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Sr. Business Analyst Resume

Providence, RI


  • Business Analyst having around 8 years of successful experience in HealthCare domain.
  • Expertise in S.D.L.C methodologies which includes significant experience in Waterfall and Agile methodology.
  • Expertise in Analyzing, Defining, Documenting and Managing Business, Technical, Functional and Non - functional requirements.
  • Extensive experience in gathering Business/Functional user requirements, creating Use Cases as per user requirements, developing/designing diagrams such as Activity, Class, and or Sequence diagrams, and in addition to creating Business Requirements Document (BRD), BDD (Business Design Document) along with use case and work flow diagram.
  • Skilled in interviewing Business users, customers and providing recommendations to resolve issues for various business/technical groups & defining strategic solutions to business problems in a multiple projects environment.
  • Experience in working in onshore-offshore model and teams located across different geographical locations.
  • Experience in Organizing and Leading Sprint Planning & Kickoff Meeting, Grooming sessions, Daily SCRUM Meetings, Sprint Retrospective Meetings.
  • Proficient in using Project Management tools like MS Project, MS Visio and Process based Test Management Tools like Quality Center, ALM, Rally and Jira.
  • Skills and experience include acquiring the traceability matrices of the business requirements.
  • Experience in business requirements gathering and writing including the EDI transactions from . Other health care projects include ICD9/10, BILLING, Benefit Configuration, Membership, and Provider.
  • Through understanding of QA methodologies. Expertise and experienced in performing black box testing, white box testing, GUI testing, integration testing, interface testing, end to end testing, backend testing, regression testing, UAT, performance testing, load, stress and Volume testing.
  • Experience with data analysis, data mapping, and data-masking, cross-functional application/domain dependencies.
  • Excellent Documentation skills to prepare Test documents like Test Plans and Test Strategies and control processes in accordance with SOX compliance.
  • Strong technical skills to perform Smoke, Functional, Integration, Regression, Performance, User Acceptance & Cross Browser tests for Desktop, Web based and Client Server applications.
  • Experience in Data Analysis, Data Validation, Data Cleansing, and identifying Data dependencies across systems.
  • Experience in testing web applications using different browsers. (IE6, 7 & 8, FireFox3, Safari 4, S60)
  • Experience on Migration, Implementation of the software releases.
  • An analytical and innovative Team Leader possessing excellent communication, interpersonal, coordination, presentation, team building and leadership skills with experience in Global Delivery Model.


Operating system: Windows-all versions, Unix

Languages: HTML, PL/SQL, Java, VB Script

Project & Test Management Tools: MS Project, MS Visio, HP Quality Center, HP ALM, Rally, VersionOne, TFS, JIRA

RDMS Technologies: SQL Server, SYBASE, NEXUS 9.01, TOAD

Other Tools/Technologies: MS Office Tools, SOAP UI, Oxygen, HP QTP, WinSCP, SharePoint, CA Service Virtualization, FACETS, Tableau, Google Test Analytics


Confidential, Providence, RI

Sr. Business Analyst


  • Analyzed massive and complex data, data manipulation, drawing conclusions and developing recommendations.
  • Extensive exposure to Agile and Waterfall Methodology.
  • Contributed as Senior Analyst to implement FEP Migration, ITS HOST Migration, NEHP (NEW ENGLAND HEALTH PLAN) Migration, Ancillary Dental, Auto Enrollment, EAM Change Packs, Government Programs 2014, Government Program 2015 and Government Program 2016
  • Attended meeting for requirements gathering for Claim Adjudication, Finance & Membership for preparing Test Specification Document. Executing both Functional Testing and Regression Testing.
  • Coordination with business owners, developers and business analyst.
  • Project followed EHS product delivery methodology and Participated in overall Confidential (Health insurance Exchange) eligibility design session elicited Confidential business requirement and Initial Data elements section session .
  • Closely work with EHS enterprise architect to finalize the final MDM data elements.
  • Investigation of defects, development of unit test cases and test case execution.
  • Walkthrough of the Test Results with Business.
  • Attend to account level Projects interdependency meeting with other on-going projects as a business analyst from Web portal Team; identify projects that affect the portal migration.
  • Work closely with 5 states initiative Translator Update project and ACA(Affordable Care Act) 270/271XML solution project, and ACA(Affordable Care Act) 276/277XML solution project
  • Part of breakup Rhode Island MMIS elig-engine and claim search engine initiative team, assisted with system Architect propose impact analyst and feasible study for breakup the MMIS engines. Logging & re-testing defects and assigning them to the developers/responsible persons.
  • Preparing dashboard reports on a weekly basis using Quality Center
  • Worked on UCDS ( Universal Claims Disbursement System) with ClearCycle
  • Tested interfaces and ANSI X12 / EDI Version 4010/5010 transactions for (270, 271, 276, 277, 278, 835, 834, TA1, 997 and 824 BRR)
  • Involved in uploading project documents on Sharepoint as per release.
  • Tested whether the number of rows in the target tables are correct according to the inbound flat file.
  • Performed System Testing and Integration Testing and Regression Testing
  • Worked on TRR and TRC of Centers of Medicare and Medicaid Services (CMS)
  • Followed the Mapping documents and HIPAA implementation guides for HIPAA Transaction Mapping.
  • Assisting with Business case, scoping and quick size the project.
  • Planning, Monitoring, Defining and documenting business and functional requirements.
  • Analyzing user requirements and providing software solutions. Documenting System Requirement Specifications, mapping, flow diagrams etc.
  • Interacted with Business users and Technical team in providing clear solutions to requirements.
  • Creation of Test Scenarios for approved business requirements.
  • Reviewing Unit testing results, creating Test Plan, performing System Testing, Partner Plan testing and supporting User Acceptance testing.
  • Creating Implementation plans and leading implementation and post implementation activities.
  • Performing the Onsite-Offshore Coordination for the SIT team
  • Communicate with technical team and business operation team to fulfill project requirements.
  • Setup knowledge transfer session with business users.
  • Authored use case document to capture user work flow.

