Description
of the project is to develop a Medicaid Management Information System for the State of Michigan to follow 5010 version of X 12\HIPAA using existing eCAMS application which is developed following HIPAA X 12 standards. Implement the Core rules to meet the CAQH CORE mandated standards by integrating it existing eCAMS application. Responsibilities: * Gathering the CORE Rule requirements for Phase I/II/III implementation and converting them into technical requirements. * Understanding Functional specifications and coordinating with India Team. * Analyzing CORE Rules for 270/271/276/277/835 transactions of HIPAA CORE Phase I/II/III rules. * Analyzing Loading business rules and coordinating with multiple technical teams. * Analyzing and Freezing Design documents for 270, 276, 277, 271, 835 X 12 Healthcare transactions. * Modify Translation maps using MapBuilder for X 12/HIPAA transactions as per new requirements for CORE Phase I/II/III. * Allocate work to the team, getting the queries clarified to the team. * Deploying XEServer projects and Configuration files in the UNIX/LINUX server and maintaining. * Reporting and tracking of the Defects in Clear Quest. * Assist the team members in test case execution. * Working with testing team to create test cases. * Working on Core Rules implementation in existing CHAMPS project to meet the CAQH CORE mandated standards. * Worked as an innovative part of the team and also guiding the respective team members to understand and complete the task. # CHAMPS - eCAMS 5010 Enhancement Client: State of Michigan Role: EDI Lead Duration: 2010 Sep - 2011 Dec Location: Rockville, MD Project Description: of the project is to develop a Medicaid Management Information System for the State of Michigan/Washington/Illinoi/South Dakota to follow 5010 version of X 12\HIPAA using existing eCAMS application which is developed following HIPAA X 12 standards. Implement the Core rules to meet the CAQH CORE mandated standards. Responsibilities: * Worked together with the clients to gather and freeze the requirements for the elements of different transactions in the design document and used these documents for development purpose. * Participate in the project development / issue mitigation plan creation activities and distribute the plan across the team members. * Analyzing the development of Validation Edits for all transactions of HIPAA/NCPDP claims by going through design documents. * Understanding Functional spec and coordinating with Offshore Team. * Analyzing Loading business rules, Tags representation for Intermediate files and coordinating with inbound & outbound teams. * Developed gap analysis report between 4010 and 5010 version in X 12/HIPAA standards. * Prepared Design documents for 837P/I/D, 270, 276, 278, 820, 834, 835 X 12 Healthcare transactions. * Created maps using Map Builder for X 12/HIPAA and NCPDP claims transactions which are used to process respective EDI files. * Design and Develop the Validation and Translation rules for transaction files. * Develop XEServer routes for MQP and integrate the same with eCAMS product. * Develop NCPDP post adjudication Validation rules and integrate the same with eCAMS product. * Deploying XEServer projects and Configuration files in the UNIX/LINUX server and maintaining. * Assist and Guide the team members in test case execution. * Worked on Core rules implementation in existing CHAMPS project to meet the CAQH CORE mandated standards. * Worked as an innovative part of the team and also guiding the respective team members to understand and complete the task. * Was part of a team that performed End to End Unit/Performance testing. * Allocate work to the team, getting the queries clarified to the team. * Defects reporting and tracking in Clear Quest. * Guide the testing team to create test cases. * Monitoring the team to make sure that the health status of the servers are kept in check and the activities to be performed in Unix and Linux servers are executed as planned. # CHAMPS Client: State of Michigan Role: EDI/EDIFECS Lead Duration: 2006 Oct - 2011 Aug Location: Rockville, MD Project Description: of the project is to develop Medicaid Management Information System (ECAMS application) for the State of Michigan to process all HIPAA 4010/5010 standards electronically. Responsibilities: * Worked together with the clients to gather and freeze the requirements for the elements of different transactions in the design document. * Analyzing Translation and Validation Edits for all transactions of HIPAA and coordinate the team to understand and implement them. * Analyzing Loading business rules and coordinating with inbound & outbound teams to understand. * Analyzing Understanding Functional spec and coordinating with Offshore team. * Design/Develop data dictionaries for both