EDI Business Analyst Resume St. Louis, MO - Hire IT People

SUMMARY

EDI Analyst and Programmer with over 22 years experience health care environments.
12 years EDI experience.
2 years EDI /Data integrity supervisor.
10 years processing health care claims.
Proficient skills in documentation, analysis and presentation tools. Expert in all HIPAA X12 related transactions.
Expert in all National Standard Formats (NSF).

SUMMARY

TECHNICAL SKILLS

EDI Business Analyst

Confidential, St. Louis, MO

Responsibilities:

Worked on AS400 system, creating proprietary EDI files for outbound trading partners and clients.
Prepared test plans on new EDI implementations.
Documented new implementations.

EDI Business Analyst

Confidential, St. Louis, MO

Responsibilities:

Worked on Amysis system, as CMS moved to QNXT, CMS’s new claims legacy system..
Created propriety claim files using Confidential SSIS.
Maintained 5 proprietary EDI formats using UNIX, and SSIS scripts.
Created new imaging system to convert the 837P from the HCFA 1500 to the New CMS1500 form using SSRS, SQL.
Supported EDI Softshare Delta 837 mapping translator.
Created specifications for the 834.
Transformed Federal Tax id’s to new NPI’s.

EDI Business Analyst Consultant

Confidential, St. Louis, MO

Responsibilities:

Supported applications for client while moving from Diamond legacy system to new QNXT system.
Created technical requirements for Diamond, Resolver, Oracle, SQL, and PowerBuilder applications.
Served as EDI analyst for all X12 transactions
Worked with internal customers to make changes to Diamond legacy system.
Supported the 835 X12 transaction, checking transactions daily to make sure the 835 was HIPAA compliant and balanced at all levels.

EDI programmer

Confidential, St. Louis, MO

Responsibilities:

Expert knowledge of all HIPAA transaction 837P, 837I, 835, 834, 270/271, 276/277, 278, creating specifications and translating X12 transactions to multiple formats.
Created EDI X12 maps using Sybase EC MAP.
Created new HIPAA 276/277 XML maps.
Created new HIPAA 270/271 XML maps
Created new HIPAA 834 map.
Created HIPAA 835 outbound map.
Upgraded all PaperFree maps for all HIPAA transaction 837P, 837I, 835, 834, 270/271, 276/277, 278 from 4010 to 4010A for 125 trading partners.
Implemented new Paper Free translator.
Held extensive knowledge of Sybase EC Map and Gateway/
Used Confidential Access and DataWatch Monarch to extract report information, to be used to create management reports.
Worked with existing trading partners to set up all communications on EC Gateway FTP.
Converted all 2.8.3 EC Gateway scripts to a new production server, using the latest 4.0 EC Gateway software.
Assisted network department to set up new FTP and BBS servers.
Used Legacy system - Unix.

EDI Programmer Employee

Confidential, St. Louis, MO

Responsibilities:

Implemented new Paper Free translator
Created new HIPAA 837 professional outbound map.
Created new HIPAA 837 institutional outbound map.
Created new HIPAA 270/71 XML maps.
Created new HIPAA 276/277 XML maps.
Created SQL queries using query analyzer to produce comprehensive reports for business clients.

EDI Supervisor/Data Integrity Employee

Confidential, St. Louis, MO

Responsibilities:

Supervised a staff of 15 employees.
Provide Data integrity for all information related to contracts, benefit and system dictionaries.
Increased EDI claims submissions from 2500 claims per month to 175,000 claims per month.
Developed comprehensive business reports that are used at executive levels for reporting and scope decisions.
Responsible for inventory control of all claims received.
Implemented EDI and OCR scanning to increase EDI volume.
Used Legacy system IDX.