SUMMARY

• Confidential has over 20 years of work experience in the following areas/industries:
• 10 years of experience in mainframe technology 10 years of experience in configuration and development in SAP.
• Provided project team leadership, configuration and integration with several world - class rganizations.
• An organized and results-oriented leader with excellent written and verbal skills.
• Career involvement includes full project life cycle experience with project planning, detailed
• functional design and development, and production support activities.

TECHNICAL SKILLS

• SAP EDI, EDI ANSI X12
• Healthcare HIPAA/EDI
• IBM Mainframe Developer (IMS DB/DC, COBOL)
• SAP EDI, Implementation and upgrades
• Mainframe EDI
• Mainframe development (IMS DB/DC)
• SDLC methodology using Waterfall or Scrum model
• Manufacturing
• Hi-Tech

PROFESSIONAL EXPERIENCE

Confidential, Scottsdale, AZ USA

Sr. Business Systems Analyst

Responsibilities:

• Facilitated meetings and gathered business requirements with business users and technical developers to drive out detailed business requirements for prescription drugs adjudication for paper, POS, electronic claims and data mapping/integration to various application/systems (data warehouse, Finance system).
• Prepared Business Requirements documents (BRD) and Functional Requirements documents (FRD) and get approval/sign-off from stakeholders.

Confidential, Phoenix, AZ USA

Sr. Business Systems Analyst

Responsibilities:

• Participated and contributed in JAD sessions with business users and various users across the department to drive out detailed business requirements.
• Gathered business requirements and prepared BRD (Business Requirement Document) for the project.
• Facilitated meetings with Business on requirement changes (if any), development/testing status.
• Facilitated and managed meeting sessions with Business and technical developers to review business mapping requirements and application development.
• Served as liaison between Business, QA and IT Developers.
• Prepared Change Control log and attended Change Control Review meetings to provide change details and justification for change and approval.
• Prepared and maintained data mapping for Encounters (837P/I/D/V/T/PAH Pharmacy), Enrollment (834), Eligibility Benefits (271) & Responses/Acknowledgment (277U, 4950) for new platform (EDM & QNXT).
• Validated test results and resolved defects.

Confidential, Owings Mills, MD USA

Sr. Business Analyst

Responsibilities:

• Benefit Enrollment business requirements for Consumer Direct and SHOP from the State & Federal Exchanges (HIX).
• Gathered Requirements & analysis for 2015 enrollment renewals
• Interacted with senior management/business owners to gain acceptance/signoff on requirements
• Dual maintenance analysis & solution for MD Exchange
• 2014 enrollments & changes/updated from old platform
• 2015 renewals & changes/updates from new platform
• Gathered Requirements for outbound Enrollment (834) effectuation / confirmation
• Monthly enrollment base-lining & reconciliation with the Exchanges
• Production/Work Request defects analysis & resolution

Confidential

Sr. Business Systems Analyst

Responsibilities:

• Edifecs HIPAA database upgrade from version 7.0.20 to 8.3.4
• Analyzed upgrade information and identified gaps between existing & upgrade environments and the requirements necessary to build upgrade end-state.
• Reviewed the gaps with business & technical team. E.g. severity edits changes, new/updated code sets, HIPAA SNIP level changes, mapping changes, ICD-10 updates, etc.
• Gathered and prepared Requirements/Functional document.
• ICD-10
• Reviewed and identified mapping changes to support ICD-10.
• Prepared technical document for Edifecs developer.
• Participated in UAT and Release Management efforts.
• Gathered business requirements and added business rules for EDI HIPAA transactions into CaliberRM.
• Prepared v5010 Companion Guides for Claims (837 Dental, Professional & Institutional).
• Responsible for inbound Dental Claims (837D):
• Prepared functional spec on business rules for Corticon developers
• Validated technical design documents on business rules created by IT developers
• Developed test plans, test cases and test scripts and run tests using Oracle Enterprise Manager
• Responsible for outbound Claims (837P & 837I):
• In pre go-live, performed business analysis and testing of v4010 to v5010 and v5010 to v5010 claims
• In post go-live, performed analysis and defect resolution for Edifecs developers
• Validated test results performed by QA test team
• Tools used in analysis are SpecBuilder and Healthcare Transaction Manager (HTM)
• Project Lead for outbound claims team:
• Led daily defect session on development/testing status attended by Project Managers, Business Analysis, QA testers & Edifecs developers
• Led weekly defect planning and release meeting attended by Project Managers, Business Managers & Test Leads where defects were reviewed and scheduled for upcoming releases based on priority, severity level and volume of claims fallout.
• Responsible for Change Requests (CRs) from initiation to implementation.
• Ensured that the CR are written accurately & completely
• Provided cost estimates & staffing breakdown
• Attended Change Control Board meeting for review and approval
• Ensured that the CR are coded, tested and implemented to production
• Managed and maintained data mapping documents from application to X12 for Claims (837P & 837I).

