EDI analyst, EDI Mapping, Programming, Business analyst, QA , Strong Team Player, Excellent Problem-resolution and Presentation skills, Good Communications skills, Analytical Thinking, Customer Focused, Attention to Detail, End to end knowledge of the entire Software Development Life Cycle
Platforms: Windows XP, Vista, Windows NT, Windows 95/ 98, Unix
EDI Tools: Ecmap/Ecgateway/Hipaa Toolkit (Sybase), Application Integrator/Enterprise/Trade Guide (Gxs)
Text Editors: Ultra Edit, VI editor, Beyond Compare
Software: SQL Plus 9.0, HTML, XML, MS Office, Spec builder, EDISIM, Mercury Quality Center, PL/SQL, Microsoft Visual Studio 2005, Visual Source safe
Standards: EDIFACT, ANSII 4010 & 3041 formats, D96.A, D93.A, D97.A
Health Care Transactions: 837 (I, D, P), 278I&O, 276, 277, 835, 270, 271, 997
Supply Chain Transactions: INVOIC, ORDERS, DESADV, IFTSTA, IFCSUM, 850, 810, 856
Ebanking Transactions: FINTSA, PAYMUL, CREMUL
Languages: Oracle PL/SQL, Visual FoxPro, PERL, Korn shell scripting
Databases: Microsoft SQL Server 2005, Access, Oracle 10i, HIPAA Repository by Sybase
Protocols: GXS VAN, SFTP, FTP, Connect Direct, SSH
Confidential: EDI/E-banking Analyst
- Provided a middleware solution for a global SAP initiative for Shells Supply Chain and ebanking business
- Analyzed and developed interfaces for converting legacy ERP systems to a global SAP while to remaining seamless to the trading partner.
- Technical Lead on project enhancements and upgrades
- Performed Project Management activities such Identifying, managing & controlling changes, Planning work according to the objectives, Analysis and design of objectives Tracking and reporting progress coordinating implementation
- Function as a liaison between internal/external business community and IT (SAP) organization in order to provide technical solution to meet users needs
- Document system specifications and solutions to satisfy project requirements.
- Provide system and customer support to users including issue resolution.
- Develop maps in Application Integrator (AI) to translate SAP IDOCs to Edifact for the Supply chain and ebanking business
- Set up Trading relationships in GXS Trade Guide and Enterprise for other Shell partners
- Created and executed queries and Stored Procedure in ORACLE (via Toad)
- Created mapping specifications and performed Gap analysis
- Set up and executed test scripts (documented on MQC)
- Wrote pre-post processing scripts via PERL
- Worked with management to set up Service level agreements and Supportability initiatives
- Implemented and complied with change management process
Confidential: EDI Analyst/Programmer
- Created custom compliance map to validate syntax against flat file claims and eligibility layout
- Created maps to connect to SQL Server and perform logging and loads into Staging DB
- Created maps to extract data from SQL Server DB’s to create flat files
- Utilized Connect Direct to create scripts to transfer files to Mainframe systems and Unix Systems
- Created ECGateway Scripts for file movement, compliance checking, loading into DB sending files via NDM
- Involved extensively in Implementing QA, Documentation, Testing, Verification and Validation processes
- Created/Modified Stored Procedures for fixes and new implementations in SQL Server
- Participated in business requirements phase for claims and eligibility file structure implementation
- Involved in design and implementation of entire EDI system and produced System Design documentation
- Develop and maintain EDI training manual and system documentation.
