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Sr. Edi Analyst/cms/center For Medire/mediid Services Project Consultant Resume

CA

SUMMARY:

Management level positions with over 18 years’ experience in EDI, Development/Mapping, GIS, Development, SAP / EDI Implementations, B2B, Project Management. Consultant for many industries Aerospace, Aviation, Automotive, Military, Entertainment studios, Manufacturing, Telecom, Accounting, Healthcare, Retail Banking. EDI Programming, Knowledge of SAP, Access, ACCPAC, Great plains Dynamics, Quick books, Syteline, Vsync, Gentran, Pervasive, Dbase, SQL query, AS400 RPG, EXTOL EDI, SAP XI, ABAP, all Microsoft office products, Word, Excel and Corel, Quatrro Pro. Knowledge of many Medical billing software’s, Over 15 years healthcare experience, EDI Transactions Analyst, knowledge in 27x transactions, Testing experience for EDI x12 4010 and 5010, 270/271 (Eligibility/Benefits), 276/277 (Claim Status), and 278 - 13/278.

 

PROFESSIONAL EXPERIENCE:

Confidential

EDI Specialists

Remote Office, CA

Sr. EDI Analyst/CMS/Center for Medicare/Medicaid Services Project Consultant

  • Responsible for CMS - CCIIO - 1095-A initiative / project
  • Support Affordable Care Act / Obamacare project integrations, Error reconciliation, analyze healthcare data and resolve disputes.
  • Work and Support CMS systems CERRS tech team, CALT, HICS, MIDAS, TM thru vpn
  • Focus on FFM - Federal Facilitated exchange and SBM - State based data
  • Analyze EDI Data, implementation guides and attend meetings with clients

New Century Healthcare

Brea, Ca / Partial Remote

Senior EDI Manager/ Consultant

Responsibilities:

  • Responsible for all Day to Day EDI operations.
  • Hold weekly team meetings and responsible for EDI team.
  • Development of all Healthcare HIPPA- EDI related transactions - 820, 834, 837,835 - 271/272, 278, etc.
  • Production Support and Training.
  • Training and working with EDI Business Analysts - Training them in QA and testing of all development work - EDI
  • Work with Humana, Cigna, Coventry, and all other Healthcare companies.
  • Automate all manual daily processing of EDI files 837 claims.
  • Upgrade to 5010 and HIPPA.
  • Use Real-time transactions, SOAP UI, SFTP, AS2 communications protocols.
  • Experience using Xtreme Translator and Biztalk - Development of all 5010 healthcare transactions and reporting to company Stakeholders.

Confidential

Remote Office, CA

Senior EDI Mapping Developer/Lead Project Consultant

Responsibilities:
  • Responsible for Sterling Integrator (SI) mapping.
  • Implementation of new clients.
  • Legacy systems (AS400) Integration projects
  • Map upgrades and new development.
  • Onboarding of EDI partners.
  • Testing and Analysis of new data and partner specifications

Confidential

Remote Office, CA

Senior EDI Developer / Project Manager

Responsibilities:
  • Responsible for Gentran and GIS - Development.
  • SAP EDI and IDOC configuration.
  • Gentran mainframe
  • Manage new partner implementations.
  • Integration of legacy systems.
  • Development of 837 Claim billing, 276 Status, 834 Enrollment, 835 Claim Payments, 829, 270-278, 820, 834 and many other healthcare maps.
  • ICD9 -ICD10 - CPT, HL7 Integration and knowledge.
  • Testing and Production support.
  • Manage team of 8 developers and work with the business on EDI B2B solutions.

Confidential

San Diego, CA

Senior EDI Application Developer

Responsibilities:
  • JAVACAPS - (JCAPS)Netbeans, SeeBeyond Developer
  • Object Oriented Programming/Development using JAVA, JCAPS, Web 2.0, Glassfish 2.0, Soap, PL/SQL, on UNIX AIX platforms.
  • Create or update existing Java Code using JAVACAPS for EDI clients
  • Develop EDI maps (JCD) for Workman’s Comp Group, Bill History, claims, EOR, 835, 837 and other healthcare related data.
  • Development of 820, 834, 837 Claim billing, 276 Status, 834 Enrollment, 835 Claim Payments, 829, 270-278 and many other healthcare maps.
  • HL7 Development and File transfer support
  • Analyze EDI mapping guidelines and Data validation
  • Support EDI Production Workman’s Comp and Healthcare claims
  • Maintain and deploy new or updated maps into Production GlassFish
  • Create workflow and support documentation
  • UAT and full cycle testing
  • Created automatic Web service for Remedy ticketing process.
  • Process Monitor for IT tickets, errors, failures and service desk

Confidential

National Headquarters

Anaheim, CA

Senior SAP EDI Manager / Consultant

Responsibilities:
  • Manage technical resources, EDI Developers and Off-shore teams.
  • Responsible for all SAP / EDI Implementations and Interfaces.
  • EDI SAP Vendor / Customer Configurations, IDOC Development, Port Configurations, EDI Map Development, Function Module configurations.
  • Configuration and testing on communication protocols (BizTalk) and GIS.
  • Upgrade TLE Communication services - for AS2 protocol.
  • Maintain and update BMPL using the GIS modeler
  • EDI Vendor/Supplier On-Boarding management.
  • Creation of Work Flow process to handle EDI exceptions.
  • Create Error Handling processes.

