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Business Analyst Resume

Grand Rapids, MI

SUMMARY:

  • Have profound experience of over 10 years as a Business Analyst with excellent project management skills in various domains.
  • Outstanding knowledge in Software Development Life Cycle (SDLC) methodologies like Agile, RUP and Waterfall.
  • Expert in Business Process Management, Business Process Reengineering, Business Process Modeling, Business Analysis, System Analysis, System Architecture, feasibility studies, Scope Documents and requests for proposal.
  • Extensive experience in requirements gathering, surveys, questionnaire, Business Requirement Documents (BRD), Functional Requirement Specifications/Documents (FRS/FRD).
  • Strong experience in GAP analysis to identify system restrictions and potentials, and creating AS - IS and TO-BE documents and Process Maps.
  • Expert in developing Use Case Diagrams, Behavior Diagrams (Sequence Diagrams and Activity Diagrams) based on the UML Methodology.
  • Strong Experience in conducting Joint Application Development (JAD) session with onsite and offsite team
  • Skilled in working with teams in Agile environment and perform as Business analyst, Facilitator, Tester, or Scrum Master
  • Proficient in all phases of Requirement Management, including gathering, analyzing, detailing, and tracking requirements.
  • Involved in Test Planning, Test Preparation, Test Execution, Issue Resolution and Report Generation to assure that all aspects of a Project are in Compliance with the Business Requirements.
  • Good understanding of health care industry, Claims Management process, Medicaid and Medicare Services.
  • Familiar with HIPAA Standards and Compliance issues, HIPAA Privacy policy, requirements gathering in compliance with HIPAA 4010 and 5010 standard.
  • Solid understanding of Membership, Claims Processing, Billing, Benefit/Eligibility, Authorization/Referrals, COB, and have experience in HIPAA standards and corresponding EDI transactions.
  • Extensive experience in Healthcare/Claims adjudication with knowledge of industry compliance standards like HIPAA and EDI X12 transactions (834, 837, 835, 270/271, 276/277).
  • Proven ability to analyze complex problems, identify risks and develop effective solutions to improve productivity, reduce cost and track progress through all phases of SDLC
  • Strong experience in all phases of Software Development Lifecycle (SDLC) using Waterfall, Agile/Scrum, RUP (Rational Unified Process) and Software Testing Life Cycle (STLC).
  • Proven ability to support multiple complex projects under tight deadlines, often with competing priorities
  • Experience in Change Management and Conflict Resolution at various stages of the project life cycle
  • Strong Experience in developing test plans, building Test Conditions and Test Cases, creating test data, analyzing bugs, and interacting with development team members to fix errors.
  • Strong SQL background, including data validation and system testing using SQL.
  • Highly motivated and organized leader with excellent client relationship, communication, and delivery skills.

SKILL:

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

Requirements Management Tools: Rational Requisite Pro, Rational Rose, MS Visio, HP ALM

Operating Systems: Windows 2000/7/XP, DOS

Languages/Standards: SQL, UML, XML, HTML

Defect management Tools: Jira, HP Quality Center

Methodologies: Agile, Waterfall

PROFESSIONAL EXPERIENCE:

Confidential, Grand Rapids, MI

Business Analyst

Responsibilities:

  • Gather requirements and document the proposed processes to the existing system. Modules included: Claims Processing Files and HIPAA Guidelines adherence across the company.
  • Experience in configuration of claims processing applications, claim adjudication process, claims management process, real time claims adjudication, Electronic Medical Records / Electronic Health Records (EMR/EHR) and Medicaid Management Information System (MMIS),and Medicaid Information Technology System (MITS).
  • Worked on QNXT including Claim processing (online and batch adjudication), Case management, Customer service, Member/subscriber administration, Provider network management and reporting.
  • Worked on claims, Claim adjudication Membership, Eligibility, Accumulators.
  • Enhanced applications associated with Claim Numbers so that duplicate Claim Numbers could be allowed in the system. Updated the Electronic Claims, Patient Screen and Sales Administration processes.
  • Claim Transactions and Billing Transactions - Created flows for adequate matching of Claims. Matched Billing File and EDI Claim File records upon receipt.
  • Worked on claims, Claim adjudication Membership, Eligibility, Accumulators.
  • Responsible for system integration testing of 837 claim files, 834 eligibility files and 270/271 interface files to ensure required interactions are met during the SDLC process.
  • Involved in creating and executing test cases, test plans and test scripts for EDI 837 Claims (I & P) Transactions.
  • Performed Data mapping to validate and customize Claims daily load into QNXT for processing the transactions.
  • Validated Inbound and outbound 837 transactions, including but not limited to the loading and correcting any errors with the process of EDI inbound and outbound files
  • Validated outbound 835 transactions including but not limited with vendor on QNXT mapping and system configuration.
  • Created Test File to be sent to the Drug Card Vendors for approval. Worked on a Paid without prejudice project for various States.
  • Testing - Developed Test Scripts using Quality Center and coordinated with developers to quickly resolve the defects associated with them.
  • Conducted JRP sessions and JAD sessions with the management, users and other stakeholders for open and pending issues to develop specifications.
  • Analyzed and evaluated User Interface Designs, Technical Design Documents and Quality Assurance Test Conditions the performance of the application from various dimensions.
  • Helped create the 'Business Glossary' to facilitate efficient understanding of the business process amongst the other teams.
  • Planned the entire Data Warehousing initiative from requirements gathering, analysis, design, identifying and analyzing the source systems, to data quality, to ETL, and to the end user data access.
  • Provided release management strategy checklists and change management techniques.
  • Presented and assisted end users for education and training about the new system.

Environment: Windows, Oracle, MS Office (MS Word, MS Excel, MS PowerPoint, MS Visio), MS Access, Agile, SQL, UML, Quality Center, and SharePoint.

Confidential, NYC, NY

Business Analyst/ Systems Analyst

Responsibilities:

  • Facilitated collection of functional requirements from system users, and prepared business and technical requirement specification documents.
  • Interacted with the Subject Matter Experts (SMEs) and stakeholders at the JAR session, gathering business requirements to get a better understanding of client’s business processes.
  • The Agile-scrum SDLC was used and I participated in writing user stories to track requirements and used SharePoint to share and maintain the document versions.
  • Conducted the scrum meetings as the scrum master, and helped maintain the product backlog and sprint backlog. Co-ordinated with scrum team for efficient delivery within designated sprint cycle.
  • Created Use Case Diagrams, and Use Case Specification document (USD). Validated the following: 837 (Health Care Claims or Encounters), 835 (Health Care Claims Payment/ Remittance), 270/271 (Eligibility request/Response), 834 (Enrollment/Dis-enrollment from a health plan).
  • Prioritized project efforts, developed project plans, process flows and SRS using scrum. Researched the existing client processes and guided the team in aligning with the HIPAA rules and regulations for the systems for all the EDI transaction sets.
  • Conducted JAD sessions with management, SME, vendors, users and other stakeholders for open and pending issues.
  • Assisted with the implementation of web services meant for Long Term Support for Inpatient Psychiatric Services for Individuals under age 21 and Services for individuals age 65 or older in an institution for mental diseases.
  • Used Unified Modeling Language (UML) for process modeling and use cases.
  • Generated daily, weekly, and monthly reports using MS Office Tools and submitted to the Team Leads and Manager for reporting, status reporting and analyzing purpose.
  • Developed gap analysis document, logical and physical design and remediation plan.
  • Captured, communicated, managed system requirements and maintained requirement tractability matrix to keep team members up to date with the latest testing results.
  • Responsible for training and testing of transactions. f member enrollment and benefits, batch jobs corresponding to the claims (837) and real time transactions like 270/271/276/277.
  • Analyzed existing procedures and reported to management to improve productivity.
  • Involved in creation of test plan, test scenarios, test cases for unit, system and system integration testing using HP-ALM.

Environment: Agile-scrum, MS Project, MS Office Suite, SQL, UML, MS Visio, Requisite Pro, Clear Case, Rational Clear Quest.

