EDI Analyst Resume Samples

Description :

1. Provided help desk support with healthcare EDI transactions and EMQ (electronic media questionnaire).
2. Experience with identity and access management, authenticating users and updating access information.
3. Experience in using tool SQL server database to gather data on various scenarios and analyze data for meaningful results.
4. Data validation and updated client profile on EDI eligibility and enrollment.
5. Performed file tracking for all trading partner sending x12 and flat files.
6. Successfully plan and implemented changes for 2018 benefit implementation for over 58 plans.
7. Experience in using the IBM mainframe to gather data on various scenarios and analyze data for meaningful results.
8. Managed employee information system; conducted monthly data audits to ensure data confidentiality.
9. Created ETL test data for all ETL mapping rules to test the functionality of the ETL mapping.
10. Tested the ETL mappings and other ETL processes (data warehouse testing).
11. Experience in validating responsible reporting entities (RRES), identity validation and access management.
12. Used ETL tool for extraction, transformation and loading the data into a target database.

Experience

2-5 Years

Level

Junior

Education

MSIT

Description :

1. Wrote SQL queries to validate the data integrity of the providers and members database.
2. Worked with core developers to sanitize the big table and remove duplicate entries.
3. Maintained requirement traceability matrix (RTM) to make sure that test plans were written for all the requirements.
4. Created test cases and test scenarios looking at the PLM business requirement documents: benefits requirement documentation, GCP documentation for testing.
5. Involved in facets implementation, end-to-end testing of facets applications like claims processing, provider, subscriber/member, utilization management, etc.
6. Executed test cases for the new market as well as an existing markets various line of business.
7. Used hp ALM quality center11. 0 and as the bug-reporting tool and testing tool.
8. Used hybrid methodology (agile + waterfall) for system integration testing.
9. Worked on the waterfall, v-model, scrum , rational clear quest , and agile sdlc processes.
10. Used select, inner joins, aggregates (sql) to verify data with expected data.
11. Wrote sql queries to validate the actual record with expected record data.

Experience

0-2 Years

Level

Entry Level

Education

BHS

Description :

1. Responsible for onboarding trading partners and implementation of HDMA standards for DSCSA/DQSA asn/856.
2. Responsible for administration of daily commerce operations for EPCIS and ASN supplier on-boarding and transaction data management processes.
3. Gather all the necessary requirements from their 3rd party provider like trace link, Synqware, RFXCEL, sterling commerce, info con.
4. Responsible for gathering internal information from the business unit like (HL code, legacy account number, sap account number, cross reference -XREF) to complete the connection between TPM AXWAY.
5. Responsible for establishing new transaction supplier set-up with electronic programs and on-going error resolution and to ensure efficiency and effectiveness of standard practices and methodologies.
6. Responsible for contacting the trading partner/customers and find their EDI capability. Based on the trading partner needs present EDI solution to them to receive their EDI solutions.
7. Perform customer trading partner onboarding activities including set-up, testing, data validation and troubleshooting in the cyclone and other related environments.
8. Responsible for unit testing internally and then system testing with the customers/trading partner.
9. Identify errors and issues and escalate as required to internal technical and functional staff, third-party networks, external suppliers and internal business partners in support of on-boarding and transaction management processes and initiatives.
10. Maintains daily transaction operations and processes. Monitors day-to-day system messages and alerts.
11. Ability to communicate with the trading partner and implement trading partner certification for all inbound and outbound transaction types.

