SUMMARY:

• Experienced and highly motivated Business Systems analyst with over 7+ years of experience in the Healthcare domain. A fluent communicator with strong problem - solving skills.
• Certified Scrum Master with experience of working with self-organizing and cross functional teams in the healthcare domain and Certified Lean Six Sigma Green Belt in business process re-engineering.
• Expertise working with different Software Development Life Cycle (SDLC) methodologies like Agile Methodologies like Extreme Programming ( XP), Scrum-Waterfall Hybrid, Scrum, Scaled Agile Framework (SAFe) and Kanban also other methodologies like Waterfall, Spiral and Rapid Application Development (RAD).
• Sound understanding of Healthcare compliances like HITECH, OSHA, HIPAA (4010 and 5010) standards and corresponding EDI transactions (837, 278, 835, 834 and 820).
• Good Knowledge of Medicaid, Medicare (Part A, B, C, & D), Preferred Provider Organization (PPO ), Medicaid Management Information System (MMIS), Health Maintenance Organization (HMO), Point-of-Service (POS) and Health Level 7 International (HL-7), International Classification of Diseases ICD-9 and 10, National Provider Identifier (NPI) and Consolidated Omnibus Budget Reconciliation Act (COBRA).
• Extensive knowledge of Health Administration - Claims Processing (receipt, determination of eligibility, pricing and proprietary edits, auto adjudication, generation of EOB, pricing and testing), Consumer Driven Health Plans (CHDP), Explanation of Benefits (EOB), Health Information exchange (HIX) and Coordination of Benefits (COB).
• Organized and participated in requirements gathering sessions such as Joint Application Design (JAD), Interviews, Interface analysis, Brainstorming, Observation, Focus Groups, Document Analysis, Surveys/Questionnaires and Prototyping to analyze the level of effort on project specifications.
• Acted as a liaison between the Business stakeholders and the Development team to provide the required inputs and solutions for a better understanding of the requirements and expected functionalities.
• Directed SWOT (Strengths, Weakness, Opportunities, and Threats) analysis, Cost-B enefit analysis, Gap A nalysis (from As-is to To-be processes), Root Cause Analysis, Impact Analysis, and Return on Investment (ROI) analysis.
• Expertise in written and verbal communication skills gathering, refining, and documenting artifacts like Project Plan, Business Case, Functional Requirement Document (FRD), Business Requirements Document (BRD), System Requirements Specification (SRS), Use Case narratives, and Requirement Traceability Matrix (RTM).
• Proficient in converting business requirements and user expectations into detailed specifications and systems while also creating business process flow charts using tools like MS Visio and Logic Gate.
• Efficient in designing UML diagrams like Use Case diagrams, Sequence diagrams, Activity diagrams, using tools like MS Visio, Lucid Chart and Smart Draw also involved in creating Data Flow and Context Flow diagrams.
• Actively involved in GUI Design by creating wireframes and mockup screens using tools like Balsamiq.
• Proficient in writing and documenting Epics and User Stories along with Acceptance Criteria.
• Deep knowledge of writing SQL queries using functions like joins, unions, group by, order by and aggregate for data analysis, verification, and performed CRUD operations on SQL Server.
• Designed prototypes for RESTful and SOAP APIs to be used for communication between different modules. Experienced in working with 3-Tier architecture, Web Services (SOAP, WSDL), Client-Side and Server-Side Validation.
• Experienced in Data warehousing and ETL process. Aware of the DW creation process including OLTP, OLAP, Data marts, ODS, Staging, Data sources, Normalization, Dimension tables.
• Created the Data Mapping document for identifying the attributes and tables in the Source database and mapping them to the Target database’s fields in addition identifying dependencies; used tools like Informatica PowerCenter.
• Used tools like Postman and SoapUI for API Testing as required by the workflow; used Swagger for documenting APIs.
• Supported the QA Team throughout the testing lifecycle by involving in the preparation of Test Scenarios, Test Cases, Test Scripts for Integration testing, GUI testing, Smoke testing, Regression testing and User Acceptance Testing (UAT).
• Performed Defect Tracking Lifecycle Management by logging, prioritizing, resolving, and updating defects using tools like HP Quality Center (QC) and Jira. Generated rich dashboards using Tableau dashboard and wrote user stories to deliver actionable insights.

