Business Analyst Resume

SUMMARY:

EDI analyst/mapper/developer with seven years of on and off experience using Sybase Confidential and one and a half years with Edifecs SpecBuilder/MapBuilder. Eager for any chance to learn additional EDI tools. Demonstrated rapid learning curve and quickly absorb new ideas and techniques. Exceptional problem solving, communication and multi - tasking skills.

SKILLS/LANGUAGES:

EDI, Sybase Confidential, ECGateway, HIPAA Accelerator Edifecs SpecBuilder/MapBuilder AutoMate 10 HIPAA X12 For Healthcare using 837P, 837I, 837D, 835, 834, 270/271 … RPG/CL programmer 12 years ago on an AS400 before becoming an EDI specialist in the healthcare field 13 years ago.

PROFESSIONAL EXPERIENCE:

Confidential

Business Analyst

Responsibilities:

Taking care of invalid father after losing his care giver.
Looking for new long term care giver so I can go back to work.

Confidential, San Diego, CA

Business Analyst

Responsibilities:

Worked with correcting claim and adjustments in EDI data after it was loaded into our databases for adjudication.
Worked on automating different processes involved in the EDI databases using AutoMate 10.
Taking care of invalid parents’ welfare, monetary and logistical affairs. Long term care is now set up and I’m ready to go back to work.

Confidential, Bloomfield, CT

Business Analyst

Responsibilities:

Hired to work on upcoming contracts but had to return home when my mother entered the hospital and passed away leaving me to take care of my father.

Confidential, Columbus, OH

EDI Specialist

Responsibilities:

Working on converting clients EDI system from 4010 to 5010 standards using Sybase Confidential .
Support production runs and fix any defects found on any of the X12 transactions or data files.

Confidential, Tustin, CA

EDI Specialist

Responsibilities:

Working on multiple projects converting clients EDI systems from 4010 to 5010 standards using Edifecs SpecBuilder and MapBuilder.
Mapping 837 5010 data files down to 4010 format for internal systems.
Mapping 4010 835 data files up to 5010 format to return to trading partners.

Confidential, Denver, CO

EDI Specialist

Responsibilities:

Working on modifying the Veterans Administration’s EDI system to handle COB crossover and 5010 standards.
Modified the Sybase 4010 compliance 837 maps to handle COB claim and service level amount balancing to match the 5010 standards.
Analyze the entire EDI system processes in order to automate and upgrade from 4010 to 5010 standards.
Manage and/maintain scripts for validating and transferring EDI files securely (FTP, PGP).

Confidential, San Diego, CA

Senior Business Analyst

Responsibilities:

Analyzed, designed, tested, and implemented the addition of dental claims processing (837D) to the current health claim system adjudication application (IDX). Work with client to prepare the Business Requirements Document, Functional Requirements Document and the Detail Design Document.
Set up trading partners and added folders for using FTP protocols for transferring inbound and outbound files.
Performed gap analysis between 4010 and 5010 formats in order to design databases that are 5010 compatible. Prepared mapping document used by mappers utilizing AI and SeeBeyond for producing HIPAA compliant X12 formatted file.
Worked with mappers to fix data file problems using Claredi and file definitions within the mapping application.

Confidential, Santa Ana, CA

EDI Specialist

Responsibilities:

Modified/maintained EDI X12 files (837P, 837I, 834) using Extreme Translator. Analyze the entire EDI system for Eligibility and Claims and document the processes in order to automate and make more efficient. Manage/maintain scripts for validating and transferring EDI files (FTP, PGP).

Confidential, Rochester, MN

EDI Specialist

Responsibilities:

Create EDI X12 files (837P, 837I …) using SYBASE EDI Adapter ( Confidential ).
Manage/maintain scripts for validating and transferring EDI files (FTP, PGP, COMSYS…).

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