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Business/system Analyst Resume


  • Four plus years of IT experience with expertise in Business Analysis/ Data Analysis/Data warehousing/Data Modeling. Dynamic and Assertive team player with strong commitment. Possess excellent verbal and documentation skills complimenting a strong Business analysis background with excellent interpersonal and problem - solving skills.
  • In-depth knowledge and experience in full SDLC with RUP, agile and waterfall methodologies.
  • Functional experience in health Care Industry with vast knowledge on Medicare and Medicaid.
  • Specialize in GAP analysis
  • Extensively used SQL queries for data verification at the backend.
  • Proficient in all phases of Requirement Management, including gathering, analyzing, detailing, and tracking requirements.
  • Experience in Business Requirement and System Specifications Analysis.
  • Knowledge of reporting tools such as SQL for underlying database tables and resolve data issues.
  • Advanced EDI reading ANSI X12 (837 Structure), using it to troubleshoot along with the implementation Guide.


Microsoft Technologies: MS Project, Visio, Excel, Word, Outlook, PowerPoint, Erwin

Requirements Management: Rational Requisite Pro

Business Modeling: Rational Rose (Use Case Diagram), MS Visio

Defect Tracking Tools: HP Quality Center, Rational ClearQuest

Languages/Standards: SQL, EDI -837 (Reading ANSI X12)

Methodologies: Agile, Waterfall

Databases: MySQL, SQL Server, Oracle



Business/System Analyst

Essential Responsibilities:

  • The IT Department serves all of All Risk’s internally departments. A lot of what is done is to develop systems, with the help of three main 3rd party vendors, to create or identify and customize tools for the All Risk’s sales team.
  • Answering or Creating User Support ticket requests and trouble-shooting to communicate with internal customers daily to assist them with their daily responsibilities of issuing out policies and their claims adjudication processes
  • Investigate root-cause of issue that Users are facing and finding solution through backend environment or logging as an administrative user on the respective system, coupled with data analysis to correct system issue.
  • Triage, Work or if necessary escalate system issues which are classified as CRITICAL to technical subject matter expect within the maintenance team.
  • Performed a reconciliation called DAILY SUSPENDS PROCEDURE, which monitored the number of transactions moving from the AS400 to ConceptOne.
  • Troubleshoot technical and user issues relating to business systems
  • Analyze and evaluate existing system functions and capabilities to identify changes and/or enhancements that will improve service levels and productivity.
  • Monitor and support production jobs, including some On- call support.
  • Conduct systems test planning and execution.
  • Design, develop and implement production reports


Business Analyst


  • Collaborated with clinical and business individuals to evaluate healthcare data within Inovalons risk adjustment and care coordination product lines. The information gathered and analyzed by our team provides the foundation for answering complex client and executive inquiries on product results and performance while supporting the continued advancement of Inovalons services capabilities.
  • Using X12 knowledge to troubleshoot, examined syntax and basic structure for both 837/(999- Standard payer response) within 24hrs.
  • The Business Analyst conducted product research, development, and program of the Accountable Care Organization (ACO) Solution suite.
  • Supported the creation of business-owned deliverables, setting goals and priorities to gather and define product requirements, assist with building out new/improved processes and continuously align deliverables with business objectives.
  • Gather and document business requirements, from multiple sources for development and enhancing ACO Solutions; participating in creating and articulating relevant solutions for clients/vendors and in developing methods or processes for implementation.
  • Provided support, research and subject matter guidance to programmers to assist with software development; Develop software documentation and process flows for external and internal clients.
  • Translated Business Requirements into Technical Specifications data models, event models, reporting output, technical architecture and related end-to-end data flow.
  • Provided data analytical input, including charts, tables, graphs and other analysis for executive-level.
  • Performed complex custom analytics as needed by clients and executive management
  • Developed solution to complex software design issues during the product development cycle, keeping in mind scope limitations and the impact of their integrated products.
  • Designed and developed specific database for collection, tracking, and reporting of data.
  • Designed, tested and debugged custom queries using Microsoft SQL and SQL Reporting Services
  • Diagnosed and addressed Operational data requests and interact with clients, as needed as both a technical and functional expert.

ENVIRONMENT: MySQL, Excel (Pivot Tables), Rational RequisitePro, Data Collection Tool (DCT)

Confidential, Columbia, MD

Business Analyst


  • Worked closely with Product Management and Product Development to translate detailed product requirements for the products into effective design specifications within a Windows development platform.
  • Experienced with Product Management, Application customization and worked on multiple system integration projects
  • Validated business rules and all artifacts with users, got approval and sign off.
  • Imported, managed and tagged requirement documents, and designed project deliverables (Attribute Matrix, and Traceability Matrix) using various tools.
  • Followed Unified Modeling Language (UML) methodology using RequisitePro and Rational Rose to create/maintain: Use Cases, Activity Diagrams, Sequence Diagrams, and Collaboration Diagrams.
  • Created MS-Visio diagrams to depict the “AS-IS” workflow of the system in place.
  • Worked with enterprise architects to create the “to-be” workflow.
  • Designed and analyzed data in the Data Warehouse and Data marts for the data conflicts or ambiguous information.
  • Designed and customized data models for Data warehouse supporting data from multiple sources
  • Wrote advanced SQL queries to test the database backend.
  • Used SQL queries to extract data from MySQL database including testing and production for data validation and data analysis
  • Planned and defined system requirements through Use Cases, Use Case Scenario and Use Case Narrative using the UML (Unified Modeling Language) methodologies.

