SUMMARY:

• Business Analyst/Agile Business Analyst/ System Analyst with 3 years of experience in Banking, IT and Healthcare domains through exposure to innovative business processes.
• Good knowledge of Business Analysis methodologies, Iterative and Incremental Software Development Life Cycle (SDLC) using Rational Unified Process (RUP).
• Proficient in gathering business and technical requirements from both formal and informal sessions through interviews, NetMeeting, questionnaire, video conferencing, JAD sessions and conference calls.
• Strong Experience in Revenue Cycle Management such as CDM (Charge Description Master) Charge Capture and Charge Routing.
• Strong Experience in Claims Processing and Claims Scrubbing in HMO, PPO, Medicaid and Medicare.
• Experience in EDI (270,271,835,834,837) transactions.
• Worked on healthcare standards such as HIPPA 4010, 5010, DICOMM, CPT, ICD - 9 and SOAP. Adept with different SDLC methodologies- Waterfall, Rapid Application Development (RAD), Rational Unified Process (RUP) and Agile (SCRUM).
• Expertise in creating Requirements Traceability Matrix (RTM) to control numerous project artifacts
• Expertise in conducting Stakeholder Analysis to get a clear understanding of the process stakeholders, and their roles & responsibilities towards the project.
• Highly skilled in writing Business Requirements Documents (BRD), Functional Requirements Documents (FRD), Request for Proposals (RFP), Statement of Work (SOW).
• Extensive Knowledge of performing of data analysis, data modeling, data mapping, batch data processing and capable of generating reports using reporting tools such as Business Objects, Crystal Reports .
• Competent in creating Narrative Use Cases, User Stories, Use Cases, Activity Flow Diagrams, and Data Flow Diagrams using UML Tools - MS Visio, Enterprise Architect, Rational Rose.
• Highly skilled in dealing with diverging perspectives, and identifying risks for project mitigation.
• Excellent experience in software testing in Client Server Application and Web based application using Manual Testing Techniques and Automated open source Testing Tools.
• Proficient in conducting User Acceptance testing extensively at both company and client’s premises.
• Expertise in assisting Testing teams with Test Plans, Test Cases and Test Scenarios, and manage defects using various Defect Tracking Systems.
• Functional Testing Tools Selenium Web Driver, HP Quick Test Pro (QTP).
• Backend testing using SQL Queries. Involved in creating the Scenarios for single and multi-user test. Expertise in Data driven testing, Back-End testing.
• Experience in writing SQL Queries to extract data and perform Data Analysis.
• Good understanding of Change management and Release managemen t.
• Proactive in coordinating with Distributed Teams for onsite- offshore model, and communicate effectively with Business Partners, Management, IT organization and the Client community.
• Outstanding written and verbal skills with explicit attention to detail during requirements elicitation.
• Excellent Leadership, Interpersonal, and Analytical skills, with ability to handle challenges with ease.

TECHNICAL SKILLS:

Methodology: RUP, Extreme Programming (XP), Waterfall, Agile, Scrum

Data Bases: SQL Server, Oracle, DB2, MS-Access, Excel

Programming Languages: SQL, PL\SQL, Visual Basic, Java, JavaScript, HTML, dBase, Cobol, Fortran.

Operating Systems: Windows95/98/00/NT/XP, MS-DOS, UNIX, Mac

Project Management: Microsoft Project, Microsoft Office.

Quality Management: ISO 9000, PMBOK

Business Modeling Tools: Rational Rose, Enterprise Suite, MS Visio, MS Project

Healthcare: TRIZETTO, FACETS, COBRA, NASCO, HIPPA, FMLA, SUR, EPSDT, TPL, BPA, BIAR, Medicare-caid, Obama Care

Banking/ Finance: Laws of Banking, Types of Banking, Financial Assets, Financial Market, Types of Payments, Bank s balance sheet

Business Skills: BRD, FRD, SRD, Project Kick-off, MOM s, Requirement gather & analyze, Mainframes, Modelling, & Analysis, Competitive Intelligence, Risk Management

Testing Tools: Test Director, Win Runner, Selenium JIRA, Rally, Swift ALM, HP Quality Center, IBM Rational Clear Quest.

PROFESSIONAL EXPERIENCE:

Confidential

Business Analyst

Responsibilities:

• Conducted Requirement gathering sessions, interviews and Joint Application Development (JAD) sessions.
• Worked on the different systems for Enrollment / Maintenance /Billing (payment credit industry)/Reporting for Direct, Small Group, Large Groups, Mid-Large Groups
• Traced current system output results for the new enhancements. Reviewed the SQL with solutions and assumptions in IAD's. Reviewed data archiving code and ETL scripts (Data Extract- Transform and loading) Data Warehousing (DWH) process flow.
• Modeled the business process flows using Rational Rose, the existing ER diagram and Data Flow Diagram (DFD) and developed UML Use case diagrams, Activity diagrams, Sequence Diagrams, Collaboration Diagrams and prototypes.
• Studied the business and technical needs and modeled the AS-is and TO-be scenarios. Conducted GAP Analysis, Impact Analysis and Risk Analysis of the to-be model. Created the Business Requirements Document (BRD) from the requirements gathered. Generated the business process model to better understand the business workflows.
• Identifying and documenting data standardizations to be performed, data enrichment operations, data validations, data security requirements, and data exception handling processes.
• Interact with different groups of Infrastructure to have the Siebel environment co-exist with other application environments.
• Identified and documented Issues, risks and gaps and their descriptions and impact, and provided recommendations and alternatives.
• Created AS-IS and TO-BE business process flow diagrams, integrate process flow diagrams to show one end-to-end business model. Responsible for creating business flow diagrams (using MS-Visio).
• Used MS Project to manage schedules, deadlines and resources and collaborate on the project.
• Created initial Test plan, and test cases for acceptance test to provide the minimum requirements validation for the business process.
• Used Rational Clear Quest to maintain and track the requested enhancements and changes.
• Working on Oracle for data warehousing and data mining purposes.
• Worked with Testers in User acceptance testing (UAT), System testing, Integration testing and build verification testing.

