SUMMARY:

• 10 years of experience with 8 years as Business Analyst and2 years as a Java/J2EE developer with strong Health Care, Retail, Public Services and Telecom experience. Designed systems for Public Services, Retail, and Health Care systems
• Proficient in Business Analysis, Requirement elicitation and documentation, Technical writing, Testing and coordinating meetings.
• Well versed with all the stages of Iterative Software Development Life Cycle (SDLC) and involved in implementing Rational Unified Process (RUP), along with Agile, Scrumand Waterfall methodologies.
• Well versed with MS Office (Word, Excel, PowerPoint).
• Experience in conducting Joint Application Development (JAD) sessions, reviews, walkthroughs, stakeholder interviews and project meetings.
• Performed GAP Analysis (AS IS to TO BE).
• Used VLOOKUP() function in MS Excel.
• Created wireframes in Balsamic.
• Used MS Visio for developing Cross Functional Flowcharts, Organizational Flowcharts, Process Flow Diagrams.
• Created Unified Modelling Language (UML) diagrams like Use Case diagrams, Activity diagrams, Class diagrams, Sequence diagrams using Visio and Rational Rose.
• Knowledge of software analysis, design, development, testing and implementation of Java/J2EE web applications using Web Services (SOAP, WSDL).
• Strong understanding of Object - Oriented Architecture (OOA) and Service Oriented Architecture (SOA) using web services.
• Extensively used SQL concepts and worked on different database tools like SQL Developer, TOAD,and databases like Oracle, SQL Server and MySQL.
• Demonstrated experience in working with cross-functional teams, ability to consistently meet project goals, excellent written/ oral communication skills and maturity to tie business requirements with project goals and milestones.
• Excellent analytical and interpersonal skills with exceptional ability to learn new concepts.
• Conducted review sessions on a regular basis with QA. Conducted shakedown, unit and smoke testing .
• Broad knowledge of Medicare , Medicaid , PPO , HMO , POS , diagnostic codes, claims process, and EDMS (electronic data management system).
• Strong experience and understanding of claims management process.
• Strong knowledge of EDI Claims, member enrollment, and billing transactions.
• Strong Knowledge EDI transactions, ASCX12 Transactions like 270/271, 276/277, 835, 837I and 837P.
• Understanding of HIPAA Standards and Compliance issues, HIPAA Privacy policy, opt in/opt out policy
• Hands on experience as an expert user of MS Excel, MS PowerPoint, MS Access, Business Objects.
• Excellent understanding of Data Models and Information Architecture and sound skills in SQL.

TECHNICAL SKILLS:

Modeling Tools: Microsoft Visio, Lucid Charts, Balsamic, Rational Rose (UML)

Version Control: CVS, Rational Clear Case, Start Team, Perforce, Visual Source Safe

Task Management Tool: Rational Team Concert, Jira, Rational Requisite Pro

Methodologies: Agile, RUP, OOAD

Testing Tool: QTP, Rational ClearQuest, ALM/Quality Center

Operating Systems: Windows, Unix

Reporting Tool: Salesforce

Languages: Java, C++, XML, UML, HTML, PL/SQL, JavaScript

RDBMS: Oracle, SQL Server, MySQL

Web/Application Servers: IBM WebSphere, IBM WebSphere Portal, WebLogic, Tomcat, Apache Axis

Suite: MS Office (Word, Excel, Power Point)

PROFESSIONAL EXPERIENCE:

Confidential, TX

Sr. Business Analyst

Responsibilities:

