Project Title: Medicare Information and Billing System (MIBS) Mainframe Project
Software Environment: COBOL , TELON, VSAM CICS, JCL , FTP, IMSDB ,IBM UTILITIES, FAIL AID, UCC7, CA 7 , PROSE , REMEDY, SQL.
Project Abstract & Scope:
The Medicare Information and Billing System (MIBS) bills Medicare Part A claims through UB92s and provides information for the Medicare RISK program. RISK, which is known to Kaiser Members as Senior Advantage, is a Medicare form of compensating HMOs based on a flat rate per month per HMO Medicare member. MIBS is a homegrown application used by KP since 1985. It creates and processes, NCAL SNF< SCAL Home Health and Hospice claims. Claims are sent to a fiscal intermediary GBA Centre for Medicare Services (CMS) . SNF claims are sent to GBA (Palmetto) for reimbursement. Home Wealth and Hospice claims are sent to NGS (National Governmental Services) for reimbursement.
- Analyzing the Business Requirements and System specifications to understand the application.
- Communicating with Business users.
- Provide 24 x 7 on call support and Technical support on Mainframe Applications as well as third party applications.
- Provide the RCA (Root Cause Analysis) and for the Abends and provide permanent solutions.
- Support delivery of batch and online programs, customized reports, application/ date conversion and process improvements.
- Designing FTP feeds using Batch JCL.
- Modified and run the BATCH jobs for generating user specific reports.
- Involving in fixing up production issues.
- Creating and Executing JOBS, PROCS and Control Cards in Test environment.
- Update the PROSE members.
- Delete, Define and Restore the VSAM files.
- Co-ordinate and communicate with Offshore.