PROFESSIONAL SUMMARY:

• Sr. Business Systems Analyst with around 8 years of experience in analyzing and gathering requirements for business processes in techno - functional roles across various domains.
• Proven Ability to understand the big picture while being detail oriented and highly motivated.
• Excellent analytical, communicational, organizational, problem-solving and interpersonal skills with experience in conflict and change management.
• Extensive working knowledge of various phases in the Software Development Life Cycle (SDLC) processes. Hands on experience in traditional and agile methodologies such as Scrum, Waterfall, Scaled agile framework (SAFE 4.0), water-scrum-fall. Knowledgeable in Rational Unified Process (RUP), Scrumban and XP.
• Experience in different areas of healthcare domain including Health Insurance, HIPAA compliance and regulations, Claims processing and adjudication, Electronic Health Records (EHR) and clinical d Confidential warehousing (CDW).
• Experience in HIPAA and ICD 9 CM- ICD 10 CM/PCS conversion project. Well acquainted with various CPT, HCPC codes and ANSI X12 Electronic Document Interchange (EDI) formats like 270/271, 276/277, 278, 835, 834, 820, 837 and 999. Thorough understanding of claims testing processes and compliance testing.
• Strong understanding of different Insurance programs like HMO (Health Maintenance Organization), PPO (Preferred Provider Organization) and POS (Point of Service) along with Medicare (Part A, B, C, D) and Medicaid programs.
• Profound knowledge in Automated claim adjudication systems, workflow of TriZetto Facet 5.0, Bundling, unbundling, pricing edits, provider network edits and Diagnostic Related Grouping (DRG). Well versed in healthcare regulatory laws like Confidential HIPAA, HITECH ACT and ACA.
• Highly proficient in eliciting, analyzing and documenting SMART (Specific, Measurable, Achievable, Relevant and Testable) business requirements using various requirements elicitation techniques like JAD session, brainstorming, user story workshop, requirements workshop, interviewing, focus groups, document analysis and prototyping.
• Skilled in conducting Feasibility analysis, Risk analysis and Impact analysis to understand business and technical risks, evaluate infrastructural requirements and determine business benefits.
• Extensive knowledge in Gap analysis and Documenting As-is and to-be situation. Skilled in Benchmarking, SWOT analysis, root-cause analysis (Fishbone diagram), cost-benefit analysis and 5why’s analysis.
• Skilled in facilitating meetings and elicitation sessions with different stakeholders and documenting Business Requirements Document (BRD), Functional Requirements Document (FRD) and Systems Requirement Document (SRD) to understand and communicate various GUI, functional, non-functional, configurational and d Confidential requirements.
• Actively assisted the Project Manager in creating Project charter, Project plans, Gantt charts, milestones and Work breakdown structures (WBS) and defining the product roadmap.
• Adept at Business process modeling using BPMN 2.0 and Workflow diagrams and various UML diagrams like activity, use case, sequence and class diagrams using MS Visio, Google Drawings and Lucid chart.
• Good knowledge of various visualization techniques like prototypes, wireframes, mockups, feature trees, mind mappings, decision matrix using tools like Balsamiq and Axure RP.
• Well versed in all Scrum ceremonies like Sprint planning, Daily Scrum, Sprint review and retrospect meeting. Experience in conducting story grooming sessions. Well familiar with story estimation techniques (Planning Poker, T-shirt sizing and bucket sizing) and Story prioritization techniques (MoSCoW and Kano model).
• Experience in supporting the Product Owner to define the Minimum Viable Product (MVP), Definition of Done (DOD). Proficient in grooming and refining Product Backlog items and accommodating any stakeholder change requests.
• Proven expertise in conceptual and logical d Confidential modeling, d Confidential integration, migration and d Confidential conversion. Knowledge of Source d Confidential identification and d Confidential profiling.
• Through understanding of d Confidential warehouse architecture and implementation techniques and various d Confidential base modeling techniques like Entity relationship diagrams (ERD) and dimensional modeling and D Confidential base schemas (Star schema and snowflake schema).
• Created D Confidential mapping documents and Source to target mapping documents (STM)/ Source D Confidential Mapping (SDM).
• Involved in identification of metad Confidential and defining entities pertaining to Master D Confidential Management (MDM).
• Meticulously worked on defining OLAP cubes, dimensions and performed various drill down, roll up, slicing, dicing and pivot operations.
• Utilized Informatica PowerCenter to transform and integrated d Confidential from different sources.
• Strong knowledge of SQL queries like DCL, DML and DDL queries which includes inner and outer joins, select statements, order by, group by and various other aggregate functions and views.
• Working knowledge of visualization and reporting tools like Tableau and Power BI to drive operational intelligence.
• Extensive knowledge of Functional testing, Unit and integration testing, Load and performance testing, Black box testing, User acceptance testing, smoke testing, sanity and regression testing. Assisted the QA in preparing test plans and test cases, actively involved in defining User acceptance criteria and conducting user acceptance tests (UAT) using HP ALM and integrating with LoadRunner, UFT and HP ALM Sprinter. Responsible for updating and maintaining the requirements traceability matrix (RTM).
• Strong understanding of XML, HTML, JSON, loosely coupled Web Services (REST, SOAP, WSDL) and various system architectures like Service Oriented Architecture (SOA), 3-tier architecture and Microservices.
• Documented RESTful and SOAP APIs (I was responsible for technical writing for both API response and requests in XML and JSON) using Swagger. Responsible for conducting API testing using Postman and SOAP UI.
• Exposure to various big d Confidential tools (Splunk enterprise) and cloud migration techniques (AWS Cloud migration).

