We provide IT Staff Augmentation Services!

Edi Manager Resume

SUMMARY

  • To obtain a position that will allow me to use my skills and knowledge in a health care environment.
  • Interface process analysis
  • Solid understanding of HL7, X12 and XML formatting and data transfer
  • Requirement specifications gathering and documentation
  • Extensive experience with project planning and implementation documentation
  • Usability - focused functional design and testing and roll out
  • Excellent personal computer skills and proficiency

TECHNICAL SKILLS

  • Microsoft Office Suite (Word,Excel,Access,Project,Visio and Power Point) various software communication programs
  • Internet Explorer
  • Crystal Reporting
  • eCR
  • MedWisdom
  • ChiroWisdom
  • Lotus Notes
  • 7Edit and Oxygen XML
  • Jira. Various classes on customized software
  • Momentum FTP software
  • Extol
  • Symphonia
  • Foresight
  • Power Mhs
  • XML
  • Edifecs
  • Elysium application
  • Mirth Results and Mirth Connect.

PROFESSIONAL EXPERIENCE

Confidential

EDI Manager

Responsibilities:

  • Coordinate various client to bring in eligibility information, pharmacy claim information, medical claim, diagnosis, procedure and clinical medical review information in various standard and non-standard formats for their Medication Therapy Management program.
  • Responsible for mapping, testing. tracking and automation incoming/outgoing data.
  • Documentation of data specifications, procedures and tracking.
  • Managing EDI team to meet timelines for new implementations and modifications of data feeds.
  • Responsible for the set-up testing and documentation of sftp sites internal and external.

Confidential

Senior Interface Analyst

Responsibilities:

  • Coordinate with various hospitals, independent labs, and independent radiology centers to bring electronic clinical reports into the Confidential Health Information Organization.
  • Responsible for mapping, testing, tracking and automation to deliver reports to EMR vendors.
  • Successfully implementing radiology and EKG images into the exchange from hospitals and independent radiology centers.
  • Coordinate and facilitate bi-weekly meetings for the Confidential consortium group.
  • Responsible for setup, testing and troubleshooting batch and real-time X12 transactions.
  • Implementation of immunization reports from practices/hospitals to NY State.
  • Operationalize the collection of HEDIS data from practices and delivering to health care plans.

Confidential

Senior Software Analyst

Responsibilities:

  • Working with technical staff to assist in the design and testing of the Behavioral Healthcare Software application eCR.
  • Managed functional portion of eCR system implementation, including requirement specification gathering, process-flow documentation, testing and training of behavioral health practices.
  • Assisted development staff with creating HIPAA compliant 837p and 837i outbound documents and automating the posting process using the 835 inbound documents.
  • Assisted sales staff by researching /collecting perspective new customer information, configuring the demo application, creating presentations and demonstrating the eCR application.

Confidential

EDI Supervisor

Responsibilities:

  • Supervised 4-person team of business professionals.
  • Ensure all medial claims were sent correctly and meet the 837 professional HIPAA standards and payments were posted using 835 transactions and paper EOB.
  • Worked with trading partners for electronic setup, research of standards, communicating specifications, and the testing of electronic transactions.
  • Oversaw office hardware (pc’s, phone system, printers, etc.).

Confidential

E-Commerce Analyst

Responsibilities:

  • Worked with 3-E-commerce team members for the data implementation of HIPAA mandated transactions. Transactions included claims (837p, 837i, and 837d), claim status (276/277), eligibility information (270/271), authorizations (278), enrollment (834), payment order/remittance advice (820) and remittance information (835) along with current proprietary formats for claims.
  • Responsible for the creation and modification of transaction maps using Extol as a translator and Symphonia as a data parser.
  • Worked with software vendor Foresight to integrate their products for data validation, creating response files, and allowing trading partners to send and receive their transactions via Transaction Assistant web site.
  • Automated data transfer using Momentum FTP software.
  • Team lead to incorporate HIPAA transaction within department current processes.

Confidential

EDI Manager

Responsibilities:

  • Led a team of eight EDI professionals that were responsible for maintaining over 1000 business trading partners across the United States.
  • Documents managed included over 80% of all purchase orders and invoices in a traditional and vendor managed inventory application. Other documents included price changes, promotion announcements, product movement, advance ship notices, purchase order acknowledgements, product transfers and item maintenance for data synchronization.
  • EDI management encompassed the support, maintenance and configuration of the Genisys system backend database (Informix Online), the application front end and user interface, as well as, the custom translator module mapping and supporting UCS and VICS EDI standards. (X.12 subsets).

Hire Now