As an EDI specialist, I download files with all memberships and analyze all changes being made and new memberships coming into system. This includes checking that all data coming in will be in the correct code for the company system to be able to read it all correctly. I also have to contact health plans about any issues and make sure all issues get resolved accordingly.
- EDI Specialist at MEDPOINT MANAGEMENT
- Uber Driver at Uber
- Surgical Tech Student at Martin Luther King Jr. ASC
- Shipping/Receiving Manager at Casco
7 months at this Job
- diploma - Surgical Technology
• Taking ownership of customer issues reported and seeing problems through to resolution
• Researching, diagnosing, troubleshooting and identifying solutions to resolve system issues
• Following standard procedures for proper escalation of unresolved issues to the appropriate internal teams
• Research and identify solutions to software and hardware issues
• Diagnose and troubleshoot technical issues, including account setup and network configuration
• Ask customers targeted questions to quickly understand the root of the problem
• Track computer system issues through to resolution, within agreed time limits
• Talk clients through a series of actions, either via phone, email or chat, until they’ve solved a technical issue
• Properly escalate unresolved issues to appropriate internal teams (e.g. software developers)
• Refer to internal database or external resources to provide accurate tech solutions
• Ensure all issues are properly logged
• Prioritize and manage several open issues at one time
• Document technical knowledge in the form of notes and manuals
• Analyze, design and develop specifications for enhancements and extensions to electronic data interchange application interfaces and maps.
• Test, implement and maintain EDI transactions.
• Provides technical expertise and support for EDI communications.
• Analyze current implementation in order to make recommendations for improvements.
• Process and monitor all inbound and outbound documents.
• Work with trading partners to resolve any operational issues.
• Coordinate and test all EDI implementations with new EDI partners.
• Administer all receiving and sending of all EDI documents and perform troubleshoot on all processes to resolve all content issues and map problems.
• Coordinate with Third Party EDI party and new Trading Partners to set up new processes and provide optimal level of customer services.
• Collaborate with trading partners and perform tests on all EDI transmissions and maintain all documents for trading partner set ups and analyze all customer requirements for processes.
• Design EDI map documents and prepare all tests data and manage all communication with trading partners and assist to produce all operational documents for all end users.
• Perform troubleshoot and repair all momentum scripts on everyday basis and evaluate all automate improvement processes and assist to internal and external technical staff in data transfer processes.
• Collaborate with all source and electronic data and assist to process all cycle data and monitor everyday production transmissions and assist in electronic data transfer within required timeframe.
- Software Support Engineer\EDI Specialist at EDI Options
- EDI Analyst/Data Analyst at Berman Blake Associates Inc
- Business Analyst Consultant at Y-Axis
- Senior Math/Science Tutor at Best Score Tutoring
7 months at this Job
- B.A. - Computer Science
• Planned, organized and executed EDI trading partner activities. Acted as liaison between PVH IT and Customer EDI team's implementation of new EDI transactions and upgrades. Ensured initial production transactions were processed accurately and data integrity was maintained.
• Assisted in the management of trading partnerships with Third Party Networks (VANS) and EDI UPC catalog in support of customer partnership activity.
• Reviewed EDI control reports, identified error transmissions, communicated issues to customer and followed through to resolution.
• Responded to customer inquiries and notifications of EDI issues. Worked with PVH IT, Customer Service, and W&D to research and resolve issues daily.
• Administered UPC catalog through problem resolution and online updates. Reviewed weekly UPC catalog error reports and implemented necessary corrections.
• Researched EDI related customer chargebacks with goal of identifying and resolving any programming or operational issues to prevent additional charges. Performed excel-based ad hoc reporting.
• Documented and maintained current EDI standard operating procedures. Oversaw daily electronic data process to coordinate FOB moves and brand launches/reassignment specific to EDI and Logistics activities.
• Occasional domestic travel to meet with customers to further the collaborative partnerships.
• Kept current of industry trends via participating in EDI training sessions, conferences and networking.
• Supported Cross functional team enabling on-boarding of new customer EDI partnerships. Partnered with IT regarding EDI requirements to set up new customers and maintain existing customers.
• Researched, tested and implemented EDI trading partner initiatives acting as liaison between IT and customers to communicate all information and resolve issues.
• Reviewed daily EDI reports, weekly UPC catalog error reports, and EDI chargebacks to identify and resolve programming and operational issues.
• Reviewed customer vendor guidelines and EDI specifications disseminating to the appropriate business units to facilitate new initiatives, improve customer relationships and increase compliance.
- EDI Specialist at PVH Corp
- EDI Coordinator at HANRO USA
- Customer Service Representative at L'Oréal USA
3 years, 6 months at this Job
Processed emails, phone calls, faxes and other support communications in a timely and professional manner. Record keeping for audit trail was essential. ⦁ Provided troubleshooting for EDI feed errors and issues.
- EDI Specialist at Superior Vision Services
- Gateway Specialist at SUPERIOR VISION SERVICES
- Group Contract Specialist at New Group Set
- Provider Relations Representative at
1 year, 2 months at this Job
- High school or equivalent - Education
- Some college
Auditing claims to ensure data integrity.
● Ensuring correct sequencing of EDI transaction salong with diagnosing errors.
● Managing Florida CPS penalty Warehouse while coordinating responses with carriers.
● Formulating training documents and leading training exercises
● Attended on-site RFP meetings with prospective clients to demonstrate claim system functionality.
● Attended IAIABC meetings to discuss future claims reporting standards.
