EDI Analyst Resume

PROFESSIONAL SUMMARY:

EDI Analyst experienced at creating custom ANSI 12 solutions for EDI implementations.
Ability to manage multiple projects simultaneously as high - performing, strategic-thinking professional.
Highly skilled in maintaining sensitive database material , tracking details, communicating deadlines and following up with internal and external partners to ensure on-time completion .
Ability to work in fast-paced environments demanding strong verbal, written, organizational, time management, and analytical skills.

TECHNICAL SKILLS:

Databases: Microsoft SQL Server, Access, Windows 7/10, Linux Administration, UNIX

Networks and Protocols: GXS VAN, SFTP, FTP, LAN/WAN, TC/ICP, Telnet, FileZilla, WINSCP

EDI Tools: Multi-State Companion, HIPPA Implementation Guide

Text Editors: Notepad/Notepad Plus+, Soft Share EDI

Software: SQL, HTML, XML, MS Office Products

WORK HISTORY:

EDI Analyst

Confidential, Atlanta, GA

Responsibilities:

Assist and collaborate with all departments with the transition of new clients on-boarding, providing upgrades and updates as needed.
Act as the liaison between EDI and technology vendors and consultants to ensure timely, cost effective EDI project delivery.
Elicit, gather, create and document new business workflow.
Maintain and Monitor EDI processes, processing EDI files, and create required EDI reports for all State NEMT programs.
Work with customer facing in obtaining specifications and requirements for modifications and product enhancements used by EDI programmers.
First point of contact for all planned implementations of new State Contracts.
Implement and maintain new contract Plans for State Medicaid for Louisiana, Indiana, Arkansas, and Virginia.

EDI Analyst

Confidential, Birmingham, AL

Responsibilities:

Acted as point-of-contact on status of EDI transactions for internal and external customers.
Educated and trained user on LoadMaster EDI application.
Provided technical support during and after implementation of LoadMaster for EDI/FTP configurations and setup.
Developed and prepared EDI documentation for internal and external use.
Conducted and performed analysis of EDI transactions, documented and produced metric reports.
Participated in resolving EDI issues related to customer facing EDI requirements.

EDI Billing Analyst

Confidential, Atlanta, GA

Responsibilities:

Worked and collaborated with Billing Analysts, Contract and Data Management Department, Confidential ’s, Branches, and Intake sites to develop and implement work plans to support new EDI development.
Researched payers and vendors for EDI, ERA, EFT, Eligibility, Referrals, Authorizations, and Claims Status opportunities.
Coordinated testing and implementation of new software and prepared new procedures.
Maintained interfaces with IS to resolve EDI billing discrepancies and developed enhanced EDI efficiencies.
Maintained interfaces with Confidential ’S and IS to design electronic and paper invoices and report formats according to payer specifications.
Performed second-level testing on IS developed enhancements prior to implementation.
Troubleshooted coding errors for ANSI X12N EDI documents to include: 837P/I/D, 834, 270, 271, 276, 820, 835, NCPDP Encounters.
Troubleshooted EDI and XML document, translation and mapping errors.
Provided training to department staff on EDI changes and enhancements.
Initiated electronic billing submission paperwork prior to payer implementation.
Participated in special projects assigned by Confidential manager.

EDI Analyst /Team Lead

Confidential, Tucker, GA

Responsibilities:

Ensured incoming and outgoing transactions followed HIPAA standards.
Provided connectivity support to external entities by providing necessary protocols required to submit claims electronically.
Troubleshooted coding errors for ANSI X12N EDI documents to include: 837P/I/D, 834, 270, 271, 276, 820, 835, NCPDP Encounters
Provided support for trading partners via email, phone, and web portal.
Researched issues related to EDI transmissions between trading partners, Billing Agents and Clearinghouse.
Updated and maintained Trading Partner Management portal.
Maintained Electronic Claim Submission Agreements with trading partners.
Tracked incoming and outgoing calls regarding EDI problems using proprietary Contact Management Tracking System (CTMS).
Troubleshooted EDI and XML document errors and troubleshoot translation and mapping errors.
Supported all EDI testing efforts with providers and vendors.
Maintained database in detail for trading partner progress for each stage of testing (UAT, ORT & SIT).