• Proficient in Microsoft Suite of Products: Outlook, Word, Excel, Access, Visio, PowerPoint, and Project
• System experience in EPIC, HBOC, HealthQuest (McKesson), SMS, AS400, Med Assets/Code Correct, Business Objects, Care Medic, MCMS (Mayo billing system), CERNER (EMR), and the Government VA system.
• Supervised staff up to twenty five. Completed reviews, training, disciplinary action, and hiring/terminations
• Years of experience with CPT and ICD-9 Coding
• Excellent collaboration skills within the department and with all Revenue Cycle departments.
• Excellent Customer Service and communication skills SYSTEM EXPERIENCE
• Epic Resolute Implementation, Maricopa Integrated Health (MIHS). Analyze TEST files for HB/PB products. Examine data elements for correct placement and usage. Identify trends/issues and collaborate with Systems, EPIC, and Billing to resolve.
• HealthQuest (McKesson), Mayo Clinic-Cleveland Clinic. Managed all training project(s) for yearly and quarterly updates. Facilitated the design and implementation of training modules. Worked collaboratively with Systems on the impact of upgrades and possible issues.
• MCMS, Mayo Clinic. Created, tested, and implemented system edits to comply with payer billing requirements and government standards. EMPLOYMENT HISTORY EDI Analyst 2011-current Maricopa Integrated Health System
• Project Lead for Claims Management System vendor review and implementation
• Project Analyst for 5010 and EPIC system implementation
• Identify all 5010 payer implementation criteria and track compliance issues
• Analyze EPIC Test files data elements for payer and 5010 compliance
• Identify all rejection trends and develop processes to correct issues
• Analyze 837, 277, 999, and 835 files and identify trends, rejections, and errors.
• Research and resolve all payer issues
- EDI Analyst at Maricopa Integrated Health System
- Operations Analyst III at Mayo Clinic
- VA Project Manager at OSI Outsourcing
- Billing Manager at Ambulatory Care Affiliates
7 years, 3 months at this Job
- Bachelor of Arts - Arts/English
Buffalo, New York 2018-2019
Global manufacturer and leader in product protection with innovative plastic molded components
Customer Service EDI Analyst
Responsible for proactive business management and customer service of Automotive and Industrial Electronic Data
Interchange (EDI) accounts. Initiate and manage communications, coordination and expediting with assigned accounts.
Determine service, production, and shipment priorities. Act as liaison with Manufacturer's Representatives, handle all
inquiries, provide order status, parts availability, packing slips, invoices, and tracking information. Consult with Sales
Teams on pricing, as well as with Engineers on custom work and Quality Assurance. Provide quotations and follow up
promptly either directly or through the Manufacturer's Representatives. Order Entry of spot buys, sample orders,
quotations, production expedites, calculating lead times, and shipping. Consult with Engineers on technical
specifications of parts. Manage communications with internal stakeholders and the customer. Handle expedites for orders requiring standard or custom procedures. Consult with Account Manager or Supervisor as needed to resolve
customer service or technical problems.
• Prepare daily shipping schedules by reviewing EDI Documents, to ensure accurate cumulative totals, accounting for any daily add-ons or changes of part requirements.
• Responsible for reviewing 139 Automotive and Industrial EDI accounts, ensuring their orders are routed to the correct Shipping Departments.
• Handle EDI Gentran Errors to ensure correct pricing and unit of measure, creating additional ship to accounts, and adding additional dock codes.
• Maintain Cross Reference updates for contracts and EDI Unit of Measure Table. Loading cross reference part numbers into EDI Unit of Measure Table and behind Customer Accounts into Navision 2013.
• Work with Production Teams to establish lead times and availability of materials, and Shipping Departments to expedite parts when needed to meet customer requirements.
• Maintain direct communication with Key Accounts regarding Rescue Trucks, Cube Outs, Expedite Requirements, and Pull Aheads.
• Manage multiple web portals daily for Purchase Order requests, Float Alarms, Pilot Orders, and Critical Shortages.
• Function as strong member of EDI Customer Service Team by regularly auditing internal processes, attending EDI Team meetings, and alternating a monthly on call schedule.
