Skills
Web Development
Database
Others
Portfolio Projects
Company
Excellus BCBS
Description
Role and Responsibilities
Development activities.
- Developed Claim balancing in the existing 837_Batch profile using EAM 8.6 balance counter in the existing workflow based on that able to track per day’s total claims received, accepted or rejected and generate a report based on that also used to identify issues if any claim unbalanced.
- Developed/Configured clearing house custom report in the existing workflow (837_Batch_profile), it will generate a daily/weekly/monthly report with total number for snip 7 edits occurred per day with error description, error id, segment/element level details etc.
- Developed/Configured an enhancement called alphanumeric prefix, alphanumeric prefix is an enhancement to handle the alphanumeric prefixed on the subscriber id, based on that specific routing will happen.
- Developed/Configured an enhancement called FTP changes in the existing 837_Batch profile in order to write the Database extract to the FTP location on a daily basis.
- Apart from the POC’s and development activities also involved in TP upgrade on a weekly basis on DEV/SYS/USR environments and also involved in upgrading External code list once in 15 days in DEV/SYS/USR environment and also involved in Java upgrades (JDK) in DEV/SYS/USR environment on a regular basis.
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Skills
Edifecs Java (All Versions)Tools
EdifecsCompany
Multiplan
Description
Multiplan
Role and Responsibilities
EDI Analyst
Development activities.
- Creation of Claims OTP Report on a daily basis
- Creation of Claims BMP Report on a daily basis
- Creation of Claims LAB Report on a daily basis
- Creation of PI Report on a daily basis
- Perform United Reason Xwalk testing whenever error occurs
- Preparation of UHN Data whenever error occurs
- Creation of test scenarios for United testing
- Rolling out Claims Otp, BMP, LAB, PI Reports on monthly basis.
Skills
EdifecsTools
EdifecsCompany
Southdakota
Description
Southdakota
Project Objective and Description:
- Performed Research & development on Seebeyond 5.1.3 for developing Translation project for all the HIPAA transactions.
- Developed various translation projects for HIPAA transactions like 276I, 278I, 837-P/D/I, 270I, O, 834O, 835 O, 271 I, O using JCAPS 6.0.
- I have developed various test scenarios, test data’s for the business scenarios and also for unit testing and E2E testing.
- In HIPAA 5010 development team I have developed 278-I translation project using EDIFECS mapbuilder 6.8.
Skills
EdifecsTools
EdifecsCompany
Illinois
Description
Role and Responsibilities
- I worked on a poc called EDIFECS-HIPAA cloud.
- The EDIFECS HIPAA cloud poc integrates multiple MMIS states to use the same environment and same EDIFECS EAM XEServer and XEngine configurations.
- I have configured and developed a common XEServer profile for Inbound validation/translation and outbound validation/translation.
- Worked on further enhancements on the poc to handle the validation/translation in common Routes in the XEServer profile instead of having multiple routes in a same XEServer profile.
- Created a common EDIFECS-EAM Server/client XEServer, XEngine, and common validation/ translation profiles with common routes to accommodate multiple MMIS states to use the same environment and tools.
- Also done a poc called “EDIFECS as standalone” (validation/translation) without any dependencies on JBOSS application
Tools
Edifecs