Sr. EDI Analyst/Developer Resume

SUMMARY:

Seeking an EDI or business analyst career opportunity where my experience, education and related skills can be an asset to the company.

TECHNICAL SKILLS:

PROFESSIONAL EXPERIENCE:

Confidential

Sr. EDI Analyst/Developer

Responsibilities:

Created and submited encounter claims to trading partners for state reporting purpose on a monthly basis.
Worked to correct the response files from state. Setup new 834 and 837 connections, including testing and continue support post implementation.
Brought in state provider file and created custom provider file sending back to health plans.
Created custom reports by modified existing stored procedure in PL/SQL.
Troubleshoot and corrected errors arise with processes.
Processed 837 file submission from clearinghouses and ensure 277 sent out to on a daily basis.
Responded to client s when they need assistance on rejected claims.

Confidential

Customer Care Analyst

Responsibilities:

Provided an excellent customer experience for vendors, by analyzing, developing, collaborating, communicating, anticipating and resolving issues in a timely manner for electronic scripts transmission issues.
In addition, managed and provided support for all MN transactions cases which include 270, 271 and Med History within Customer Care team.
Worked with variety of file formats such as HL7, ANSI X12, EDIFACT, and XML.

Confidential

Sr. Implementation Analyst

Responsibilities:

Ensure providers to receive their 835s which include but not limited to new enrollment or re - enrollment, test data, set up configuration records, researching on missing remits and improper syntax file from payer.
Convey information between providers and payers to resolve issues in a timely manner.

Confidential

EDI Analyst

Responsibilities:

Responsible to setup new inbound mapping for image claims.
Troubleshoot and researched all payer related issues for ANSI X12 4010 (837, 835, 276/277) ranging from missing reports, claims not on file, rejected claims, and rejected 997 and resolved issues in a timely manner.
Cleaned up six months back log in a month time.
Worked with payer to place proper edits saving clients thousands of dollars.
Wrote user requirement and documentation on various working processes.

Confidential

Business Analyst

Responsibilities:

Setup new accounts and responsible for designed, development of specifications and testing per client s custom detail.
Maintained and managed web access database.
Reviews, recommends, and implemented activities related to assigned tasks.

Confidential

EDI Analyst

Responsible for all new clients setup which included transferring electronic files (835, 837 I and P) to meet each individual payer s system requirements.
Maintained a positive relationship with payers for EDI (Claim/837 ANSI X12 transaction sets) and ERA(835) setup.
Troubleshot and researched on missing or error files and resolved issue in a timely manner.