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Systems Business Analyst/edi Analyst Resume


  • Over 5 years of experience in design and Implementation of B2B and Integration for diverse industry verticals.
  • Hands on experience in HTTP, HTTPS, FTP, FTPS, SFTP, SMTP, AS2 and VAN communication protocols.
  • Experience in various domains like Healthcare, Logistics, Supply Chain, Retail, Transportation and Manufacturing.
  • Expertise in Industrial standards HIPAA, ANSI X12, UN/EDIFACT, SAP IDocs, HL7, CCDA, and XML Schema formats.
  • Experienced with IBM Mainframe (ES9000), and IBM Midrange (AS/400), and PCs. Began as a computer operator and was quickly promoted to the technical services area and was responsible for all PC and Mainframe peripherals, including acquisition, installation and maintenance
  • Excellent experience in Install, Configure, Develop, Troubleshoot, Maintain and support Enterprise Applications using Sterling B2B Integrator, GPM, Mapper, BPML
  • Expertise in Sterling Integrator, Gentran Integration Suite (GIS).
  • Developed business process for FTP, FTPS, document routing, file edits, Integration and database reporting.
  • Worked on ANSI X12 EDI transactions like 850, 855, 856, 810, 811, 820, 834, 835, 837, 860, 865, 867, 945, 940.
  • Worked on EDIFACT transactions like ORDERS, ORDRSP, DESADV, INVOIC, and REMADV among others.
  • Worked with IDOC Structures like ORDERS05, INVOICE02, DELVRY03, DELFOR01, PEXR2002, and ORDERSP among others.
  • Expertise in integrating with major ERP applications like SAP (ALE / iDOC), Oracle APPS.
  • Extensive experience in Map Analysis, Design, GAP Analysis and Map development.
  • Expertise on Sterling File Gateway.
  • Expertise on creating community groups and partners on Sterling File Gateway (SFG).
  • Extensive implementation experience of MFT products like Sterling Connect Direct, Sterling File Gateway, Axway Cyclone.
  • Expertise in creating Static routing channel templates.
  • Good scripting skills in communication and file handling
  • Experience in Orchestrating Business Process and Optimizing Business Solutions
  • Outstanding communication skills; interfaces effectively with upper management, vendors, staff, peers and users
  • Expertise on providing 24/7 production support for Sterling Integrator and Sterling File Gateway.
  • Extensive experience in working on multiple environments AIX, Linux, Windows.


EDI Standards: EDI ANSI X12, UN EDIFACT/EANCOM, HL7 ADT, ORU, VXU, SAP IDocs, XML Schema, Delimited and Custom file formats

Transaction sets: 810, 811, 820, 850, 855, 856, 204, 214, 210, 240, 834, 835, 837, 270, 271, 276,277, 834, 997 and 999

EDI Mapping Tools: Sterling Integrator Mapping Editor, Gentran Server 3.3, EDIFECS

EAI Middleware: Sterling B2B Integrator 5.2, Web Sphere Transformation Extender V8.4, Gentran Integration Suite, EDIFECS, See Beyond eGate* integrator 5.0.4, Web Methods 6.1, GXS, Inovis BizManager BizLink3.2, Inovis Application Integrator, Inovis Works, Mirth Connect Server, Sybase ECMap/ ECGateway

Language: UNIX shell scripts, VB scripting SQL, PL/SQL, SAP ABAP, PGP, SSH, SSL

Databases: Oracle, DB2, iScala and MySQL.

Version Controls: Visual Source Safe, CVS and SVN.

Operating Systems: Windows 95/98/NT/2000/XP, UNIX, Linux.

