Senior IT Business Analyst
- Support system conversions, upgrades, enhancements
- Support and align efforts to meet customer and business needs
- Elicit and clearly document business and systems requirements
Confidential, Greenbay, WI
- Supported the InfoLease portfolio and asset management product developed in UniData and running under AIX servers.
- Developed UniBasic programs to replace applications that use the UniData MODIFY Function to alter data without logging. Now a simple call will achieve the same processing a list, but will also log data changed to the appropriate tables provided by the InfoLease application.
- Developed Shell scripts as needed to automate some functions.
Confidential, San Antonio, TX
Senior Developer / Consultant
- Consulted as Confidential 6.0 Medical Claims advanced developer supporting government and state programs.
- Provided working knowledge of SQL and PL/SQL best practices.
- Worked with Micro Focus COBOL with Embedded SQL, UNIX Shell scripting, Oracle Procedures and Functions, PL/SQL, and Suprtool on HP - UX.
- Maintained EDI and supported the applications and COBOL programs.
- Gathered business requirements and built modules around the main Claims Adjudication Confidential application.
- Implemented Invoice and Orders EDI applications between their client Confidential and Confidential .
- Developed using Pick/Basic
- Automated the SFTP server application using ColdFusion engine and batch scripting.
- Continued to support the application remotely following implementation.
Confidential, Boise, ID
EDI Analyst / Pick/Basic Developer
- Consulted and responsible for the analysis and design of healthcare X12 maps created on Microsoft BizTalk to an in-house mapping engine, a process that has saved Primary Health about $30,000 yearly for support and licensing of the BizTalk Mapper.
- Designed and developed EDI/B2B encryption/decryption of files between Confidential and Emdeon Clearinghouse.
- Developed 837 Companion Guides for new trading partners.
- Led EDI implementation meetings with new trading partners.
- Tested validity of transactions using Claredi core testing and certification and fixed rejected messages and resubmitted to trading partners as appropriate.
- Worked as project lead, project manager, and developer on several projects
- Remapped 4010 837 professional to NSF file which replaced Microsoft BizTalk Maps.
- Remapped 837 Institutional claims to Confidential BCP formats by replacing Microsoft BizTalk Maps.
- Implemented a transactional Gateway, replacing the Microsoft BizTalk application server.
- Developed and implemented a routing process for 837 claims to Confidential (NSF), Facets (837), and the Instant Payment Notification (IPN) for reprising sending out 837 and CMS1500 and UB04 paper claims with allowed amounts.
- Designed EDI modules/applications with adherence to HIPAA, and for Claredi certification criteria and industry standards/specifications.
- Provided HIPAA integration and applied ANSI ASC X12 standards for 837 (P, I, D), 270/271, 276/277, 278, and 835 transactions.
- Provided mapping, gap analysis, and database designs for HIPAA codes sets and EDI transaction processing between Confidential IPN, Clearinghouse, and Payers.
- Analyzed ICD-10CM (Diagnosis Codes) in preparation for the switch from ICD-9CM.
Lead Programmer / Analyst / Consultant
- Acted as lead programmer on the Trizetto/Facets application for claims processing and provider database, using Sybase database.
- Used Access and SQL to produce management style reports, and coded using COBOL, CICS, VB 6.0, and UNIX/AIX Shell scripting to automate EDI process.
- Worked with data extractions to validate provider information.
- Updated provider tables with address and license changes, using COBOL and SQL.
Confidential, Columbia, SC
Team Lead EDI Analyst
- Worked on the Reverse Engineering Approach project and became familiar with Confidential and Confidential from Sybase.
- Developed and responsible for software and application implementation.
- Developed and supported EDI 837, 837, and HL7 interface.
- Helped design applications for web wrap-around for UniVerse backend using UniObjects, Java, and Visual Basic.
- Led team to analyze and write technical requirements for transitioning practice management from UniVerse database to Windows SQL Server database.
- Served in the lead role to in corporate the Entrinsik Informer Web Reporting tool for IBM U2 family of database products into UniVerse application. Helped enhance the reporting capabilities of the application.
- Configured ICD-9 codes, HCPCS (Revenue Codes), and CPT (Procedure Codes) media to be loaded into the application by clients.
- Acted as configuration management team lead responsible for daily builds to QA servers and development servers.
- Automated application installations/updates using UNIX and Batch scripting on Windows, AIX and Linux Servers.
- Installed Java and Tomcat Web server.
- Developed and responsible for installation documentation used by support personnel.