- Customer Service EDI Analyst at CAPLUGS
- Pricing & Rebate Specialist at VERMED, A NISSHA COMPANY
- Technical Customer Service Associate at IVOCLAR VIVADENT, INC
- at IVOCLAR VIVADENT, INC
1 year at this Job
- Bachelor of Science - Forensic Science/Crime Scene Investigation
- Associate in Arts - Humanities and Social Science
72201 EDI Analyst Within a real-time service bureau environment: Responsible for application interface connections between third parties and internal connection points. Analyze, design, and develop specifications for enhancements and extensions with EDI application interfaces and maps including IBM WebSphere MQ, Connect Direct, FTP, execution points and other data linkages used for programmatic electronic data interfaces. Support EDI projects. Maintain EDI industry standards. Monitor and develop MQ settings for IBM Web Sphere connections. Communicate with vendors regarding ports, IP addresses, and services requested. Maintain logins for EDI and user account interfaces. Develop scripts to process EDI artifacts. Configure Connect Direct (NDM) PROCS and other settings for EDI transmissions. Configure FTP settings for receipt and transmission of EDI artifacts. Develop monitoring or configure existing monitoring tools for EDI interfaces. Troubleshooting of complex issues On Site Client Installs.
- EDI Analyst at CSS Hosted Solutions
- Operations Analyst at CSS Hosted Solutions
- Computer Operator at Stephens Inc
1 year, 2 months at this Job
YRC Freight is the leading transporter of industrial, commercial, and retail goods, specializing in solutions for businesses across North America through a full-service network, advanced information technologies and proactive customer service.
The YRC Freight EDI team supports the standard EDI transaction sets used to make administrative tasks related to shipping more efficient—from paying shipping charges to filling orders and replenishing stock. The EDI communication team provides supports for direct connections via AS1 (SMTP), AS2 (HTTP), or FTP, which eliminates VAN use. The transmission of EDI documents carried using WebMethods. Our Translation team supports EDI transactions like 204 (Load Tender/Pickup Notification), 211(Bill of Lading), 210(Electronic Freight Bill (Invoice)), 214 (Shipment Status Messages), 820(Remittance Advice) and 997 (Functional Acknowledgement) using Gentran Basics 6.0 on mainframe platform and on Sterling Integrator 5.2.5 on the open system platform.
The major involvement in the strategic projects to migrate from the legacy system to open system. I have acted as one point of contact for the new architecture design on the Sterling Integrator administrator, integrating all the existing feature of the legacy application and introducing new features of applications for the future business usage. ***My Unique Impact on the Project:
• Prior experience on both the system, using Gentran Basics 6.0 on mainframe legacy platform and Sterling Integrator 5.2.5 on the open system platform is an added advantage.
• Experience of Java, Unix, mainframe is a perfect blend to deliver seamless integration solutions for the system.
• Experience in previous Agile project management, PMP and ITIL is adding spice to day today work to understand the business need and management priority.
• Good Listener, In-time delivery, honesty, agility to changes are my strength in this project which made my position unique in the team and keep extending my tenure at this client site. Roles and Responsibility: Senior Business Analyst
• Responsible for documenting and communicating the standard documentation changes.
• Acts as IT's representative on technical issues and decisions related to EDI platform/project
• Actively Participate in restructuring the architecture
• Identifies and assesses areas of functionality that can leverage existing tools, applications and services.
• Participate in Requirement Gathering, Understanding Customer Requirements & documenting
• Estimate level of effort for work requests as well as assess the feasibility and compatibility with other systems.
• Mapping these Requirements to the Product Functionality
• Participates in all phases of the development lifecycle including analysis, design, development, testing, code reviews and documentation as needed.
• Participates in the development and/or integration of architectural level components
• Communicate with the Trading Partner SME to establish the communication channel for EDI document exchange.
• Actively Participate in Trading Partner on-boarding process.
• Actively participate in the certification testing; communication testing and end-to-end Trading Partner EDI document interchange testing with the External Trading Partner SMEs.
• Document and communicate the successful process and any best practices.
• Auditing and monitoring of EDI processes including; reporting, monitoring application files and debugging translation errors.
• Provides regular status reports to management
• Responsible for directly supporting the EDI needs of the TP business.
