Featured Member: Terrence Simms on HBCU CONNECT!

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Terrence Simms
EDI Operations Associate III, CGS Administrators LLC
Location: Vergne, TN United States
Joined: May 19th, 2013

About (request update)

Education (request update)

Tennessee State University class of 2000

Undergrad Major: Business Information Systems

High School: Whites Creek High Schl in Nashville, TN class of 1995

Experience

I currently work with CGS Administrators LLC as EDI Operations Associate III
I have 8 years of experience working in the Internet/E-Commerce industry.

EDI Operations Associate III | CGS Administrators, LLC
From January 2013 to Current • 13 year(s)
Conducts EDI training for new hires, serves as subject matter expert on external web portal, and provides Tier III help desk support to internal and external customers.

EDI Operations Associate II | CGS Administrators, LLC
From January 2012 to January 2013 • 1 year(s)
Provided Tier II help desk support, handled escalations and special projects, and served as team trainer on EDI systems applications.

EDI Implementation Analyst | Emdeon Business Services
From May 2011 to January 2012 • 1 year(s)
Implemented Commercial and Government payers from 4010 format to 5010 format by testing various EDI transactions and managing technical analysts.

Healthcare Applications Analyst | PathGroup, Inc
From November 2006 to May 2011 • 5 year(s)
Assisted with IDX system interfaces, developed claim form designs using Visual Basic, and transmitted Medicare and Commercial claims electronically.

Account Manager | AIM Healthcare/Compliance Resource Group
From May 2006 to November 2006 • 0 year(s)
Investigated payment discrepancies by insurance companies and calculated potential underpayments based on fee schedules and contracts.

EDI Help Desk Analyst / Tech Support | CIGNA Government Services
From April 2005 to May 2006 • 1 year(s)
Provided help desk support for EDI activities, processed EDI applications for new providers, and provided tech support to providers and vendors.

Liability/MSP Analyst | CIGNA Healthcare
From July 2001 to April 2005 • 4 year(s)
Investigated and resolved potential MSP liability cases, coordinated with various stakeholders, and calculated overpayments for refund requests.

Data Entry Clerk | CIGNA Healthcare
From June 1999 to July 2001 • 2 year(s)
Made corrections to insurance claims on mainframe system and maintained 99% accuracy with 192 transactions per hour in production.

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