SUMMARY

• Over 7+ years of experience in the analysis, development, unit testing, trading partner testing, and implementation of EDI - Integration applications that involves the complete Software Development Life.
• Highly Experienced in HIPAA (Health Insurance Portability and Accountability Act), Health Care, Supply chain, Logistics, Retail, industry providing Business Process Assessment, Requirements Gathering, Gap Analysis, Implementation and Testing.
• Experience in Migrating Trading Partner setups with Communication setups to Sterling Integrator 5.1 (GIS) from Gentran Server for Windows.
• Strong experience in the analysis, development, unit testing, trading partner testing of EDI - Integration applications that involves the complete Software Development Life cycle from Analysis, Design, Testing & Implementation.
• Proficient in creation, modifications, testing of envelopes, maps, business process, service/adapters and AS2/FTP communications. Worked on Migrating Communication setups (AS2, FTP), Envelopes and Maps from GIS 4.3 to SI 5.1.
• Experience in Migrating Trading Partner setups with Communication setups toSterlingIntegrator5.1 (GIS) from Gentran Server for Windows.
• Strong experience in development and implementation experience in EDI ANSI X12, HIPAA, VICS, UCC, EDIFACT, XML, Sterling Integrator, Sterling’s Gentran Server on UNIX, Gentran Integration Suite (GIS), GXS Application Integrator Workbench, GXS Enterprise Gateway & XML/XSLT applications.
• Highly Experienced in HIPAA (Health Insurance Portability and Accountability Act), Health Care industry providing Business Process Assessment, Requirements Gathering, Gap Analysis, Implementation and Testing.
• Expertise in Design, Development and Implementation of Integrated SAP EDI applicationsand Seeburger.
• Installed Sterling File Gateway and configured community, partners, groups, mailboxes, Channels and templates. Added new file gateway protocol for FSA handling. Added Connect Direct protocol handling
• Experienced in EDI implementations, New EDI Map Development and Testing, Standards Upgrades, Translator Upgrades, Conversions to New ERP Systems with Gap Analysis for New systems and EDI Re-Certification Testing. On Boarding of EDI Trading Partners, 24x7 Production support.
• Trading Partner set up in SFG. Configuration sssh2 connectivity methods, authentication certificates
• Work on 837 and 835 projects, including syntax and business rules for X12 HIPAA 4010 and 5010 validation for loops, segments, elements, qualifiers and code sets.
• Experience in working with EDI Transactions X12 - 835, 837, 270, 271, 276, 277, 278, 204, 210, 214, 404, 410, 834, 810, 820, 830, 832, 850, 846, 855, 856, 857, 940, 943, 945, and 997
• Retail and Supply Chain Management experience with EDI transaction sets, 810, 880 (invoices), 832 (Price Sales Catalog), 846 (Inventory Inquiry/Advice), 850, 875 (Purchase Orders), 852 (Product Activity Data), 855 (Purchase Order Acknowledgment), 856 (Advanced Ship Notice/Manifest), 860 (Purchase Order Change Request), 867 (Product Transfer and Resale Report), 870 (Order Status Report),940, 943, 945, (Advice Transaction Set), 997 (Functional Acknowledgement), and 820 (Payment File).
• Developed Maps to and from trading partner’s to Internal Order Management applications (SAP IDOC’s) in supporting Delivery Order, Goods Receipt, ASN etc
• Health Care Industry experience with HIPPA Compliance EDI documents including EDI transaction sets: 270 Benefits inquiry, 271 Benefit info, 276 claim status request, 277 Status Notification, 278 Service Review, 834 Benefit enrollment, 835 Payment Advice, 837 Claim form. Good understanding of 5010 upgrades to support ICD-10 code Compliance.
• Create export and XML processes for Lotus Notes. Create EDI Export and Import processes and work with EDI Trading Partners, Payers or Vendors. Perform a range of telecommunications processes, including FTP, Dial-up, TCP/IP, Web transfers.
• Manage the requirements and selection for Trading Partners and Vendors. Schedule conferences, JAD sessions, participate in negotiations, set/create/resolveEDITP issues and create draft points for corporate meetings.
• Development or oversee others in developingEDISpecifications, Test plans and/or companion guides forthe 837 Institutional, 837 Professional, 837 Dental,835,820, 278,270/271, 276/277, others. Test plan design, from stage to production, including both internal and external requirements.

TECHNICAL SKILLS

EDI Standard: EDI X12 (ANSI), EDIFACT, XML, VICS, BPML, SAP IDOCS, SOAP, ROSETTANET.

Transaction sets: 835,837,270,271,276,277,278,204,210,214,410,834,810,820, 830, 832, 850, 846, 855,856,857,862,879,875, and 997

Application Server: Sterling Integrator 5.0/5.2 (GIS 4.2/4/3), Sybase EC Map, EC Gateway, Gentran on Unix 5.2,5.3,6.1.