Environment: FACETS 5, SQL Server 2008, Sharepoint, HP Quality Center, Soap UI, SQL Developer, Citrix, Windows, MS Office, MS Visio, Nexus 9.8, IBM Lotus, NotePad ++

Confidential, Danville, PA



  • Tested the Web based application built on Java for exchanges
  • Generated numerous Business Requirement Documents, Functional requirements specification documents, Use Cases, system flow and work flow diagrams.
  • Gathered requirements by conducting JAD sessions, facilitating meetings and interview with Business Units and Technical Supports & Development team. Identifying the business flows and process flows, conducting detailed and comprehensive business, functional and system analysis to determine High Level and Low Level artifacts and deliverables.
  • Analyzed business requirements and developed test cases
  • Dealt with Medicare/Healthcare Payers and Providers and processing of Paid Claims, Denied Claims, Shopper Claims (for Fraud detection) and county based member claims.
  • Performed a major role in the accomplishment of three major deliverables - Requirement Definition Deliverable (RDD), Functional Specification Deliverable (FSD) and the Technical Design Deliverable (TDD) to MNSDOH
  • Defined and designed the Data and Application security matrix spreadsheet which spans through different organizations in MNSDOH and describes their capability of accessing specific applications and data elements in the Medicaid Data Warehouse Executing both Functional Testing and Regression Testing.
  • Developed SQL queries to query Facets database setup test data and review test results.
  • Logging & re-testing defects and assigning them to the developers/responsible persons.
  • Preparing dashboard reports on a weekly basis using Quality Center
  • Ensured credibility and accuracy of business specifications by carrying out brainstorming sessions, development meetings and other collaborative efforts.
  • Detailed knowledge of business process to help determine the user needs.
  • Developed business and functional requirements for the National Provider Identifier (NPI) Crosswalk and Crossover Claims Crosswalk solution.
  • Developed Test Plans and Test Execution Procedure Document based on the Business & Functional Requirement Document and numerous Test Cases and Test Scenarios to cover overall aspect of quality assurance.
  • Successfully tested all the test conditions documented the defects and discussed with technical analysts the discrepancies between expected and actual results for the test conditions.
  • Conducting and participating Peer review meetings, Weekly project and Test Team meetings
  • Tested the Configuration to ensure that fixes were working as planned.
  • Tested billing system which has been updated to support ICD 10 codes.
  • Used Edifecs transaction management solution for monitoring transaction, notification and alerts.
  • Validated signoff documents were developed to conclude the testing efforts.
  • Documented test plans, test suite design and test cases.
  • Developed workflows that demonstrate current and proposed business requirements. Along with providing weekly updates to project stakeholders on the progress of project development activities. Assisted with configuring key data into database from Informatica
  • Experienced in testing key applications as part of Facets upgrade from 4.71 version to 5
  • Verified the Installed data into FACETS

Environment: FACETS 5, SQL Server 2008, QTP, Quality Center, QTP, Soap UI, TIBCO, SQL Developer, VPN, Citrix, Windows, MS Office


Business Analyst/QA


  • Part of dedicated UAT Test team
  • Worked with Use-Cases and wrote test cases.
  • Tested the functionality in various subsystems like Claims Adjudication and pricing, PA, PAS, Provider, Member management.
  • Responsible for communicating with the consumer and technical team groups in collecting the required data to make the correct disposition for each case
  • Exported the EDI transactions and conducted testing using the Claredi testing tool Tested the edit and audit processing to ensure that claim records are edited and audited in accordance with the claim processing policy.
  • Conducted Functional and System Integration testing.
  • Worked to build and populate client dashboards in Tableau.
  • Involved in Developing test scenarios and test cases for Data conversion interfaces.
  • Involved in Developing test scripts and execution using Rational Manual Tester and CQTM
  • Tested the ETL work flows and batch logs.
  • Used Rational Clear Quest for defect tracking
  • Tested interfaces and ANSI X12 / EDI Version 4010/5010 transactions for (270, 271, 276, 277, 278, 837P, 837I, 837D, 835, 834, TA1, 997 and 824 BRR)
  • Managed and completed end to end-testing for several interfaces including Credit Card testing and EPIC performance testing
  • Wrote detailed test scripts in HP Quality Center for numerous interfaces. Involved in the testing of the UI Interface and cross browser testing.
  • Maintained Test Logs, Test Summary reports and participated in defect review / Status Meetings.
  • Proactive interaction with the client for the resolution of issues.

Environment: Rational Suite 7.0, SOAP, Toad, MS-Office, Oracle 10g, Trizetto Facets, ANSI X12, Message Broker, MS Visio, Edifecs and Quality Center.

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