Terry Cooper

Subcontractor at HealthEdge - 03/05/2012 - 05/15/2025

• Supported multiple healthcare organization customers with HealthRules Payor remotely as well as commuting on-site.
• Assisted multiple healthcare organization customers accomplish Implementation to Go-Live with HealthRules Payor remotely as well as commuting on-site.
• Triaged and resolved HealthRules Payor SalesForce tickets that consisted of connector and payor weblogic issues.
• Triaged and resolved all webservice issues mainly 270/271, 276/277.
• Triaged and resolved HealthRules Payor SalesForce tickets that consisted of Enrollment, Provider, Claims and Financial issues.
• Triaged SalesForce tickets to determine if issues needed to advance to product engineers or if the reported issue is working as designed with recommendation for customer to submit a product enhancement.
• Triaged and resolved Portal Integration Kit (PIK) that provides data services for Enrollment, Benefit Eligibility, Claims Inquiry, Authorization Submission/Inquiry and Provider Selection.
• Triaged and resolved HealthRules Answers reporting and analytics issues.
• Reproduced webservice issues by performing the webservice request in SoapUI.
• Worked closely with UST to gather additional information to timely resolve Salesforce tickets when part of the Agile Services - UST team account.
• Worked closely assisting Project Managers, Ops and Product Engineers to timely resolve Salesforce issues.
• Used OLTP and Data Warehouse oracle databases to assist in triaging issues as well as create scripts to extract requested reports and scripts for data cleanup.
• Performed conversion data loads that consisted of members, benefit plans, providers and claims.
• Performed database bootstraps to resolve syncing issues between oracle's oltp and data warehouse.
• Gathered requirements from healthcare organization's trading partners to assist with creating technical stories and mapping crosswalks for inbound/outbound 834 and 837 for multiple customer's lines of business.

• Supported the conversion and testing of all inbound EDI 834 feeds from ANSI 4010 to ANSI 5010.
• Used EDIFECS Transaction Management for compliance and validation checks against 834 file data.
• Met with the Client/Vendors to review required and recommended changes from 4010 to 5010.
• Reported back to the Client/Vendors any recommended 5010 update failures and discrepancies.
• Defined Trading Partner information as well as connectivity information to assist with setup.
• Provided documented feedback to the Client/Vendors on test results.

• Analyzed 834 EDI Transaction layouts and Custom File layouts in order to create different test case scenarios during Open Enrollment and Ongoing updates.
• Created and executed test plans for testing benefit data interfaces from organization’s clients to many different health plan carriers for Open Enrollment and Ongoing life event updates.
• Reviewed carrier requirements to develop test plans before executing the test plans internally.
• Utilized SQL, EDI, HippaEDIViewer, PGP Encryption, FTP, Claredi, TextPad, Access and Oracle on a Linux platform in order to accomplish end to end testing.
• Worked with developers to resolve discrepancies between the client and the carrier.

• Developed new EDI maps, modified existing maps and performed test based on customer request using ECMap for Healthcare customers on 837, 835, 834, 820, 270, 271, 276, 277, 278 and 997 Transaction Sets for HIPAA Version 4010.
• Performed unit, system and integration test of developed EDI maps and modified existing EDI maps.
• Used Gentran and ECMap for trading partner setup, mapping, scheduling and processing.
• Supported EDI Mainframe Translator which consisted of a series of COBOL programs that converted EDI data from one format to another through use of VSAM, batch and online.
• Assessed the following languages: COBOL, SAS (UNIX and Mainframe), ALC, FOCUS for the Y2K project at customer sites.