SUMMARY:

• Over 9 Years of experience in Healthcare domain as Sr. Business System Analyst.
• Extensive knowledge of workIng in Medicaid and Medicare process, Managed Care plans like HMO (Health Maintenance Organization), PPO (Preferred Provider Organization), POS (Point of Service).
• Excellent Knowledge of HIPAA and various Transactions codes like 270/271(Inquiry healthcare benefits), 276/277 Claim status, 834 (Benefit Enrollment), 837 (Healthcare Claim), 835 (Payment explanation of Benefits) and PPACA (Health care reform and Patient Protection and Affordable Care Act)
• Experience in all phases of Software Development cycle (SDLC) methodologies like Waterfall and Agile that is Scrum, Scrum fall.
• Experience in writing the User Stories following the INVEST criteria, experience in defining the Acceptance Criteria, and prioritizing User stories based on MOSCOW and KANO.
• Elicited the Requirements using techniques such as Surveys, Questionnaires, Interview sessions, Brainstorming sessions, Root cause analysis, Document Analysis, cost benefit analysis, SWOT analysis, GAP Analysis and JAD sessions with Internal and External Stakeholders.
• Gathered Business Requirements using BRD (Business Requirement Document) and FRD, interacted with Users, Designers and Developers, Project Manager and QA Team to get the better understanding of the business.
• Hands on experience in the field of Business process flow, Business process modeling and Analysis and UML diagrams like Use cases, Sequence diagrams.
• Efficient in Prototyping Application User Interfaces using Wireframes, mockups with focused attention to detail in enriching User Experience and User interaction.
• Encouraged best practices including continuous integration, Test driven development, Behavioral Driven Development, Acceptance Test Driven Development and Pair programming.
• Proficient in Database Management system with SQL queries such as Update, Create, Selection expert in Query optimization for Joining and Protection.
• Experience with Datawarehouse Architecture (Centralized, Federated, Hub and Spoke).
• Experience with ETL process cleaning and cleansing Data, Data table structures, Schemas and Data Marts and OLAP operations such as Roll up, Drill down, Slice, Dice and Pivot.
• Skilled in creating and maintaining ETL specification Document, Source to Target mapping Requirement Traceability Matrix (RTM), performing impact Assessment, and Practical JIRA, SharePoint Knowledge for managing User stories, Label, Components, Issue type, Sub task and queries
• Expert in analyzing and reporting using tools like Tableau, IBM Cognos, SSRS.
• Good Knowledge and experience on Team foundation Server.
• Understand the AS IS system and develop the TO BE system and prepare the System process maps.
• Solid Understanding of Business requirement gathering, Evaluating Data Sources and Translating requirements into specification, Application design and Business Analysis.
• Excellent communication skills both verbal and written.
• Strengths include quick learner, problem solving capability, and ability to work as a team player and ability to lead the team.
• Skilled at building a strong team and achieving the work in tight deadlines with quality product.
• Expert in analyzing and reporting using tools like Tableau, Power BI.

TECHNICAL SKILLS:

Database and Data Analysis tools: Tableau (v 9.3,10.0,10.1) MS SQL Server (2012,2014) MS. Access, Informatica Power Center, Microsoft BI SSIS.

Programming Languages: My SQL, T SQL, C, C++, HTML5, CSS3, JAVA, PHP

Requirements Test and Defect Management: JIRA (v 6.3,7.0), HP Quality Center V11,12, Confluence, Sharepoint, Selenium v3.3,3.4,3.5,3.6. Cucumber v (3.0,2.0), Postman v (3,4,5,6) IBM, Rational Requisite Pro.

Data warehousing: Data Marts, Data Modelling, OLAP, OLTP, Data mining, ETL, OLAP operations like (Slicing/Dicing, Drill down/Roll up, Pivot)

Modelling designing: Ms.Visio(v15,16), Smart draw, Mock up screens, Lucid chart.

Project Productivity tools: Ms. Office, Ms. Project, Ms. SharePoint, Ms. Power point, Ms. Excel

Operating Systems: Windows XP, Windows 8, Windows 10, Linux, Unix, Mac Os.