Environment: Rational Suite (RUP, UML with Rational Rose, Rational Requisite pro, Clear Quest, Rational Robot, Clear Case, Web Services, Share Point Server 2007, Lotus Notes, Siebel, MS-Visio, Oracle.

Confidential

Business Analyst

Responsibilities:

• Gathering requirements from Current Account Group, Saving Group, Mortgage Group, Tax Group, identifying functional requirements and documenting them into a Business Requirement Document (BRD).
• Created Narrative Use Cases, Use Case diagrams, Work flow diagrams, flow diagrams using MS Visio.
• Worked with Business Owners, IT Group, QA Team to scope and prioritise development releases.
• Prioritised project efforts, developed Project plans, Process flows, Use Cases and System requirement specification and analysed the Business requirements and the site specifications.
• Documented Detailed Business Requirements for Automated Management, Automated Financial Reporting and Automated Process Notifications to relevant departments.
• Analysed System and Functional Specification documents for the Web System.
• Worked on writing functional specification for reporting module that handled credit and consumer risk management services.
• Developed RUP Analysis Model that included entity classes, use case diagram that provided a view of the requirement and implemented a modified RUP process for managing requirements.
• Worked with IT Development team to identify bottlenecks that could hinder progress of development.
• Played a key role in helping the company adopt Rational Unified Process and used UML notations.
• Created a Test Strategy to be implemented across multiple projects across the web integrated system. Developed the Testing Strategy for the entire application and developed various test cases.
• Initiate, coordinate and implement the system testing Process. Tested security privileges of the application for individual users as well as group access.
• Extensive interactions with the client and the management teams to understand the requirements and report the status of the testing efforts on their applications.
• Involved in formulating the test plans and test cases along with the Testing lead for streamlining the testing process and also involved in the functional testing of the system.

Confidential

Business Analyst/ Knowledge Analyst

Responsibilities:

• Involved in gathering the requirements that were critical to the business process flow and using those requirements for the Business Requirements Document (BRD), for the implementation of the NPI in EDI X12 transactions as mandated by the Federal Regulation.
• Conducted JAD sessions with Subject Matter Experts (SME’s) to obtain domain level information, interviewing and asking detailed questions and carefully recording the requirements in a format that can be reviewed an understood by both business and technical team.
• Responsibly handled HIPAA EDI validation from Medicare, Medicaid and other payers of government carriers Created documents that incorporated both the technical and functional details.
• Involved in creating documents and diagrams for Membership Enrollment according to the HIPAA 834 Compliance Standards for Membership Enrollment.
• Understanding on Adobe Experience Manager (AEM), it is a server side program that runs on various platforms (Windows, Mac or Linux).
• Worked with user to define user acceptance test cases. Involved in UAT testing (User Acceptance Testing) and Implementation.
• Worked on NASCO for claims adjudications for individuals, small and large group members.
• Responsible for making LIMS Development System (It is to manage data & manage Inventory)
• Involved in HIPAA/EDI Medical Claims Analysis, Design, Implementation and Documentation
• Entered numerous claims for testing purposes to ensure accurate and quality adjudication and implementation of business and operational requirements
• Conducted Data analysis using SQL on the backend databases for producing mapping documentation and transformation rules for developers
• Analysis of existing data requirements using SQL to document functional requirements.
• Worked on Data Mapping to map Facets billing data to outbound eligibility extracts
• Wrote complex SQL queries to extract and validate the data from the Facets database
• Designed Activity, Sequence and Process Flow Diagrams using MS Visio to simplify and elaborate certain selection criteria and filter conditions.
• Performed complete and accurate data entry of qualifying services into HEDIS.
• Involved to prepare a visual representation of flow charts using BPMN
• Documented requirements using Use Case (UC) analysis for the development team. Also, stored the documentation in a common SharePoint Repository for version control
• Facilitated the User Acceptance Testing (UAT) with System Administrators and Business Users, documented any issues or defects and eventually got sign off from the right parties
• Assisted in development of User Interfaces and prepared screenshots to get business’s buy-in on the requirements
• Used Rally to track requirements and to maintain different versions of the project documentation

Confidential

Project Manager

Responsibilities:

• So we have done the project management aspects of the task by performing project management side like Stake holder analysis,
• Time Management plan, Cost management plan, Risk assessment, Gantt Charts, WBS (Work Breakdown Structure), Network Diagram, Resource allocation, Break Even Analysis, and Critical Path.

Tools: Used: MS Project 2007, MS Visio 2010

Confidential

Team Leader

Responsibilities:

• This project was a projection of business strategy concepts like Revenue Models, Cost Models, Project Methodology (Agile or Waterfall) and Business Plan and the Harvest Plan.