Madhav Agrawal

EDI Analyst with experience in US healthcare and benefits EDI processing, specializing in X12 834 enrollment files, HIPAA compliance, and carrier integrations. Skilled in managing EDI implementations, NPY transitions, file validation, production support, and timely issue resolution while meeting SLA requirements for major carriers including UnitedHealthcare, Aetna, Cigna, MetLife, and Blue Cross Blue Shield. Experienced in secure file transmissions using SFTP and working with BenAdmin platforms and clearinghouses to validate, route, and exchange enrollment data securely between clients and insurance carriers.

Proficient with XML, flat files, Salesforce, Excel, and Optum for accurate and compliant benefits data processing.

EDI Analyst at A3 Logics (Client: PlanSource) (2024-07 – Present)

• Managed end-to-end EDI implementations and post-production support for healthcare and insurance integrations involving X12 834 enrollment transactions, proprietary carrier files, XML, and flat-file formats.
• Gathered carrier and client requirements, performed EDI mapping, data validation, testing, and discrepancy resolution to ensure accurate enrollment and member eligibility processing.
• Developed and maintained EDI maps and business processes aligned with HIPAA compliance standards and secure PHI handling practices.
• Acted as the primary point of contact between clients, carriers, brokers, and internal teams for resolving EDI transaction issues and ensuring timely communication and support.
• Supported secure file transmission workflows using SFTP and AWS-based integrations to ensure reliable and compliant data exchange.
• Investigated and resolved production issues, error reports, and transaction failures while ensuring SLA adherence and minimizing recurring escalations.
• Worked extensively with X12 834, XML, flat files, Excel datasets, and proprietary file structures for data transformation, validation, troubleshooting, and analysis.
• Collaborated with cross-functional teams and external stakeholders to identify process gaps and implement operational improvements that enhanced turnaround time and issue resolution efficiency.
• Managed multiple EDI implementation and production support activities simultaneously while maintaining strong attention to detail, prioritization, and client service standards.
• Demonstrated strong ownership by troubleshooting issues end-to-end and implementing long-term resolutions to prevent recurrence.
• Mentored and supported team members through knowledge sharing and collaborative problem-solving to improve overall productivity and delivery quality.

B.Tech in Electrical Engineering – Madhav Institute of Technology and Science (2018-07 – 2022-08)