CAREER SUMMARY:

International experience and exposure to diverse technologies, cultures, and business operations underscores more than 9 years of experience in the IT sector.

SUMMARY:

• Over 7+ years of extensive Data Analyst - Business Analyst skills - Understanding of Software Development Life Cycle (SDLC), Rational Unified Process (RUP), Agile/Scrum methodology, Unified Modeling Language (UML), Object Oriented Analysis and Design Concepts (OOAD), Business Process Re-engineering (BPR), Test Life-cycle, Data Modeling
• Expert in business process engineering and software development life cycle, including analysis, design, development, testing and implementation of software applications.
• In-depth knowledge of Rational Unified Process (RUP); risk engineering; data modeling and mapping; and design using UML, Rational Rose, and Visio.
• Familiar with current industry standards, such as HIPAA, SOX, ISO, Six Sigma, and Capability Maturity Model (CMM).
• Adept at reducing development costs and providing traceability of projects.
• Excellent communication, analytical, interpersonal, and presentation skills; expert at managing multiple projects simultaneously.
• Experience in facilitating Joint Application Development (JAD), Rapid Application Development (RAD), interviews, workshops, and requirement elicitation sessions with end-users, clients, stakeholders and development team
• Experience creating Traceability matrix to better manage the requirement gathering process and keeping track of the milestones.
• Extensive experience in interacting with stakeholders, gathering Requirements and creating Business Requirement Documents (BRD), analyzing and Creating Use Cases, Use Case Diagrams, Activity diagrams, Business Flow Diagrams
• Broad knowledge of HIPAA Standards (Title I & Title II), Medicare, Medicaid, PPO, HMO, POS, diagnostic codes and claims process.
• In depth experience in HIPAA ANSI X-12 EDI series such as 270/271, 276/277, 278, 834, 835, 837 and version 5010 of this transaction. HL7, ICD9/ICD10 and 4010/5010 versions
• Professional with extensive experience in the development, implementation and integration of strategies within a team oriented environment, utilizing quantitative and qualitative analytical skills.
• Self-starter, quick learner with excellent communication skills to perform well both independently and as a team player.

TECHNOLOGIES:

Management Tools: MS Project, MS Visio, Word, Excel, PowerPoint

Methodologies: RUP, Agile, Waterfall

GUI Tools: JFC/SWING, Applets, AWT, Dream-weaver, Tomcat5x, Visual Basic 5.0/6.0.

Development Tools: JBuilder3.5, BEA Workshop, Eclipse2x/3x, Visual Cafe, Rational Rose

Tools: Informatica, SQL Loader, Toad, Oracle Developer, Oracle Forms

Reporting tools: Cognos, Crystal reports

RDBMS: Oracle 7x/8x/9x/10x, DB2, MS Access 97, SQL Server 7

Web & App Servers: IBM Websphere6.x, BEA WebLogic5/6/8x, Tomcat, Apache and Jboss.

Operating Systems: HP-Unix, Sun Solaris, Win vista/7/8.1/10/ Linux

Version controls: CVS, Rational clear case/clear quest, Subversion.

Capture Tools: EMC Captiva Input Accel 5.3, Koufax Capture 9.

Version Control: Visual Source Safe 6.0, Tortoise SVN

Tracking tools: ALM Quality Center 9.0, PVCS, SQA Administrator, SOAP UI

PROFESSIONAL EXPERIENCE:

Confidential, FL

Business Analyst

Responsibilities:

• Interacted with the User’s, Designers and Developers, Project Manager and Subject Matter Experts (SMEs) to get a better understanding of the business process and its scope.
• Assisted in building Business Process Modeling for clear understanding of the business case using tools like IBM Web Sphere Business Modeler, Rational Software Modeler and MS Visio.
• Gathered Business requirements and documented them.
• Used Rational Unified Process (RUP) as the software methodology.
• Prepared Business Requirement Document and then converted in to Functional Requirements specification and Technical Specification using Rational Requisite Pro.
• Identified Use Cases from the requirements. Created UML Diagrams including Use Case Diagrams, Activity Diagrams and Sequence Diagrams using Rational Process Modeler and MS Visio.
• Assisted in the technology selection for the application, based on Cost effectiveness and quality with an eye towards the future.
• Continuously communicated with the design, development and test team using MS exchange Messaging and Defect Tracking System.
• Conducted JAD sessions with various stake holders on various phases of the Software Development Life Cycle (SDLC) to discuss open issues and resolve them.
• Participated in the testing process and involved in completion of the project in set time.

Environment: IBM Web Sphere Business Modeler, Rational Software Modeler, MS Visio, Rational Requisite Pro, Rational Rose, SQL Server 2000.

