Works with groups of individuals in the analysis, design, development, and delivery of technical Integration Solutions.Works closely with project teams on customer-specific initiatives which involve message movement, translation, or integration development to solve technical messaging communication and transformation issues.Assists team members with troubleshooting technical issues related to message transformations and flows as well as analyzing customer messaging specifications and providing gap analysis.Creates documentation for future reference, training and support purposes.Communicates with customers and vendors to clarify messaging format requirements.Writes translation plans to move development work into various environmentsSupports integration testing as requiredSuccessfully developed and implemented a master data management solution that acts as a centralized repository for various enterprises application. Integrated millions of records from other systems into SQL Server to ameliorate errors and complications in the compilation of accounting reports. Conducted in-depth research to resolve configuration/application issues. Upgraded the systems and enterprises application to increase organizational efficiency and adoption of technology. Reviewed contracts on all vendors before releasing any data external.Knowledge of all data formats used in healthcare integration messaging (HL7, EDI, CSV, XML, etc.)

Primary function is supporting state medical exchanges by submitting electronic files to enroll individual into a healthcare medical plan. Managed and monitored escalated client cases within 24 hours; providing guidance and developing root cause analysis and issue resolutions skills using Axosoft: Agile Project Management - Scrum Software. Responsible for the ongoing analysis, in EDI processes to maintain accuracy in all inbound and outbound documents. Maintained various methods of electronic communication and file transmission, followed all EDI processes, communicated information to existing clients. Maintain knowledge on working of all HIPPA EDI protocols• Utilized multiple business systems/applications such as SharePoint, Baregreps, Ultra Edit, Remote Desktop Connection, EDI files portal, Axosoft and IPL processorProvided training to new contractors on the IPL processAnalyzed errors on 834’s and provided feedback to the Development team

Saved the company over $500,000 per day by monitoring files daily and carefully detected and eliminated claims errors by consistently testing client data before the files went live Consistently reconciled monthly reports and compared member files which protected the company and provided clients with accurate dataProvided strategy recommendations (layout feasibility, programming options) to the sales department which helped them consistently meet the file deadlines for their clients using HMO, PPO, Med-D and Medicaid. Coordinated annual readiness activities for client data files to ensure proper implementation of eligibility project plans and communication of accomplishments, risks, and key deliverables. Researched and analyzed eligibility, other health information, and group data for issue identification and root cause, developed and tested interim solutions, managed eligibility implementations, and monitor results.Diagnosed process improvement opportunities, developed solutions to non-standard complex problems, provided explanations and information to others on difficult issues, and lead solution implementation in support of continuous quality improvement. Assisted with the overall implementation process for each assigned vendors for new business. supported major changes to existing vendors based on platform procedures Tracked the progress of the implementation using a Project Plan and conducted weekly update calls by creating and maintaining an Action Log until all implementation tasks are completed Assisted with the implementation process, gathered vendor requirements and worked with internal partners that implement client needs and mentored others in the existing and/or best practicesConsistently solved Vendors/TPA's and internal department problems that interrelated with data submission and processing from the following platforms: Sentry, RxClaim and PeopleSafe.

Performed account corrections including re-bills, adjustments, or clearing of any financial billing transactions. Analyzed and resolved issues within customer accounts which ensured proper billing and increased customer satisfaction Processed billing transactions beyond scope of support manually or within customer informational systems. Investigated questions and inquiry disputes within other departments that may have been caused by: move-in, move-out, switches and transfers in market. Resolved escalated customers issue and complaints forward from Customer Call Center to prevent customers reporting the issue to PUC.

▌ ACCOMPLISHMENTS: ▌ Reduced cost 20% by effectively purchasing materials and supplies and keeping within budget; reducing cost through streamlining processes; Increasing profits by 15% and improving bad debt through electronic payment process Took on a new project of sending letters to customers when receiving payments and unable to locate their account and had a successful turn around which decreased misapplied payments and increased customer satisfaction Successfully reduced and reversed an average of 50 UI payments monthly; average of $1,000 to $5,000 by sending a letter to unidentified accounts; and runs chargeback process that reduced fallout in a timely manner.Duties included: Processed more than 59K or $1.2B wire payments annually for wholesale and National Billing customer Implemented recommendations for process improvements Created Electronic Data Interchange (EDI) comma delimited files from remittance spreadsheet and transmits payments files to EDI Monitored file transmission to ensure payments post successfully to customer account within 48 hours Interfaced with Wholesales and ESG account managers, Cash Control, and vendors that obtained remittance advice and resolve balancing/reconciliation issues Provided benchmark status quarterly to all vendors who did not meet the elements required by Verizon to process payments via EDI file formats Performed root cause analysis, gathered and analyzed data to write reports, provide recommendations, and offer solid solutions Met precise payments posting time commitments to ensure month-end balancing