SUMMARY:

• A competent professional 11 years of rich & extensive experience in EDI/HIPAA/NCPDP.
• Expertise in Gentran Application Integrator, JCAPS 6.0, EDIFECS Spec Builder XEngine v6.0, 6.1, 6.2, 6.8, 7.0, 8.2 & 8.6, MapBuilder 6.8, 7.0, 8.2 & 8.6 and XEServer 7.0, 8.2 & 8.6
• Sound Experience in using Gentran Application Integrator (AI) / Netbeans / MapBuilder (EDIFECS) for developing inbound and outbound maps.
• Main strength is to balance between handling different projects, roles and responsibilities at the same time
• Developed a Translation/Validation Project module prototypes for EDI using JCAPS 6.0 / MapBuilder 7.0, 8.2, 8.6.
• Substantial development experience in SQL.
• Working Experience in java, java - script.
• Obtained good knowledge in the HealthCare & HIPAA Domains.
• Got good analyzing skills in Health Insurance domain using X12 standards (4010, 5010 version) and also in paper formats like HCFA-1500, UB-04, ADA and NCPDP claims.
• Worked on Core ACA rules for 5010.
• Working in both Technical and Functional perspective of EDI.
• Strong analytical and problem solving skills, excellent communication, presentation skills and a good team player.
• Worked as onsite coordinator between the Client and offshore teams.
• Conduct code reviews to check adherence to Coding Standards.
• Ability to quickly adapt to new and challenging environments
• Quick learning skills on new EDI (COTS)/EAI tools and understanding the expected requirements from the client side and also guiding them if required to accomplish it in an even better way.

TECHNICAL SKILLS:

Operating Systems: Windows 7/10, Windows XP/Vista, UNIX, Linux

Database: SQL Server2005, SQL Server 2008, SQL Server 2008 R2

IDE’s and EDI Tools: EDIFECS, Gentran Server for UNIX, Edit Plus 2.0, Toad, Sql developer, Eclipse, Specbuilder, XEngine, Gentran (AI), JCAPS 6.0, Microsoft Visual SourceSafe 6.0, Clear Case, MapBuilder, XEServer, Transaction Manager, XEConnect

Web/Internet Technologies: HTML, XML

Concepts: EDI, HIPAA/X12 (4010, 5010 version), NCPDP Telecom, NCPDP Post Adjudication, CAQH CORE rules

Data Transfer Protocols: FTP, SFTP, https

PROFESSIONAL EXPERIENCE:

Confidential

Sr. Software Engineer/EDIFECS Lead

Tools: & Technologies: SpecBuilder, XEngine, XEServer, MapBuilder, EAM, Oracle, Java, JavaScript, XML, HTML, SQL Developer.

Responsibilities:

• Gathering the CORE Rule requirements for Phase I/II/III implementation and converting them into technical requirements.
• Understanding Functional spec and coordinating with India Team.
• Analyzing CORE Rules for 270/271/276/277/835 transactions of HIPAA CORE Phase I/II/III rules.
• Analyzing Loading business rules and coordinating with multiple technical teams.
• Analyzing both 5010 version in X12 standards and their difference.
• Analyzing and Freezing Design documents for 270, 276, 277, 271, 835 X12 Healthcare transactions.
• Worked together with the clients to gather and freeze the requirements for the elements of different transactions in the design document and used these documents to analyse the requirements for development purpose.
• Modify Translation maps using MapBuilder for X12/HIPAA transactions as per new requirements for CORE Phase I/II/III.
• Allocate work to the team, getting the queries clarified to the team.
• Deploying XEServer projects and Configuration files in the UNIX/LINUX server and maintaining.
• Reporting and tracking of the Defects in Clear Quest.
• Assist the team members in test case execution.
• Working with testing team to create test cases.
• Working on Core rules implementation in existing CHAMPS project to meet the CAQH CORE mandated standards.
• Worked as an innovative part of the team and also guiding the respective team members to understand and complete the task.
• Involved in daily and weekly team meetings.

Confidential

Sr. Software Engineer/EDIFECS Lead

Tools: & Technologies: SpecBuilder, XEngine, XEServer, MapBuilder, EAM, Oracle, Java, JavaScript, XML, HTML, SQL Developer.

Responsibilities:

• Worked together with the clients to gather and freeze the requirements for the elements of different transactions in the design document and used these documents for development purpose.
• Understanding Functional spec and coordinating with India Team.
• Analysing the requirements using design documents.
• Analyzing Validation Edits for all transactions of HIPAA/NCPDP claims.
• Analyzing Loading business rules and coordinating with inbound & outbound teams.
• Analyzing both 4010 and 5010 version in X12 standards and their difference.
• Analyzing and freezing the Tag names for intermediate file.
• Analyzing and Freezing Design documents for 837P/I/D, 270, 276, 278, 820, 834, 835 X12 Healthcare transactions.
• Developing maps using MapBuilder for X12/HIPAA and NCPDP claims transactions.
• Develop the Validation and Translation rules for MQP transaction files.
• Develop XEServer routes for MQP and integrate the same with eCAMS product.
• Develop NCPDP post adjudication Validation rules and integrate the same with eCAMS product.
• Deploying XEServer projects and Configuration files in the UNIX/LINUX server and maintaining.
• Creating Test data and Test cases.
• Assist the team members in test case execution.
• Working on Core rules implementation in existing CHAMPS project to meet the CAQH CORE mandated standards.
• Worked as an innovative part of the team and also guiding the respective team members to understand and complete the task.
• Was part of a team that performed End to End Unit/Performance testing.
• Allocate work to the team, getting the queries clarified to the team.
• Reporting and tracking of the Defects in Clear Quest.
• Working with testing team to create test cases.
• Working on Core rules implementation in existing CHAMPS project to meet the CAQH CORE mandated standards.
• Maintaining the XEServer/XEngine Unix and Linux servers.
• Worked as an innovative part of the team and also guiding the respective team members to understand and complete the task.
• Involved in daily and weekly team meetings.