Programming Languages: SQL, PL/SQL, C, Java, Cobol, Unix Shell Scripts (Korn/Bash), XSLT

Web Technologies: XML, HTML, XSLT, Web services (SOAP, WSDL, UDDI, REST)

Testing Tools: QTP 9.2, Quality Center 9.0/Test Director, Win Runner 7.5, Load Runner 7.8, Rational Clear Quest, Claredi

RDBMS: Oracle 8i/9i/10g, MS SQL Server 2000/2005, DB2, MySQL, Toad

Development Tools: Ab initio, Cognos Report net, SeeBurger

Operating Systems: Windows Server 2003/2000/NT, MVS, UNIX, LINUX

Packages: MS Office, CVS, PVCS, adobe master collection

Network Protocols: FTP, HTTP, SFTP, SMTP, AS2, Connect Direct, Cyclone, VAN

Other Tools: PUTTY, WS FTP, UltraEdit, Telnet, control - M, EDIFECS Tools

PROFESSIONAL EXPERIENCE

Confidential, Gainesville, FL

EDI Developer

Environment: IBM Sterling B2B Integrator, SQL Explorer, Confidential ’s own technology system to generate and transfer data to clients using ANSI X12, 837, 834, 835, 820 transactions.

Responsibilities:

• Internal and customer specifications for eligibility, healthcare claims, and financial transactions to create and support data exchanges in ANSI ASC X12 (e.g., 837 Professional, 270/271, 820, 834, 835) and proprietary formats.
• Using trading partner specifications create the necessary mappings to fulfill the interface requirements between Confidential ’s enterprise application and trading partner systems by applying analysis techniques and procedures
• Analyze, review, alter, test, and document custom EDI applications toadapt to new requirements.
• Develop and exercise business interface use cases, performance testing, regression testing, user acceptance testing, and end-to-end integration testing to deliver comprehensive EDI solutions
• Use SQL queries to extract data and use custom mapping to transformit to meet partner interface requirements
• Adhere to development guidelines, coding standards, projectobjectives and schedule.
• Create new export definitions coded by using Macro software language in Confidential ’s own technology environment for encounters and member imports sent to and received from clients
• Generate and maintain process flows and procedure documentationrelating to EDI interfaces
• Create maps using Sterling Integrator and business processes with drag-and-drop technology
• EDI 834 (enrollment/benefits), 835 (claim payment), 837(the claim billing)

Confidential, McLean, VA

Sterling Integrator

Environment: FileZilla, VPN Connection, HICS Website, SharePoint, CMS Portal, SOAP UI Testing, FTP Sites, ACA, FFM, ANSI X12, 834, 820

Responsibilities:

• Deal with HIPAA transactions and EDI 0 transaction set data
• Extensively involved in documentation of Implementation guide summary sheet.Implemented HIPAA/EDI Transactions like
• Develop Business and Technical Requirements for 834 and 820 transactions
• Monitored daily EDI and case analysis activity ensuring that the business ran appropriately.
• Responsible for the daily production support and on-going development of the EDI business process & 1095A Dispute Analysis cases
• Involved in HIPAA Certification process of 834& 820 using HIPAA guidelines.
• 1095 Affordable Care Act A, B, C (ACA Plans)
• Validate IRS 1095A data from the Federal Facilitated Marketplace (FFM)
• Validate effective and termination dates with Centers for Medicare and Medicaid Services (CMS)
• Excel to repository and put notes in, and send back thru SharePoint
• SOAP UI testing to EDI file
• Work on accurate data flows in retrieving data, testing, analyzing and resolving cases
• Deal with HHS
• Document and perform Technical, Business, and 1095A Dispute Analysis cases on implementations, fixes and enhancements.
• Participation in all phases of testing
• Perform testing and thoroughly document issues
• Work with the technical and development team to resolve identified issues in a timely manner
• Assist in end user training and support about how to ensure to deal with business processes, protocols, flow of data in analyzing 1095 Dispute Analysis cases and reach to result accurately
• Deal with Enrollment Business Process
• Retrieve data from various databases and places requesting to analyze the data accurately to place them into daily 1095 Dispute Analysis cases and give reports at the end of the day
• Support management to enhance the project quality and effectiveness when competing with time
• Testing EDI transactions and moving into production. Involved and resolved analyzing and production issues

Confidential, Omaha, NE

EDI Developer

Environment: Sterling Integrator 5.0/5.2, Gentran Server on Windows, GIS 4.2, SQL, Biz manager, Sterling Integrator QSS, Unix, UltraEdit, FTP, XSL, MS Access,, GXS AI & Enterprise, GXS Enterprise Gateway,GXS Trade guide