• Responsible for requirements elicitation, definition & analysis, Business process design and mapping.
• Played the role of a ScrumMaster in his absence in Agile environment to conduct Daily Scrum meetings.
• Used MS-Visio BPMN for developing Medicaid AS-IS and TO-BE business process flow, from Synchronous Information Sharing System to Asynchronous Information Sharing System.
• Support for, and documentation of, required changes to business processes in connection with Exchange Periodic Data.
• Created data requirements to extract data from HIX.
• Knowledge of HL7 and xml interface messaging.
• Actively participated in preparation of Sprint Backlog, Sprint Review meeting and Sprint Retrospective meeting.
• Provided suggestions and ideas more from a strategic and long-term perspective for each Sprint.
• Responsible for data mapping of HL7 messages into relational database.
• Worked with development and IT Infrastructure team to work on security requirements for web service calls.
• Worked in capturing requirements for module IFSV (Income Family Size Verification)
• Defined the data mapping values for data integrity and security through all the modules that interacted with BRMG i.e. ESB, EPD and IFSV.
• Conducted interviews with the clients for gathering requirements and evaluation/analysis of their data. Converted the business rules into user stories.
• Assisted in defining the initial common terminology to be used throughout the project lifecycle.
• Conducted walkthroughs and acted as a liaison between the business users, stakeholders and the team to perform requirements, quality and risk analysis.
• Documented and reported the progress to the management on an ongoing basis.
• Worked on fetching data from CDR via SQLqueries used in Submission Tracking Tool
• Created change requests in RTC whenever a ticket was raised to include a functionality from RTM
• Extensive use of Rational Team Concert for reviewing and analyzing and managing the user requirements.
• Maintained Traceability matrix throughout the project.
• Used Rational Clear Quest to maintain and track the requested enhancements by the stakeholders.
• Interacting with the development team to explain to them the various design documents: Business Use Case Model, Detailed Use Cases, and Vision Document.
• Creating detailed design of the system with the project team including class diagrams, activity diagrams, sequence and collaboration diagrams.

Environment: Scrum, Agile, UML, SQL Developer, Visio, Rational Team Concert, Rational Clear Quest, Windows, MS Office, HTML, Java, Oracle.

Confidential, Tampa, FL

Business Analyst

Responsibilities:

• Gathered user and business requirements through open-ended discussions, brainstorming and prototyping to achieve the following goals.
• Prototyped the automation and enhancement of the manual processes in member enrollment, terminations and reconciliation
• Designed process flows of EDI Transactions (Portal --> (HIX) --> Carriers) using MS Visio.
• Facilitated JAD sessions for Updating Member Billing capabilities / processes and reporting Updates to Delegate/Vendors Interfaces, Develop / Enhance Call Center and Customer Service Processes
• Analyzed and documented differences between the AS-IS and TO-BE processes.
• Ensured claims adjudication and processing is in accordance with EDI 835 HIPAA transactions set.
• Involved profoundly in comprehending revenue cycle management and claims processing between the provider and payer for EDI 835 and 837 transactions.
• Worked with Health Care Reform / Customer Service team to establish a dedicated Customer Service Model to address member needs at each point in the customer experience (pre-enrollment, during enrollment, post-enrollment etc.).
• Worked on different EDI scenarios for batch processing and ensured day-to-day EDI transmission reject tracking and Reconciliation.
• Prepared client process maps for the provider transactions for the Facets process.
• Designed and developed UseCase Diagrams for the Facets process modules.
• Working on SOA Web Service testing, using SOAPUI to test web service request and response between two ends.
• Tested the ability to store Identification number received from the Exchange and create a unique identifier for members received through the Exchange.
• Prepared UAT Materials, including the UAT Process, UATTestdocument which would include step-by step process for UAT as well as all the tests that would cover all requirements.
• Worked with IT in developing a new capability that will allow tracking new HIX membership’s alignment across their consumption and utilization within organization’s plans/products.
• Used RationalClearCase to keep different versions of the documents and RationalClearQuest to report bugs or defect.
• Maintained a Requirements Traceability Matrix (RTM) in order to keep the clients and all the teams up to date with the current progress of the project.
• Designed the test plan and testcases, involved with reviewing defects reported from UAT efforts and analyzed for root cause and took actions based on the findings.

Environment: Rational Rose, Jira, Rational Requisite Pro, SQL Server, MS Office (MS Word, MS Excel, MS PowerPoint), MS Visio, Windows, Java, Oracle, Agile, Facets.

