SUMMARY

• Over 7+ years of progressive IT experience as C & UNIX Developer in design, implementation, and testing production environments.
• Hands on Experience in C, C++ and UNIX & Shell Programming.
• Strong development, support and administration knowledge on Oracle, SQL, PL/SQL
• Experienced in Automation using Shell Scripting.
• Good experience in connecting with Oracle database through UNIX command line and using SQLPLUS.
• End - to-End product development, from Research and Design to Production and Support.
• Excellent analytical and problem-solving skills along with good verbal and written communication skills.
• Design & development lead on Claims & Reference - Adjudication, Edits-Audits, and Pricing& Rules Engine modules. This effort involved Pro*C, C, C++, Unix, PL/SQL
• Experience in developing C/C++, Pro*C/Batch programs using Multithreading Programming for handling.
• Strong Knowledge with HIPPA EDI Transactions such as 835, 837(P, D, I) 276, 277, 278 and experienced in creating maps in inbound and outbound EDI interfaces for 810, 850, 855 etc.
• Involved in HIPAA/EDI Medical Claims Analysis, Design, Implementation and Documentation.
• Major work was involved with Inbound and Outbound 837 I and 837 P claims processing systems.
• Having Strong experience on Database & UNIX OS troubleshooting and development experience in Oracle and executed Unit Tests.
• Strong understanding of systems architecture and pattern concepts. C, STL, Multithreading, High Availability, and Shell scripting, all on a UNIX platform.
• Written a PL/SQL procedure to find out the billing details of a Customer for a year by providing customer account no as an input.
• Developed and implemented EDI documents and Clients using knowledge of standards and business systems.
• Conducted tests and enabling customers and carrier partners to send and receive EDI documents.
• Customized patching and maintenance of HPUX, Linux servers on regular schedule.
• Network and Application management software on Windows, Sun Solaris, Linux and HPUX platforms and participated as a development team Member and as well as code reviews.
• Installation, configuration, support of Windows XP/ 7/8/2000/2003/2008/2012/2016 R2 client/server, MAC OS X, many flavors of Linux/HPUX etc.
• Exposed to Medicare and Medicaid domains of the healthcare systems and industry for inpatients, outpatients, Reimbursement Methodology and Medicaid Management Information System MMIS.
• Trained and mentored Junior Medicaid Analyst on the Medicaid mechanisms, policies and procedure and worked with Web site Development teams.
• Managed federally-mandated HIPAA ANSI/EDI transaction format implementations for communicating Claims, Acknowledgements, Remittances & Adjudication / Eligibility inquiries & responses.
• Re-factored and re-engineered the FEP Health Benefits Claims Translation/Adjudication process to meet the New HIPAA compliant Claims System requirements.
• Implemented various requirements stipulated in the HIPAA (Health Insurance Portability and Accountability Act).

TECHNICAL SKILLS

Languages: C, C++, PL/SQL, and MySQL.

Operating Systems: Red Hat Linux (Release 5.9), HP-UX (Release 11i), SunOS (Release 5.10).

Databases: Oracle 11g, SQL Server.

Others: UNIX Shell Scripting, Make file, SAS programming on UNIX, LINIX, Perl Scripting.

Tools: MS-Office suite (Word, Excel, MS Project and Outlook)

PROFESSIONAL EXPERIENCE

Confidential, Madison, Wisconsin

C UNIX Developer

Responsibilities:

• Design and software coding and Enhancing using C, C++, multi-threading, data structure and Algorithms in different OS environments like WINDOWS, UNIX, Linux for Migration Work.
• Developed and Implement code changes using Pro*C, C++, UNIX, LINUX and Oracle.
• Worked on Batch process in claims subsystem that uses Pro*C (C program embedded SQL (Oracle)), DB2, C++ programming, which involved change orders for enhancements and special projects for new implementation.
• Worked with audit teams and provided them with the File system modifications using tripwire tool on various distributions of UNIX.
• Writing shell scripts to automate the administrative tasks and management.
• Created new C/C++, Pro*C/Batch Programs with embedded SQL's, PL/SQL Procedure calls, Arrays and Dynamic SQL .
• Installed and configured ORACLE database on all flavors of UNIX.
• Reviewed codes in Shell Script, C++, PL/SQL & T-SQL; created subprograms, procedures and functions, DB triggers, cursors and optimization techniques for T-SQL.
• Experience in Data Modeling using Erwin Design Tool, Make file creation.
• Generated and DDL (Data Definition Language) scripts using ERWIN 8 and assisted DBA in Physical Implementation of data Models.
• Developed logical data models and physical database design and generated database schemas using Erwin 8.
• Participated in Re-designing of the application from procedural language (C) to C++.
• Base on client requirements upgrading, developing and managing Software Application using knowledge of C++.
• Enhanced the existing UNIX scripts to achieve better performance and highly efficient algorithms were developed through pair programming and the use of SQL server, Oracle for database activities and Oracle Development as well.
• Developed load balancing configuration front end for Windows and UNIX platforms. Configuration file stored as XML document.
• Developed health care related data like Claims, Medical, Risk, Prevention data.
• Experience in HIPAA EDI 834 (Benefit Enrollment), 270/271 (Eligibility/Enquiry Response), 276/277 (Claim Status Eligibility and Response), 820 (Premium Payment), 278 (Review and authorization), 837 (Professional, Institutional, Dental Claims).
• Developed C, Pro*C/Batch programs using Multithreading Programming for handling large volumes of data for parallel processing/load.
• Designed and developed PL/SQL functions/ stored procedures/ cursors/ triggers/ packages.
• Design & development lead on Adjudication, Edits-Audits, and Pricing& Rules Engine modules.

Environment: C, Pro*C, C++, Windows, Unix, Linux, Shell Scripting, SQL and Oracle, Oracle SQL Developer, EDI, Claims, UNIX, PL/SQL, SQL, Quality Center, MS Office (MS Word, MS Excel, MS PowerPoint), Project Work Books(PWB)

Confidential, Hampton, West Virginia

C & UNIX Developer

Responsibilities:

• Participated in Re-designing of the application from procedural language (C) to C++
• Base on client requirements upgrading, developing and managing Software Application using knowledge of C++.
• Enhanced the existing UNIX scripts to achieve better performance and highly efficient algorithms were developed through pair programming and the use of SQL server, Oracle for database activities and Oracle Development as well.
• Developed load balancing configuration front end for Windows and UNIX platforms. Configuration file stored as XML document.
• Developed health care related data like Claims, Medical, Risk, Prevention data.
• Experience in HIPAA EDI 834 (Benefit Enrollment), 270/271 (Eligibility/Enquiry Response), 276/277 (Claim Status Eligibility and Response), 820 (Premium Payment), 278 (Review and authorization), 837 (Professional, Institutional, Dental Claims).
• Developed C, Pro*C/Batch programs using Multithreading Programming for handling large volumes of data for parallel processing/load.
• Designed and developed PL/SQL functions/ stored procedures/ cursors/ triggers/ packages.
• Design & development lead on Adjudication, Edits-Audits, and Pricing& Rules Engine modules. This effort involved Pro*C, C, C++, Unix, DB2, PL/SQL
• Build windows applications using C programming.
• Performed retrieval, decoding and processing of settlement file.
• Evaluated decoded values against the database entries.
• Created UNIX shell scripts to generate reports.
• Created trace in SQL Profiler and used Data base engine tuning advisor for Performance tuning on stored procedures and Scripts.
• Manage HPUX environment through setting standards and infrastructure design
• Primary administrator for all open systems HPUX and Linux.
• Generated all Medicare claims review and transmit to Medicare.
• Review state Medicaid invoices for Fee for Service, MCO, JCODE & Supplemental and log invoices received into Medicaid Control Log
• Processes, reviews and validates all Medicaid rebate claims, ensuring all payments are made within the required timeframes, as stated in the contractual agreements.
• Conducted system integration testing and defect resolution of the HIPAA ASC X12N 837 conversion processes in a testing group setting for various health plan product systems within the Confidential .

Environment: C, Unix, SQL Server 2010, EDI, Claims, Windows XP, UNIX, PL/SQL, SQL, Quality Center, MS Office (MS Word, MS Excel, MS PowerPoint), MS Access, XML.