Confidential

National Corporate Headquarters

Torrance, CA

EDI Consultant / Project Manager - MFT Integrations

Responsibilities:
  • Upgrade of GIS Business processes (over 100 BPML’s) Upgraded to support new Linux environment.
  • Manage MFT project team and off-shore team.
  • Responsible for new project implementations for Managed File Transfers, EDI, B2B, and using Connect Direct, FTP, SMTP, AS2 and other communication protocols.
  • Create integration design documents and configurations to support new upgrades.
  • Create, configure and Seed XML to update or implement changes.
  • Raise Change requests for Production.
  • Provide ongoing support to Business units, Development, production, trading partners and other Toyota teams.

Confidential

EDI Integration Engineer / Project Consultant

Irvine, CA

Responsibilities:
  • HIPAA related EDI development for 837, EDPS, 835 and other EDI processes using Pervasive EDI translator.
  • 5010 Upgrade mapping for new B2B and existing B2B clients.
  • Building XML Schemas with Pervasive Mapping Designer.
  • Development of 820, 834, 837 Claim billing, 276 Status, 834 Enrollment, 835 Claim Payments, 829, 270-278 and many other healthcare maps.
  • Create new Business Processes and Control jobs using Process Designer.
  • Create related database tables using SQL Server Management Studio.
  • Create and update new and existing maps for EDPS implementation.
  • Configure and Implement IBM Connect Direct software.
  • Create communications configurations for Network Map, Nodes and custom processes.

Confidential

EDI Project Consultant

Tempe, AZ

Responsibilities:
  • Development of (SI) Sterling Integrator map V.5.1
  • GIS map conversion to Seeburger BIS(6) application
  • Manage EDI group and off-shore developers.
  • Convert Seeburger BIS(5) to Seeburger BIS(6) and communication protocols.
  • Mapping from IDOC to X12, XML, Flat file, Oracle Database, Inbound/Outbound.
  • SAP configuration of EDI trading partners, B2B Partners, Customers, vendors, etc
  • Full cycle testing and knowledge transfer, process documentation.
  • Work and coordinate with offshore teams.

Confidential

SAP IDOC Implementation Project

Sr. EDI Project Consultant

Los Angeles, California

Responsibilities:
  • Responsible for On-time Project Implementation of SAP IDOC Project.
  • Implement new Banking transactions in SAP.
  • Develop 820 and 824 IDOC transactions.
  • Create ABAP Script to translate inbound/outbound data.
  • Create Custom IDOCS to capture specialized data fields.
  • Work with Basis and FI groups to test in all areas.
  • Create communications protocols.
  • Create and test payment transactions in all SAP environments.
  • Work with Wells Fargo and Bank of America implementation teams.

Confidential

EDI Administrator / SAP ERP Interfaces.

San Diego, California

Responsibilities:
  • Project Management of multiple IT, SAP, EDI implementation projects, Worldwide.
  • Responsible for day to day support and Development of all EDI - SAP and Microsoft Dynamics Interfaces
  • ERP systems worldwide Implementations and support of new releases and support for new releases.
  • SAP partner configurations of distribution models, vendors, customers.
  • Future ERP enhancements and initiatives/ P2P support Global solutions for all SBU’s.
  • Support EDI Subject expert using and supporting, Gentran, SAP, XI, EGATE, BizTalk, Webmethods and many other solutions..
  • Develop and maintain multiple Business process, experience with BPML and GIS BP Modeler.
  • Support and Configure Sterling Order Management solutions.
  • Responsible for EGATE set up, error handling, control of EWAYS, testing, etc.
  • Implementation of new EDI customers B2B partners and planning for Enterprise EDI
  • Manage all EDI related implementation projects
  • New upgrade to GIS from Gentran, responsible for all mapping and business process set up.
  • Responsible for Gentran, INOVIS Trusted link, BizTalk mappings.
  • Experience in Basic ABAP coding with RICEF
  • TLi SAP module configuration.
  • Experience with Business Objects
  • Participated in LEAN and training events.
  • Provide support to BASIS, FI, CRM, Supply chain and other enterprise groups.

Confidential

San Diego, California

Sr. EDI Project Manager and Programmer/Developer

Responsibilities:
  • Responsible for EDI Project Management from Operations.
  • Make improvements and support current EDI architecture, processes in SSIS.
  • Make recommendations to CEO, COO and operations team for new generation and planning for Future EDI growth.
  • Support any Day to Day EDI issues.
  • Meet weekly with EDI team members and review current issues and resolve.
  • Spec evaluation, trading partner issues, overall improvements in all parts such as mapping time to complete, map deployments, EDI issues turnaround time, etc.

