SUMMARY:

• Over 9+ years of IT experience in various projects doing Analysis, Design, Development, Maintenance and Production Support in Banking and Finance, Insurance and Health care Applications.
• Excellent knowledge of industry standard methodologies like Software Development Life Cycle (SDLC) such as Rational Unified Process (RUP), Agile methodologies such as Agile XP and Agile Scrum, and Waterfall.
• In - depth knowledge of healthcare regulatory environments and supporting management in creating tools based on changing needs
• Expertise in impact analysis on the key application systems (claims processing, reporting, payments) and business process of health insurance companies.
• Well versed with ANSI X12, HIPAA, Medicare and Medicaid standards.
• Over 8.5 Years of Mainframe Experienced in business application development with Systems Analysis, Application Design, Development, and Maintenance with COBOL, JCL, CICS, DB2, VSAM,SAS and REXX
• Strong Experience in Claims Processing and Claims Scrubbing in HMO, PPO, Medicaid and Medicare.
• Performed UAT testing and end to end testing. Solid experience working on claims adjudication lifecycle
• Worked On IBM Cognos BI 10.2.2 for all business related reporting’s. Good knowledge on deployment of Cognos specific reports, Creating business reports and accessing data via cognos cubes, IBM DB2.
• Certified Application developer in collaboration with Massachusetts Institute of technology.
• Performing in different roles as a Technical Lead, Senior Developer proficient in obtaining project requirements from user and manager, formulating the requirements into design specs, preparing system specifications, assigning tasks to team members, and tracking the progress.
• Good Experience in working with waterfall model as well as Agile environment ( SCRUM framework)
• Experience with claims test data preparation - 837 transactions.
• Exceptional ability to maintain and build client relationships with business owners to identify, prioritize and document business requirements.
• Extensive experience in Healthcare/Claims adjudication with knowledge of industry compliance standards like HIPAA and EDI X12.
• Expertise in Claims, Enrollment, Provider, Billing Modules of Facets
• Expertise in the Mainframe tools like TSO, ISPF/SDSF, Endeavor, Xpeditor, Abend-Aid and NDM, File AID.
• Experienced in creating JCL and JCL PROCs using various JCL utilities like DFSORT, FILEAID, IEBCOPY, IEBGENER, IEBCOMPR and ICETOOL.
• Experienced in creating High Level Design, Detailed Design and Functional Requirement documents.
• Strong skills in support activities, analysis, technical design, testing, trouble shooting for both batch & online application programs in mainframe applications.
• Extensive knowledge in onsite offshore model of working.
• Attained immense experience in usage of mainframe DB2 tools - SPUFI, File Manager for Db2 & QMF.
• Strong skills in working with various debugging tools in the mainframe environment for trouble shooting using XPEDITOR (CICS/Batch), Debugger, CEDF and Trace Master.
• Good knowledge on version control tool like Endevor.
• Strong Experience with CICS Transaction processing with DB2 application including Map/Map set creation.
• Experience with preparation of report using reporting tool/Language like SAS/REXX.
• Strong experience in DB2 application like cursor (Declare, Open, Fetch), SQL query optimization.
• Good experience in Cobol-VSAM application with VSAM database like KSDS and ESDS cluster
• Developed new inbound/Outbound program in CICS Web Services Environment with support of CICS Transaction Server 3.1.
• Possess very good organizational, analytical, teamwork and Project management skills along with excellent interpersonal skills.
• Having an Attitude of willing to learn, accept the challenging environment and confidence in delivering the results within timelines by constantly motivating the concerned teams to provide the best solutions to the clients.
• Good experience working with offshore teams and ability to train the team members on process and technology updates in the project by conducting Knowledge sharing sessions and regular telecom meetings, and extensive knowledge in onsite offshore model of working.
• Scheduling/allocating/monitoring work among the team and being responsible for the successful delivery of the entire project/sub-project(s).