Responsibilities:

• Responsible for creating technical and functional mapping specs and converting the maps from Sybase EC mapper to AI mapper using Map Editor.
• Worked on EDI Implementation with new trading partners using Gentran Server on Windows.Did performance tuning and enhancement/scalability of Gentran Server.
• Performed migration of maps, BP's, service configurations, and adapters from Gentran Server to Sterling Integrator.
• Experience in Migrating Trading Partner setups with Communication setups to Sterling Integrator 5.1 (GIS) from Gentran Server for Windows
• Review EDI Integration requirements and develop technical configurations, physical mapping, communication protocol setups and application support.
• Develop and program integration programs using procedural language, standards compliance, and mapping syntax.
• Work on developing logical mapping for new trading partners, setup mailboxes, develop cross references, and store inbound and outbound data files.
• On boarded new partners using SFG 2.2 (SterlingFileGateway).Created partner profiles, routing templates and routing channels in SFG.
• Customized generic SFG business process to enhance the functionality to meet different partner requirements.Migrated existing AS2, SFTP partner’s communications to SFG.
• Experience in Troubleshooting of EDI and IDOC related Errors and creating pride tickets and re-processed the IDOC’s in SAP.
• Creating Maps for Purchase Orders (850), Advanced ship notices (856), Invoices (810), Price/Sales catalog (832)
• Inventory inquiry (846), Vendor Managed Inventory (855), and Order Status inquiry/response (869/870), EDI Bookings(300,301)
• Responsible for Set up the new trading partners(communities, AS2, Code Lists etc) in Sterling Integrator. Created Application Integrator maps for 850, 810, 856, 846 and 852 etc.
• Created TP setup for new partners, involved in development and testing.Configured and tested various communication protocols FTP, SFTP, AS2, JDBC, and JMS adapters
• Testing all EDI transactions and moving into production. Involved and resolved production issues.
• Extensively involved in documentation of Implementation guide.Implemented EDI Transactions like 850,810,994,995,820.
• Setup partner profiles, setup of EDI as an application output, RFC calls setup and monitoring from GXS to SAP.
• Implement and test inbound and outbound flows from GXS to SAP OTC. Create and test mapping specifications and GXS mapping objects.
• Created BPML design, data translation, and transformation mapping, Business workflows using Business Process Modeling Language (BPML) within Sterling Commerce.
• Involved in migrating TP’s from FTP to SFTP, SSH, AS2, AS3, HTTP, HTTP/s protocols.
• TP set up, onboarding new partners, development and QA testing, monitoring business processes and troubleshooting failed processes.

Confidential, Tampa, FL

EDI Developer

Environment: Sterling Integrator 5.0/5.2, Gentran Server on Windows, GIS 4.2, SQL, Unix, UltraEdit, FTP, XSL, MS Access

Responsibilities:

• Extensively involved in documentation of Implementation guide, Payer/Payee summary sheet.Implemented HIPAA/EDI Transactions like 834,835,837,276,277.
• Involved in HIPAA Certification process of 835 using Claredi online system using HIPAA guidelines.
• Develop Business and Technical Requirements for all5010EDItransactions: 270, 270, 276, 277, 278, 820, 834, 835, 837i, 837p, and 837dand unsolicited transactions (271U, 277U)
• Design logical and physical documentation for the XML-to conversion and web clearinghouse.
• Extensive hands on experience in AFT and MFT. Developed and implemented managed file transfer(MFT) partner communities, routing rule set, route provisioning using Sterling File gateway(SFG).
• Created configurations for mailboxes, users, profiles, and auditing for Managed file transfer(MFT) using SFG.
• Experience in implementing Managed File Transfer (MFT) applications to support FTP/SFTP, HTTP, and AS2 file transfer protocols.
• Configured partner profiles for both inbound and outbound for various partners
• Created and tested Scripts for the premium calculations and Claims limits and deductibles (Claims calculations).
• Analyzed and testedthe user interface and constantly redesigning the system to increase its user friendliness for the clients.
• Implemented SDLC which included requirements, specifications, design, analysis and testing utilizing RUP methodology.
• Training in BPML design, data translation, and transformation mapping, Business workflows using Business Process Modeling Language (BPML) within Sterling Commerce.
• Involved in migrating TP’s from FTP to SFTP, SSH, AS2, AS3, HTTP, HTTP/s protocols. TP set up, onboarding new partners, development and QA testing, monitoring business processes and troubleshooting failed processes.