• Response to the issuer day-to-day queries, perform analyses, and present findings.
• Participate in a rotational on-call productions support responsibilities. Environment: IBM Sterling Integrator 5.2, UNIX, GENTRAN Basics 6.0 on Mainframe Platform, WebMethods, COBOL, CICS, VSAM, JCL, EDI X12 Transactions (204,211,214,820,210).
- EDI Analyst at
- EDI Analyst at NYSOH Health Exchange Benefit Enrollment
- EDI Analyst at Capital District Physicians' Health Plan
- EDI Analyst at Capital District Physicians' Health Plan
4 years, 10 months at this Job
- Bachelor of Engineering - Electrical
Responsibilities (Level 3 support) Lead EDI Analyst with SAP. Have been integrally involved in migrating 3 of our plants to SAP. This involved working with local plant IT to fine tune requirements for maps, teaching how to interact with the new EDI process and also how to setup in SAP necessary EDI items. Outside of migration projects on a day to day basis: working with Plants to coordinate the on boarding of new customers and suppliers. SAP SD t-codes: WE20, OVAI, OVA9, VOE2, VOE4, VL03N, VT03N, VD03, EMFOR, EMORD, EMASN, ZACS_ASNMON are all used on a regular basis. Approving EDI related changes for the rest of the team from level 2 and level 1. Production Support. Liaison with our EDI host, Open Text. SAP EDI and SD related transactions in sap. Create Mapping specifications to match IDOC fields with EDI fields, testing with Customers and Vendors in Edifact, X12 and VDA formats for Purchase Orders, Releases, JITS, ASN's, Invoices. (850, 855, 830, 862, 856, 810)
- Lead EDI Analyst at Private
- SENIOR EDI IMPLEMENTATION CONSULTANT at Edifecs
- EDI ANALYST at FEDERAL-MOGUL
- EDI DEVELOPER at CENTRAL TRANSPORT
3 years, 6 months at this Job
- Bachelor of Science in Computer Information Systems - Computer Information Systems
• Implement EDI
- EDI Analyst at Truck Hero
- Senior EDI Business Analyst at The Wasserstrom Company
- EDI Technical Lead at Worthington Industries
- Senior Program Analyst at The Scotts Miracle-Gro Company
2 months at this Job
- BSEET - Electronic Engineering
• Check the data flow between suppliers and clients
• Correct error on the exchange of data
• Retrieve and provide data to client
• Prepare monthly metrics
• Work with several EDI Messages for ANSI and EDIFACT
• Request EDI Map changes
• Request new EDI Setups
• Work with the EDI implementation for new customers
- EDI Analyst at Penske/Delphi
- Systems Analyst at Penske/Delphi
- Sales Representative at University Ticket Center
3 years, 2 months at this Job
- Master of Business Administration - Business Administration
- Bachelors of Business Administration - Business Administration
- Associates of Arts
Detroit, MI (Contract) Jun'17 to Till Date
Projects: EDI Applications Production Support & New system implementation
Role EDI Analyst Sr/Developer Responsibilities:
• Analyzed Health plan Enrollment and Maintenance ANSI X12 834 and Premium Payment ANSI X12 820 file specifications under HIPAA framework for ACA Affordable Care Act for Medicaid 834 files (4976, 5790), Exchange 834 files and Commercial groups Enrollment 834 files.
• Prepared implementation plan and negotiated agreement on EDI file specifications with Trading Partners and vendors in accordance with HIPAA guidelines.
• Interfaced with technical staff, trading partners, Clearinghouses (SDS, Change Healthcare/Emdeon, Ingenix, NETWORKS) and internal staff including programmers on HIPAA related information and changes.
• Created reports and system design change requests and workflows affecting Medicaid processing in compliance with Government Compliant Process.
• Worked with various vendors like Delta Dental for Dental benefits for Medicaid members, EnvisionRX for drugs benefits, Beacon Health for mental health benefits.
• Worked on EDI Portal from its inception to completion and then support it.
• Performed EDI technical and operational customer support to trading partners and customers related to their operational and business needs, requirements and issues.
• Extensively worked on create maps using Altova Mapforce to convert data in different file layouts.