TECHNICAL SKILLS:

Languages: VS COBOL II, OS/VS COBOL, JCL, SQL, SAS, Cobol/390, REXX, VB.Net, IBM Cognos 10.2.2

Tools/Interface : SPUFI, CICS, TSO ISPF, QMF, File Aid, MQ, SAS EG 6.1, Oracle Toad

RDBMS : DB2

File System : VSAM - KSDS, RRDS, ESDS

Operating Systems: MVS, OS/390, Windows

Hardware Platforms: IBM Mainframe S/390, Z/OS

Online Transaction Processing Environment : CICS, CICS Web Services, CICS Transaction Server 3.1

Debugging Tool : Xpeditor, CEDF, Omegamon, TMON

Scheduler: Tivoli Work Scheduler (TWS job scheduler)

Other Utilities: File manager, Endevor, OPC, JCL utilities such as Sync sort, DFSort, ICETOOL,CA Workstation Web version

PROFESSIONAL EXPERIENCE:

New York, NY

Sr. Data Analyst

Responsibilities:

• Analyzed claims to determine appropriate reimbursement for par and non-par providers.
• Involved in all Critical issues and ensured proper resources for the completion of tasks.
• Regular meeting with Management and provided them time bounded dates for the resolution of existing issues.
• Analyzed claims by type of service interpreting Medical and Claim Policy and Procedures.
• Supporting all of the accounting applications from a production support standpoint, attending to
• Software failure issues, managing software upgrades, enhancements and daily support and job Runs.
• Documenting software capabilities, specifications and enhancements. Ensuring that vendor products work properly in VNSNY environment.
• Supported business needs to provide software capabilities that will satisfy business needs and requirements.
• Analyzed the whole claim payment system by pulling information such as Total claim, Payments made, check released to providers, remittance etc.
• Worked problem aged claims and there cause to support claims processors for quickly clearing the backlogs.
• Maintained all documentation for claims processing reference manuals.
• Worked in Various technology which includes, Oracle, Cognos 10.2.2, SAS and Mainframe.
• Managing the disaster recovery and SOX audits for business-critical accounting applications.

Application Operation Lead/Associate Manager

Responsibilities:

• Worked in Accounting domain and Lead 30 Applications which includes Earnings, Expense and Reporting across Cigna overall business.
• Involved in End to End coding in COBOL, JCL, VSAM, CICS, DB2.
• Worked in Various technology which includes, IBM Cognos 10.2.2, SAS and Mainframe.
• Acts as single point of contact between Business and offshore counterparts.
• Managing the flow of work from onshore to offshore and ensuring the timely completion of the same.
• Involved in critical business decision changes and ensuring the technical feasibilities of the same by providing the current structure of the system to business.
• Involved in all Critical issues and ensured proper resources for the completion of tasks.
• Gathered Daily status from the offshore and communicating the same with business to ensure regular updates and building the confidence with business.
• Provided technical assistance to Offshore counterparts in case of any hiccups.
• Regular meeting with Management and provided them time bounded dates for the resolution of existing issues.
• Worked with senior management on resource alignment within project so as to ensure timely  Delivery of critical requirements.
• Supporting all of the accounting applications from a production support standpoint, attending to
• Software failure issues, managing software upgrades, enhancements and daily support and job Runs
• Managing 10 onshore/offshore technical team members to ensure successful maintenance of the accounting environment.
• Documenting software capabilities, specifications and enhancements. Ensuring that vendor products work properly in Cigna's IT environment.
• Supporting business needs to provide software capabilities that will satisfy business needs and requirements.
• Managing the disaster recovery and SOX audits for business critical accounting applications.

Basking Ridge, NJ

Technical Lead /Sr. Mainframe Developer

Responsibilities:

• Served as a First point of contact for any technical issues.
• Kept track on all major releases/Enhancements.
• Distributed work across the team members and ensured timely completion of the work.
• Performed daily status of the allocated work to team members.
• To ensure budged is not exceeded, involved in effort tracking of all resources.
• Reviewed Plan for new Releases/Enhancement.
• Facilitated regular meetings with all team members to understand any issues and challenges they faced in the project. Worked towards the improvement in those areas.
• In case of any issues, ensured that team is technically ready to tackle various scenarios.
• Conducted various sessions specific to project.
• Interacted with Business leads for better understanding of the current system issues.
• Performed Impact analysis of the new requirements or change requests on the existing programs initiated by the client.
• Designed new components using COBOL, CICS and DB2 Database design Concepts.
• Ensured scalability of new modules developed within team.
• Identified and verified impact based on the changes in downstream/upstream applications
• Generated metrics on the performance of the system.
• Participated in Internal Audits and External Reviews.
• On a weekly basis met with Sr. Management for project feedback.
• Extracted and analyzed Journal’s data for issue analysis.
• Used Abend Aid for Dump reading which include system and user abends.
• Automated manual monitoring process by creating New Tools via REXX language.
• Automated repetitive actions/tasks by creating macros (IBM PCOMM).
• Worked on various macros in Excel via VB scripts for reporting purpose.

Sr. Mainframe Developer

Responsibilities:

• Worked on critical SPRF’s for end to end delivery which involved Requirement gathering, coding, Unit testing, coordination with BA’s and SA’s
• Executed cleanups from production data analysis by using Abend Aid Tool on IBM Mainframe.
• Monitored various system processes as assigned.
• Acted as SME for various Business related modules.
• Escalated production timelines to meet client requests.
• Identified production issues impacting code modules.
• Ensured complete and accurate issue tracking and reporting.
• Coordinated various activities with offshore team by providing them logic design for any issue.
• Daily interaction with business and understanding there concerns and provided them a feasible way for remediation or any kind of solution to their problems.
• Acted as SME at onshore and provided SME assistance to offshore people.
• Solved tickets and all critical tasks related to production support.
• Involved in the Analysis of critical incidents problem tickets, online CICS regions monitoring.
• Involved in remediation process, disaster recovery and risk analysis.
• Involved in End to End coding of various modules using COBOL, CICS, and DB2.
• Used various tools in Mainframe such as Sort, ICETOOL, File AID and CICS related transaction to analyze files and setups such as CEMT, CEDA CEDF.
• Worked with Scheduler team to setup Batch Jobs in correct order for daily and weekly run.
• Set correct dependencies of Job with any files or resources to ensure correct order of Jobs running in production environment.
• Used OPC and TWS for monitoring and Upgrading Daily Batch Jobs.
• Involved in regular updates of JCL’s and PROC’s.
• Involved in File reorganization activities for critical files.
• Coordinated of DB2 reorganization activities with respective DBA’s.
• Kept track of all problem tickets, incidents and service requests coming to system, ensuring timely SLA compliance on all of the above.

 Mainframe Developer

Responsibilities:

• Integrated existing designs with new requirements.
• Involved in the Analysis, Build, Design and Test Planning phase of the modules
• Worked closely with the Business analysts to stabilize the requirements and brought important issues to the BA’s notice
• Facilitated brainstorming sessions to report major concerns related to designing of the requirements technically.
• Prepared Test Estimations, Test Plan, Test Scenarios and Test Cases for the same
• Performed Integration Testing, System Testing
• Provided Testing Support for User Acceptance Testing having direct interaction with the user.
• Resolved complex and conflicting design issues.
• Supervised component and code test activities.
• Developed flowcharts for the actual flow of the process for new requirements
• Coded program to validate the files received and extract the details from database
• Used BMS MAPSET to code the screen changes for the enhancement purpose.
• Used XPED tool for Unit Testing.
• Performed checkouts on release day for new functionality added to ensure nothing will break in production environment.
• Kept track of all problem tickets, incidents and service requests coming for our system so ensure timely SLA compliance on all of the above.

Mainframe Developer

Responsibilities:

• Involved in the requirement gathering phase with Business and translating them to Technical design.
• Coded various modules in COBOL/PL1 languages for new enhancements.
• Designed new screens using BMS, attached them through COBOL-CICS module for data retrieval.
• Prepared Test Estimations, Test Plan, Test Scenarios and Test Cases.
• Developed flowcharts for the actual flow of the process for new requirements
• Coded program to validate the files received and extracted the details from database.
• Used XPED tool for Unit Testing.