Experience

August **** – Now

Solution Developer Consultant

Paul Fredrick (On Assignment Thru Eltas EnterPrises INC -Econosoft, Inc.)

Implement U2 RESTful Web Services for Paul Fredrick Payment Handling of Credit Cards, Amex, Gift Cards, Electronic, Refunds and Pin less transactions with Chase

Develop Restful Code in UniBasic – Pick Basic

Process real time Authorization requests

Process Address Validations

Pass Response data to Client Payment Authorization Application

Work with Trading Partner Chase to produce the solution

Gather Business Requirements to implement solution

April 2019 – July 2019

Senior Developer Consultant

\CDKGlobal Portland, OR (On Assignment Thru TCS)

Support CDKGlobal l Pick Basic (Reality) Drive Application and C and PHP Front end

Maintenance of Pick/Basic Programs, PROCS

Support and align efforts to meet customer and business needs

Elicit and clearly document business and systems requirements

Maintenance of the PHP and C code supporting Desktop Applications

Peer review on Other programmer’s code changes

Participate in Agile standup meetings and Methodologies

Feb 2018 – May 2019

Senior IT Business Analyst

Serta Simmons Atlanta

OHM ERP for Bedding making, Invoicing, Inventory Control Pick Basic Application and Java Front end

Support system conversions, upgrades, enhancements

Support and align efforts to meet customer and business needs

Elicit and clearly document business and systems requirements

Develop Pick/Basic (Universe Basic) to provide Customization solutions

Develop Display, Report, Input forms for the OHM ERP

May 2017 – Feb 2018

Senior Developer

Schneider transportation– Green Bay, WI

A leading technology logistics company. Supporting Transpiration Application. EDI Implementation with companies like Overstock, Amazon using Reality Application

Implemented 215 for Amazon and Ashley Furniture

Maintenance 210 x12 Motor Carrier Invoice Transactions

Support of x12 Transactions for Many Trading Partners

Meetings for gathering Data and analysis to understand business requirements

Oct 2016 – May 2017

First Data – Coral Springs, FL

A leading technology in POS systems for easy customer checkout and connectivity -

Title

Lead UniBasic Programmer / Analyst / Consultant

Supported the InfoLease portfolio and asset management product developed in UniData and running under AIX servers.

Developed UniBasic programs to replace applications that use the UniData MODIFY Function to alter data without logging. Now a simple call will achieve the same processing a list but will also log data changed to the appropriate tables provided by the InfoLease application.

Developed Shell scripts as needed to automate some functions.

Apr 2016 – Sep 2016

Community First Health Plans – San Antonio, TX

Locally owned and managed, non-profit health plan services provider

Title

Senior Developer / Consultant

Consulted as Amisys 6.0 Medical Claims advanced developer supporting government and state programs.

Provided working knowledge of SQL and PL/SQL best practices.

Worked with Micro Focus COBOL with Embedded SQL, UNIX Shell scripting, Oracle Procedures and Functions, PL/SQL, and Suprtool on HP-UX.

Maintained EDI and supported the applications and COBOL programs.

Gathered business requirements and built modules around the main Claims Adjudication Amisys application.

Oct 2015 – Mar 2016

Synoptek Technologies – CA / ID (remote work)

Managed IT support services provider

Title

EDI Consultant

Implemented Invoice and Orders EDI applications between their client Shell Oil and Allied Lube. Developed using Pick/Basic

Conducts data gathering and analysis to understand business requirements

Automated the SFTP server application using ColdFusion engine and batch scripting.

Continued to support the application remotely following implementation.

Feb 2008 – Oct 2015

Pacific Source Health Plans – Boise, ID

Healthcare solutions to businesses and individuals throughout the Pacific Northwest

Title

EDI Analyst / Pick/Basic Developer

/ Consultant

Role(s)

Project Lead

Project Management

Analysis

Design

Development

Testing

Implementation

Compliance

Support

Maintenance

Consulted and responsible for the analysis and design of healthcare X12 maps created on Microsoft BizTalk to an in-house mapping engine, a process that has saved Primary Health about $30,000 yearly for support and licensing of the BizTalk Mapper.

Designed and developed EDI/B2B encryption/decryption of files between Pacific Source and Emdeon Clearinghouse.

Performed Gap Analysis of 4010 to 5010 x12 transactions (837, 835, and 834). Gained familiarity with 270/271 and 276/277.

Developed 837 Companion Guides for new trading partners.

Led EDI implementation meetings with new trading partners.

Tested validity of transactions using Claredi core testing and certification and fixed rejected messages and resubmitted to trading partners as appropriate.

Worked as project lead, project manager, and developer on several projects

Remapped 4010 837 professional to NSF file which replaced Microsoft BizTalk Maps.

Remapped 837 Institutional claims to Amisys BCP formats by replacing Microsoft BizTalk Maps.

Implemented a transactional Gateway, replacing the Microsoft BizTalk application server.