TECHNICAL SKILLS:

Project Management/ ALM: Atlassian JIRA, Microsoft Project, HP ALM, Rally

Communication and Collaboration: Atlassian Confluence, Microsoft SharePoint

Modeling and mockup Tool: MS Visio, Lucid Chart, Google Drawing, Balsamiq, Axure RP

Reporting tool: Tableau, MS Power BI, MS Excel

API testing and documentation: Swagger, SOAP UI (Ready API), Postman

Testing and Test management tools: HP Quality Center, HP LoadRunner, HP UFT, Sprinter, Selenium

Languages: C, C#, SQL, XML, JSON, HTML, Java, JavaScript

D Confidential bases: MySQL DB Server, DB2, Oracle DB, Oracle SOA 11g

ETL and ETL testing: Informatica PowerCenter, Talend, Informatica D Confidential Validation Option (DVO)

Technologies: Splunk enterprise, Amazon Web Services (AWS)

PROFESSIONAL EXPERIENCE:

Confidential, NY

Sr. Business Systems Analyst

Responsibilities:

• Performed document analysis, conducted interviews with SME s, business owners and referred to previous project artifacts to analyze the As - is system and To-be system.
• Created current process workflow using BPMN 2.0.
• Conducted feasibility analysis by defining the legacy system and creating feasibility matrix. Assisted in Initial risk assessment and developing a risk mitigation plan.
• Conducted brainstorming sessions to analyze the existing situation and discuss possible solutions.
• Gathered stakeholder requirements by conducting User story workshop.
• Worked with the PO to document the user stories in INVEST format and defined a clear user acceptance criterion for each of them.
• Worked with the facets team to analyze the HIPAA compliant X12 837 transaction sets and performed claims validation and adjudication as a part of As-is analysis.
• Wrote DML SQL queries to extract and analyze FACET d Confidential .
• Created use case diagram, activity diagram, sequence diagram and other UML diagrams in MS Visio to understand the target system and system workflow.
• Assisted the systems architect in breaking down the target system architecture.
• Assisted the PO and the team in prioritizing and estimating user stories and extensively used JIRA incident management tool to maintain and manage product backlog and sprint backlogs.
• Used Atlassian Confluence to write and maintain various artifacts like meeting minutes and UML diagrams.
• Actively helped the PO in creating POC s and accommodating any change request from the users and refining and re-prioritizing the backlog in backlog grooming meeting.
• Created wireframes and mockups using Balsamiq to provide better visualization and obtain stakeholder approval.
• Participated in various scrum ceremonies like initial backlog grooming, sprint zero, sprint planning, daily scrum, sprint retrospective, sprint review and backlog grooming meetings throughout the project.
• Assisted the team in analyzing and routing the existing claim submission portal, sterling B2B EDI, IIS web server,
• WebSphere application server MQ, Sybase facet performance monitor d Confidential into Splunk.
• Extensively used Splunk enterprise and created WebSphere MQ status reports, real-time system monitoring dashboards, claim submission portal reports and other mandatory HIPAA regulatory compliance reports to help the business gain an end to end system visibility.
• Documented all the key performance indicators (KPI) like Mean time to repair and First pass qualification rate to report and track the team progress.
• Worked on implementing distributed (scaled) version of Splunk to meet large scale requirements of the insurer.
• Assisted in Smoke testing to check for critical functionalities. Used HP ALM for test plans, test cases, execution and bug tracking.
• Assisted the team with User Acceptance Testing (UAT) to make sure that system meets stakeholder needs.
• Involved in JSON and XML Technical documentation for documenting REST API response and request formats.
• Involved in Splunk REST API testing in Postman. Assisted in creation of end user documentation with end user manual.
• Explored and integrated various Apps and add-ons like Splunk DB connect, Splunk enterprise security (SIEM solution) and Splunk for IIS to facilitate the machine d Confidential indexing process.
• Involved in Production support, user and problem resolution after completion of Splunk integration.

