SUMMARY OF QUALIFICATIONS/skills Eighteen years of experience in the IT field of the health care industry with a thorough understating of all major states of Software Development Life Cycle (SDLC). Experienced in all stages of SDLC for various methodologies including Waterfall and Agile Fifteen years of experience in gathering requirements, defining, analyzing, testing, implementing system enhancements, and documentation Ten years' experience Research and Resolution of claim adjustments. Eleven years' experience in Provider and Customer Service. Seven years' experience in EDI and Claims training and developing deliverable materials. Experienced in writing Business Requirements (BRDs) Experienced in leading teams in the testing phase writing test plans, coordination testing for Quality Assurance purposes executed tests against specifications Strong experience and understanding of Medicaid Management Information System (MMIS) Strong experience and understanding of Claim Processing, Medicaid and Medicare services Strong experience and understanding of Claims, Eligibility, and HIPAA 5010 standards Well-versed and experienced in EDI transactions such as 837I, 837P, 837D, 834, 820, 278, 270, and 271 Experienced in EDI Data Mapping Experienced in conducting interviews, meeting and JAD sessions required in ay phase SDLC. Experienced in writing SQL queries for performing database related works such as identifying data sources, verifying data integrity, and data migration for development, and quality assurance purposes Experience interpreting business contracts for systems configuration of commercial medical benefits

Highlights:

• Benefit Plans
• Management
• Medical
• POS
• Software
• Test
• Unit Testing
• EDI
• Electronic Data Interchange
• Quality Assurance