Experience

2-5 Years

Level

Junior

Education

MSIT

Description :

1. Experienced with EDI system administration with advance mapping skills using ANSI x12 and Edifact standards.
2. Responsible for analyzing, designing and developing functional specifications for enhancements and extensions with EDI application interfaces and maps.
3. Coordinated EDI testing and trading partner implementation initiatives.
4. Monitored, audited and reconciled the transmission and receipt of EDI data in accordance with company policies, procedures, and regulatory compliance.
5. Implemented, maintained and troubleshoot EDI transmissions between CTSI and ITS trading partners.
6. Coordinated and conducted EDI testing with new trading partners by verify trading partners information and set up of EDI transaction sets: 850 purchase orders, 110, 210, 310, 810 invoices, 856 advanced ship notices, 820 transmittal receipts, 997 acknowledgments and various other EDI transaction sets as required by the customer. 
7. Facilitated troubleshooting efforts between the carrier, it supports, and product development groups.
8. Responsible for maintaining and keeping up with progress status for EDI maps, and documentation for each trading partnership.
9. Initiated contact with new carriers and clients to gather necessary information for implementation.
10. Prepared up-to-date specifications, client requirements and sample transactions to trading partners for implementation.

Experience

2-5 Years

Level

Junior

Education

BS

Description :

1. Involved in the project where the system initiates all the necessary procedures, standardizes and validates the data according to HIPAA regulations, and provides error-processing for the transactions that could not be fully processed through the system.
2. Examined initial test files for structural compliance and data quality using 834 implementation guide and in accordance with KP plan specifications.
3. Performed scenario testing on 834 transaction sets for additions, changes, and terminations.
4. Gathered requirements on facets interfaces for 834 benefit enrollment and maintenance subsystems.
5. Performed technical analysis for 834 (EDI file for enrollment and benefit maintenance) 4010a to 5010 version control.
6. Participated in enrollment reconciliation process to resolve data discrepancies with trading partners.
7. Responsible for testing HIPAA EDI transactions and mainly focused on claims and payments transactions and troubleshooting of the entire claim processing issues.
8. Tested daily claims processing and uploading of EDI 837/835, files into the database.
9. Responsible for testing the 837 professional edits testing for 4010 and 5010.
10. Involved in writing extensive SQL queries for backend testing Oracle database. Retrieved files using SQL statements and Unix commands.
11. Enhanced test scripts using various utilities provided in quick test pro like checkpoints.
12. Validated records, the structure of tables, indexes, triggers in tables after migration from facets 4. 31 to facets 4. 81 databases.

Experience

2-5 Years

Level

Junior

Education

MA

Description :

1. Working as an EDI developer team lead for the EDI team size of 8 members.
2. Spearheaded EDI migration from EDIHQ tool to a sterling b2b integrator.
3. Responsible for scope and transaction requirements; manage expectations with trading partner and internal teams.
4. Mitigated team issues by identifying challenges holding meetings with clients and end users.
5. Created maps in ANSI x12 for transactions like 850, 856, 810, 855, 865, 860, 823, 820, 210, 211 and 214. And for Edifact messages like orders, ORDRSP, Iftmin, INVOIC, DESADV.
6. Created SQL DB maps for insertion, updating, deletion to tables and retrieving data from the database.
7. Delivered EDI business processes using GPM, configured services, and adapters in gis and scheduled the BPS.
8. Created as2 profiles, remote profiles for SFTP connections and EDI profiles using identity, transport, delivery channel, doc exchange and packaging records.
9. Managed trusted certificates for as2, CA certificates for FTPS and known host key for SFTP.

Experience

7-10 Years

Level

Executive

Education

B.Tech

Description :

1. Played a vital role in WTX production support. Worked on different applications like ETMS, FGV, SPLUS, GWS, GI, EXE, ts32 on several interfaces.
2. Developed, deployed various maps on production, worked on trading partner setups and adding new launchers.
3. Conducted and documented session for the preparation of logical design documents and physical design documentation.
4. Interacted with a group of SMEs on daily basis to prepare and update the functional requirements documents, prepared non-functional requirement documents (SRS).
5. Worked on 856 - advance shipment notice 214 - shipment status 110- air freight details and invoice, 210- motor carrier freight details and invoice, 810- general invoice, 997- acknowledgment.
6. Worked on various tickets and resolved in a timely manner according to severity level.
7. Spoke to different business partners and provided requested information and monitored the flow.
8. A loaded business requirement, generated reports for the business team into the quality center, monitoring quality center to make sure all requirements are uploaded correctly and ready for the testing team.
9. Worked with testing team for development and provided data from production servers.
10. Participated in the documentation of the requirement traceability matrix and performed gap analysis.
11. Checked from level 3 to 6 compliance of the inbound data by running them through the HIPAA compliance maps provided with the DSTX.
12. Implemented business rules in the maps to check for input errors before generating the output in EDI format.