Confidential

San Diego, California

EDI Sr. Programmer/Developer

Responsibilities:
  • Responsible for New Worldwide GIS and SAP implementation.
  • Project management and Implementation of GIS and all business process for Customers and B2B clients.
  • GIS, Sterling Order Management and SAP configuration.
  • Configuration of SAP Suite Adapter.
  • Communications, AS2 configuration.
  • Procure to Pay, SCM and other business unit support.
  • Development of over 150 inbound and outbound maps using IDOC’s.
  • Resolve day to day EDI issues.

Confidential

EDI Consultant/Technical writer

Responsibilities:
  • Contracted to evaluate current EDI documentation and create and implement a new format for all applications supported by EDI for Florida Power and Light Company.
  • Responsible for project management of the EDI group.
  • Evaluate current EDI processes and make recommendations in the weak areas.
  • Evaluate DR (Disaster recovery) processes.
  • Review GIS 4.0, BP’s, maps, envelope setups, communication methods and make recommendations where needed.

Confidential

EDI Consultant/Sr. Developer

Responsibilities:
  • Fashion apparel industry Current project responsible for Implementation of Gentran Intergrated Suite - GIS with SAP for 2 major corporations in South Florida area.
  • Manage Project team, Developers and Off-shore support teams.
  • Evaluation of current and propose EDI work flow.
  • Evaluation of current systems including Trusted Link day to day operations.
  • Upgrade from TLE to GIS.
  • Responsible for development of all trading partner maps .4010 and .4030
  • AS2 set up
  • BPML and all trading partner set ups.
  • Configure EDI to work with IDOC and new SAP implementation.
  • Support and Configure Sterling Order Management solutions
  • Coordinate all unit testing.
  • Manage tasks assigned to offshore resources and work in conjunction with several other technical firms.

Confidential

Tamarac, Florida

Sr. EDI-Manager and Developer

Responsibilities:
  • Day to day operations of all inbound and outbound EDI for multi-million dollar gold business, with 98% EDI business. (All major department stores, Target, Wal-Mart, etc). Currently the top producer of gold in the country.
  • Support Production and also manage development
  • Create new maps and business logic for existing and new trading partners
  • Experienced with Extol on the AS400 platform, some RPG
  • EDI programs used were Extol and Trusted Link (TLE).
  • Set up new communication methods to reduce VAN costs, i.e. (FTP/AS2)

Confidential

Medley, Fl

IT/EDI Developer-EDI Project Manager

Responsibilities:
  • Implementation of GIS (Gentran Integration Suite) 3.0 and 3.1 from Gentran 5x
  • Manage multiple IT and EDI development teams and Off-shore teams.
  • Experience with installing Gentran 3.0-5.0 and converting to GIS.
  • Develop business processes and mapping for all existing partners using Sterling Mapping Editor.
  • Testing of all inbound/outbound maps.
  • Responsible for building new custom Business Processes (BPML) within GIS.
  • Analyze and testing of records in Oracle financials from GIS.
  • Extensive use of UNIX, Xsession.
  • Experience using Mapping Editor.
  • Evaluate and create specs for all vendors and Distribution centers.
  • EDI project management

Confidential

Miami, Fl

Senior EDI Developer

Responsibilities:
  • EDI Developer using Gentran Server.
  • Project Manage for all IT and EDI projects.
  • Installation of Gentran and all EDI related updates.
  • Integration from TLE to Gentran Server
  • Experience with Visual, AL Mapper, and mapping editor.
  • Integration of GIS (Gentran Integration Suite) 2.0.
  • Set up of all new partners, mapping, communications, FTP.
  • Provide support to BASIS, FI, CRM, Supply chain and other enterprise groups
  • EDI Gentran / Microsoft Dynamics implementation Support all groups.
  • Perform all testing functions for all new partners.
  • Set up of UCC128 label formats, UPC numbers, web base catalogs
  • Experience with QRS, Commerce Hub, Global Exchange testing and set up.
  • Performed all testing and EDI setup of major partners such as Target Corp, May Company, Federated Group, HSN, Bed Bath & Beyond, Marshall Fields, Sears Merchandising, Kohls Dept Stores, Gottchalks, Toys r Us, etc.
  • Experience with Vsync and Vship.
  • Knowledge of DBASE and Vendor routing guides.

Confidential .

Doral, Fl

EDI Developer/Programmer analyst

Responsibilities:
  • EDI Developer w/Gentran Server3.11-4.0 and Director Experience.
  • Windows NT server, 2000, XP, and SQL Server knowledge.
  • Extensive mapping experience for many inbound and outbound documents. 856,810,850,997,856TL, 315 and many others.
  • Coordinate testing and implementation of new partners and transactions.
  • Administer transmission of all EDI data through VAN and internet.
  • Experience with EDI communications more specifically VAN and FTP.
  • Knowledge of EDI standards and methods.
  • Coordinate testing and implementation, monitor and maintain daily EDI transactions.
  • Experience with Sterling Commerce and G.E.
  • Experience with VPN, C+ +, Visual basic, SQL and many more.

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