TECHNICAL SKILLS:

AgileScrum, RUP, SDLC, Waterfall: Scrum, Waterfall, XP, Spiral

Business Modeling Tools: MS Visio, MS Project, Smart draw, visual paradigm, Lucid Chart

Requirement Management Tools: MS Office, JIRA, Rally, HP ALM, VersionOne, Visure, SharePoint, Confluence, Informatica, Tableau

Microsoft Office Suite: Word, Excel, Project Outlook, Exchange server and PowerPoint, Confluence

Business Skills: Process Modeling, GAP Analysis, Impact Analysis, Risk Analysis, Cost-Benefit Analysis, SWOT Analysis

Databases: SQL Server, MS Access, Oracle

Testing Tools: Selenium, Cucumber, POSTMAN, SOAPUI, Dynatrace, Zephyr

Operating Systems: Windows XP, Windows 8, Windows 10, Windows 7, UNIX, IOS

Software Languages: HTML, CSS, C#, C++, SQL, JAVA

PROFESSIONAL EXPERIENCE:

Systems Analyst

Confidential, Norfolk-Virginia

Roles and Responsibilities:

• Product was developed in Agile-Waterfall Hybrid called Water-Scrum-fall
• Worked alongside key stakeholders and Business users in eliciting, defining and documenting the business needs and business process flow
• Assisted the PM to write and prioritize the User stories using JIRA based on the Requirements gathered and also assisted with writing the acceptance criteria for the user stories.
• Performed GAP analysis and Impact Analysis on the Requirements gathered to analyze whether the business requirements are being met
• Performed data analysis using different SQL queries
• Gathering requirements for processing a transaction, manipulating a data and triggering responses accordingly using RPA tools like Blue Prism
• Involved with understanding and analyzing the product roadmap to successful execution of the project.
• Assisted the team with performing daily scrum ceremonies effectively by providing the resources to the team.
• Facilitated the daily stand up meetings and helped the team with managing and reducing their impediments to enhance transparency and collaboration among the team members.
• Assisted with setting up RPA technology along with the team for enhancing the streamlined enterprise operations and reduce costs.

Environment: Agile-Waterfall hybrid, MS Word, MS Excel, MS SharePoint, Oracle, JIRA, Confluence, RPA, Blue Prism

Sr Business System Analyst/ Scrum Master

Confidential, Brea- California

Roles and Responsibilities:

• Performed JAD sessions, Focus Groups, Interviews and Brainstorming to understand if any current systems are affected by the EDI X12 transaction and identifier aspects of HIPAA.
• Traced 5010 standards for 837I/P and 835 EDI X12 transactions, related to providers, payers, subscribers and related entities. Involved in documenting the process flows and test requirements to receive initial HIX premium payment from the individuals and recurring payment functionalities.
• Documented Business Requirement Documents, Functional Requirement Documents, User Requirements Documents, also provided continuous improvement of requirements gathering process.
• Performed GAP analysis and Impact Analysis on the Requirements gathered to analyze whether the business requirements are being met, also determining the potential consequences resulting on the project.
• Assisted the Product Owner to prioritize the Product Backlog Items (PBIs) for developing Sprint tasks during sprint planning meeting by taking suggestions from the cross-functional development teams.
• Created UML diagrams, workflows, business process, sequence diagrams, state diagrams, activity diagrams and use cases to provide users with expressive models.
• Determined if claims data satisfies the 5010 format and standards and also conducted analysis of HIPPA EDI ANSI X12
• Performed data analysis using different SQL queries like comment, create, delete and rename also to optimize SQL queries, Query Analyzer was used.
• Helped with Data mapping to process the Medicaid claims. To understand the data set elements for a particular record set we closely worked on EDI transactions like 270, 271, 835 and 837.
• Assisted team using the RPA tool- Blue Prism for the application to be able to run on cloud platform
• Assisted in creating the 3- tier architecture consisting of user interface presentation, functional process logic and data storage, database and Datawarehouse for the system. Documented the REST APIs using Swagger.
• Assisted with testing like non-functionality testing and functional testing like, integration testing, regression testing and UAT (User Acceptance Testing), also worked on bug and defect analysis.
• Wrote test cases, test scenarios, test scripts and added the testing module on Jenkins to automate the testing.
• Involved in analyzing the change request and collaborating with the Product owner to determine the change of scope and distribution of tasks between mainframe and Business Process Models development teams using Requisite Pro.
• Involved in making the Medicare patient profiles compliant with HIPAA regulations and Managed Patient Profile Transfer (PPT) records created by data team.
• Created and modified many ETL transformations such as, format revisions, look up, handing of null values, decoding fields, merging of data, character set conversion, deduplication and so on.
• Developed strong dashboards using Tableau and wrote user stories to develop dashboards to deliver actionable insights.
• Updated the SharePlus tool for the team, for better collaboration and effective communication within the team.