Architectural Framework: Service Oriented Architecture, 3Tier Architecture and N Tier Architecture.

Technologies: AWS S3, AWS Redshift, Amazon S3, Amazon EC2.

PROFESSIONAL EXPERIENCE:

Business Analyst

Confidential, Illinois

Roles and Responsibilities:

• Analyzed the current business by understanding the preset business rules and conditions.
• Worked with Product Owner and required Stakeholders to determine requirements at elicitation stage using Agile methodology of Scrum.
• Designed User Stories and developed process flow models using Visio.
• Prioritized the User stories with Product Owner and estimated the completion of PBIs with the help of Development Team.
• Was part of Sprint Planning meeting and interacted with the Product Owner, Scrum Master to prioritize the User stories and Stakeholders for scheduling the duration of sprint and commitment of PBIs.
• Conducted regular JAD sessions with Stakeholders, SME, System Architect, developers, database developers, quality testing during the elicitation stage to assure that the minute as well as critical details of the project were discussed, and issues were resolved before hand.
• Followed a Structured approach to organize requirement into logical groupings of essential business processes, Business rules, information needs, ensure that the critical requirements are not missed.
• Facilitated the discussion between the Commercial Operations, Web Portal Development Team and Vendor, to ensure that the proposed technical solution adequately meet the business needs.
• Build and Maintain close relationship with internal stakeholders and vendors to ensure efficient development process are being followed and that business priorities, rules are met and that project developments are on schedule.
• Worked with Developer team to create Screen Mock ups as per Requirement process.
• Conducted Data profiling/Data mapping with Business Subject Matter experts SMEs, Data Architects, ETL Developers and Data models.
• Used SQL queries for the retrieval and management of data.
• Develop and maintain Sales reporting using MS Excel queries. Produce Performance Reports and implement changes for improved reporting.
• Worked with the Data warehouse team to gather all requirements to streamline all data elements needed
• Using MS Office Suite (Word, Excel, Access, Visio, Power point) for project tracking, documentation and presentation.
• Involved in backend Testing by verifying the data integrity using SQL.
• Environment: Scrum, JIRA (v 5.3), Ms. Vision 2012, MS Excel 2010, Ms. PowerPoint Working with the QA team for designing Test plan and Test cases for User Acceptance Testing (UAT).

Sr. Business Systems Analyst

Confidential, Dallas, Tx

Roles and Responsibilities:

• Facilitated JAD sessions with SMEs, Stakeholders to collect healthcare services and process information.
• Used JIRA for maintaining and tracking issues, bugs, User Story Management, Workflow management and creating Requirement Traceability Matrix (RTM) for transparent requirement Traceability.
• Prepared graphical description by Use cases, State diagram, Activity diagrams using Microsoft Visio.
• Analyzed the inefficiency of healthcare system by using Bizagi BPMN modeler to improve the efficiency.
• Identified the dependency rate of readmissions in the hospital on the other independent variables by considering HCPCS, CPT, ICD - 10 codes, EMR/EHR, Claims Submission data, Administrative Data, CMS Data and Patient Demographic data.
• Performed Data profiling and checking for Data integrity by looking for various Data anomalies, doing data normalization and data verification, followed by Data cleansing process.
• Performed SQL queries to retrieve the required information.
• Assisted in the identification of most relevant dependent variable in terms of Readmission rate with the help of Forward and Backward selection technique.
• Collaborated with the Data team in employing R Platform for performing Predictive analysis.
• Collaborated with QA team to design and develop Test strategy, Test plans, Test cases, Test Scenarios for performing Functional Testing, Regression Testing in both manual and Automation environment and reviewed Test results.
• Recommended cost and performance improvement through documentation and data reporting by using Tableau.
• Visualized results of the analysis over Tableau by making histograms, pie charts.
• Environment: OLAP, Tableau, Excel, Microsoft Visio, MySQL, HCPCS, CPT, ICD-10 codes, (JIRA v 5.3). Trusted with the Management of confidential, personal and professional information/HIPAA compliance.