Confidential, Tampa, FL

C & UNIX Developer

Responsibilities:

• Design and software coding using C, C++, multi-threading, data structure and Algorithms in different OS environments like WINDOWS, UNIX
• Developed and Implement code changes using Pro*C, C++, UNIX and Oracle 10g
• Worked on Batch process in claims subsystem that uses Pro*C (C program embedded SQL (Oracle)), DB2, C++ programming, which involved change orders for enhancements and special projects for new implementation.
• Worked with audit teams and provided them with the File system modifications using tripwire tool on various distributions of UNIX.
• Writing shell scripts to automate the administrative tasks and management.
• Created new C/C++, Pro*C/Batch Programs with embedded SQL's, PL/SQL Procedure calls, Arrays and Dynamic SQL
• Installed and configured ORACLE database on all flavors of UNIX.
• Reviewed codes in Shell Script, C++, PL/SQL & T-SQL; created subprograms, procedures and functions, DB triggers, cursors and optimization techniques for T-SQL.
• Experience in Data Modeling using Erwin Design Tool
• Generated and DDL (Data Definition Language) scripts using ERWIN 8 and assisted DBA in Physical Implementation of data Models.
• Developed logical data models and physical database design and generated database schemas using Erwin 8.
• Developed the claims processing with EDI transactions in HIPPA and HL7 Environment.
• Created standard operating procedure documents outlining EDI best practices for the EDI production system that handles interactive and batch 5010 HIPPA standard transactions.
• Prepared and maintained EDI maps for translating HIPAA 4010 transactions using Softwares.
• Involved in performance monitoring and tuning of TSQL queries using SQL Profiler and database engine tuning advisor.
• Support System Testing, Acceptance (UAT) Testing and Production changes.
• Debugging and troubleshooting production issues.
• Responsible for designing integrated HIPAA and Medicare solutions.

Environment: C, Pro*C, C++, Windows, Unix, Shell Scripting, SQL and Oracle, EDI, Claims, MS Visual Studio 2015, STL, MS-Office, Test cases.

Confidential, Exton, PA

C/Unix/SQL Developer

Responsibilities:

• Analysis of the Functional Specifications and Business Requirements.
• Prepare Design and Development Deliverables.
• Work on the Low Level and High-Level Design Documents.
• Develop the middleware components using C++ and ATL.
• Prepare UNIX shell scripts for testing the application.
• Prepare SQL queries for Sybase database.
• Created shell scripts and updated the scripts as per the requirement.
• Using Oracle SQL Developer for Database Activities.
• Using the best UX strategies (UCD UX, Lean UX, Agile UX) and practices such as Content Management
• Create and maintain the XML schema and collaborate with SOA developers during WSDL creation.
• Assign, review/edit and approve RFPs, consultant questionnaires and ad-hoc requests based on team workload, complexity of requests and deadlines.
• Developed brand new and critical UNIX shell scripts for archiving, restoring and purging data. Implemented in multi-thread approach and process waits approach.
• Perform as Landscape Owner for ERP-based landscapes (HPUX & Linux).
• Experience in design review, Code walk through and test scripts, test cases reviews etc.
• Peer reviews of the Design and Source Code (C, C++, and Shell Scripts).
• Understanding of system and enhancements
• Involved in developing tool to verify and test the performance posted values in performance module.
• Having good knowledge on creation and scheduling of T-SQL jobs and Expertise with job scheduling using SQL Server Agent to perform hourly/daily/nightly updates.
• Used advanced features of T-SQL to design and tune T-SQL to interface with the Database and other applications in the most efficient manner and created stored Procedures for the business logic using T-SQL. Optimized existing T-SQL code
• Support System Testing, Acceptance (UAT) Testing and Production changes.
• Debugging and Troubleshooting production issues
• Involved in developing the business logic tier, performing enhancement and maintenance activities.

Environment: C, C++, Shell, Unix, XML, Shell Scripts, Batch scheduling software and SQL, Oracle 10, HP-UX 11.0, 11.11, 11.23, 11.31