Environment: Rally, SharePlus, MS Office Suite, Visio, Java, IBM DB2, Swagger, Java Eclipse, Agile, Tableau, RPA

Sr Business System Analyst/Scrum Master

Confidential, Bridgewater, NJ

Roles and Responsibilities:

• Conducted JAD Sessions, focus groups, Brainstorming sessions for requirements gathering with the SMEs and the key stakeholders; also collaborated with IT team to bring about the desired solutions to the customers.
• Involved with understanding and analyzing the product roadmap to successful execution of the project.
• Documented the requirements in the form of BRD and FRD; Maintained User Story Mapping and maintained RTM for the team to validate the completeness of the requirements.
• Managed and maintained Sprint burn down and burn up charts and facilitated sprint review meetings. Facilitated and maintained adequate communication in the team regarding the project status. Worked alongside the product owners assisting them with prioritizing the product backlog and a feasible workflow operation.
• Lead, Managed, facilitated and coached the scrum team responsible for delivering the customer requirements.
• Solved and helped the team to overcome any impediments they might have during the ongoing sprints. Facilitated the Sprint Retrospective meetings for the team to enhance team collaboration.
• Assisted the team with performing daily scrum ceremonies effectively by providing the resources to the team. Facilitated the daily stand up meetings and helped the team with managing and reducing their impediments to enhance transparency and collaboration among the team members.
• Involved in reviewing and revising project processes to ensure accurate and timely results. Facilitated meetings with Salesforce developers, the sales team and the Marketing team to discuss about the data that needs to be analyzed and transported into Sales cloud and Marketing cloud. Extensively used SQL for source and target data validations; verifying the ETL process (Extraction, Transformation, and Load).
• Involved in writing SQL queries to research and analyze data for issue resolution and also to modify the HL7 messages.
• Created UML diagrams for the team like use-case diagrams, activity diagrams, class diagrams, sequence diagrams, component diagrams, collaboration diagrams and more.
• Knowledgeable of AutoCAD, as it was used by our development team to create various business models.
• Maintained a Requirement Traceability Matrix (RTM) to trace back the requirements during the project development.
• Involved in conducting Smoke Testing, Regression Testing and also non- Functional Testing along with documenting the defects to be managed using TFS.
• Assisted the team with quality checks like UAT and Manual Testing on each Microservice before it is released to the QA department and provided support to software development and QA staff as needed.

Environment: Agile-Scrum, HP ALM, Version one, Tableau, Informatica Tomcat, JBoss, AngularJS, HTML, CSS, MS Word, MS Project, Excel, PowerPoint, Linux, Swagger, Eclipse, Postman

Business System Analyst

Confidential, Fairfield NJ

Roles and Responsibilities:

• Worked alongside key stakeholders and Business users in eliciting, defining and documenting the business needs and business process flow, project was constructed in agile methodology.
• Assisted with claims adjucation processing in HMO, PPO, Medicare and Medicaid using facets. The payment process and claims processing were automated including the detailed as well as basic edits of the received claims.
• Participated in the Product Increment (PI) planning meeting, breakout sessions, Scrum of Scrum (SoS), meetings for Agile Release Train (ART) and also helped with consolidating the System Demos.
• Assisted the team with embracing SAFe Core values, adopt and apply SAFe principles and practices.
• Maintained Scrum artifacts like Product Burndown, Sprint burndown chart and Impediment list.
• Conducted scrum ceremonies like daily scrum, sprint planning, retrospective, product backlog refinement meetings and facilitated scrum meetings with the scrum development team.
• Assisted the teams with conducting Estimation Techniques to estimate the user stories also added them on Rally.
• Introduced various scrum best practices, principles and benefits to my team which eventually led to successful projects.
• Assisted the Product Owner to prioritize the Product Backlog Items (PBIs) for developing Sprint tasks during sprint planning meeting by taking suggestions from the cross-functional development teams.
• Experience with the use of clinical laboratory information system within a medium to large clinical laboratory.
• Conducted the Requirement workshops to understand the requirements and documented them on SharePoint.
• Conducted GAP Analysis and Impact Analysis of current state (As-is) and proposed state (To-be) situations also assisted with creating business process models using BPMN 2.0.
• Created UML diagrams to design Process flow diagrams, Use Case diagrams, Activity diagrams, Sequence diagrams.
• Created and maintained the Requirement Traceability Matrix (RTM) in Jira throughout the project execution.
• Wrote SQL queries to analyze the data in collaboration with DB team during data mapping, warehousing, normalization, and meta-data analysis for Medicare.
• Proficient creating ER models, Dimensional models, conceptual models using tools like ER win.
• Involved in making the Medicare patient profiles being compliant with HIPAA regulations also created and Managed Patient Profile Transfer (PPT) records created by data team.
• Involved in User Acceptance Testing (UAT) and Manual Testing on the recent application, so that the application is ready to be reviewed by the QA team.