Environment: Agile (Scrum), JIRA, BPMN 2.0, Confluence, Oracle SOA 11g, MS Visio, Balsamiq, Postman 5.1, HP ALM 11.5, HP LoadRunner 12.5, XML, JSON, SQL, REST API, Splunk enterprise 7.2, Splunk DB connect, Splunk enterprise security, Splunk for IIS, Splunk for WebSphere, MS Excel, MS Word.

Confidential, Denver

Sr. Business Systems Analyst

Responsibilities:

• Confidential requirements from stakeholders by conducting JAD sessions, User story workshops and Interviews.
• Actively involved in documenting user stories and assisting PO in estimating and prioritizing stories.
• Analyzed disparate source systems d Confidential like claims, billing, in Confidential t, out Confidential t d Confidential, Electronic Health Records (EHR) and lab reports.
• Performed gap analysis to consolidate d Confidential from multiple sources to fill the target d Confidential models.
• Developed logical and conceptual d Confidential models. Created d Confidential dictionaries and defined metad Confidential fields.
• Assisted the Systems architect to create dimensional models, fact tables, dimensions and defined technical requirements for project implementation.
• Adopted a just enough D Confidential warehouse architecture approach.
• Involved in creation of d Confidential marts like Operational d Confidential mart, Diagnosis d Confidential mart to meet different business needs.
• Utilized Informatica PowerCenter for Extraction, Transformation and Loading process (ETL) to extract and manipulate the source d Confidential .
• Assisted in defining Worklets, Mapplets and Workflows to execute the ETL process.
• Documented the conformed dimension grid to define conformed dimensions and dimensional dependencies.
• Helped with d Confidential normalization up to 3NF for elimination of d Confidential redundancy and faster query processing.
• Participated in all Scrum events and gathered stakeholder feedbacks and change requests.
• Used JIRA to manage stories, tasks and change requests. Utilized SharePoint to store all project related artifacts and meeting minutes.
• Assisted in defining OLAP cube dimensions and performing various roll up and drill down OLAP operations.
• Actively involved in creating ETL Mapping Sheets to define source to target mapping (STM).
• Worked closely with QA and the development team to create test cases, test plans for ETL testing.
• Documented User acceptance tests (UAT) and collected test d Confidential from business users for User Acceptance Testing (UAT).
• Extensively used inner and outer joins, select statement and aggregate functions in SQL for source d Confidential extraction and target d Confidential validation.
• Created different views to assist front end users in monitoring the D Confidential warehouse.
• Designed and developed various reports and dashboards like Pie chart of ER visits by gender, Bar chart of Readmission by diagnosis and gender to drive Business intelligence and analytics using Tableau.
• Assisted the development team in documenting and testing API request and response formats using POSTMAN.
• Engaged in creating user manuals, providing user and post-production support.

Environment: Agile (SCRUM), JIRA, Informatica PowerCenter 9.6, D Confidential Integration, SQL, Tableau 8.0, POSTMAN 4.3, MS Office tools (Word, Excel, PowerPoint), SharePoint, Informatica D Confidential Validation Option (DVO), MySQL DB server.

Confidential, Dallas, TX

Business Systems Analyst

Responsibilities:

• Conducted JAD sessions, one on one interviews, brainstorming and Story grooming workshops to elicit requirements from stakeholders and documented them in form of user stories.
• Performed feasibility analysis and gap analysis to understand and validate the As-is and To-be situations.
• Assisted the Product owner (PO) in prioritizing and estimating user stories and worked closely with the development team to create user story map and define a clear roadmap for the system.
• Created Use case, activity and sequence diagrams using Google Drawing.
• Involved in creating prototypes, wireframes and mockups in Axure RP to obtain stakeholder approval in sprint review meetings.
• Worked with the system architect to define the 3-tier system architecture for the application.
• Created and maintained requirement traceability matrix (RTM) to track user requirements against actual system functionalities throughout the system development life cycle (SDLC).
• Attended all Scrum ceremonies like Sprint planning, daily scrum, review and retrospect meetings to plan for sprint, discuss impediments and suggest any improvement.
• Handled change requests in backlog grooming/ story grooming meeting and made sure they were accommodated in the product backlog.
• Worked with the development teams to create Source D Confidential Mapping (SDM) and defining the d Confidential flow.
• Assisted in defect tracking using HP QC. Assisted in creation and management of test cases.
• Used d Confidential Manipulation SQL queries like select and joins to query the source d Confidential .
• Defined User Acceptance Criteria and assisted in planning and conducting User Acceptance Tests (UAT).
• Tested various third-party APIs used in the application using SOAP UI. Utilized Swagger for API documentation.
• Extensively utilized Power BI to help the provider gain insights into their operations.

