SUMMARY

• Around 11 years of Profound experience in the EDI Transformation tools and the EAI Integration tools
• Successfully implemented Gentran mapping and Edifecs validation rules for the Washington and the Michigan states. Led the EDI team and emerged with grand success
• Having strong EDI integration best practices.
• Installed and configured the Gentran and XEngine in the Solaris Server and in the local windows workstation.
• Strong Experience inInstallation and Configuration with various EDI environments like Gentran with UNIX, EDIFECS, WTX, WMB and WMQ.
• Exultant Production support for the EDI and EAI tools (WTX, WMB, WMQ) of the Sentinel system
• Magnificent Production support using Edifecs (Version 7.0.8) and provided prompt resolution to the tickets and thus ensured that the BX score of the client is always more than 90%; was instrumental in keeping in achieving 100% consecutively for 3 months.
• Profound experience in WTX 8.2 Websphere Transformation Extender for splitting and formatting the claim files
• Sound Experience in Gentran Application Integrator (AI) for developing inbound and outbound HIPAA transactions
• Expertise in HIPAA 837 Professional, 837 Institutional, 837 Dental, HCFA1500, UB04, ADA, 834, 820, 835, 270, 271, 276, 277 and 278
• Expertise in testing Healthcare 4010 & 5010 EDI Transactions (834, 837, 835, 270, 276 & 278), ICD - 10 Concepts, Facets Application and Edifecs
• Experienced in Subscriber/Member, Claims Processing, Provider & Utilization Management modules of Facets Application
• Explored and Intensively worked on Technical and Functional perspective of EDI using the Third-party software tools like Edifecs (Xengine Specbuilder) and Gentran
• Adept expertise in EDIFECS Spec Builder and XEngine V5.6, 6.0, 6.1, 6.2 and 7.0.8
• Dexterous in preparing Data Dictionaries using Spec Builder
• Scholarly expertise in both Inbound and Outbound Transactions for the HIPAA/X12 standards
• Proficient Health Care domain knowledge in the Medicare and Medicaid Insurance environment
• Have been scholarly appreciated by the client for the sincerity, quality and the due diligence possessed and exhibited.
• Efficient in making EDI proposals and have prepared various proposal materials like Flyers and Brochures
• Sound knowledge in Transportation and Logistics
• Hands on Experience in JCAPS 6.0
• Substantial development experience in SQL
• Efficient in understanding the business requirements, interacting with clients, analyzing the unique characteristics of the requirement and providing the best and appropriate solutions
• Well versed in Configuration Management
• Experience in Visual Source Safe (VSS), Clear Case, Tortoise SVN and HP ALM tools which are used for version control and JIRA for defect tracking.
• Effective adherence of CMMI Quality compliance
• Theoretical exposure to Mulesoft Integration.

TECHNICAL SKILLS

EDI Tools: Edifecs (Version 7.0.8), Gentran Server for UNIX 6.1, Specbuilder 6.2, XEngine, JCAPS 6.0, Websphere transformer Extender (WTX 8.2), Websphere Message Broker (WMB 6.1) and Websphere Message Queue (WMQ 7.0), Facets

Standards: EDI, HIPAA/X12, EDIFACT and HL7

Version and defect tracking Tool: VSS (Microsoft Visual Source Safe), SVN, ClearCase, HP ALM, JIRA

IDEs & Tools: Sqldeveloper, Toad and My Eclipse

Domain Knowledge: Health Care HIPAA, Transportation and Logistics

Web/Internet Technologies: HTML, XML, XPATH and JavaScript

RDBMS: Oracle, SQL

PROFESSIONAL EXPERIENCE

Confidential

EDI Delivery Module Lead

Responsibilities:

• Expertise in setting up the all the Development and the test environments with the required toolsets.
• Installed and configured EDIFECS XEngine, WTX and WMB in the server and in the client machines.
• Key responsibilities are ticket handling, client interaction and co-ordination of offshore team.
• Worked as an SME for BSC SA Testing - Offshore Module Lead role in ICD-10 project.
• Expertise in the application knowledge and provided knowledge transfer about the application/domain to the new buddies in the team and make them understand the basic functionalities of the application
• Was highly appreciated by the client for the dedication, involvement, sincerity exhibited and the deep knowledge possessed.
• Rendering full-fledged support and efficiently handling Tickets in the areas of Mapping, EDIFECS rules, Severity Configuration, Trading Partner Agreement, Java Coding, JavaScripting, Groovy, Profile and Route changes
• Quickly adapted and mastered the new environment edifecs version 7.0.8
• Efficiently handling the tickets in the new environment; resolving tickets with the precise quality
• Learned and mastered in FFC (Full File Compare) a complex area in the BSC’s work flow to handle the 834 enrolment X12 files by the trading partner.
• In addition to the project work, proactively provided the Innovative ideas and single handedly developed a Data Generation tool using Specbuilder to minimize the test data creation exercise.
• Contributed for other innovation tools like stuck file handling, 27X default response as well
• Daily interaction with the BSC business analyst ensuring faster and qualitative resolution
• Providing crystal clear status to the client on ongoing basis and keeping the stake holders informed of any potential risks.
• Manage the team members within the project, assign the work to the team, consolidate the day to day tasks and report the status to onsite coordinator
• Involved in Project Estimation based on complexity of requirements and availability of resources & schedule
• Worked as “Idea Champion” in Innovation Team and achieved high Innovation Index Score by encouraging team members to contribute new ideas and innovations
• Performed SCM role to maintain the project artifacts and prepared metrics reports for internal quality audits
• Taking part in daily status calls to update the status