Confidential

Sr.Software Engineer

Tools: & Technologies: SpecBuilder, XEngine, XEServer, JCAPS, Oracle, Java, JavaScript, XML, HTML, SQL Developer.

Responsibilities:

• Worked together with the clients to gather and freeze the requirements for the elements of different transactions in the design document and used these documents for development purpose.
• Understanding Functional spec and coordinating with India Team.
• Analyzing Validation Edits for all transactions of HIPAA.
• Analyzing Loading business rules and coordinating with inbound & outbound teams.
• Analyzing both 4010 and 5010 version in X12 standards and their difference.
• Analyzing and freezing the Tag names for intermediate file.
• Analyzing and Freezing Design documents for 837P/I/D, 270, 276, 278, 820, 834, 835 X12 Healthcare transactions.
• Analyzing the HCFA 1500, UB-92 and ADA paper formats and design the standard guidelines for the paper formats according to the client requirements using the delimited guideline format.
• Developing maps using Netbeans in JCAPS 6.0.
• Creating test-cases and test-data using data dictionaries.
• Deploying translation projects and ECS files in the UNIX server.
• Worked together with the clients to gather and freeze the requirements for the elements of different transactions in the design document and used these documents for development purpose.
• Maintaining the XEngine and JCAPS 6.0 UNIX servers.
• Worked as an innovative part of the team.
• Analysing the requirements using design documents.
• Allocate work to the team, getting the queries clarified to the team.
• Reporting and tracking of the Defects in Clear Quest.
• Assist the team members in test case Creation/execution
• Deploying XEServer projects and Configuration files in the UNIX/LINUX server and maintaining.
• Worked as an innovative part of the team and also guiding the respective team members to understand and complete the task.
• Involved in daily and weekly team meetings.

Confidential

Sr. Software Engineer/EDIFECS Lead

Tools: & Technologies: JCAPS, Oracle, Java, JavaScript, XML.

Responsibilities:

• Developed translation maps using JCAPS 6.0 for both 4010 and 5010 version in X12 standards which replaced the existing Gentran application in an even better way.
• Lead a small member team for developing this prototype and provided a better results than expected.
• Have done analysis, design, development and testing
• Gave demos to the clients
• Worked as an innovative part of the team and also guiding the respective team members to understand and complete the task.
• Involved in daily and weekly team meetings.

Confidential

Software Engineer

Tools: & Technologies: SpecBuilder, XEngine, XEServer, JCAPS, Oracle, Java, JavaScript, XML, HTML.

Responsibilities:

• Worked together with the clients to gather and freeze the requirements for the elements of different transactions in the design document and used these documents for development purpose.
• Functional spec and coordinating with India Team.
• Analyzing Validation Edits for all transactions of HIPAA.
• Analyzing Loading business rules and coordinating with inbound & outbound teams to understand.
• Analyzing and freezing the Tag names for intermediate file.
• Analyzing Understanding Functional spec and coordinating with Team India.
• Developed data dictionaries for both inbound and outbound transactions in Edifecs.
• Understanding and freezing the Random data dictionary columns in the mapping document for all transactions.
• Analyzing the HCFA 1500, UB-92 and ADA paper formats and design the standard guidelines for the paper formats according to the client requirements using the delimited guideline format.
• Developing maps using Application Integrator (AI).
• Creating test-cases and test-data using data dictionaries.
• Deploying developed maps and maintaining trading partner profiles into Gentran Server.
• Worked together with the clients to gather and freeze the requirements for the elements of different transactions in the design document and used these documents for development purpose.
• Maintaining the Gentran UNIX server.
• Worked as an innovative part of the team.
• Research and development on both Gentran and Edifecs security administration.
• Worked as an innovative part of the team.
• Analysing the requirements using design documents.
• Allocate work to the team, getting the queries clarified to the team.
• Reporting and tracking of the Defects in Clear Quest.
• Assist the team members in test case Creation/execution
• Worked as an innovative part of the team and also guiding the respective team members to understand and complete the task.
• Involved in daily and weekly team meetings.

Confidential

Software Engineer

Tools: & Technologies: SpecBuilder, XEngine, XEServer, JCAPS, Oracle, Java, JavaScript, XML, HTML.

Responsibilities:

• Gathering functional spec and coordinating with India Team.
• Analyzing Validation Edits for all transactions of HIPAA.
• Analyzing Loading business rules and coordinating with inbound & outbound teams to understand.
• Analyzing and freezing the Tag names for intermediate file.
• Analyzing Understanding Functional spec and coordinating with Team India.
• Developed data dictionaries for both inbound and outbound transactions like 837, 834, 270, 271 etc for the HIPAA standards in Edifecs.
• Developed validation rules for both inbound and outbound transactions in Edifecs.
• Developed the maps for both inbound and outbound transactions in Gentran and translated the files from application to standard and vice versa.
• Worked together with the clients to gather and freeze the requirements for the elements of different transactions in the design document and used these documents for development purpose.
• Maintaining the Gentran UNIX server.
• Worked as an innovative part of the team.
• Research and development on both Gentran and Edifecs security administration.
• Reporting and tracking of the Defects in Clear Quest.
• Assist the team members in test case Creation/execution
• Deploying XEServer projects and Configuration files in the UNIX/LINUX server and maintaining.
• Worked as an innovative part of the team and also guiding the respective team members to understand and complete the task.
• Involved in daily and weekly team meetings.