Confidential, Louisville, KY

Business Analyst

Responsibilities:

  • Gather requirements and document the proposed processes to the existing system. Modules included: Claims Processing Files and HIPAA Guidelines adherence across the company.
  • Experience in configuration of claims processing applications, claim adjudication process, claims management process, real time claims adjudication, Electronic Medical Records / Electronic Health Records (EMR/EHR) and Medicaid Management Information System (MMIS), and Medicaid Information Technology System (MITS).
  • Worked on claims, Claim adjudication Membership, Eligibility, Accumulators.
  • Enhanced applications associated with Claim Numbers so that duplicate Claim Numbers could be allowed in the system. Updated the Electronic Claims, Patient Screen and Sales Administration processes.
  • Claim Transactions and Billing Transactions - Created flows for adequate matching of Claims. Matched Billing File and EDI Claim File records upon receipt.
  • Worked on claims, Claim adjudication Membership, Eligibility, Accumulators.
  • Responsible for system integration testing of 837 claim files, 834 eligibility files and 270/271 interface files to ensure required interactions are met during the SDLC process.
  • Involved in creating and executing test cases, test plans and test scripts for EDI 837 Claims (I & P) Transactions.
  • Worked on Facets including Claim processing (online and batch adjudication), Case management, Customer service, Member/subscriber administration, Provider network management and reporting.
  • Worked on claims, Claim adjudication Membership, Eligibility, Accumulators.
  • The process included importing claims into Facets that had been adjudicated and setting them in a "PAY" status so that a payment cycle could be run to create checks on Facets.
  • Performed Data mapping to validate and customize Claims daily load into the system for processing the transactions.
  • Validated Inbound and outbound 837 transactions, including but not limited to the loading and correcting any errors with the process of EDI inbound and outbound files
  • Created Test File to be sent to the Vendors for approval. Worked on a Paid without prejudice project for various States.
  • Testing - Developed Test Scripts using Quality Center and coordinated with developers to quickly resolve the defects associated with them.
  • Conducted JRP sessions and JAD sessions with the management, users and other stakeholders for open and pending issues to develop specifications.
  • Planned the entire Data Warehousing initiative from requirements gathering, analysis, design, identifying and analyzing the source systems, to data quality, to ETL, and to the end user data access.
  • Provided release management strategy checklists and change management techniques.
  • Presented and assisted end users for education and training about the new system.
  • Generated reports using SQL and MS Excel spreadsheets.
  • Involved in Source Data Analysis, analysis and design mappings for data extraction.

Environment: Windows, Oracle, MS Office (MS Word, MS Excel, MS PowerPoint, MS Visio), MS Access, Agile, SQL, ETL, UML, Quality Centre, and SharePoint.

Confidential, CA

Business Systems Analyst

Responsibilities:

  • Proactively communicate and collaborate with stakeholders from various business units to uncover and document business information needs using interviews, document analysis, requirements workshops, process and workflow analysis
  • Formulate and define systems scope and objectives through research and fact-finding, combined with an understanding of applicable business systems and industry requirements
  • Analyze business needs and uses system knowledge to formulate functional solutions, which may take the form of new, enhanced, or adaptations of existing functionality with forethought to the business implications of the proposed functionality to the current environment
  • Develop and deliver for approval, business and functional requirements document(s) consisting of analysis of “As-Is” and “To-Be” functionality to identify business process gaps and containing various process diagrams such as activity, system interface, use cases, user stories, and GUI wireframe prototypes
  • Maintain organization methodology standards for requirements gathering and documentation and provides traceability of project objectives to business requirements to proposed solutions
  • Perform back-end data analysis and provides a data dictionary to assist developers in mapping new functionality to existing functionality with internal or external applications
  • Act as the liaison between Business and IT throughout the entire lifecycle of the project
  • Manage project documentation library, version control, and maintains historical record of requirement activities in the requirements document
  • Identify and communicate business requests that require change control initiation to the PM
  • Wrote business rules for migration from legacy system to web-based application.
  • Interfaces include: Executive Project Owners, Business Stakeholders, Subject Matter Experts, Quality Assurance Team, User Acceptance Teams, Software Developers (both internal and external offshore resources), Vendors, Project Managers, IT Executives and Managers

Environment: MS- Project, Visio, Word, Access, Power Point, Excel, SharePoint, Office 365, Quick Base, Jira, Confluence Wiki, Outlook, Kronos ; Quality Center ;MS Access, Oracle, SQL Server; Windows, Server.

