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Title Claims Processing Front End
Target Location US-PA-Bensalem
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Candidate's Name
PHONE NUMBER AVAILABLE (C)Bensalem, Pennsylvania Street Address
EMAIL AVAILABLESUMMARYMainframe 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 ExperienceSenior Application Developer  CAI Technologies, client - Division of New Jersey State Police.Teleworker, NJ August 2022 - currentModify 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 2022Project: 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 supportPerforming 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 resultsInvolved in Impact Analysis, Code review, Test results review, UAT and implementation processesCoordinating 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 environmentSupported the production release and testing teams; identified issues originated during the release and addressed all defects by determining the severity and possible resolutionEnvironment: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 2019Maintaining 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 issuesPerformed unit testing and production promotes following company standards and proceduresConducted 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 EasytrieveSenior Programmer - Stefanini Inc, client - Carpenter Technology Corporation.Reading, PA. June 2015  November 2017I was rresponsible for transition and support of Carpenters 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 Carpenters 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 2015Provided analysis, design and detail construction for clients 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 ScriptsFranklin Lakes, NJ September 2012  July 2013Provided 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 EasytrieveMainframe Application Developer - Volt, Inc, client  YPG (Yellow Pages)Blue Bell, PA June 2010  March 2012Participated 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, PLIDeveloper - CIBER, Inc, client - DE Department of Health and Human ServicesNew Castle, DE March 2008  June 2010As 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 TechnologiesFort Washington, PA August 2007  November 2007Worked 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 tablesMentored junior team members, and supervise quality control tasks.Environment:Micro Focus COBOL, UNIX, DB2Senior Programmer/Analyst - SAKS INCORPORATEDLawrenceville, NJ, October 2000 - April 2007Functioned 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 commissions 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, LIBRARIANProgrammer/Analyst - COMPUTER AID, INC (CAI), client - DuPontWilmington, DE June1997 - October 2000Worked 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 SeminarsDB2 Administration Tools V3 by IBMFileAid training courseEducationVisual Basic Programming (VB.NET)Bucks County Community College (BCCC), PA (GPA 4.00)DATA PROCESSING TRAINERS BUSINESS SCHOOL (DPT), Philadelphia, PADiploma in Computer ProgrammingAdvanced courses in Data Processing and Data Managing training.KYIV NATIONAL UNIVERSITY OF CONSTRUCTION AND ARCHITECTURE, Kiev, UkraineBS in Construction Engineering.TECHNICAL Programming Languages and Technologies Overview:COBOL/COBOL II, CICS, EASYTRIEVE, Micro Focus COBOL, SpeedwareProgramming 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, WaterfallDatabase Experience:DB2, SQL, IBM/DB2 Utilities. VSAM, SQL Server, TeraData, WinSCP, Oracle, Datacom/DB.Operating Systemsz/OS, MVS/XA/ESA, OS/MVS, UNIX, Windows/NT & MS/DOS

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