• Good knowledge on automate jobs using Altova Flowforce to run reports or file creations as per specific requirement.
• Experience with the Altova Mapforce tool to map XML files to SQL Server database.
• Utilizing Altova's MapForce performed various data mapping tasks based on client specific needs.
• EDI development using Altova Map Force Oracle database.
• Worked on EDGE server (CMS) XML files using Altova XML spy.
• Experience with Edifecs testing tool to validate a test file against the base HIPAA.
• Used EDIFECS SpecBuilder for updating Guides, Maps. Analyzer, Translator and Data Explorer used for various EDI ANSI transaction 834, 837I/P/D, 820, 999, 276/277 to analyze and create test data or resolving issues.
• Monitored production jobs in EDIFECS Xengin/eam and trouble shoot production job issues.
• Worked on Professional, Facility and dental Encounter submission to state.
- EDI Analyst Sr/Developer at Total HealthCare
- System Analyst Sr at Blue Cross Blue Shield of MI
- at Blue Cross Blue Shield of MI
- Business Analyst Sr at Blue Cross Blue Shield of MI
1 year, 9 months at this Job
- Masters of Computer Applications - Computer Applications
- Bachelors of Arts
• Support, maintain and monitor all electronic transactions, ensuring efficient functioning of electronic data interchange and compliance of all EDI communication. Ensure operational readiness for new products and new market entries by planning, recommending, testing, and implementing processes or data aggregations that produce accurate customer invoices
• Programmed Electronic Documents following the EDI Standards for both inbound and outbound Documents, 80K Customers. Documents included 810, 820, 814,867HU, 824, using Microsoft Navision Lanham EDI solution
• Using Gentran mapping utility, a translation map from EDI data to Excel documents for 810, 820, 824 invoice documents. Tracking invoices of accounts payable and receivable
• Research new market requirements and map with existing systems.
• Monitor EDI/XML transactions, process failed transactions and resolve missing acknowledgments
• Ensure all transactions comply with EDI standards with internal systems -Also Worked with Hiring Manage & Director of Operations
• Conducting Preliminary interviews and choosing good candidates for digital marketing team, customer service, and Billing department.
• Scheduled meeting for second round interviews with CEO and candidates.
• Trained New Hire for Customer service department, Data Entry, and EDI department. -Started as Data Entry and Reporting specialist for Customer Service Department and Compliance Department
• Manage Reporting from MIS Access, SUGAR CRM database for customers that requested to activate, deactivate services, or needed price change of rates for their electric or gas accounts, with their utility company.
• Maintained records and tracked customer's refund check send wire payments to Coned and other utility companies, and also direct pay to National Grid customers.
• Worked with Book keeper and Billing department ensure company compliance and customer refunds are resolved.
- EDI Analyst at MPower Energy LLC
- Administrative Secretary at J&D Auto
6 years, 9 months at this Job
- Bachelor's - Business Administration
- Associates Degree - Business Administration
Serves as primary contact between Harvard Pilgrim Health Care and EDI trading partners for information, status and opportunities regarding eBusiness transactions, eBusiness direct channels, HPHConnect branded web-portal, and HIPAA requirements for EDI transactions and eBusiness channels.
• Performs registration, enrollment and authorization tasks as needed to ensure timeliness of production work or effectiveness of trading partner HIPAA transaction testing and implementation.
• Provides second tier support services to trading partners regarding questions, issues and strategies related to 837 claims submission, 835 and EFT remittance advice receipt.
• Maintains current and thorough knowledge of EDI transactions. Acts as subject matter expert regarding provider EDI transactions, brings this knowledge to enterprise and team based projects. Leads team based projects as required. Perform out-of-the-box thinking, collaborate with others, creates ad-hoc reports and make a difference every day.
- EDI Analyst at Harvard Pilgrim Health Care
- Staff RN at WEBSTER PARK REHABILATION AND HEALTHCARE
- Senior Systems Administration Analyst at ENERGY SERVICES GROUP
- Staff RN (Per diem work) at OLD COLONY CORRECTIONAL CENTER
6 months at this Job
- Bachelor of Science - Marketing
- Associates Degree - Nursing