inbound and outbound transactions in EDIFECS. * Understanding and freezing the Random data dictionary columns in the mapping document for all transactions. * Analyzing the HCFA 1500, UB - 92 and ADA paper formats and design the standard guidelines for the paper formats according to the client requirements using the delimited guideline format. * Developing maps using Application Integrator (AI). * Creating test-cases and test-data using data dictionaries. * Worked as an innovative part of the team. * Research and development on both Gentran and Edifecs security administration. * Analyzing the requirements using design documents. * Allocate work to the team, getting the queries clarified to the team. * Reporting and tracking the status of Defects by using the defect tracking tools. * Assist the team members in test case Creation/execution to perform unit testing on the developed product # SD MEDX Client: State of South Dakota. Role: EDI Developer / Analyst Duration: 2009 Aug - 2011 Sep Location: Rockville, MD Project Description: of the project is to develop a Medicaid Management Information System for the State of South Dakota to follow 5010 version of X 12\HIPAA using existing eCAMS application which is developed following HIPAA X 12 standards. Responsibilities: * Coordinate with clients to gather the requirements and prepare design documents. * Understanding Functional specifications and coordinating with India Team. * Analyzing Validation Edits for all transactions of 4010 HIPAA. * Analyzing Loading business rules and coordinating with inbound & outbound teams. * Analyzing both 4010 and 5010 version in X 12 standards and their difference. * Analyzing and freezing the Tag names for intermediate file. * Analyzing and Freezing Design documents for 837P/I/D, 270, 276, 278, 820, 834, 835 X 12 Healthcare transactions. * Analyzing the HCFA 1500, UB - 92 and ADA paper formats and design the standard guidelines for the paper formats according to the client. * Developed maps using Netbeans in JCAPS 6.0. * Contributed in Developing pl/sql Packages in oracle. * Creating test-cases and test-data using data dictionaries. * Deploying translation projects and ECS files in the UNIX server. * Monitoring the XEngine and JCAPS 6.0 UNIX servers. * Worked as an innovative part of the team. * Analyzing the requirements using design documents. * Allocate work to the team, getting the queries clarified to the team. * Reporting and tracking of the Defects in Clear Quest. * Assist the team members in test case Creation/execution * Deploying XEServer projects and Configuration files in the UNIX/LINUX server and maintaining. # Technology and Innovation Client: CNSI Role: Sr. Software Engineer/EDI Lead Duration: 2011 Feb - 2011 Apr Location: Rockville, MD Project Description: * The purpose of this Technology and innovation project is to develop new ways to implement or modify the existing eCAMS project to achieve better results which will strive in improving eCAMS application. Responsibilities: * Lead a small team for developing this prototype and provided a better execution in completing the planned tasks on time. * Contributed in all major areas of the project like analysis, design, development and testing * Developed translation maps using JCAPS 6.0 for both 4010 and 5010 version in X 12 standards which replaced the existing Gentran application in an even better way for low cost. * Gave demos to the clients. * Worked as an innovative part of the team and also guiding the respective team members to understand and complete the task. # PROVIDER ONE Client: State of Washington Role: Software Engineer Duration: 2006 Oct - 2013 Jun Location: Rockville, MD Project Description: of the project is to develop Medicaid Management Information System (ECAMS application) for the State of Washington to process all HIPAA 4010 standards electronically. Responsibilities: * Analyzing Technical specifications and coordinating with Team to complete the assigned tasks. * Developed data dictionaries for both inbound and outbound transactions like 837, 834, 270, 271 etc for the HIPAA standards using specbuilder tool. * Developed validation rules for both inbound and outbound transactions in Edifecs. * Developed the maps for both inbound and outbound transactions in Gentran and translated the files from application to standard and vice versa. * Monitor and Maintain the Gentran UNIX server. * Worked as an innovative part of the team. * Reporting and tracking of the Defects in Clear Quest. * Assist the team members in test case Creation/execution * Deploying XEServer projects and Configuration files in the UNIX/LINUX server and maintaining.
Education
| SCHOOL | MAJOR | YEAR | DEGREE |
|---|---|---|---|
| Anna University | 2006 | Master Degree | |
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