Environment:: Oracle SQL 10, MS-Visio, MS-Excel, MS-Word, MS-PowerPoint, MS-Project

Confidential, Baltimore, MD

Business Analyst


  • Conduced Joint Application Development (JAD) sessions and walk in interview with the business users to gather requirements
  • Created Use Cases diagram and Activity diagram to depict the interaction between the various actors and the system in Rational Rose for the Business Use Case and System Use Case.
  • Prepared the business requirement document (BRD) and system requirement document (SRD).
  • Prepared functional requirement documents
  • Develop business glossary for Enrollment and Eligibility, Claims, Facets and Revenue
  • Develop business glossary/dictionary for the selected metadata areas
  • Prepared user manual and administration manual for Informatica Metadata Manager 9.5
  • Assist testers to develop test cases and test plans
  • Perform UAT testing with end-user and log in defects.
  • Performed data lineage, data profiling, data modeling and also ensure data integrity
  • Developed SQL queries for data extraction, analysis and reporting.
  • Wrote SQL queries to validate data from source and target
  • Gathered Business Requirements. Interacted with the Users, Designers and Developers, and the Project Manager to get a better understanding of the Business Processes.
  • Focused with provider eligibility and worked with claims and benefits.
  • Fully engaged and mentored the development and management teams in the Agile/Scrum process.
  • Created Use Cases, Sequence Diagrams, Collaboration diagrams, Activity Diagrams, and Class diagrams using business Process Models using MS-Visio, MS-Excel, MS-Project.
  • Organized and performed walkthrough of my requirements document with the stakeholders as well as the development team.
  • Performed Gap Analysis to identify the deficiencies of the current system and to identify the requirements for the change in the proposed system.
  • Identify data elements from the source systems, performed data analysis to come up with data cleansing and integration rules for the ETL process.
  • Performed extensive requirement analysis including data analysis and gap analysis.
  • Assisted the testing team in developing the test plan, test conditions, and test cases based on business requirements and technical specifications.
  • Created SQL scripts to supplement the ETL process and to verify on final target data.
  • Helped in redefining existing practices, methods, and formats used in creating source to target mapping documentation, and documented several source to target data flows.
  • Developed Excel applications (pivot tables, vlookups) to streamline processes for analysis and reconciliation.
  • Constructed data models and data maps to be used from the central data warehouse using Erwin.
  • Reconciled discrepancies in current state logical and physical data models, and collaborated with other team members to model additional entities and relationships.
  • Resolved primary and foreign key discrepancies on database tables, documented causes of duplicate, missing, and incorrect data, and identified and corrected Data Stage coding errors.
  • Involved in walkthroughs and meetings with development team to discuss related issues.

Confidential, Tampa, FL

Business / Data Analyst


  • Conduct gap analysis between the current system and new requirements to be implemented thereby mapping the business requirements to the application
  • Prepared high level and detailed system requirements documents for the application
  • Using X12 knowledge to troubleshoot, examined syntax and basic structure for both 837/(999- Standard payer response) within 24hrs.
  • Identified the requirements for accommodating ICD-10 standards for 837P transactions and captured these requirements to create BRD.
  • Participated in the walkthroughs and meetings specifically for Claims and Membership modules.
  • Write high level and low level business requirements and design mock-up screens for the application
  • Validated the process flow for “AS IS” system and understand where exactly ICD-9 Procedural and Diagnosis Codes are used.
  • Analyzed SQL queries that were used by the testing team to validate the data in the back-end Oracle Database.
  • Conducted meeting with the team members to discuss the requirements and mock-up screens
  • Translated the requirements gathered during interview with SME’s and created process flow diagram based on the requirement captured.
  • Worked closely with the business team, development team and the quality assurance team to ensure that desired functionalities will be achieved by the application
  • Provided business and technical suggestions and recommendations during the project life cycle.
  • Using X12 knowledge to troubleshoot, examined syntax and basic structure for both 837/999
  • Analyzed the requirements for Benefit Configuration, fraud and abuse solution to be developed
  • Worked on defining and implementing Clinical policy
  • Prepared high level and detailed functional requirements documents for the clinical policy
  • Involved in strategic planning and analysis of enterprise systems to assist in the healthcare fraud and abuse solution development
  • Tested the validity of the data cleaning done by the ETL by writing SQL and by using Informatica.
  • Involved in meetings with director of health analytics, project manager and other stakeholders to identify the cost associated, values delivered and break even time
  • Tested the validity of the data cleaning done by the ETL by writing SQL.
  • Facilitated Electronic Data Interchange and storage in the ICD 9.
  • Created the data dictionary for the clinical aberrancy rules
  • Defined input and output data elements to and from the rules processing engine
  • Analyzed the integration requirements between various tools for Payment Integrity solution
  • Work together with the architects and team responsible for supporting rules processing tools during the project to assist with the required support.
  • Work closely with the business team, development team and the Quality Assurance team to ensure that desired functionalities have been achieved by the application.

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