SUMMARY:

• Accomplished Business Analyst with 7+ years of experience working in Agile/Scrum & Waterfall environment in all phases of the Software Development Life Cycle (SDLC) with excellent communication and strong requirements gathering skills.
• Board experience with SDLC requirement gathering and Software deployment using Agile Scrum and Waterfall Process.
• Specific expertise in Business Analysis, GAP Analysis, Data Analysis, and creating business process documents.
• Detailed knowledge of the Software Development Life Cycle (SDLC) phases.
• In depth knowledge and hands on experience working with SDLC methodologies like Waterfall, Scrum, and Agile.
• Expertise in preparing Business Requirement Documents, Use Case Specifications and Functional Specifications.
• Experience in Use Case Methodology, creating UML diagrams like Use Case diagram, Business Workflow Diagram and Activity Diagram using tools like, MS Visio, Blismiq, Gliffy.
• Experience in using Joint Requirement Planning (JRP) and Joint Application Deployment (JAD) sessions for gathering requirements and brainstorm ideas.
• Strong experience in healthcare domain - Claims Processing, Benefit Administration, EDIs (837, 835, 834, 270, 271, 276, 277), ICD 9, ICD 10, system, Provider Information system, Revenue Cycle Management (RCM).
• Well experienced with the complex tasks of ICD 9 to ICD 10 conversion and mapping.
• Researched, defined and analyzed changes to both state and federal laws affecting the Medicaid Management Information System (MMIS).

PROFESSIONAL EXPERIENCE:

Confidential, Bethlehem, PA

Business Analyst

Responsibilities:

• Working on User Stories/Features/Epics in Jira.
• Working closely with Scrum Master and reporting to Product Owner.
• Managing other offshore business analysts to deliver the stories.
• Reviewing test cases on all the stories before demo and delivering to the business users.
• Created process flow diagrams and data flow diagrams to show interaction of various systems and the data flowing through various systems.
• Analyzed and confirmed the source and target data in the database using Oracle SQL Developer. Updated Electronic Enrollment/Reconciliation Data Form.
• Created mapping for EDI transactions, specially 820 and 834. Outlined the updated processes for Payment Reconciliation, Eligibility, and Premium Payment Transactions.

Environment: Agile-Scrum, User stories, JAD, MS Office, MS Project, JIRA, Confluence, MS- Visio, MS SharePoint.

Confidential, Sacramento, CA

Sr. Business Analyst.

Responsibilities:

• Worked as a liaison between technology and the business clients to improve business processes and support critical business strategies.
• Utilized industry knowledge to provide executive management, the development and implementation of interactive business tools, and strategic analysis, vital for use in mission-critical decision-making.
• Gathered requirements by using interviews, observation, JAD, brainstorming sessions, and documents analysis
• Performed Gap analysis for both private and government plans, designed business rules and requirements for privacy issues, and managed development of technical specifications for data interfaces conforming to HIPAA requirements and data transaction sets.
• Participated in various scrum ceremonies such as Product Backlog grooming session, Sprint planning, daily Scrum, Sprint review and Retrospective meetings.
• Worked closely with EDI team to map EDI transactions which included but not limited to EDI-837 I-,270/271 & 277/278
• Developed process flow diagrams and created Script Files containing the test cases. These would later help the testing team to properly comprehend the scope and extent of testing required

Environment: Agile-Scrum, User Stories, /Use Cases, JAD, Rally, MS-Office, MS Project, SharePoint, MS Visio, One Note, UML, SQL

Confidential, Philadelphia, PA

Business Analyst

Responsibilities:

• Worked with business users to understand the Eligibility Reconciliation and Payment Reconciliation process.
• Created and maintained data mapping document(s) in to the HIPAA mandated X12 format EDI transactions 820, 834, and 835. Performed GAP Analysis on (X12) transition
• Gathered business requirements, analyzed data sources, workflows by conducting interviews and meetings.
• Created business process models, flow diagrams, activity diagrams, use cases and wrote Business Requirement Documents (BRDs) and Functional Requirement Documents (FRDs) using tools and applications such as MS Word, MS Excel, and MS Visio.
• Held JAD sessions to make sure all requirements were well understood by the team.
• Implemented the suggested changes and finalized the design to be presented to the developers.
• Worked on CCD implementation guide for sharing Continuity of Care Record (CCR) patient summary data using the HL7 Version 3 Clinical Document Architecture (CDA). Outlined important information for stakeholders.
• Worked on Dental Claims process flows and error reporting.
• Validated CCD templates contained correct information in different Templates i.e. Header, Procedures, Family History, and Social History etc.

Environment: s: Waterfall, MS Office, MS Access, MS Project, SharePoint, SQL Server TFS, QTP, Quality Center, EDI 820/834/837/X12

Confidential, Chicago, IL

Business Analyst

Responsibilities:

• Working on highly prioritized projects focusing primarily on Harmony’s applications used to service external constituents (Members, Plan Sponsors, Brokers, and Providers etc.)
• Coordinated with Product Manager to develop and adept the product vision for Medicare, Medicaid and other commercial business.
• Facilitated architect in resolving business concerns regarding Billing on-line payment system enhancements.
• Working with other Product Owners to manage dependencies and prioritizing the backlog through business cases.
• Participated in Daily-Scrum, Product Backlog refinement meeting, sprite review, sprint retrospective meetings.
• Working closely with QA Team to specify acceptance criteria for User-Stories and helping writing Acceptance Tests.
• Extensively worked on ANSI X12 EDI 834 & 837 file format and in Medicare & Medicaid eligibility requirements.

Environment: s: Agile-Scrum, Jira. MS-Office, MS Project, Microsoft Outlook, SharePoint, MS Visio, UML, SQL, Confluence.

Confidential

Business Analyst

Responsibilities:

• Worked with the project manager, and technical teams to document the project vision and scope.
• Analyzed and synthesized results from Joint Application Development (JAD), proposed alternative tasks and transformed those into Business Requirement Document. (BRD)
• Created Business Flow diagrams, activity diagrams, use cases.
• Create both Business Requirement Documents (BRDs) and Functional Requirement Documents (FRDs) using tools and applications such as MS word, MS Excel, and MS Visio.
• Redesigned the previous user interface to a new design to better enhance the user experience.
• Create Process flow diagram and modified the file format and layout for Discussion boards.
• Wrote SQL queries for data validation during ETL Process.

Environment: s: Waterfall, Microsoft Outlook, MS Access, MS Project, SharePoint, UML, SQL, TFS.

Confidential

Data Analyst

Responsibilities:

• Understand the Project Goals and Document the features and User stories by working with the board.
• Create Workflow diagrams, Swim lanes and Kanban Flow.
• Creating reports from single or various frameworks.
• Help Creating a Kanban board to visualize the process of work flow.
• Helping develop reports and analysis.
• Handling confidential data and information concede to guidelines.
• While in such positions I was educated extensively on lean principles of management.

Environment: s: Kanban, MS- Office, MS Outlook, MS Project, TFS, SQL, Gliffy, UML.