Protocols: FTP, HTTP, HTTPS, VAN, AS1, AS2, AS3, Web Services/SOAP



Systems Business Analyst/EDI Analyst


  • Interacted and arranged meetings with Business and End users to gather business requirements for changes triggered by Government regulations and HIPAA, business needs and Process improvement.
  • Drive modification to any EDI transactions maps as required by Trading Partners.
  • Worked on Medicare, HIX (ACA/ Obama Care) ICD - 10 implementations, Health Assessment Systems, HL7 Standards, HIPAA, EDI.
  • Analyzes business and user needs, documenting requirements and revising existing systems.
  • Ensure that coordinators effectively research, verify and evaluate all case information based on state/federal regulations under the Affordable Care Act (ACA).
  • Designed flow between objects (tables and views) across different layers to support HIX data by using MS Visio.
  • Acted as a primary liaison between the Client and the Information systems department.
  • HIPAA compliance rules are implemented in EDI applications which involves in testing maps for 270, 271, 820, 834, 837, 835 transactions. Mapping was done from X12, XML to Database and vice-versa.
  • Tested HIPAA Transactions and Code Sets Standards such as 820, 834, 837/835, 270/271, 276/277 transactions.
  • Wrote functional and technical requirements to support development and testing efforts for PCP ACA project, MA migration.
  • Research system issues through HIX to determine root cause relating to eligibility determination errors, monitor trends within appeal process to identify potential system problems.
  • Participated in writing data mapping documents and performing gap analysis on the systems.
  • Managed data flows and systems configurations for EDI 834 and 820 processing.
  • Analyzed business needs and created Business Requirement Document (BRD) Application Use Case (AUC) documents for business and end user review.
  • Troubleshoot any identified transaction errors.
  • Worked on Facets UMI Process for Medicare Migration and Existing Vendors.
  • Manage test file trading with external Trading Partners (Clients / Payers, Providers, Clearinghouses).
  • EDI and Medicaid Insurance claim related inquiries explained and enforced guidelines in the X12 Implementation guides (820, 834, 837P, 837I, 837D, 270/271).
  • Coordinate with IT any EDI map customizations, including assistance with Design and internal testing
  • Analyzed system requirements and developed detailed Test plan and Test cases for EDI testing.
  • Dealt with ETL (extraction, transformation, and load) processes using Oracle and Database.
  • Monitor the trading partner's migration from test to production status
  • Communicate testing status to the appropriate business process owner and Trading Partner contacts.
  • Worked with various ETL tools for the generation of data marts for reporting purpose.
  • Act as the main contact with the external trading partners and internal business owners related to EDI questions.
  • Maintain the transaction specific Companion Guides
  • Stay current with HIPAA Edi regulations.

    Environment: MS Office, Quality Center, Facets, MS Project, MS Visio, Oracle, Toad, Linux, ETL, Data Warehouse, Rational Requisite Pro, Rational Rose, Windows XP.


    EDI Developer/Analyst

    • Responsibilities:
    • SAP Upgrade: Analyze the already existing legacy ERP system, EDI maps and prepare the gap document required for migration. Analyze the optimum number of maps necessary. Had meetings with SAP technical Architect to design the IDOC specifications necessary for the implementation.
    • Created/ modified technical mapping specifications involving formats X12(850, 856, 810, 852, 820, 855, 875, 880, 940, 824, 214, 812), IDOC, XML, flat file.
    • Updated mapping specification documents to reflect any changes made to existing maps and processes.
    • Liaise between back end SAP ERP and business teams for resolving issues related to cross-functional teams.
    • Create/maintain partners, communities, certificates, communication protocols (SFTP, FTP, HTTPS, VAN, AS2), routing for new/existing partners.
    • Create embedded servers, routing profiles, Delivery Exchange, Integration Delivery and necessary configurations to facilitate large volume of file transfer.
    • Coordinate with business and clients for planning an appropriate date for migration/split of the Routing ID’s(Final Switch Off)
    • Primary point of contact for trading partners and business teams for support issues and data related failures. Resolve, create and assign tickets as necessary for day-to-day activities.
    • Create Interchange pick up/delivery exchange for on boarding new trading partners in Axway.
    • Deploying Production Maps into server with the help of Axway Integrator.
    • Experience using Axway Sentinel used to provide real-time data-flow visibility for business and IT users. Production Support in troubleshooting processing issues
    • Update code list, database entries and config files as necessary. Monitor Archive/ purge process for issues and space issues on system.
    • Coordinate with offshore team for coordination and completion of new change requests
    • Raised support tickets and worked with Vendors and VAN customer support to resolve application issues.
    • Prepare test cases for all trading partners with critical scenarios for go live approval to ensure all timelines in the project status are delivered.