Confidential

Responsibilities:

• Together with the pre-sales team, diligently prepared project proposals for the Projects 'UTi', 'Ryder' and ‘20Cube'.
• Successfully won the projects ‘UTi’ and ‘20Cube’ and made revenue for the Organization.
• Educated the pre-sales team and the delivery team with the basic EDI knowledge and made them adept to face client confidently.
• Prepared sales collateral for Go to Market and various presentations on 'EDI basics', 'Methodology document for EDI' like Flyers, brochures etc
• Explored the Transportation and Logistics domain and mastered the same. Built the EDI practice for Transportation and Logistics industry unanimously, an asset for the Organization which could be used at any point of time.
• Created a new service line for the Organization in EDI for Transportation.
• Conducted sales school on the new service offering for Geo Sales meet.
• Actively involved in the Interview Panel and weighed the knowledge of candidates and selected appropriate associates to enlarge the EDI strength of the Organization.
• Well trained in “WORKDAY” cloud based ERP tool.

Confidential, Nashville, TN

Module Lead

Responsibilities:

• Installing and configuring all the software’s in Development and in the test environments.
• Providing ongoing support for Sentinel System which identifies the fraud and abuse claims
• Proficiently handing the production tickets around mapping issues in WTX which is used for splitting multi claim files and converting X12 to XML
• Handling enhancements in WMB which integrates all the components in the module
• Efficiently monitoring the claim flow of the Sentinel system with the help of WMQ tool
• Analyzing the requirements and drafting project plan and use cases for the enhancement activities
• Preparing metrics plan and monitoring the variance using internal tool C2.0 and thus ensuring the CMMI Quality compliance
• Interactive client calls and coordinating the offshore team
• Reporting the status to clients on ongoing basis

Environment: WTX, WMB, MQ, ORACLE, SQL Server 2005, HIPAA EDI (4010,5010), Windows XP Professional, WINSCP, EDIFECS, XML

Confidential, Nashville, TN

EDI X12/HIPAA Business Analyst

Responsibilities:

• Created mapping specification from Claim XML to HIPAA EDI translation
• Worked extensively in UNIX environment to test inbound and outbound translators
• Proficient on ANSI X12 standards for all HIPAA transactions
• Worked on gap analysis between HIPAA 4010 and transactions
• Extensively worked on creating use cases for Real Time Eligibility Adapter Services, Lookup Services, Duplicate Claim check and Front-End Rejection service
• Exhaustively Tested HIPAA transactions manually and using EDIFECS testing tool for HIPAA compliance
• Profound experience in XPATH & claim XSD changes to generate claim XML in Inbound and EDI X12 in Outbound
• Extensively worked on mapping internal format PCDS/ICDS to and from CXML
• Skilled in evaluating XPATH for single and multi-dimensional index from XSD
• Experienced in Agile/Scrum development methodologies

Environment: WTX, WMB, MQ, ORACLE, SQL Server 2005, HIPAA EDI (4010,5010), Windows XP Professional, WINSCP, EDIFECS, XML

Confidential, Michigan

Software Engineer and Analyst (Functional)

Responsibilities:

• Installed and configured the Gentran and XEngine in the Solaris Server and in the local windows workstation.
• Created and maintained the trading partner’s information in XE selector configuration
• Analyzed and Implemented Type 0 to Type 7 Edits for all the transactions of HIPAA
• Evaluated and froze the Random data dictionary columns in the mapping document for all the transactions
• Developed data dictionaries for both Inbound and Outbound transactions in Edifecs
• Understanding Functional specification and coordinating with the Team
• Analyzed Validation Edits for all the transactions of HIPAA
• Scrutinized Loading business rules and coordinating with Inbound & Outbound teams to understand the same
• Analyzed and froze the Tag names for Intermediate file
• Developed maps using Gentran Application Integrator (AI)
• Drafted test cases according to the business requirement
• Constructed test data using data dictionaries
• Created and maintained trading partner Profiles in GENTRAN Server
• Deployed the developed maps into Environments
• Worked together with the Clients to gather and freeze the requirements for the elements of different transactions in the mapping specification
• Generated and maintained trading partners’ information in GENTRAN Server
• Maintained the Gentran UNIX server
• Active contributor for the innovative part of the team
• Performed In-depth Research and Development on both Gentran and Edifecs security administration

Confidential, Washington

Software Engineer and Analyst (Functional)

Responsibilities:

• Analyzed and froze the Random data dictionary columns in the mapping document for all the transactions of HIPAA
• Developed data dictionaries for both Inbound and Outbound transactions in Edifecs
• Analyzed and implemented Type 0 to Type7 Edits for all transactions of HIPAA
• Created and maintained trading partner Profiles into GENTRAN Server
• Developed maps using Application Integrator (AI) and deployed the maps into Environments
• Created test data using data dictionaries

Confidential, South Dhakota

Software Engineer and Analyst (Functional)

Responsibilities:

• Installed and configured JCAPS, EDIFECS Specbuilder and Oracle in the development workstation.
• Analyzed and froze the Random data dictionary columns in the mapping document for all the transactions of HIPAA
• Developed data dictionaries for both Inbound and Outbound transactions in Edifecs
• Analyzed and Implemented Type 0 to Type7 Edits for all transactions of HIPAA
• Created the entire project in JCAPS
• Created Gentran Map for 275 Transactions
• Created and maintained trading partner Profiles into GENTRAN Server
• Developed maps using Application Integrator (AI) and deployed the maps into Environments
• Created test data using data dictionaries