Rajesh Kumar Email & Phone Number

Monroe Township, Nj, Us

Chicago, Illinois, United States

New Jersey, U.S.A

Apr 2016 - July 2020New York City/New YorkFrom last 4 years working with one of the New York based biggest Healthcare client, this project is a part of BPaaS (Business Process As A Service) Solution and I look after complete migration of existing Customer Service applications including various portals to a brand new platform.Dec 2011 - Mar 2016Franklin Lakes/NJWorked with Medco Health Solutions/Express Scripts client on various projects like Universal Order Processing, F14 Integration and Client Testing Environment (CTE). The F14 integration was one of the biggest integration in the USA history where out of every 10 Americans, 1 was definitely impacted.Jan 2011 - Nov 2011Atlanta/GeorgiaWorked with ACS (A Xerox Company) client for their BI Reporting and HIPAA 5010 Remediation for for Medicaid clients.Dec 2008 - Dec 2010Teaneck/NJHealthcare Solution GroupHelp the client for understanding of new/future requirement in Healthcare, build capability in Healthcare Solution space and providing High level guidance/Training on EDIFECS Product to the Technical team.

Minneapolis, Minnesota, United States.

Worked as a EDI Manager at the client Allianz Insurance to ensure smooth functioning of standard feeds coming/going from/to DTCC/DST.As a Project Manager involved in Software Validation of the Package used for Medical Device Manufacturing client, Boston Scientific at Minneapolis, MN. As a Test Manager involved in End to End testing of Care 360 Lab Portal of Quest Diagnostics at Mason, OH.

India

Built/Trained Team on Electronic Health Record, HIPAA, HL7 and Claim Processing. Involved in several large deal Proposal for Healthcare/Life Sciences company. Managed required coordination between Healthcare Operation/Business and Strategic Accounts team

Chennai, Tamil Nadu

Manged BCN Reporting Project for the client Blue Cross Blue Shield Michigan.Writing different business scenario related with 270/271 and 837 transactions which is used by FACETS HIPAA GatewayPrepared detailed analysis document for Small Group Renewal Process including inputs, outputs and the Process flow diagram for the client BSC (Blue Shield California).

California, United States

Trained a team which can execute HIPAA 278 Transaction for DMA(Department of Medical Assistance) and Neighborhood Health Plan, Boston, MA.Train Team on SYBASE’s Healthcare Tool (ECMap, ECGateway)

Santa Clara County, California, United States

Worked as Senior Business Analyst for client AHCCCS, Phoenix, AZ for HIPAA Transactions and Code Set Project. The main objective of HIPAA Transactions and Code Sets(TCS) project of AHCCCS(A Medicaid organization of Govt. of AZ) is to identify and implement the systems and administrative changes necessary to support achieving the HIPAA Compliance.Worked as a Senior Functional Analyst for Assessment and gap analysis Tool: This involves the development for the CAP (HIPAA-privacy & security) & MAP (HIPAA-EDI) tool to do the assessment and gap analysis for existing system as per HIPAA Compliance Rule. Worked as a Senior Developer for ClinicAmerica.com Project at SFO, CA: This product offers a virtual clinic for physicians to provide care to their patients over the Internet. It enables traditional physician practices to extend their services online. The services include full front office functionality with secure physician/patient messaging, one-on-one live chat, self service appointment system, provider schedule/calendar, provider web pages, patient personal health records, electronic encounter records and financial transaction capability on a proprietary, patent-pending platform.