Confidential, San Francisco, CA. USA

Sr. B2B Analyst

Responsibilities:

• Performed enterprise analysis which included requirements analysis and elicitation for all EDI HIPAA transactions {Claims (837D), Acknowledgments (277CA, 277U) & Remittance Advice (835)} and middleware processing for enterprise business transformation.
• Participated and contributed in JAD sessions with business users and various users across the department to drive out detailed business requirements.
• Prepared end-to-end HIPAA solution and validation which includes visio modeling for better illustration of the business flow and application to business partners and IT.
• Gathered requirements, performed functional analysis and prepared BRD (Business Requirement document) and FRD (Functional Requirement document) for the project.
• Facilitated and managed meeting sessions with IT and testers to review business requirement capture and application development.
• Responsible for creation of Data Dictionary to benefit application users by establishing data consistency throughout the organization.

Confidential

EDI Developer

Responsibilities:

• Reviewed and recommended latest IDoc types for various EDI transactions for upgrade from 4.6B to ECC 6.0.
• Redesigned previously customized IDoc types, process code and/or function modules with standard SAP functionalities.
• Developed new mapping specs for X12 830, 862, 856 and EDIFACT DELFOR, DELJIT & DESADV for map development by 3rd party vendor.
• Redesigned 824, 864, APERAK with Workflow capability.
• Performed integration testing between SAP & EDI subsystem.

Confidential

EDI Developer

Responsibilities:

• Provided support for all aspects of EDI processes during divestiture which entails splitting a single SAP environments into two independent SAP environments.
• Continued to support GM after divestiture.
• Developed EDI 830, 862, 924, 861, 864 and 810 transactions with Chrysler.
• Developed EDI DELFOR, APERAK and DESADV transactions with various GM plants.
• Provided day-to-day business and technical EDI production support.

Confidential, Nashville, TN. USA

EDI Specialist

Responsibilities:

• Conducted an in-depth assessment of client’s EDI software and processes in the mainframe environment for migration to SAP platform.
• Wrote a proposal for EAI solution with middleware architecture that will support a gradual deployment from the mainframe production system to the SAP ERP system.

Confidential

SAP EDI Specialist

Responsibilities:

• Implemented SD/EDI invoice for the Italian affiliate using UN/EDIFACT standard.
• Re-designed a 3rd party Warehouse Replenishment interface using BDC session to IDoc/Workflow.
• Gathered requirements and wrote functional spec and created mapping spec for the Orders IDoc/Workflow interface.
• Responsible for test scripts/testing of Sales Order & Delivery interfaces to external data warehouse.

Confidential, Memphis, TN. USA

SAP IT Analyst

Responsibilities:

• Responsible for blueprinting, requirements gathering and fit/gap for Order Management.
• Co-wrote “External Partner eConnectivity” design document for the purpose of defining standardization and providing recommendation for B2B transactions. The recommendations included:
• Communication methods
• Data formats and standards
• Roles and responsibilities
• Process standards for any type of electronic connectivity that the company supports
• Analyzed AS-IS Order Management external party processes into TO-BE processes.
• Developed and maintained project plan.
• Developed mapping specs from X12 & XML (xCBL & papiNet standards) to IDoc and vice versa.

Confidential, Rochester, MN. USA

EDI Business Analyst/Developer

Responsibilities:

• Implemented Order-to-Cash IDoc requirements which requires writing functional and technical specifications.
• Developed and maintained X12/IDoc maps with IBM DataInterchange translator in the mainframe platform.
• Provided mainframe & SAP jobs/maps/programs/transactions production support.

Confidential

EDI Lead

Responsibilities:

• Led a 5 member team in support of the EDI Order-To-Cash implementation from blueprinting to realization to go-live.
• Developed Sales Order & Invoice mapping specifications for translator mapping and SAP setup and configuration.
• Implemented SAP EDI Workflow and documented/trained end-users to fix workflow process errors.
• Wrote technical documentation and provided knowledge transfer.

Confidential

EDI Lead

Responsibilities:

• Led a team in the review and selection of 3d party EDI translator.
• Defined and developed EDI standards documents and guidelines.
• Prepared mapping specs for EDI IDoc interfaces.
• Developed EDI/IDoc maps with Harbinger TrustedLink Enterprise.
• Prototyped and configured SD/EDI interfaces in SAP 3.0E.

Confidential

Mainframe & EDI Developer (IMS DB/DC, COBOL)

Responsibilities:

• Developed IDoc maps suing TIGER, a European mapping tool.
• Setup SAP EDI configuration.
• Responsible for creating all EDI transactions maps on the mainframe translators (Sterling Gentran & IBM DataInterchange).
• Responsible for daily production jobs and maintained all electronic mailboxes (GEIS & Advantis).
• Interfaced with technical counterparts and trading partners for the purpose of establishing new transactions and problem solving.
• Worked with VANs technicians for setup connectivity and resolve transmission problems.
• Provided continued enhancements and ongoing maintenance of job flow/programs/maps/transactions.
• Provided technical support to both internal and external on electronic services.
• Wrote and maintained online and batch programs for Warehouse System and Customer Service Level system.