Data Architect And Project Manager
Current• Designed, developed, and implemented a new healthcare EDI X12 system for the UHIN clearinghouse to replace a legacy system. The improvements increased the stability and performance of the UHIN clearinghouse, allowing it to validate, transform, and deliver over 1 million claim, remittance, and eligibility transactions per day, while achieving 99% system up-time and an average real-time turnaround of sub-2 seconds. The new system was backwards compatible with all legacy systems, currently connects to over 40 other clearinghouses nationwide, and supports the quick on-boarding of new customers with industry standard technologies such as CORE and SFTP.• For ICD-10 implementation, updated claims validation and generated reports that empowered our team to identify and pro-actively reach out to providers who were struggling with their own ICD-10 implementation ahead of the deadline. This lead to a smooth transition into ICD-10 with no interruptions in claims processing.• Created new data collection and aggregation methods that traced claims, acknowledgements, and remittances, as well as monitored partner connection to performance. This enabled our team to quickly identify, diagnose, and react to potential issues in claims processing, providing relevant information quickly to our partners to assist them in troubleshooting issues, minimizing downtime both internally and for our partners.