Confidential, Minneapolis, MN

E-commerce Business Systems Analyst

Responsibilities:

  • Interfaced with Team Leaders to identify and analyze the given information, procedure and decision Flows.
  • Worked with end users to Map Business Processes (BPM) to technical specification.
  • Worked on BRD, and FSD.
  • Created daily, weekly and summary reporting and performance insights for the following programs: even performance for tab, including Advertised vs. non-advertised sales, Power Hours, Early Birds, BOGO and like-themed events.
  • Generated dashboards, metrics, analytics, goals, alerts using Business Objects XI enterprise edition to streamline processes and procedure.
  • Responsible for POS installation in the Confidential store in Minneapolis area.
  • Conducted previews and User Acceptance Test (UAT) sessions with the marketing team.
  • Worked with system Analysts to create application’s Functional and Non- Functional requirement document.
  • Developed USE Cases for the application and prepared the detailed Workflow Diagram based on the proposed enhancements, business logics and rules and translated them to USE Cases for Live Archive.
  • Worked with application team in developing Test Plans, Test Scenarios, Test Cases, Test Matrixes, Test Reports and documentation of Manual and Automated Testing for POS implementation
  • Devised extensive E-mail marketing campaigns regularly & kept a track of positive as well as negative feedback for improvisation.
  • Collected Requirements Interviewing Stakeholders, Business Partners, and End Users.
  • Organized JAD sessions with Business stakeholders/SMEs for gathering requirements for the new upgraded platform: estimated project resources, timing, and sequence of deliverables.
  • Building templates and dashboards for customized views of the data specific to each group and line of business.
  • Generated Real time statistics available to Upper management- via “Dashboards”.
  • Produce different levels of prototypes to aid the design and usability testing process: interactive HTML prototypes, and wireframes.

Environment: MS- Project, Visio, Word, Access, Power Point, Excel, SharePoint, Office 365, Quick Base, Jira, Confluence Wiki, Outlook, Kronos ; Quality Center ;MS Access, Oracle, SQL Server; Windows, Server.

Confidential, New York City, NY

Business Analyst

Responsibilities:

  • Performed stakeholder analysis to identify key players for project success
  • Identified and involved all key stakeholders, contributors, business, operations and technical resources that must participate in a project and ensured that contributors are motivated to complete assigned tasks within the parameters of the project plan.
  • Experience in Merchandising, Pricing, Campaign Management, Content Management Systems.
  • Prepared interview questionnaires for the clients to gather requirements.
  • Played an active and lead role in gathering, analyzing, and writing business requirements.
  • Collected and documented business processes as well as business rules. Provided key input in working with users in defining project and system requirements.
  • Performed Testing in Airline Retail/E-Commerce projects with different browsers and iO/S
  • Executed SQL queries and documented them as part of validating the Business Object reports and for testing purposes.
  • Responsible in authoring the functional specification documents, data architecture designs for setting up customized receipt management and revenue adjustment modules in the ERP application.
  • Responsible for maintaining and enhancing the ERP application according to the changing business requirements.
  • Worked with UAT team and Managers during requirement enhancement sessions.
  • Wrote integration requirements document for common processes, functionality, and business rules between multiple applications.
  • Created Use Case diagrams, activity diagrams, State Chart Diagrams according to UML methodology.
  • Created Story Boards, Wireframes, mockup screens, User Stories using tools like JIRA, Wireframes, MS Visio.
  • Performed validation testing on the application for various scenarios and reported the errors.
  • Analyzing User and Functional requirements to point out gaps between used SQL queries to extract the data from the database
  • Conducting JAD sessions and gathering software requirements and Business intelligence rules.
  • Developed Data Flow, Work Flow, Process Flow, and Entity Relationship Diagrams in MS Visio, and analyzed them.
  • Documented the System Specifications Document and performed Integration and Regression testing along with testers.
  • Collaborated with Quality Assurance Analysts to track defects.

Environment: Agile, Waterfall, Rational Rose, Rational Req Pro, HTML, Windows, MS Visio .

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