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Claims Processing Front End

Location:
Bensalem, PA
Posted:
January 25, 2024

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Resume:

VITALIY DANILCHENKO

267-***-**** (C)

Bensalem, Pennsylvania 19020

ad23db@r.postjobfree.com

SUMMARY

Mainframe Professional with 25+ years of results-oriented, progressive experience in application development and support to batch and transactional processes hosted on an IBM mainframe, with a core focus in COBOL, DB2, CICS, JCL and VSAM.

Has extensive knowledge of retail, publishing industry, health and human services, health claims processing, State Police applications processing. Plays a key role in SDLC including design, development, testing and implementation phases.

Professionally adaptable to 'get on board' quickly with new technologies and new assignments, able to work independently or in a group/team setting to meet deadlines while handling multiple assignments.

Well versed in trouble-shooting problems in a wide variety of abnormal terminations in a batch and pseudo conversational environment.

Team player with excellent communication and interpersonal skills.

Professional Experience

Senior Application Developer – CAI Technologies, client - Division of New Jersey State Police.

Teleworker, NJ August 2022 - current

Modify an online and batch program to update the list of authorized users that are allowed to do the recommendations on the Volunteer Request screen.

Capture the ethnicity value from incoming files from a state agency and update the Identification table on the Computerized Criminal History (CCH) system.

Create the technical specifications for the state audit request process using the code from the online program.

Senior Mainframe Developer for Claims Processing System – Gainwell Technologies.

Teleworker, NJ March 2020 – August 2022

Project: Medicaid/Medicare: Government business division which includes Medicaid and Medicare products in New Jersey Medicaid Management Information System (NJMMIS). Involved in working with Claims Processing System, Front End (FE).

Responsibilities:

Program modification, codding, support, maintenance and development using COBOL, JCL, CICS, DB2, VSAM, EASYTRIEVE, Endevor.

Analyzing software PRR/specifications and identification of application functionalities for design, development, testing, implementation and production support

Performing RTB (Run the Business) activities, such as fixing all the Front End (FE) related issues and bugs that may come up during the production phase.

Interacting with business and formulating the solutions for the newly proposed requirements.

Handled all the phases including drafting Tech response, functional design, and technical design walk through documents with the client.

Estimation of time and efforts for the Enhancements.

Support/Guidance for SIT, UAT and Code Implementation. Prepared RTM (Requirement traceability Matrix) and reviewed test cases and test results

Involved in Impact Analysis, Code review, Test results review, UAT and implementation processes

Coordinating with business clients, supporting the application and implementing the process as per specification provided.

Answering the technical queries, driving the product initiatives and analysis.

Reviewing work products and deploying the application in the test environment and initiating the process of user acceptance testing. It includes fixing of bugs and technical errors that may come up during this phase.

Supporting the system components during system testing, integration testing and during promotion of these components to production environment

Supported the production release and testing teams; identified issues originated during the release and addressed all defects by determining the severity and possible resolution

Environment:

Mainframe, TSO, COBOL, JCL, CICS, DB2, VSAM, EASYTRIEVE, Endevor, Stored Procedures.

Senior Developer/QA Analyst for United Claims Processing System (UCPS) – Randstad Technologies, client - United Health Group (UHG).

Horsham, PA February 2018 – November 2019

Maintaining and developing United Claims Processing System:

Developed (coding) project to support Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)

Performed functional and technical analysis to implement business requirements and to fix production issues

Performed unit testing and production promotes following company standards and procedures

Conducted quality assurance of Medicare and Retirement Insurance Solutions system assuring Claims processing system performs according to the HIPAA standards and company business rules.

Prepared input data, executed test cases and documenting testing activities and results using Application Lifecycle Management (ALM), ReqPro - requirement management tool, Subversion, Serena Business Manage (SBM Team track)

Analyzed JCL and COBOL/CICS programs to understand dependencies, making sure the files flow correctly from one job to another.

Recognized logical batch sequencing and document the flow across programs using Visio.

Developed and modify JCL at the job step level to support both batch and online snapshot requirements.

Executed the batch claim stream and electronic claim stream to process and validate test data.

Conducted research, troubleshoot / resolve abends and other issues encountered during the batch stream execution process.