Sr. Business Analyst

Confidential, KY

Responsibilities:

• Worked closely with the Product Owner to maintain a Product Backlog and release plan for Application.
• Conducted the JAD session with Stakeholders and developers to have a clear picture of Project
• Created User Stories based on the requirement of the workflow
• Worked on incorporating changes as per the HIPAA guidelines.
• 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 the development team and QA team to ensure all requirements have been covered in scripts and tested properly.
• Performed Backend Testing and was in regular contact with the 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.
• Developed Test cases and Test plans on the basis of the requirements and also did Manual testing of the functionality to ensure that the application can handle a lot of data.

Business Analyst

Confidential

Responsibilities:

• Responsible for gaining good understanding of User needs and actually representing them in a well-documented software functional documented specification.
• Gathered Business Requirement, interacted with Users, Designers, Developers, Project manager and QA team to get the understanding of the business process.
• Facilitated JAD sessions with Business and technical units to fine tune, prioritize and detail requirements and Use cases.
• Helped in defining the ETL process with Data quality requirement definition and testing. Worked with HIPAA X12 Electronic transactions Standard Version 5010 with EDI with 834 transaction set for benefit Enrollment.
• Performed Data mapping to map Data related to Membership and claim management.
• Created UML diagrams including Use case diagrams and Activity diagrams using MS. Visio.
• Managed Changes for the requirement and associated Requirements for Traceability.
• Involved in generating Test plans and Test Scenarios as per the business requirement and conducted Manual and Automated testing for various phases of the project development.

Business Analyst

Confidential

Roles and Responsibilities

• Worked with the Stakeholders in reviewing the business requirements document and functional requirement documents in waterfall framework. Actively participated in walkthrough and enhancement meetings. And maintained Requirement Traceability matrix.
• Analysis of inbound and outbound interfaces and extension to Claim processing system.
• Involved in full HIPAA compliance lifecycle from GAP analysis, Mapping, implementation and testing for processing of Medicaid claims. Worked on EDI transactions 270,272,834,835,837 to identify key data set element for recorded data set. Interacted with Claims, Payment and Enrollment hence analyzing and documenting related business process.
• Analyzed HIPAA 4010 and 5010 standards for 837P EDI X12 transactions, related to providers for professionals.
• Extensively used ETL process to address Data cleansing.
• Used change data capture (CDC) to simplify ETL in Datawarehouse application.
• Coordinated with BI Team for developing Support and maintenance for the ETL process using Informatica Power center.
• Observe and analyzed correct specific workflows to adapt the EMR and provide optimizer efficiency and success.
• Used SQL server to run basic queries and obtain necessary data for Medicaid and Medicare encounters.
• Used SharePoint for content management.
• Performed Batch testing, Functional and Regression testing using QTP Automation tool.
• Environment: Microsoft SQL, HIPAA 5010, EDI, XML, HP Quality Center, QTP. Executed Test cases found errors, reported defects, determined repair priorities did regression testing and closed by using HP quality center.

Confidential

Jr. Business Analyst

Roles and Responsibilities:

• Interviewed Business Users and conducted JAD session with internal stakeholders to gather requirements and analyzed the feasibility of their needs by coordinating with the Project Manager and Technical lead and drafting BRD.
• Executed SQL queries to check the data results.
• Performed Data mapping and historic data integration flow into the new system.
• Defining and documenting logic for Customer eligibility in Underwriting process.
• Designed and documented wireframe.
• Ensured that the application adhered to Change management notification process for any change request.
• Environment: SharePoint, Waterfall SDLC, Ms. Visio, Ms. Excel, Ms. PowerPoint Coordinated with the Testing team and ensured that new release to be deployed was error free.

Confidential

Market Research Analyst

Responsibilities:

• Compiled and analyzed Statistical data.
• Required Survey Data gathering using communication support and guidance from
• Business users and end customers.
• Was responsible for Cost Benefit analysis, Risk Assessment, SWOT analysis.
• Interpret Data formulate report and make recommendations.
• Environment: Windows XP, Microsoft Access suite, SQL, Visio, Microsoft Excel. Microsoft PowerPoint. Responsible for workflow analysis and coordinate with the Business Development team.