Jessica Claire
Montgomery Street, San Francisco, CA 94105
Home: (555) 432-1000 - Cell: - - -
Professional Summary

Knowledgeable Analyst able to adapt freely to diverse situations and changing demands. Well-versed in EDI Health Care Technology and skilled in EDI Business processes. Looking to apply 12 years of Health Care experience to a dynamic new position with room for advancement performing as an Analyst or Implementation.

  • Project Management
  • Implementation of EDI X12 HIPAA 4010, 4010A1 and 5010 ANSI Formats
  • Troubleshoot EDI Transactions; 837I and 837P Claims, 997, 835 and Coordination of Benefits
  • Medicare Part A and Part B
  • ETL Tool
  • Teamwork and Collaboration
  • Remote access troubleshooting
  • Multiple Operating Systems
  • SQL report writing
  • Microsoft access database, Power Point, Excel, JavaScript, Microsoft SQL Server, Heidi SQL
  • Problem Resolution and Customer Service
  • Client Implementation
  • ADP, EDI, Payroll, Troubleshooting
  • XML, ETL, Programming
  • Business analysis, Instruction, Requirement
  • Business operations, Inventory, Research
  • Data Analysis, Microsoft office, Technical support
  • Data entry 85 wpm, Office, Telephone
Work History
04/2019 to Current
EDI Analyst Synnex Corporation Garland, TX,
  • Work closely with customers, stakeholders, and other internal departments to coordinate Implementation and Integration of EDI.
  • Troubleshoot file layouts and perform data analysis to improve operations and provide exceptional client support.
  • Import into the system variety of file layouts, csv, xlsx, pgp, txt, and xml via SFTP protocol utilizing client file specifications.
  • ETL tool to accommodate implementation of connections for EDI.
  • Implementation and of a variety of client types, i.e.
  • City, state, government, utilities, and municipal.
  • Perform EDI functions for accounting, inventory, placement, new accounts, payments, closed accounts, reconciliation, and trust.
  • Troubleshoot EDI workflows, EDI implementation, data analysis and other data/application support activities.
  • Leads the customer through initial EDI onboarding through first file production, by identifying business needs, providing file specifications, testing, providing feedback, and providing overall EDI consultation.
  • Responsible for timely and accurate tracking of cases and status for management requirements and reports.
  • Partner with internal team members (Sales, Implementation, etc.) and external partners (Ben Admins and brokers) to build strong relationships.
  • Responsible for timely and effective communication and follow up to ensure EDI development of the group is progressing in a manner that aligns with our customer service goals.
  • Perform Data Analysis using Heidi SQL to resolve problems with EDI data, system enhancements, and client resolution.
  • Project manage invoices, letters, and statements coordinate implementation and daily processes with two different letter Vendors.
  • System testing of updates and enhancements of accounting software.
  • Daily processes and document processes via internal portal, confluence.
  • Ability to learn new concepts, technical systems, and new languages quickly.
01/2012 to 01/2019
Administrative Assistant Sewell Corporation Fort Worth, TX,
  • Provided multifaceted services to career professionals, running errands, managing mail, scheduling appointments, and arranging transportation.
  • Handled 50 incoming and outgoing correspondence, including mail, email, and faxes daily.
  • Managed large range of services including pet care, phone screening, shopping and bill paying to provide clients with premium family time.
  • Managed mail and both incoming and outgoing correspondence, mail, email, and faxes.
  • Executed basic banking and bookkeeping tasks.
  • Handled incoming mail, bills and invoices and completed appropriate actions.
  • Created and managed office systems to efficiently deal with documentation.
01/2007 to 01/2011
Connection Support Specialist Adp Sacramento, CA,
  • Coordinated EDI testing of updates, enhancements, and programmed changes.
  • Resolved, and performed data analysis of EDI transaction data sets; 837P, 835, 270/271, 997 and COB, Coordination of Benefits.
  • Communicated effectively with clients, trading partners, vendors, and clearinghouse to achieve effective implementation of EDI claims, payroll, open enrollment files in ANSI 5010 HIPAA Format.
  • Performed initial client assessment and analysis to report, research and enhance ADP's Human Resource and Benefits, HRB, database.
  • Responded to customer via telephone and email within 24-hour requirement.
  • Managed five major shareholder accounts, specific connection files created.
  • Shareholders connections consisted of different reporting of information requested by client.
  • These clients treated with higher classification of daily interaction, analysis, and communication.
  • Utilized test and production environment for EDI updates, changes, problems and or enhancements from daily case load assigned minimum of ten cases per day.
  • Assigned case work to be completed by co-workers in India and specific programming instruction, mapping requirements.
  • Effectively doubled amount of team’s case load and positive feedback from clients.
  • Achieved team goals.
  • Monitored after hours queue to provide urgent programming changes requiring immediate resolution, primarily east coast clients.
  • Received awards from different co-workers and management; outstanding work completed, goal oriented, flexibility, sensitive and respectful of needs of others, efficiency/accuracy with many others.
  • In total of 140 award acknowledgments received.
01/2001 to 01/2007
EDI Technical Analyst Regence Blue Cross Blue Shield Of OR, Medicare Northwest City, STATE,
  • Provided technical support, excellent customer service and set-up of EDI X12 4010A1 HIPAA transaction data sets 837I, 997, 276/277, 835 and 270/271 to Medicare Part A, for states of OR, WA, and UT.
  • Created and Implemented HIPAA project offered by management to coordinate conversion of all testing and approval from current NSF 6.0 format to ANSI 4010 X12 transaction sets: 837, 835 and 270.
  • Implemented Electronic Data Interchange production by specific date for all hospitals in OR, WA and UT and their affiliated vendor and or clearinghouse.
  • Date of conversion/transition of formats to be moved into production was communicated per guidelines set by CMS, Centers of Medicare, and Medicaid Services.
  • Completed this project successfully and timely.
  • Set up and troubleshoot different software offered by CMS, Centers for Medicare, and Medicaid Services, PCPrint, Ace and Aecho.
  • Streamlined EDI rejection process and reduced number of incoming phone calls EDI department received by creating new specific error report that included specific highlights and grammar from Implementation Guide, worked with programmers to develop specific error report.
  • Developed effective rapport with different Clearinghouse and Hospital Administrators located throughout United States.
  • Monitored all 837I incoming electronic submissions received daily via NDM connectivity, Mainframe and Bulletin Board System.
  • Ensured all files were delivered/accepted daily, 837I, 835, 997, 270/271, 276/277 and eligibility response to all contracted vendors, clearinghouse, COB carriers and hospitals.
  • Identified and programmed issues within electronic submissions, billing software or system problems that were reported.
  • Set up Electronic Funds Transfer, EFT.
  • Tested and approved any update, change or enhancement to Medicare Northwest system or software prior to moving into production.
  • Traveled to various locations representing CMS, Centers for Medicare and Medicaid Services, Baltimore, MD, Seattle, WA and Las Vegas, NV, and many other local seminars.
  • Created, logged, and scanned supporting documentation on internal portal.
  • Assisted provider enrollment department with Project Management of reorganization and implemented new processes of daily job duties to correct audit findings that CMS, Centers for Medicare, and Medicaid, investigated.
Expected in 2018
SQL Certification:
Clark Community College - Vancouver, WA
Expected in 1998
Associate of Arts: Business Administration
Clark Community College - ,

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Job Titles Held:

  • EDI Analyst
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  • Connection Support Specialist
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