Environment:

Mainframe, TSO, COBOL, DB2, JCL, SPUFI, Stored Procedures, Mainframe Utilities and Easytrieve

Senior Programmer - Stefanini Inc, client - Carpenter Technology Corporation.

Reading, PA. June 2015 – November 2017

I was rresponsible for transition and support of Carpenter’s mainframe systems/processes as stipulated by the Applications Managed Services (AMS) agreement.

Analyzed and documented eighteen mainframe applications currently in use at Carpenter. Including the Online Order Requirements System (OORS), Nondestructive Testing System (NDT), Melt accounting, Electronic Data Interchange (EDI), Annealing Time and Production Reporting (ANPT), Advanced Supply Chain Planning (ASCP), Cost Management (CMS), Manufacturing Production Planning Scheduling (MPPS), Material Safety Datasheets (MSDS), Referred Material Review (RMR), applications used by Carpenter’s Reading Production and Maintenance (P&M) employees within short period of time (nine weeks).

Managed Incident Ticket pipeline ensuring correct assignment, classification and resolution of AMS mainframe systems.

Performed enhancement (coding) and provided productions support of major mainframe applications (Electronic Data Interchange (EDI), etc.)

Environment:

Mainframe, TSO, COBOL, DB2, JCL, SPUFI, Mainframe Utilities.

Software Engineer - IntelliSource HealthCare Solutions, client - DST Health Solutions.

From remote office, PA September 2013 – March 2015

Provided analysis, design and detail construction for client’s health claims processing systems. Application programming in MF COBOL, Oracle, Shell Script, Speedware under UNIX.

Converted Speedware claims reporting application to MF COBOL.

Played instrumental role in setting up and maintaining data integrity in the company's testing environments to include Oracle subsystems, AMISYS and WinSCP.

Performed unit and system testing using AMYSIS - HIPPA compliance software.

Software Engineer – GalaxE Solution, client - Express Scripts

Franklin Lakes, NJ September 2012 – July 2013

Provided analysis, design and detail construction, programming (coding), testing, implementation, and surveillance for new and existing application utilizing COBOL, DB2, CICS, Easytrieve and JCL running under MVS. System is the largest healthcare/PBM system on the IBM mainframe at Express Scripts.

Provided proven problem research and resolution skills via 24/7 weekly on-call production support of daily batch jobs and CICS transactional processes for Client Benefit Management (CBM) system.

Wrote TSD's (technical specifications document), creating test cases, making recommendations for design, code reviews (evaluating code for efficiency, ensure that requirements are satisfied, and code adheres to standards).

Extensively interacted with the client's user community to gather business rules, functionality requirements for new and enhanced products.

Actively worked to mentor the offshore team.

Environment:

Mainframe, TSO, COBOL, DB2, JCL, SPUFI, Stored Procedures, Mainframe Utilities, TearaData and Easytrieve

Mainframe Application Developer - Volt, Inc, client – YPG (Yellow Pages)

Blue Bell, PA June 2010 – March 2012

Participated in developing the technical and business requirements for integrating publishing data into the directory management legacy system and ad management production legacy system. This included contract data, publishing data, marketing data, commission data, and financial/billing data.

Analyzed and compared “as-is” sales reports to “to-be” sales reports. Analyzed data fields and identified information gaps. Developed business requirements to ensure continued reporting capabilities.

Participated in entering requirements into Quality Center testing database. Linked requirements to testing packages and releases.

Responsible for developing, modifying and maintaining systems software for ZipLocal, CanPages projects.

Designed and developed application for the DMS White Pages Business books. Resolved production issues.

Performed DB2 LOADS, UNLOADS, Image copies, RUNSTATS, BINDS and other DB2 core utilities in developer test and staging DB2 environments.

Coordinated the project changes and implementation process.

Exceled in a multi-task work environment.

Environment:

Mainframe, COBOL, CICS, DB2, JCL, Mainframe Utilities, PLI

Developer - CIBER, Inc, client - DE Department of Health and Human Services

New Castle, DE March 2008 – June 2010

As a team member, played active role in technical design, development, system and unit testing for the Operations module of Audit and Recovery Management Services (ARMS). The multi-platform web system is designed and built to support both manual and automated overpayment cases creation; individual and business case management, generation of various operations management reports, client forms and notices. The contributions included:

Worked with Integrated Eligibility/Public Assistance Systems for Food Stamps (SNAP), Medicaid and TANF.

