DAVID L LIDDICK
Enola,PA
Summary
- Software Results-driven, detail-oriented professional with over 10 years’ experience in Health Care fraud detection, deterrence and prevention. Knowledgeable in both Medicare and Medicaid. Over 10 years’ experience in Quality Assurance. Developed expertise in both Business Analyst and Data Analyst roles. Superior computer skills and proven analytical ability. Excellent time management skills to meet timeliness requirements and deadlines. Additional experience in areas of loan servicing, records management, team leadership and customer relations. Strong problem-solving skills as well as a proven ability to boost efficiency and productivity. Excellent interpersonal skills with an energetic approach to the task. Peoplesoft
- Lotus Notes
- Microsoft Office suite- Word, Excel, Access, Outlook and Power Point/ IBM Reflection application/ Citrix/ Ascent Capture/ Teleform/ PECOS/ Business Objects and ONE PI/ UCM/SAS/RACDW.
Overview
25
25
years of professional experience
Work History
Medicare Fraud Support Clerk/Quality Assurance Engineer/ Business Analyst
Peraton Inc./SafeGuard Services LLC
05.2013 - 06.2024
- Functioned as the Subject Matter Expert for the Zone Restriction process
- Point person with Customer (CMS) to receive final determinations for open investigations based on Law Enforcement triage
- Served as the primary developer of the esMD process for the Northeast UPIC contract
- EsMD is the CMS-mandated software utilized to transmit electronic medical records
- Relied upon by all teams and Management for Ad Hoc research, analysis, reporting and/or support to projects and workload requests
- Quality assurance review of outgoing workload to assure HIPAA compliance
- Support the timely completion of the UPIC monthly deliverables by generating various workload reports, prepping spreadsheets and entering information on the CMSARTS website
- Responsible for entering all suppressions, exclusions and release suppressions into the RAC Data Warehouse for the NE UPIC investigative Team
- Responsible for records management for the NE UPIC, which includes oversight of all storage and disposal as well as the proper retention of all documents
- Write, develop and generate BO reports in ONE PI and Citrix environments
- Contributor to multiple efficiencies for end users such as the development of the esMD process
- Prepare and scan Pre-pay and Post Pay Claims for review
Medicare Imaging Clerk/ Provider Enrollment
FCG Solutions
Camp Hill, PA
10.2011 - 04.2013
- Prepared multiple claim type documents for Imaging
- Managed Medicare documents
- Preparing PES (Provider Enrollment Services) documents for Imaging while adhering to CMS guidelines and policies
- Classification QC and Verifying in the Teleform OCR system
- Faxes, Med Recs, Provider Enrollment, Claims and Appeals
- Managed all aspects of provider enrollment mail
- Thorough understanding of PHI to prevent HIPPA breaches
- Knowledge of MCS and PECOS Systems
Lead Records Associate III
AES/PHEAA
Harrisburg, PA
01.2000 - 01.2011
- Functioned as supervisory assistant
- Performed Data Entry Optical Character Recognition (OCR) /Non-OCR with speed and accuracy
- Performed Promissory Note Exams for Converted Loans
- Conducted Quality Assurance checks for all employees in Conversions department and Quality Analysis on Federal Promissory notes
- Delegated assignments to team members, plus created and maintained weekly schedule for team members
- Processed Federal Loan Service Contracts
- Acted as Staff Liaison between shifts for any procedural or general changes
- Performed quality assurance of processed work
- Assisted Supervisors and Project Managers with testing of software & special projects
- Researched, analyzed and resolved issues with aberrant data for all Business Units
- Trained associates, created and updated policies and procedures
- Maintained integrity of sensitive documents such as Promissory Notes and Legal Documents
- Designed and tested a Macro for Conversions Note Exam that increased production by over 450% without compromising the quality of work.
Education
HS Diploma -
ICS Newport-Pacific High School
2000
th -
Susquenita School
Skills
- Quality Assurance-HIPPA
- Data Analysis
- Research & Analysis
- Document management
- Computers/Hardware & Software
- One PI/Business Objects
- SAS
- Ability to work independently or with a team
- Continuous Improvement
- Spreadsheet & Macro Creation
- Data Entry
- Customer Service
- Time Management
- Highly proficient in Adobe Acrobat Pro
- Microsoft Office Suite 2010, 2013
- Program testing
- Team Leadership & Training
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Medicare Fraud Support Clerk/Quality Assurance Engineer/ Business Analyst
Peraton Inc./SafeGuard Services LLC
05.2013 - 06.2024
Medicare Imaging Clerk/ Provider Enrollment
FCG Solutions
10.2011 - 04.2013
Lead Records Associate III
AES/PHEAA
01.2000 - 01.2011
HS Diploma -
ICS Newport-Pacific High School
th -
Susquenita School
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