Sunsi Lal

Result-driven EDI Analyst with over 3 years of experience designing, implementing, and optimizing Electronic Data Interchange (EDI) systems. Proven expertise in onboarding trading partners, Expert in navigating HIPAA compliance regulations, safeguarding PHI, mapping complex X12 transactions, and resolving transmission errors to ensure seamless supply chain workflows. Adept at bridging communication gaps between technical teams and external business clients.

EDI Business Analyst - Healthcare Industry

(2023-09)

Managing over 15 hospital accounts and 74 in total as a team

• Manging Post onboarding monitorings and assited onboarding for 25+ major trading partners, configuring AS2 connection endpoints and end-to-end testing maps.
• Designed and maintained document translation maps for X12 850 856 and 810 formats using Opentext and GHX tenet connections.
• Collaborated with ERP teams to integrate EDI document transactions directly into corporate SAP modules.

AR Caller - CareRevenue Kochi - Kochi

(2010-11 - 2022-11)

Healthcare Industry

• Made outbound calls to US insurance payers (e.g., Medicare, Medicaid, and commercial carriers) to verify claim statuses, investigate outstanding balances, and expedite reimbursements.
• Analyzed and rectified denied claims due to missing information, coding errors, lack of precertification, and eligibility issues
• Ensured strict HIPAA-compliant communication and documentation during all calls and correspondence with insurance carriers.
• Handled sensitive Patient Health Information (PHI) and medical records with maximum confidentiality and adherence to privacy regulations.

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