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Business Analyst Resume

Bethesda, MD

OBJECTIVE

Seeking a position as a Business Analyst in a result- driven work environment where I will have the opportunity of utilizing my experience and knowledge of analyzing business models to meet business objectives, hence ensuring client satisfaction and increased employee productivity.

SUMMARY

  • Business Analyst with over 7 years of Information Technology experience.
  • Ability to use oral and written communication skills to express ideas effectively and persuasively with all organizational stakeholders.
  • Excellent Client Interfacing Skills. Ability to interface with business owners in other to understand current processes, business issues and data challenges of client's organization.
  • Solid understanding of all phases of Software Development Life Cycle (SDLC) methodology (such as requirement, analysis, design, data modeling, business process modeling, implementation and deployment).
  • Experience working in Medicare and Medicaid projects.
  • Experience in conducting SWOT Analysis, GAP analysis, Cost Benefit and ROI Analysis.
  • Broad knowledge of Test plans, Test Cases and Test Scripts from the Requirements Document.
  • In-depth knowledge of Rational Unified Process (RUP); risk engineering, data modeling and mapping, and design using UML (Unified Modeling Language), Rational Rose and Visio.
  • Excellent knowledge of HIPAA (Health Insurance Portability and Accountability Act) transaction codes such as 270/271 (inquire/response health care benefits), 276/277 (claim status), 470 (benefit codes), 835 (payment or remittance advice), 837 (health care claim) and 834 (benefit enrollment).
  • FACETS experience, knowledge of medical coding and billing, ICD-10-CM, ICD-10-PCS, HL-7, HIPAA 4010/5010 initiatives and regulatory compliance framework.
  • Extensive experience in conducting Joint Application Development (JAD) sessions for project definition involving analyzing requirements, creating prototypes, user interface, database schema and system design.
  • Experience reviewing existing Organizational Process Assets.
  • Familiar with test automation tools such as HP QuickTest Professional and IBM Rational Functional Tester
  • Experience in writing Use cases and Functional Requirement Document.
  • Knowledge of Sarbanes–Oxley Act, Six Sigma, Capability Maturity Model Integration (CMMI) standard and Project Management Body of Knowledge (PMBOK).
  • Created Requirements Traceability Matrix to keep the stakeholders informed of the progress of the project.
  • Strong expertise in Health Insurance Claim process, social services, Medicaid and banking.
  • Good knowledge of Oracle, SQL, Business Objects, Report Scripting and Data Modeling/Warehousing.
  • Participated in project planning activities including defining detailed project tasks.
  • Conducted project administrative tasks, such as work plan administration, time and expense tracking, and project schedule maintenance
  • Ability to make effective management decisions that exhibit high ethical standards ethics within the working environment.
  • Ability to manage the effective use of technology in an organization to achieve superior performance and operational effectiveness.
  • Exceptional problem solving and sound decision making capabilities.
  • Experience in writing queries/scripts for data analysis ad QA report testing.
  • Conducted successful projects with the help of teams to achieve deadlines timely and proficiently.
  • Experience in User Acceptance Testing, Smoke Testing, Regression Testing Performance Testing and Functional Testing.
  • In-depth experience in financial analysis, financial modeling, Research, Accounting, and good knowledge of Assets, Liabilities, Equities, Fixed Income and Taxation.
  • 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).
  • Organized, goal-oriented, self-starter, and ability to learn new technologies, manage multiple tasks while following through from start to completion.
  • Ability to adapt to a wide range of work environments.
  • Extensive experience in working in a Customer - oriented environment.
  • Ability to inculcate new relevant skills with ease in a time sensitive frame.

SKILLS

Operating Systems: MS-DOS, OS/2, Windows 3.x Windows 95/98/2000/XP/Vista/NT/7 Project Management: MS Office Suite (Microsoft Visio, Microsoft Project, Microsoft Outlook, Microsoft Access, Microsoft Excel and Microsoft PowerPoint) Change Management: eB CM, Aldon Affiniti and IBM Rational ClearCase Business Modeling Tools: MS Visio, Rational Rose, MS Project. Testing Tools: HP QuickTest Professional, IBM Rational Functional Tester Databases: MS SQL, MS Access, Oracle Languages: SQL, Visual Basic Methodologies: SDLC, RUP, UML, CMM

PROFESSIONAL EXPERINCE

Confidential, Bethesda, MD Feb 2010-Present Business Analyst

Coventry Health Care, Inc. operates as a managed healthcare company in the United States. The company's Health Plan and Medical Services division provides health plan commercial risk, commercial management services, Medicare advantage coordinated care plans, and Medicaid products. It also offers commercial risk products, including health maintenance organization, preferred provider organization, and point of service products to individuals and employer group. CoventryOne continues to lead the way with its CoventryOne line of products, including HSA, HRA and RRA options. The project that I have worked on was to improve the claims reimbursement user interface of CoventryOne for a better user experience and incorporate changes as per HIPAA guidelines. The main objective of the system was to secure the health information entered by the user at the time of submitting the claim, and to also ensure the veracity and privacy of the user information.