Environment: Agile (Scrum), oracle DB, Rally, SQL, HP QC, Google Drawing, Axure RP Informatica PowerCenter, Power BI, MS Word, MS Excel, SOAP UI, Swagger.

Confidential, Philadelphia, PA

Business Analyst

Responsibilities:

• Performed Document analysis and interviews with ICD 10 team to understand the HIPAA transition process and the As-is and To-be system (Gap analysis).
• Conducted JAD sessions, one on one interviews with SME’s and ICD 10 team to understand and document the business requirements in forms of Business requirement document (BRD) and Systems requirement document (SRS).
• Assisted in conducting feasibility analysis and assessing the impact of the change.
• Created use case and activity UML diagrams in MS Visio to visualize the To-be system.
• Facilitated JAD sessions with business owners to discuss any Business level impact due to HIPAA 5010/ ICD 10 implementation, like changes in existing systems and applications. Facilitated the Discussion of coordination strategies with our trading partners and helped establishing the Project timeline in MS Project.
• Worked closely with the ICD 10 team to document the required changes in various Electronic Document Interchange (EDI) ANSI X12 transactions like 270/271, 276/277, 278, 834, 835 and 837. Assisted in breaking down the general equivalence mapping document (GEM) to assist our developers in understanding the transition process.
• Assisted the facet configuration team in understanding the changes to implement ICD 10 CM and PCS codes.
• Worked with the development team to implement changes in existing claim processing system to process modified X12 999 acknowledgment form and CA277 forms as per new HIPAA standards.
• Created and maintained requirement traceability matrix (RTM) and assisted QA in preparing test plans and test cases. Utilized HP QC for monitoring defects.
• Performed User Acceptance Testing (UAT) and wrote DML SQL queries to test the target d Confidential base.
• Responsible for defining trading partner policies, user post-transition monitoring.

Environment: Waterfall, HIPAA, MS Visio, TriZetto facet 5.0, HP QC, SharePoint, MS office suite (Word, Excel, Outlook), MySQL, MS Project.

Confidential

Business Analyst

Responsibilities:

• Conducted interviews and JAD sessions with SME’s, doctors and Business owners to elicit requirements and transformed them into Business Requirements Document (BRD).
• Assisted the Project Manager in defining the roadmap, project charter and project plan.
• Worked closely with design, development and testing teams in explaining the Business Requirements Document (BRD) and assisting with the creation of System Requirements Document (SRS) for defining functional and nonfunctional requirements. Responsible for documenting use cases to accompany the SRS.
• Worked in a Water-Scrum-fall hybrid environment. Assisted with creation of workflow diagrams using MS Visio and various UML diagrams like activity diagrams and use case diagrams.
• Involved in gathering Graphic User Interface (GUI) requirements for the web portal and created wireframes.
• Assisted in defining the D Confidential Mapping Document (DMD) to maintain Confidential t appointment records, insurance and contact information and prescriptions in the system d Confidential base.
• Documented and maintained requirement traceability matrix (RTM).
• Wrote SQL queries to assist the QA in application d Confidential validation testing.
• Assisted the QA in creation of positive and negative test cases and actively involved in performing user acceptance tests (UAT) using Selenium and HP Quality Center.
• Interfaced with the development team in bug fixing and worked with production teams in defining release management policies and procedures.

Environment: Water-scrum-fall hybrid, MS word, MS Excel, SQL, MS Visio, HP Quality Center, Selenium, Windows XP.

Confidential

Tester/ Quality Analyst

Responsibilities:

• Worked closely with the Functional team and development team in understanding the functional and Design documents .
• Worked with the QA lead for test planning, environment requirement planning and deciding test metrics .
• Created test scripts, performed Test execution and defect tracking .
• Involved in developing test cases for smoke, system and regression testing .
• Performed backend testing using multiple SQL queries .
• Responsible for writing and executing positive and negative test cases based on the Functional Specification Document (FSD).
• Assisted the Business analyst in updating the requirements traceability matrix .
• Responsible for performing manual testing and User acceptance testing (UAT).
• Responsible for updating and maintaining Quality center for all the defects found during functional and regression testing and managing the defect life cycle .
• Attended daily defect status meetings and weekly team status meetings for reporting testing status and shared ideas for improved testing efforts.

Environment: Waterfall, Balsamiq, HP Quality Center, HP UFT, SQL, MS Office tools (PowerPoint, Excel, Word)