Experience

2-5 Years

Level

Junior

Education

CE

Description :

1. Fully converted Microsoft BizTalk 2009 to BizTalk 2013 including migrating current setups, remaking data maps, creating document templates for ease of use, and restructuring existing setups to match new agreement and party structure.
2. In-depth knowledge of HIPAA related EDI transactions including 834 eligibility file.
3. Manage EDI connections between northwest administrators (NWA) and healthcare companies including multiple fortune 500 companies (Anthem, UnitedHealth group, express scripts) for client health and welfare trust funds.
4. Setup, implement and test new EDI connections and documents for clients using IOMS applications (Microsoft BizTalk) to transform XML client data extracts into HIPAA standard EDI documents.
5. Communicate and coordinate with multiple departments (software development, accounting, and eligibility, application support, operations) to ensure data within EDI transactions is accurate as well as within the HIPPA standard and receiving the script and schedule jobs using batch files and job-scheduling/ERP software.
6. Create HIPAA transactions and transmit to client SFTP sites.
7. Develop solutions working with IOMS application and internal software developers.

Experience

2-5 Years

Level

Junior

Education

BA

Description :

1. Documenting all EDI solutions for system development life cycle and maintain all documents.
2. Specifications and develop various transaction specifications as per requirement.
3. Working with the technical and development team to resolve identified issues in a timely manner.
4. Reviewing documented training material for accuracy and assist end-user training and support.
5. Maintaining a dictionary of common bugs and typical fixes, such as software and ie bugs and related fixes.
6. Preparing and analyzing defect-tracking reports on existing applications.
7. Participation in all phases of testing. Perform testing and thoroughly document issues.
8. Performing ad-hoc testing on recently developed applications or application components.
9. Participating in all system tests and analyze all data and processes and recommend improvements to same and manage all communication with individuals and internal and external stakeholders and ensure compliance with all policies and procedures.
10. Responding to regular EDI inquiries and troubleshooting issues from internal organizations, trading partners, and vendors regarding healthcare transactions (claims, enrollment, payments).

Experience

2-5 Years

Level

Junior

Education

BBA

Description :

1. Processed during the upgrade from EBI 2.6 to clarify 4.8; designed and created the processes the split of data during the transition from EBI 2.6 to clarify 4.8.
2. Redesigned tXMLxml interfaces between Oracle and EBI 2. 6 to prepare for the eventual move to the JCI standard EDI software; eliminating the need to update and read Oracle tables to meet customer requirements.
3. Reviewed and updated the full extol environment to remove obsolete trading partners, rulesets, and business processes to prepare for the upgrade to.
4. Worked with EXTOL to install extol secure exchange; designed and updated the business processes to meet JCIS requirements to use as2 and SFTP for servers in the DMZ.
5. Updated and tested EBI 2.6 on the new servers when EXTOL was moved to the standard Red Hat environment; redesigned and updated the business.
6. Updated and tested EBI 2.6 on the new servers when the data center was created new business processes and rulesets for new and existing trading.
7. Redesigned the process to handle HCS customers requirements to for drop ship orders; created new processes to handle new types of buying groups.
8. Implemented the outbound purchase orders using oracles e-commerce gateway.
9. Responsible for creating and maintaining the business processes VISIO flows.

Experience

10+ Years

Level

Senior

Education

BA