Confidential, Kansas City, KS

EDI Analyst/Developer

Responsibilities:

• Responsible for the daily production support and on-going development of the EDI business process & systems for client of EDI Consulting Services.
• Creating Maps for Purchase Orders (850), Advanced ship notices (856), Invoices (810), Application Advice (824), Price/Sales catalog (832), Inventory inquiry (846)
• Text Message (864), Reports for Test results (863), PO change Req Acknowledgement (865), Vendor Managed Inventory (855), and Order Status inquiry/response (869/870), 940, 943, 945, (Advice Transaction Set), 997 (Functional Acknowledgement)
• Developed Maps to and from trading partner’s to Internal Order Management applications (SAP IDOC’s) in supporting Delivery Order, Goods Receipt, ASN etc.
• Responsible for the complete design, development and Implementation of 850, 846, 204, 990, 214, 210, 997, 940, 810, 820, and 856 transaction sets.
• Creation of implementation guides to document detailed exchange requirements such as structures, timing and business rules (GAP analysis documents.) Creation of application layout files
• Used SAP transactions BD87, WE19, W05, W02, WE20 to process inbound and outbound IDOCS through RFC
• Set up new trading partners and maintain existing partners
• Developed SQL queries to interact with the lifecycle database and provide monthly capacity reports reflecting on the utilization of EDI infrastructure.
• Developed and upgraded EDI maps for transactions 810, 820, 830, 832, 850, 852, 855, 856, 857, 864, 867, 875, 879, 880, 940,943,945 and 997 using the map editor. Maps created were for both inbound and outbound trading partner relationships.
• Performed Unit and system testing on all EDI transactions both inbound and outbound.
• Responsible for Set up the new trading partners(communities, AS2, Code Lists etc) in Sterling Integrator. Created Application Integrator maps for 850, 810, 856, 846 and 852 etc.
• UNIX script writing for both communicational and file handling
• Maintenance of EDI Documents, data managers, and Gentran life cycle Database.
• Configured and tested various communication protocols FTP, SFTP, AS2, JDBC, and JMS adapters.
• Set up and configured the AS2 communication protocol for exchanging the EDI documents for trading partners with digital Signature.
• Collaborated with SAP, Sterling Commerce and Business teams to facilitate EDI changes. Worked with (810 invoices, 850 purchase orders, 855 PO Acknowledgement, 860 PO Change req.), using GIS software 4.3 in a Unix environment.
• Provided Support for AS2 and TCP/IP connectivity. Defined all test cases to satisfy each business requirement for the application being tested, combined test cases into test scenarios.
• Write and executed test plans, ran load testing and recorded results. Queried data to validated results.
• Tracked and resolved issues identified in testing. Documented and updated and organized all testing materials according to defined procedures.
• Produced high quality documentation. Provided 24/7 support as needed.

Confidential, Seattle, WA

EDI Business Analyst

Responsibilities:

• Document and perform Technical, Business, and Trading Partner Analysis on implementations, fixes and enhancements.
• Define problems & solutions at Country/Region, Trading Partner, and Global levels. Initiate prioritization process and obtain Business support for changes.
• Handled requests for proposals, making presentations to customers, and negotiating project timelines and deliverables.
• Involved in creating test cases forEDI837 Claims (I & P) Transactions.
• Designed and implemented MainframeEDIsystem utilizing ANSI X12 standards.
• Developed detailed Use Case to describe the functionality of the system including claims transactions.
• Created different Trace ability views to maintain the Trace ability of the requirements.
• Identified gaps between current policies and procedures and new HIPAA 5010 compliance and developed an action for the migration process.
• Tested the ANSI X12 Version 4010 /EDItransactions (HIPAA) for Claims Status and Eligibility (270, 271, 276, 277, 834, 837P, 837I, 837D, 835 remittances and NCPDP Claims).
• Created and tested Scripts for the premium calculations and Claims limits and deductibles (Claims calculations).
• Analyzed and testedthe user interface and constantly redesigning the system to increase its user friendliness for the clients.
• Implemented SDLC which included requirements, specifications, design, analysis and testing utilizing RUP methodology.

Confidential, Dublin, OH

EDI Analyst

Responsibilities:

• Converted maps from 3010 versions to new version (4010 & 4030).
• UNIX script writing for both communicational and file handling.
• Involved in creating new Trading Partner.
• Implemented other EDI Transactions like 810, 812, 820, 850, 856, and 997’s.
• Worked on integration with new trading partners using GENTRAN: SERVER for UNIX 5.1v.
• Maps were created in 5.3 version upgraded to Gentran server 6.0 version.
• Verified data formats in new version of Gentran server.
• Modified maps to support newer versions
• Creation of application layout files
• Maintenance of EDI Documents, data managers, and Gentran life cycle Database.
• Worked with configuration of data managers.
• Responsible to verify all data was successfully processed and trouble-shoot any failures during translation and address the issues to the team.