Healthcare Claims Processing Automation
Horace Lawrence
Client: Consolidated Healthplans Inc.
Job Title: Technical Consultant / Software Engineer
Summary: The client processes EDI data received to determine the validity of claims and what payments should be made. The process was highly manual and time-consuming. This situation resulted in a high-stress environment, with many supervisors/managers having to work long hours to fulfill their other responsibilities.
Actions:
Constructed a tool to manage the EDI process.
Trained less-experienced developers on how to improve and maintain software quality.
Established coding standards appropriate to the business of the client.
Accomplishments:
Managers could now proactively manage the EDI process and fulfill their other responsibilities in a normal workday.
Instituted a new software development process to produce and maintain high-quality software in support of the business.
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Posted Jul 19, 2023
Created custom web application to automate EDI data processing. Established coding standards to ensure that the quality of the software is maintained.