Confidential, Baton Rogue, LA

Sr. Healthcare Data Analyst

Responsibilities:

• Examined different types of claims: Medicare, Medicaid, Commercial, Professional, Institutional, etc.
• Identified issues with the claims / eligibility data.
• Identified issues with the claims / eligibility data, SQL queries and databases
• Gathered requirements by conducting meetings and brainstorming sessions with end users and Subject Matter Experts (SMEs) and documented them using Requisite Pro.
• Did Gap analysis on the ICD9 to ICD 10 conversion and subsequently the mapping between those.
• Analyzed requirements for developing a cross-walk for understanding major changes from ICD-9 to ICD-10 with the help of SME’s.
• Propose strategies to implement HIPAA 4010 in the new MMIS system & eventually move to HIPAA 5010.
• Prepared Business Requirement Documents (BRDs) after the collection of Functional Requirements from System Users that provided appropriate scope of work for technical team to develop prototype and overall system.
• Gathered requirements and modeled the data warehouse and the underlying transactional database.
• Performed Gap Analysis of the processes to identify and validate requirements.
• Identified/documented data sources and transformation rules required populating and maintaining data warehouse content.
• Make changes for HIPAA 277, 278, 835, 837 may also be receiving an (ORU) HL7 message.
• Defined and analyzed test cases, test scripts, bugs, interacted with QA/ development teams in fixing errors and conducted User Acceptance Test (UAT).
• Organized requirements into High level Use Cases and Low level Use Case Specifications and modeled them into UC, Activity and Sequence Diagrams using Rational Rose and MS Visio.
• Created Business requirement document (BRD), Functional Requirement Specification (FRS), Technical Requirement Specification for application development following the Agile methodology.
• Apply UML notations and methodology in developing models that accurately represent the business process and workflows and clearly communicate them to the stakeholders.
• Conducted JAD sessions involving the management, development and user teams for clarifying requirements and facilitating better communication.
• Analyzed the laws and regulations (HIPAA, HL7) before implementing the electronic medical record software
• Involved in data modeling process for designing the data warehouse.
• Analyzed and prepared Risk Analysis and Impact Analysis reports.
• Coordinated and prioritized outstanding defects and enhancement/system requests based on business requirements, allowing sufficient time frame to ensure accuracy and consider deadlines
• Reviewed Test Plans developed by the testing team for testing the application.
• Assisted the QA personnel in the creation of Test Cases using Rational Test Manager.
• Involved in performing version control and defect tracking activities using Rational Clear Case and Rational Clear Quest.

Environment: UML, MS Visio, MS Project, Ms Office, C++, Java, SQL, RDBMS, XML, Windows

Confidential, Louisville, KY

Healthcare Data Analyst

Responsibilities:

• Gathered requirements from stakeholders for provider management and member management.
• Identified and validated business rules and data elements.
• Propose strategies to implement HIPAA 4010 in the new Medicaid (MMIS) system & eventually move to HIPAA 5010.
• Created 837(P, I, D) claims, and maintained data mapping documents in reference to HIPAA transactions primarily 837(P, I, D), 835, 270/271, 276/277 and 278.
• Modeled the ‘as-is’ process flow and the ‘to-be’ process flow and analyzed the gap and developed the action steps to fill the gaps.
• Analyze EDI - X12 data elements captured by the existing system to validate it against the data elements required for new system.
• Worked with legacy team in developing BRD for multiple system change requests and participated in system testing.
• Worked within project team to identify and interpret state Medicaid policies as applicable to customer defined algorithm research as well as assist with internal development of new healthcare analytics.
• Conducted Impact analysis when there is any change in the requirements and updated the Business Requirements Document (BRD) and Systems Requirements Specification (SRS).
• Facilitated meetings with the technical team and client team to analyze the current process and gather requirements for the proposed process.
• Created functional requirement specification documents such as UML diagram, use case diagram, scenarios, activity diagrams and mapping.
• Developed the User Interface (UI) prototypes to capture and validate requirements and spike solutions to the current problem.
• Facilitated JAD sessions for Requirement Validation with Dept. of Cleveland clinic to gather requirements for the new MMIS.
• Participated in developing test plan, test scripts, and test scenarios and designed user documentation.
• Examine the system design deliverables & validating it against the SLA.
• Developed UAT test cases associated with the functional requirements.

Environment: MS Office, Windows, .NET, Agile, MS Visio, MS Share Point, TFS, MS Project, MS Visio, SQL, Oracle, SOA, HTML.

Confidential, Clearwater, FL

Healthcare Data Analyst

Responsibilities:

• Requirements gathering from various insurance companies to develop a system to check for the outstanding balance from various accounts using highly efficient RUP process of software development.
• Liaison between the Business needs (business users and sponsor) and the Technical solutions (development and testing staff), ensuring technical solutions satisfied business requirements.
• Web Page Mock-Ups using MS Visio and thus defining the Business Process Model and Data Process Model.
• Experienced in RUP software development cycle methodology with four consecutive phases - Inception, Elaboration, Construction and Transition.
• Ensured that the claims processing is strictly under the HIPAA compliance regulatory document to safe guard patient information.
• Authored Business and Functional requirements with supporting diagram, use cases, traceability matrices, and training manuals for Provider Portal web-based application.
• Developed training material and trained the users on newly developed application.
• Analyzed and wrote technical documentation for risk analysis on customer support issues.
• Part of the team assisting in documentation involved in this project such as RFP, proposal, evaluation criteria, proposal approval, design document, project plan, project scheduling, project report, release document.
• Prepared and presented monthly collection reports.
• Involved in training and quality of the overall workflow process.
• Documenting workflow and results of analysis for the aging accounts.

Environment: RUP, Rational Requisite Pro, UML Use Cases, VB.NET, SQL Server, Rational Rose, XML, Use Case Documentation.