- EDI Specialist at York Risk Services Group
- Lake Mary - Claims Examiner II at Sedgwick
4 years, 7 months at this Job
- Bachelor's - Political Science
• Development process ◦ Contribute to an industrial development process to enhance EDI module, terminal OS system, for Total Terminal Internationals at Long Beach and Seattle; Responsible for requirements analysis and beta testing. ◦ Continuously supervise system's stability and enhance system's performance for 10% per year. * Refactoring UNIX scripts and translation maps. * Conduct extensive tests and system quality checking.
• Technical support for EDI module ◦ Oversee, diagnose and repair internal problems in order to ensure the system availability 24/7. ◦ Inspect technical problems and requests from Total Terminal Internationals for port of Long Beach and Seattle and their ocean carriers.
• Data management ◦ Supervise data transmission and backup procedure. ◦ Maintain raw data storage format. ◦ Manage system scripts to clean up and inspect system environment.
- EDI Specialist at CyberLogitec America Inc
- requirement team leader, capstone project at Van Lang University
- software project manager, internship at SDS Vietnam
- project leader, software engineering project at Anh Quan Software Company
2 years at this Job
- - software engineering
- - Software Engineering Group
• Manage electronic data interchange of medical insurance billing
• Prepare and organize patient paper billing claims
• Perform audits on electronic billing throughout the EDI department
- EDI Specialist at LogixHealth
- Research Assistant at Georgetown University
- Private Maid at LS House Cleaning
- Sales Associate/Customer Service at Jo Ann's Fabric and Craft Stores
10 months at this Job
- Master's - Mental Health Counseling
- Prerequisite courses for Graduate School - Psychology
- BS - Fashion Design & Retailing
• Driven, well-developed, innovative thinker and leader with excellent organizational, interpersonal, teamwork and leadership skills
• Identifies opportunities/problems and takes initiative to learn, listen, think and speak up by providing open/honest communication to solve issues
• Motivated towards organizational and personal success by never quitting/accepting less Roche Diagnostics - Indianapolis, Indiana Senior Electronic Data Interchange (EDI) Specialist June 2004-Sept 2007 and March 2010 - Present Analyze, organize, manage and maintains data flow of electronic information entering and leaving Roche communication systems (AS2, FTP, VAN, Frame Relay) and create Trading Partner set up. Responsible for establishing new connections and maintaining existing ones with Trading Partners directly or through third-party, Value-Added Network Organizations (notably, GHX) to drive order automation.
• Team lead and ERP Subject Matter Expert within my department. Technical and Business
• Project management leader experience through cross-functional and inter-departmental testing
• Leading change by fostering new business growth by selling features of EDI to Trading Partners
• Consistently exceeding goals in driving automation alleviating manual order entry
• Leader of Community Partnerships within Roche for the LGBTQA Business Resource Group
• Create and execute all technical FDA regulated documentation to support position and policies
- Senior Electronic Data Interchange (EDI) Specialist at Roche Diagnostics
- Customer Fulfillment Specialist at Roche Diagnostics
- Sales Manager at Digital Communications Technology
- Sales and Catering Coordinator at Radisson Hotel City Centre
3 years, 3 months at this Job
- Masters of Business Administration - Executive Management
July 2011 - Current
• Initiate and maintain EDI/ERA/EFT enrollments for over 50 center locations across several states.
• NextGen system maintenance - involving contract rate changes and implementation of contract escalators and new Managed Care Contracts. New provider additions and changes. Research yearly fee schedules and upload to NextGen. Contract additions to NextGen for Occupational Health.
• Clearinghouse - EDI Specialist - Weekly Clearinghouse calls to coordinate new center's EDI and ERA enrollments.
• Managed Care Liaison to Tenet and USPI - Identify contract underpayments, coordinate with the USPI and Tenet Managed care contracting team to resolve underpayment issues and oversee claims reprocessing project with payers. Assist in identifying areas for new contracting opportunities with the Managed Care team at USPI.
• Oversee Managed Care Contracting updates and changes with our Center Managers.
• AR team staff support for Managed Care Contracting or System related issues.
• Credentialing - Experience with credentialing of new and existing providers with various payers, DEA license renewals, etc. Presently I work closely with our Credentialing team in Brentwood, TN identifying and researching claim denials and rejections for Credentialing issues.
- EDI Specialist/Managed Care Contracting Liaison at CareSpot Express Healthcare
- Collections Representative - Collections Team Lead - Collections Manager at Parallon Business Performance Group (HCA)
- Accounting Manager at Clinic for Kidney Diseases
- Occupational Medicine and Workers Compensation Collections Manager at US Healthworks
7 years, 8 months at this Job
- High school or equivalent
• Manage daily EDI transactions types: ◦ 810, 850, 855, 856, 860, 940, 846, 816, 820, 997 while utilizing a B2B integrated MAS90 system
• Troubleshoot EDI errors
• Document EDI errors while implementing preventative measures
• Correct and retransmit EDI documents as necessary
• Manage the complete order cycle for all orders received via EDI
• Work closely with Sales to resolve inventory issues, cost discrepancies, and shipping delays
• Maintain EDI trading partner cross references
• Enter inventory receipt of goods for goods returned, issuing the appropriate account credit
• Post Invoices daily; provide daily invoice reports to upper management
• Coordinate the return of damaged and/or unwanted goods
• Manage vendor portals for purchase order acknowledgements, routing requests, inventory availability updates, and other important information as it applies to EDI - Amazon's Vendor Central, Kohl's Commerce Hub, Wal-Mart's Retail Link
- EDI Specialist at EPOCA International
- EDI Specialist at Just Play Products LLC
- Inventory Control Specialist/Operations Support at Falic Fashion Group, LLC
- Customer Relations / E - Commerce Coordinator at Urban Decay /Hard Candy Cosmetics, LLC
4 months at this Job
- Bachelors - History