Career Summary
7+ Years’ experience in EDI healthcare as an Sr.EDI Technical Analyst and as an EDI Project coordinator. Hands on experience on EDI 834,837,835,277, 997,856,855,810. & US Healthcare implementation/operations and 5+ years of experience in Team handling and client support. Have demonstrated effective team management skills and achieving targets consistently. Worked as a Team Lead for 4+ years and handled a team 50+ members, I believe in hard work and outperforming. More than 4 Years of professional experience in B2B integration environment as EDI coordinator in HealthCare Insurance domain for Major Clients in USA.
Working domain: Purchase/Invoicing orders with adherence of EDI, US Healthcare, Employee Benefit administration and Support.
Experience in Healthcare process, Benefits Enrolments process, HRIS system, HIPAA, Benefit and COBRA administration.
Good understanding of HIPPA ANSI X12 EDI, EDIFACTS and all other transaction sets.
Extensive experience in Business analysis, Development and Support of EDI Implementation guidelines and Mapping Specifications.
Direct communication with client for requirement gathering and actively involved in converting the requirements into business design.
Professional Experience’s
Organisation: Pratyin Infotech Pvt ltd, Pune
Client: Confidential.
Project: EDI PO/IO/997,855-56-10.
Tenure: Dec 2020- Present
Project Features: EDI MAPPING with vendors n customers. Implementation of serialization of project and supports Tracelink application, Project serialisation to the customers and distribution across 11 countries in US and Europe. The project is exactly what Amazon does, for healthcare products .
Key Responsibility Areas
Direct reporting daily to director of the implementation.
Working on the EDI tracelink mapping tool.
Implementing of serialization project and new clients onboard.
Monitoring of Invoices and purchase/sales order notifications.
Resolving the file failures.
Reconciling the errors on the tool and reship the package from the system.
Looking after mulesoft errors.
Working with carriers to setup the sales/purchase Admin EDI integration.
Coordinating Conference Calls with business stakeholders for gathering requirements.
Providing technical support to the customers post implementation for EDI configurations and setups to business trading partners.
Testing of the files prior sent to the providers over the sandbox testing.
Close monitoring of the file’s successful transaction to the provider ends.
Working on AS400 server.
Leading a team of 6 members.
Project Features
EDI (Electronic Data Interchange) is the transfer of data from one computer system to another by standardized message formatting, without the need for human intervention. EDI permits multiple companies -- possibly in different countries -- to exchange documents electronically. Data can be exchanged through serial links and peer-to-peer networks, though most exchanges currently rely on the Internet for connectivity.
Organisation: A3logics (I) Private ltd, Jaipur.
Client: Plansource.
Project: EDI & BENEFIT ADMIN (Healthcare domain)
Tenure: Mar 2020 to Dec 2020
Key Responsibility Areas
Implemented and configured of new clients in Healthcare domain.
ACA and Cobra point configuration of newly configured clients.
Conversion and loaded of Census and enrollment data files into the benefits administration system.
Provided solutions to team regarding healthcare benefits and new client implementation. Requirement gathering from carriers for EDI setup.
EDI 834 Feed file and Flat file building with the help of Bswi tool and testing those files.
Worked with different carriers like Guardian, Metlife, VSP, Cigna etc to built EDI files.