Gokulakrishnan V

Chennai

Summary

Diligent EDI Analyst with a proven track record of optimizing electronic data interchange processes to enhance efficiency and accuracy. Skilled in analyzing, troubleshooting, and implementing EDI solutions to meet business objectives. Proficient in EDI standards, Mapping, and integration, with a commitment to delivering high-quality results and exceeding client expectations.

Work History

cognizant technology solution

EDI Analyst (6+ Years of Exp)

06.2018 - Current

Job overview

Set up and maintain EDI connections with trading partners (vendors, customers, carriers) to ensure seamless data exchange.
Monitor inbound and outbound EDI transactions, ensuring timely and accurate data processing.
Troubleshoot and resolve EDI errors and failures (e.g., 997 rejections, mapping issues, transmission failures).
Develop, test, and maintain EDI maps for document types such as 850 (Purchase Orders), 810 (Invoices), 856 (Advance Ship Notices), 997 (Acknowledgments), etc.
Onboard and implement new trading partners, ensuring compliance with EDI standards and business requirements.
Work with EDI standards (ANSI X12, EDIFACT) and communication protocols (AS2, FTP, SFTP, VAN) to support integration.
Generate and analyze EDI transaction reports, ensuring compliance with regulatory and business standards.
Collaborate with internal teams (IT, Business, Supply Chain) and external partners to improve EDI processes and integration strategies.
Perform EDI testing and validation to ensure seamless data exchange and system functionality.
Document EDI workflows, mapping rules, and troubleshooting procedures to enhance team efficiency and knowledge sharing.

Cognizant Technology Solutions

Claims Adjudication Specialist (4+ Years of Exp)

06.2014 - 06.2018

Job overview

Apply policy rules and guidelines to determine payable amounts, denials, or adjustments for healthcare claims.
Accurately calculate co-payments, deductibles, coinsurance, and maximum benefit limits based on plan policies.
Generate and send recovery notices to providers or members with detailed repayment information.
Initiate offsets (adjustments in future payments) or process refund requests as needed.
Set up payment plans for large recoveries in coordination with internal teams and stakeholders.
Recover overpaid amounts from healthcare providers through structured repayment processes.
Manage overpayment recoveries for patients/members while ensuring compliance with regulatory guidelines.
Monitor and track recovery progress, ensuring timely repayment and addressing delays.
Collaborate with legal and compliance teams to resolve disputes and ensure adherence to recovery protocols.

Skills

ANSI X12, EDIFACT, XML, JSON

Certification

Certification: Data Science & Artificial Intelligence –(Ongoing) -2025 - Topics: Python, Pandas, Machine Learning, AI Fundamentals

Timeline