    Environment: SI 5.2.2, Map Editor, SharePoint, MS Viso, SAP Suite Adapters, SQL Server 2005, Stored Procedures, SQL, Java Keytool. SAP IDOC’s.

    Confidential, WA

    EDI/HIPAA Business Analyst


    • Participated in designing and developing Premera Blue Cross's business specifications for HIPAA Compliance for different HIPAA Transactions.
    • Claims were received in ANSI X12 format from trading partners at Bulletin Board System on Windows NT platform.
    • Wrote multiple Test-Cases (unit, compliance, integration) for multiple transactions include 837, 835,276, 277, 270 271 - (both inbound and outbound) transactions.
    • Documented all defects to ensure application software functionality for present and future builds.
    • Logged defects and created various defect reports using Test Director.
    • Used EDI-SIM tool for X12 data Creation and testing purposes.
    • Gap Analysis: Analyzed the client's applications programs to determine the impact of the HIPAA final rule one EDI Transaction Set and Code List implementation and defined the changes to bring affected systems into HIPAA compliance.
    • Interacted with the application and Gap Analysis team to resolve Mapping issues and offer recommendations.
    • Analyzed legacy system documentation, file and record formats, system flow charts and otherinformation to develop a comprehensive depiction of the existing environment as it relates to HIPAA rulings.
    • Developed the Business Crosswalks for 837(P, I, D), 835 and 276/277 according to HIPAA implementation rules.

      Environment: HIPAA, EDI, ANSI X12 (4010), Test Tracking System, SmartFTP, Ultra-Edit, FILE-AID, MVS Utilities and MS-Office


      Business Analyst/ EDI Tester


      • Interacted and arranged meetings with Business End users to gather business requirements for changes triggered by Government regulations and HIPAA, Business needs and process improvement
      • Gathered the business requirements and prepared the analyzed data/workflows for business users
      • Analyzed business needs and created Business Requirement Document (BRD), Application Use Case (AUC) documents for businessand end user review
      • Extensively worked on Medicaid Management Information System (MMIS) and with Medicare agency
      • Involved in Life Ray Applications (Managed Care applications), Healthcare claims, HIPAA /EDI(834/837), Medical management portals and Claims Processing applications
      • Developed Test Plans, Test Cases, Test Data, Traceability Matrix and Test Summary Reports and followed Agile/Scrum process
      • Translated user needs to business requirements using Unified Modeling Language (UML)
      • Worked with the software architects/developers to ensure that the applications conform to customer requirements
      • Worked with business and technical teams to develop Business requirements for implementation
      • Involved in developing and executing test scripts, test cases, data sets and user procedures
      • Performed Defect Tracking and Change Control Procedures using Rational Clear Quest, and Configuration Management and Version Control using Rational Clear Case
      • Experience with Microsoft Word, Excel, Microsoft Outlook, Microsoft Visio, Microsoft Access, and Project Workbench
      • Involved in the peek review of Test Plans, Test Cases with the QA team to verify implementation of new features and enhancements
      • Involved In Processing 834EDI Files for HIX 834 Enrollment Project and Validating 999 and TA1EDI Transactions

        Environment: RUP, Rational Requisite Pro, Rational XDE, Rational Rose, UML, Use case, Activity/ state diagram, MS Visio, Test Director, MS Office, Windows 2000/XP, MS Office, SQL, DB2.

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