Responsibilities:

  • Used the Rational Unified Process (RUP) to build the different phases of Software Development Life Cycle (SDLC).
  • Prepared the Functional Specification Document (FSD) and Software Requirement Specifications (SRS) as per SEI-CMM standards.
  • Conducted the JAD Sessions with stakeholders and developers to have a clear picture of a project.
  • Conducted interviews with key stakeholders to analyze existing data and gather requirements.
  • Used UML to create use case diagrams, sequence diagrams and activity diagrams.
  • Worked on improvement of Claims Reimbursement User Interface for a better experience and incorporate changes as per HIPAA 4010/5010 guidelines using the gap analysis.
  • Developed flowchart and process diagram using MS Visio.
  • Wrote SQL scripts for creating performance evaluation reports
  • Clarified QA team issues and reviewed test plans and test scripts developed by development team and QA team to make sure all requirements have been covered in scripts and tested properly.
  • Performed Backend testing by using PL/SQL queries to test the integrity of the application Was in regular contact with Business partners on the status of issues, action plans and timeframe for resolution throughout the development cycle.
  • Identified bugs during the test phase and reported them using HP Quality Center.
  • Maintained Traceability Matrix throughout the project.
  • Developed Test Cases and Test Plans on the basis of requirements and also did manual testing of the functionality of the application to ensure that the application is able to handle a lot of data

Environment: Rational Unified Process (RUP), SQL, MS Visio, MS Project, MS Office, UML, Windows XP, Rational TestManager.

Confidential, Phoenix, AZ Feb 2009- Jan 2010 Business Analyst

The Allstate Corporation is primarily engaged in the personal property and casualty insurance business and the life insurance, retirement and investment products business. It conducts its business primarily in the United States. Allstate is the 2nd largest personal property and casualty insurer in the United States on the basis of 2010 statutory direct premiums earned. I worked on the improvement of the existing system and also did testing for the proper use of the existing system. There was also new additions to the system such as COB (Coordination of Benefits) which is an arrangement in health insurance to discourage multiple payment for the same claim under two or more policies.

Responsibilities:

  • Was responsible for understanding the business logic and assisted other business analysts in generating Functional Requirement specifications (FRS) and User Requirements Specifications (URS).
  • Developed use cases, workflow, screen mock-ups and conversion requirements.
  • Coordinated work plans between project manager and client using MS Project.
  • Helped in reviewing and editing of the test scripts.
  • Followed UML based methods using Rational Rose to develop use cases and activity diagrams; assisted developers in creating sequence diagrams and collaboration diagrams.
  • Reviewed business process, URS, and functional requirements.
  • Assisted in process modeling; conducted and participated in JAD sessions with system users; helped with design walkthroughs with stakeholders for base lining architecture.
  • Created and tested scripts for the premium calculations and claim limits and deductible.
  • Involved in detailing project mission, data process flow diagrams, and timelines.
  • Developed Test plans and Test cases according to business requirements with the help of Mercury Test Director.
  • Used Rational ClearQuest for handling change requests.
  • Participated in automated regression and Non-functional test plans.
  • Provided assistance in building EDI’s 270, 271, 276, 277, 470, 835, 837 and 834 transactions.
  • Maintained Requirement Traceability matrix throughout the project.

Environment:Rational Requisite Pro, Rational ClearQuest, MS Office, Visio, MS Visio, MS Project, Windows XP, UML, SQL.

Confidential, Rockville, MD May 2008- Jan 2009 Business Analyst

Kaiser Permanente is one of America’s Top private Health plans. This not-for-profit entity is among the largest integrated health care systems in the US. The company offers health care services through a network of more than 15,000 physicians belonging to Permanente Medical Groups. Kaiser Permanente also operates three dozen hospitals with more than 8,500 beds and almost 600 medical offices that make up Kaiser Foundation Hospitals. Permanente Medical Groups, which provide care for Kaiser Permanente members, continuously develop and refine medical practices to help ensure that care is delivered in the most efficient and effective manner possible. The goals of the project included depicting a clear vision of an electronic claim processing life cycle and implementing an electronic data interchange standard transmission format, for securing the bidirectional flow of information between health care providers and reimbursement agencies/entities.

Responsibilities:

  • Assessed the requirements, audience, and organizational process assets to determine the level of formality appropriate for business analysis communication
  • Implemented the SDLC for the developing life cycle and followed the standards process in the application.
  • Translated business requirements into functional requirements and approaches for developers.
  • Provided management support to the off-shore End to End integration/ Regression Test Team.
  • Workflow documentation and comprehensive training to the healthcare clients.
  • Analyzed corporate healthcare business processes to develop customized solutions.
  • Worked with Medicare operational management to monitor trends and report on operational metrics such as timeliness, workload, and staff trending, customer satisfaction, and other key measures to facilitate performance excellence.
  • Interacted with healthcare clients to gather requirements, objectives, and input and output requirements.
  • Developed test cases and scripts for front end testing.
  • Performed execution of test cases manually to verify expected results.
  • Ensured the accuracy and consistency of the data during the data loading process.
  • Developed Use Case, Class and Deployment diagrams using Rational Rose.
  • Responsible for architecting integrated HIPAA, Medicare solutions, Facets.
  • Was involved in managing the Daily Standup meetings and also ensured that quality standards were enforced as per the build-release schedule.
  • Developed a detailed test plan and test cases to cover all the requirements.
  • Used rational Rose to create UML diagrams such as use case, activity, sequence, class and component diagrams.
  • Developed Flowchart and process diagram using Microsoft Visio.
  • Analyzed data architecture, documented and delivered data mapping, performed risk analysis.
  • Frequently communicated with developers to resolve technical issues.
  • Environment:SQL, Test Director, MS Office, UML, Rational Rose, Windows XP. MS Visio, MS Project.

    Confidential, Indianapolis, IN Jan 2007 – Mar 2008 Business Systems Analyst

    State Farm is a family of insurance and financial services companies that together serve tens of millions of customers in the U.S. and Canada. Its mission is to help people manage the risks of everyday life, recover from the unexpected, and realize their dreams. The project type was a new-in-house software development platform, which collected and synchronized information of every client in a central repository. These information included medical claims, lab results, self –reported data and other relevant information in an efficient and effective manner.

    Responsibilities:

    • Developed Use Cases, Activity Diagrams and Sequence Diagrams for a clear understanding of the vision document.
    • Designed Test Plans and Test Cases for User Acceptance testing (UAT) with the help of QA teams.
    • Conducted Joint Application Development (JAD) sessions with stakeholders throughout SDLC to resolve open issues.
    • Wrote SQL Queries in MS Access to sort data and analyze the large set of data during project life cycle.
    • Prepared Business process models; used Visio to create use case diagrams.
    • Utilized RUP to configure and develop process, standards and procedures.
    • Interfaced with business users to prepare and update Business Process Requirements for the new release of Healthcare tools.
    • Prioritized outstanding defects and systems problems, ensuring accuracy and deadlines were met.
    • Worked with the management for improving and giving new ideas for designing future processes of the HIPPA transactions dealing out with EDI’S 271, 276 and 270, 470, 835, 837, 834, HIPAA 4010 claim adjustments, claim processing from point of entry to finalizing, claim review, identifying claims processing problems, their source and providing alternative solutions using best practice model and principles and also well versed with ICD10, FACETS.
    • In depth knowledge of Medicare/Medicaid Claims processes from Admin/Provider/Payer side which were later part of the training program to vendors.
    • Performed GAP analysis of business rules, business and system flows, user administration and requirements.
    • Tracked and maintained Stakeholder requested enhancements and changes using Requirement Traceability Matrix (RTM).
    • Used the Rational Unified Process (RUP) to develop the different phases of Software Development Life Cycle (SDLC).
    • Designed mockup and wireframes to communicate visual data flow to the end users.
    • Conducted Risk Engineering to derive and execute action plans on time.
    • Used Rational Clear Quest for defects and bug testing.
    • Recommended corrective actions, if necessary, along with the progress against Development/Action Plan routinely to the Project Manager.
    • Administered and coordinated User Acceptance Testing and obtain final system acceptance sign-off with the help of Program Manager.
    • Environment:MS Visio, MS Project, Ms Office, User Acceptance Testing (UAT), Rational Unified Process (RUP), Rational Clear Quest, Joint Application Development (JAD), MS Access, Rational Test Manager, Requirement Traceability Matrix (RTM).

      Confidential, Port Harcourt, RV Jan 2002 -Nov 2006 Business Analyst

      First Bank of Nigeria is a Nigerian bank and financial services firm. It is the country's third biggest bank. First Bank of Nigeria maintains a subsidiary in the United Kingdom, FBN Bank (UK), which has a branch in Paris. The bank also has representative offices in South Africa and China. The bank has several product lines which includes – Pension Funds, General Insurance, Custodial Services, Private Equity, Mobile Banking, Point of Sale Merchant Acquisition, Advisory Services, structured products etc – each one of these initiatives having a huge potential for growth. The project was to develop an information management system for the educational loans division in order to monitor the interest rates, period of payments, maximum amount of getting loans and also to make it user friendly for the users.

      Responsibilities:

      • Gathered Business Requirements and wrote Business Requirements Document (BRD) by working with the client IT staff, project managers
      • Translated Business requirements to functional and technical language with the help of Use cases and UML diagrams for developers.
      • Developed test plans and test cases.
      • Documented various workflow diagrams like AS-IS and TO-BE processes
      • Interacted with the developers on resolving the reported bugs and various technical issues.
      • Assisted the project manager in managing changes to the project scope.
      • Assisted the Account Management people in reviewing the account of the customers.
      • Clarified client requirements, business needs and project objectives, via feedback sessions and client meetings, in collaboration with all stakeholders.
      • Environment:Project Plan, MS Visio, MS Project, Ms Office, Use Cases, Sequence Diagrams, Production Plan, Business Requirements Document, UML.

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