
extensive analysis of the issue that was causing the data application
problem and finding the best solution for it. Handled data
correction request cases from both authorized NASD users and external
users permitted access to the NASD proprietary reporting system (Web
CRD). Completing the correction entailed writing a set of technical
instructions that referenced the database, and submitting the
instructions to the technology department, who wrote the necessary
code to finish the data correction. Evaluated the programmers' work
by confirming the completeness and accuracy of the data
post-correction in Web CRD. Assisted the User Testing Department
with verifying, after periodic release deployments, the validity of
the upgraded applications to Web CRD. Assigned other tasks and
projects by supervisors which required adherence to strict company
privacy and compliance standards. THE DATA ENTRY COMPANY,
Chantilly,
VA
1997-1999_Paralegal_
Worked
on a major computer system transition for the financial compliance and
regulatory authority known then as NASD (today called FINRA) was
undergoing. The transition involved moving from a reporting system
based on manually capturing information submitted by the member
firms, Legacy CRD (Central Registration Depository), to the
development of an electronic Web CRD. Web CRD utilized emerging
internet technology to create an on-line reporting system that could
be accessed by all affiliated broker dealers and licensed registered
representatives. The duties performed made a significant
contribution to the successful transition, and included, reviewing
stockbroker and brokerage firm disciplinary information and
"translating" by converting the discrete data elements into codes
using a set of business rules that numbered 200-plus pages that were
continually revised and updated.TECHLAW, Chantilly,
VA
1996-1997_Paralegal_Abstracted
required information from legal, financial and regulatory materials
for law firms, regulatory bodies and government agencies. Entered
the abstracted data into the appropriate forms, a function that
required data entry accuracy in order to meet client-contracted
requirements. The work also entailed the ability to able apply
knowledge of separate contractor coding guidelines. Promoted to data
quality function in which involved reviewing the products of others
in the work group for accuracy.TRACK LEGAL SERVICES, Sterling,
VA
1995-1996_Paralegal_Worked
on the initial stages of the extensive NASD system conversion effort
to the internet-based Web CRD described under the Data Entry Company
position, above. The job required working knowledge of legal
terminology and possession of strong analytical, communication and
intrapersonal skills. The project involved the review of legal
documents, identification of relevant information, and summarization
of the data. Consistently achieved above average coding rates both
in terms of number of events processed and accuracy rate. Promoted
to data quality spot checker and assisted project in meeting targeted
goals. ..EDUCATIONSANFORD BROWN COLLEGE, Vienna,
VA
2009-2010 _Associate Degree in Medical
Billing &
Coding_,
Graduated on Presidents List with 4.0
GPAPARALEGAL INSTITUTE, Tyson's Corner, VA
1992-1993
_Paralegal Certificate_OLD DOMINION
UNIVERSITY, Norfolk,
VA
1974-1978
_
B .S. Business Administration, Marketing Management_ REFERENCES
AVAILABLE UPON REQUEST AS IS A CAREER PORTFOLIO FOR REVIEW.