Confidential, Richardson, TX

Business Analyst

Responsibilities:

• Involved in creating a VBScript that was run to create each dispute registered on the North Texas Tollway Authority (NTTA) tolls.
• Consult with executive level stakeholders to define business need or problem.
• Facilitated JAD sessions to elicit requirements for preparing Business Requirement Documents (BRD) which defined the scope of work for the technical team
• Created Test Plans and Test Cases based on business requirements.
• Interacted with the development team and made sure the Technical Design Document(TDD) and Technical Specification Document (Tech Specs) were in alignment to the BRD developed
• On completion of every Sprint of Agile Development of modules, participated in presentation to the client the business goals achieved till date.
• Tracked the iteration process of development with requirements document and conducted Test reviews.
• Worked closely with project manager and other high management, producing workflow diagrams using MS Visio/UML.
• Identified and analyzed the data requirements for the various teams and made sure the data was available in different environments like development and production.
• Involved in project status meeting, QA review meeting and client update meetings.
• Interacted and coordinated with onshore and offshore team during the entire software development life cycle (SDLC).
• Produced documents for GAP analysis (AS IS to TO BE)

Environment: SQL Server, MS Visio, Java, XML, Struts, Hibernate, Jira, Eclipse, MS Word, SharePoint, VB.Net, HP Quality Center, Perforce.

Confidential, Bentonville, AR

Business Analyst

Responsibilities:

• Involved in design for new enhancements support & maintenance activities.
• Interacted with client to gather requirements and planning.
• Developed class diagram, sequence diagram by using Microsoft Visio.
• Developed Technical design document for the module I worked.
• Interacted in status update meetings with offshore team on a daily basis.
• Followed Agile methodology.
• Developed Technical Specification document for item creation and maintenance.
• Performed integration testing and regression testing.
• Data mapping, logical data modeling, created class diagrams and ER diagrams and used SQL queries to filter data within the Oracle database
• Analyzed and Documented Business Requirement Document (BRD), Functional Specification Documentation, and System Requirement Documentation, using UML methodologies
• Reviewed test scripts and made sure that the Test scripts covered all scenarios of the requirements.
• Created technical design documentation for the data models, data flow control process, metadata management.
• Logged defects into QC while doing Functional Testing and followed through the process until the defects were closed.
• Reviewed the Defects entered by the QA team and prioritized the defects and assigned them to the development team
• Worked extensively with the QA team for designing Test Plan and Test Cases for the User Acceptance Testing.

Environment: RSA, Java, JSP, EJB, Struts, Design Patterns, Ant, Junit, Log4J, Web Services, SOAP, UDDI, WSDL, SQL Server 2000, Unix, Shell Script, TOAD, WebSphere

Confidential

Software Engineer - Partner Relationship Management (PRM)

Responsibilities:

• Developed UML diagrams (Use Cases, Class & Sequence) on Rational Rose.
• Involved in high level design
• Developed Stateless Session Beans for Product module.
• Developed JSP to provide user interface for adding/editing information about product.
• Developed role-based Navigation bar by using XML.
• Performed activities like environment set up, code review, code refactoring, DB activities & Deployment.

Environment: Java, JSP, Taglibs, EJB, Design Patterns, JavaScript, XML, Junit, Oracle 9i, PL/SQL, WebLogic, Clearcase, Eclipse.

Confidential

Software Engineer - Customer Service Application (CSA)

Responsibilities:

• Worked on Arabization of the entire product.
• Performed bug fixing of the already existing product.
• Developed JSP to support Arabic language and format.
• Involved in Code Reviews as per Fagan's Inspection rules and ensuring code quality across module.
• Involved in UAT & maintenance of the multiple modules.
• Involved in code refactoring.

Environment: Java, JSP, Taglibs, EJB, CVS, Design Patterns, JavaScript, XML, Junit, Oracle 9i, PL/SQL, WebLogic, Eclipse.