Developed applications to access data in DB2 for both supporting web screen functionality and generating batch reports.

Prepared and promoted applications into production and support system implementation by addressing technical issues.

Participated in integration testing.

Environment:

Mainframe, COBOL, CICS, DB2, JCL, Mainframe Utilities, Shadow Studio.

Programmer/Analyst - Robert Half, client - RAM Technologies

Fort Washington, PA August 2007 – November 2007

Worked as an Information Systems Consultant to develop software to simplify the complex business of healthcare administration. Actively involved in the HEALTHsuite® project for a Family Care members Conversion. Designed, implemented and tested the modules for data conversion from the flat files to DB2 tables

Mentored junior team members, and supervise quality control tasks.

Environment:

Micro Focus COBOL, UNIX, DB2

Senior Programmer/Analyst - SAKS INCORPORATED

Lawrenceville, NJ, October 2000 - April 2007

Functioned as member of the Sales Audit team. Supported the package of legacy applications (COBOLII, JCL) and successfully completed miscellaneous work requests.

Designed, developed and implemented an application processes that performed commission’s calculations for Saks Fifth Avenue Specialists.

Collaborated with Loss Prevention user community to identify fraudulent activity on cash refund documents and store credits. This led to the savings of $1M due to fraudulent activity in 2006.

Supported multi platform data interchange activities, sending data from IBM Mainframes (zOS) to IBM Regattas (AIX, JCL and FTP).

Managed the leased vendor chargeback system for 3rd Party purchases in Saks Fifth Avenue stores. This led to annual savings of over $350,000.

Worked closely with the Control Division and Accounting to enhance monthly summary reporting to support General Ledger and Stock Ledger adjustments.

Environment:

Mainframe, COBOLII, JCL, DB2, VSAM, Stored Procedures, FTP, FILEAID, LIBRARIAN

Programmer/Analyst - COMPUTER AID, INC (CAI), client - DuPont

Wilmington, DE June1997 - October 2000

Worked as an Information Systems Consultant for a major chemical company. Responsibilities, as a member of the Data Store Team and then the DuPont Core and Reporting System Team, included the maintenance and enhancement of a number of programs and jobs related to the Extract Systems for X-Polymers and Core/Reporting.

Modified existing programs and job streams to correct production issues, developed the code, application and system test suites and implemented the change requests.

Involved in all stages of the Export/Import Database System projects life cycle from architectural design to coding, testing, and promotion into production environment.

Participated in the recreation of Monthly Archiving System, for "Multi-Department Order System (MOS) – Datastore orders" and inventory adjustments.

Environment:

Mainframe, COBOL/COBOL II, DB2, CICS, MF COBOL, JCL.

Training/Development Seminars

DB2 Administration Tools V3 by IBM

FileAid training course

Education

Visual Basic Programming (VB.NET)

Bucks County Community College (BCCC), PA (GPA 4.00)

DATA PROCESSING TRAINERS BUSINESS SCHOOL (DPT), Philadelphia, PA

Diploma in Computer Programming

Advanced courses in Data Processing and Data Managing training.

KYIV NATIONAL UNIVERSITY OF CONSTRUCTION AND ARCHITECTURE, Kiev, Ukraine

BS in Construction Engineering.

TECHNICAL Programming Languages and Technologies Overview:

COBOL/COBOL II, CICS, EASYTRIEVE, Micro Focus COBOL, Speedware

Programming Environments & Tools:

TSO/ISPF, JCL, SPUFI, FILEAID, QMF, CA7/CA-11, XPEDITOR, INTERTEST, ZEKE, FTP, SYNCSORT, IBM Utilities, IDCAMS, TCP/IP, CHANGEMAN, LIBRARIAN, ENDEVOR, Shadow Studio, MS Office, AMISYS, PuTTY, Code Collaborator, Clarify, Clarity, Remedy, Waterfall

Database Experience:

DB2, SQL, IBM/DB2 Utilities. VSAM, SQL Server, TeraData, WinSCP, Oracle, Datacom/DB.

Operating Systems

z/OS, MVS/XA/ESA, OS/MVS, UNIX, Windows/NT & MS/DOS



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