- Created maps which called Stored Procedures written in PLSQL to create flat file dependent on inputs from a User Interface written in .NET
- Involved in implementing C# code working with C++ called from Ecmap to send messages to MSMQ to trigger claims processing
- Scheduled all tasks using NT Scheduler to kick off Gateway processes
9/04-7/06 Philadelphia, PA
Intracorp Disability Management Division
- Involved extensively in Implementing QA Test Plans, Documentation, Testing, Verification and Validation processes
- Worked on Analysis of Disease management and disability management for communications with trading partners
- Created 837 translation and custom compliance maps for Electronic Mailroom Initiative
- Created Design documents and process/data flow charts for communication and implementation with other business units
- Created maps for Claims Intake, Adjustor Notes, Nurses Notes, etc for Telephonic Case Management Migration project
- Completed Analysis, Specification creation and maps for Smart Steps (Care Allies)
- Worked efficiently and effectively with EDI Administration to implement maps and ECGateway processes
- Involved in data and requirements gathering to implement numerous projects
5/04 – 8/04 NY, NY
- Complete knowledge of the entire Software Development Life Cycle including Development, Design, Business Implementations, Procedures and Guidelines.
- Analyzed, Developed, Tested, SAPIDOC implementation for 850, 810, & 856 transactions
- Contacted clients to set up new implementations involving gathering requirements, performing Gap Analysis, creating map, performing testing, and production implementation.
- Assisted in production support of existing clients.
- Worked on a front-end application written in Progress.
- Wrote stored procedures in PL/SQL to retrieve invoice numbers and to create special trading partner Id’s to link to ISA identifiers.
05/03- 11/03 Raleigh, NC
Confidential: South Carolina Medicaid Remediation Project
- Worked on development of the translator for HIPAA requirements
- Extensive work understanding and explaining National Electronic Data Interchange Transaction Set Implementation Guides
- Developed Inbound/Outbound Authorization and Referrals – X12N 278, Inbound/Outbound Claim Status Enquiry/Response - X12N 276/277 for the claims processing systems for hipaa compliance
- Completed unit testing & Automated Testing on all transaction maps during development into production
- Implementing QA Test Plans, Documentation, Testing, Verification and Validation processes
- Learned how to create and edit processes using ECGateway to archive files, move files, call run map functions, manage created output files to the appropriate outbound mailbox, call ftp scripts to move files to mainframe, etc.
- Created a users manual for Provider Outreach which entailed setting up Trading Partner Agreements utilizing ECGateway, accessing numerous severs using TightVNC to allow user rights for Trading Partners to access our server using Secure FTP and Asynchronous Dial up
- Conducted a training class for the Provider Outreach Group on setting up Trading Partners mailboxes and Trading partner agreements
- Wrote procedures in ECMap to connect to the HIPAA repository and call a SQL stored procedures to send and return needed data to create compliant outbound transactions
- Gave providers access to the Unix server to deposit and retrieve x12 files using FTP and dialup by toggling and creating users in Active Directory and Users (linking to different test and production servers)
11/01- 05/03 Middletown, NY
Edi Analyst / Visual FoxPro Programmer
- Communication with our clients, third-party payers, to discuss the process of re-pricing claims and setting up a common layout and network identifiers.
- Analysis and manipulation of EDI data to conform to ANSI Standards (Examples: construct rules in Paperfree to calculate HCPCS and splitting diagnosis codes to the correct qualifiers)
- Mapping data to Visual FoxPro and Oracle Databases via connections of ODBC Drivers
- Formulated rules, and created flow using Paper free, in the creation of - 837 dental, 837 professional, and 837 institutional maps in accordance with HIPPA compliance
- Created Any to Any Maps to read data from a text file formatted in 'Full Form' (text file formatting data entered HCFA or UB92 form) into our databases. Received information from processed claims and created an outbound map within 837 transaction sets from this data into 4010 Standards.
- Altering all current maps to conform to the new addendum for specific clients
- Mapping data elements to particular codes sets specified by HIPPA and 4010 Standards
- Created cross reference table to convert segment data
- Performed joint queries and imbedded SQL statements to link tables to create and normalizes databases
- Created FoxPro Applications utilizing Mabry active-x which connects to the server and executes FTP connections and email commands
- Produced a project to split flat file, and parse data into tables to create reports and forms which duplicate HCFA and UB92 forms
Diploma in Web Development and Business Programming
Bachelor of Science in Applied Mathematics and Statistics