Environment: Agile-SAFe, HP ALM, Jira, Confluence, Eclipse, Tableau, Teradata, Tomcat, JBoss, Java, HTML, CSS, Postman, MS Word, MS Excel, MS Visio.

Sr. Business Analyst

Confidential, Bridgewater NJ

Roles and Responsibilities:

• Performed critical analysis of the information from stakeholders, business users and other different sources, reconciled conflicts and decomposed the gathered information into understandable details using SCRUM methodology.
• Ensured that the team adheres to the compliances like NCPDP, HIPAA and HL7 regulatory transactions.
• Documented all aspects of IT, in accordance with FDA regulations, particularly CFR 21 part 11 and GCP regulations.
• Documented functional specifications for Patient Clinical Information, Health Records, Pathology Test Ordering and Results, Physician Requirements and Hospital needs.
• Worked with Business Analysis team to prepare a detailed BRD, FRD and SRS.
• Assisted the PO to write and prioritize the User stories using JIRA based on the Requirements gathered and also assisted with writing the acceptance criteria for the user stories.
• Created low-fidelity and high-fidelity wireframes and mockups for the allocation, transaction reconciliation, reports, analytics and dashboard modules.
• Helped the Product Owner to Prioritize the Product Backlog items for developing Sprint tasks by taking suggestions from the cross-functional development team.
• Analyzed the Iteration Burn Down charts and reviewed defects.
• Delivered the technical user stories to the developers within an Agile environment resulting in delivery of small enhancements, programs, features, modules and/or project components in a timely and cost-effective manner.
• Monitored change requests and documented requirements, integrating them with Use Cases.
• Identified and documented Issues, risks and gaps and their descriptions and impact, and provided recommendations.
• Wrote SQL queries using functions like joins, unions, outer joins, group by, order by and aggregate functions to extract data for timely reporting, validation and also created stored procedures.
• Worked closely with business users, in-house technical team and external vendor to conduct data mapping and migration, system configuration/customization for the ERP system.

Environment: Agile/Scrum, Service Oriented Architecture (SOA), MS Visio, JIRA, QlikView, Swagger, InformaticaUML, UAT Testing, Selenium, Cucumber, HP ALM.

Jr. Business Analyst

Confidential

Roles and Responsibilities:

• Involved in all the SDLC phases of the project development from initiation to the deployment phase including testing.
• Responsible for business analysis of outbound and inbound transactions; assisted with day to day EDI translation support. Conducted Gap Analysis between internal system and partner specifics.; compared implementation techniques.
• Collaborated with project team, project leads, project managers and fostered with them to understand the system, business analysis, review plans, systems testing and overall testing of software.
• Maintained the Kanban Board for the team to help optimize the workflow and communicate the status, progress and issues to team. Created Use Case Diagrams, Test Scenarios, Test Cases and Test Plans for federal employee program.
• Assisted with building claims processing system using the Service Oriented Architecture (SOA). Designed use case scenarios and also developed different business workflows and business processes.
• Analyzed the existing claims process and specific business rule logic will be applied in the ACP model.
• Involved in extensive DATA validation by writing several complex SQL queries and Involved in back-end testing Provided support during the integration of the system and also performed User Acceptance Testing (UAT).
• Performed retesting in order to verify resolution of defects and added the defects to JIRA for tracking. Wrote detailed oriented specifications for various reports generated using Cognos.

Environment: Facets, MS Word, MS PowerPoint, MS Excel, MS Visio, Confluence, Tableau, JIRA, Kanban.

Jr. Business Analyst

Confidential

Responsibilities:

• Product was developed in Agile-Waterfall Hybrid called Scrum-Waterfall.
• Participated in the Scrum Ceremonies like Sprint 0, Release planning, Backlog Grooming, sprint planning meeting, Daily Stand up meetings, sprint review meetings and sprint retrospective meetings.
• In the absence of the Product Owner, attended meetings with the stakeholders to elicit requirements using various techniques like JAD sessions, Interviewing and brainstorming.
• Documented BRD, FRD and FRS.
• Wrote Epics and user stories, assisted with maintaining the product backlog and also helped with organizing PB (Product Backlog) grooming sessions for prioritization, estimation of user stories.
• Relevant data from the company’s database was collected using SQL queries and performed CRUD operations. Built data mapping document for defining data flow between the source and the target.
• Assisted with developing virtualized APIs by building sample API request and Response messages. Coached our team for best practices, processes and tools related to the UAT activities.
• Assisted with defect management, defect tracking and reporting using tools like Jira, ALM and confluence.
• Jira Project Management database was utilized to store the scripts and to track defects.

Environment: MS Word, MS Excel, MS Visio, MS Project, MS SharePoint, Oracle, JIRA, Confluence, Agile-Waterfall hybrid, Tableau, Dynatrace.