Developed and implemented a routing process for 837 claims to Amisys (NSF), Facets (837), and the Instant Payment Notification (IPN) for reprising sending out 837 and CMS1500 and UB04 paper claims with allowed amounts.

Designed EDI modules/applications with adherence to HIPAA, and for Claredi certification criteria and industry standards/specifications.

Provided HIPAA integration and applied ANSI ASC X12 standards for 837 (P, I, D), 270/271, 276/277, 278, and 835 transactions.

Provided mapping, gap analysis, and database designs for HIPAA codes sets and EDI transaction processing between Pacific Source IPN, Clearinghouse, and Payers.

Loaded and responsible for ICD-9CM (Diagnosis Codes), HCPCS (Revenue Codes), and CPT (Procedure Codes) update.

Analyzed ICD-10CM (Diagnosis Codes) in preparation for the switch from ICD-9CM.

Nov 2007 – Feb 2008

BlueCross BlueShield of Tennessee – Chattanooga, TN

Largest independent not-for-profit health benefit plan company in Tennessee

Title

Lead Programmer / Analyst / Consultant

Acted as lead programmer on the Trizetto/Facets application for claims processing and provider database, using Sybase database.

Used Access and SQL to produce management style reports, and coded using COBOL, CICS, VB 6.0, and UNIX/AIX Shell scripting to automate EDI process.

Worked with data extractions to validate provider information.

Updated provider tables with address and license changes, using COBOL and SQL.

Nov 2003 – Nov 2007

BlueCross BlueShield of South Carolina – Columbia, SC

Largest independent not-for-profit health benefit plan company in South Carolina

Title

Team Lead EDI Analyst / Configuration Team Lead and UniVerse DBA / Consultant

Role(s)

Team Lead

DBA

Analysis

Design

Development

Testing

Implementation

Documentation

Support

Maintenance

Worked on the Reverse Engineering Approach project and became familiar with ECMAP and ECGATEWAY from Sybase.

EDIFACT

Developed and responsible for software and application implementation.

Developed and supported EDI 837, 837, and HL7 interface.

Helped design applications for web wrap-around for UniVerse backend using UniObjects, Java, and Visual Basic.

Led team to analyze and write technical requirements for transitioning practice management from UniVerse database to Windows SQL Server database.

Served in the lead role to incorporate the Entrinsik Informer Web Reporting tool for IBM U2 family of database products into UniVerse application. Helped enhance the reporting capabilities of the application.

Configured ICD-9 codes, HCPCS (Revenue Codes), and CPT (Procedure Codes) media to be loaded into the application by clients.

Acted as configuration management team lead responsible for daily builds to QA servers and development servers.

Automated application installations/updates using UNIX and Batch scripting on Windows, AIX and Linux Servers.

Installed Java and Tomcat Web server.

Developed and responsible for installation documentation used by support personnel.

Dec 2002 – Oct 2003

The Men’s Warehouse – Houston, TX

Men's suit and clothing retailer

Title

System Analyst/Programmer / Consultant

Worked on the TMW Documentation Reverse Engineering Approach project, which included analyzing and writing new requirements.

Played a key role in the data conversion module and the upgrading of FORMS application to 9I.

Created the indexes and provided specifications for the rollback segments and table space/data files to be used for data and the index.

Apr 1995 – Jul 2002

Per-SE Technologies (Acquired by McKesson Corporation) – Alpharetta, GA

Leader in solving clinical, financial and business process challenges facing healthcare

Title

Senior Analyst/Team Lead / Pick/Basic Developer

Role(s)

Project Lead

Management

Business Analyst

Analysis

Design

Development

Testing

Implementation

Compliance

Support

Maintenance

Served as project leader for Year 2000 and assimilations for two years.

Spent 60 percent of my time during this period on management activities.

Spent 20 percent of my time on actual coding for hospital patient and billing software.

Mapped and responsible for EDI X12 and processing 837 and 835 claim detail and payments to more than 2000 partners with variations that required using NEON and BizTalk for mapping and messaging.

Analyzed data formats with more than 200 payers to determine EDI requirements and communicated those requirements to programming staff.

Performed QA of EDI before going live with different partners.

Served as a senior business analyst for hospital billing and claims (EDI) applications.

Met with divisional managers and devised a plan of action and completed weekly summaries of the project in MS Excel spreadsheets.

Assisted programmers with technical issues.

Analyzed requirements with regional business analysts, gathered regional exceptions, and ensured coding was complete.

Designed and developed the client billing (lab billing) documentation for users, administered training, and provided support of the module.

Worked with clients and teams of programmers to set guidelines for HL7 standards and compliance, including HIPAA requirements.

Led a team to determine programming requirements and communicated directly with clients and in-house business analysts to determine methodology of the interface programming.

Education

University of Nebraska, Kearney, NE - 1995

Bachelor of Science, Computer Information Systems

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