- Have profound experience of 7 years as a Business Analyst with excellent project management skills in Pharmaceutical, Healthcare and Legal domains.
- Outstanding knowledge in Software Development Life Cycle (SDLC) methodologies like Agile, RUP and Waterfall.
- Experience in Business Process Management, Business Analysis, System Analysis, Scope Documents.
- Extensive experience in requirements gathering.
- Strong experience in GAP analysis to identify system restrictions and potentials, and creating AS - IS and TO-BE documents and Process Maps.
- Experience in conducting Joint Application Development (JAD) session with onsite and offsite team.
- Skilled in working with teams in Agile environment and perform as Business analyst, Facilitator and Tester.
- Proficient in all phases of Requirement Management, including gathering, analyzing, detailing, and tracking requirements.
- Involved in Test Planning, Test Preparation, Test Execution, Issue Resolution and Report Generation to assure that all aspects of a Project are following the Business Requirements.
- Good understanding of health care industry, Claims Management process, Medicaid and Medicare Services.
- Experience in configuration of claims processing applications, claim adjudication process, Electronic Medical Records / Electronic Health Records (EMR/EHR) and Medicaid Management Information System (MMIS), and Medicaid Information Technology System (MITS).
- Solid understanding of, Claims Processing, Benefit/Eligibility, Authorization/Referrals, COB, and have experience in HIPAA standards and corresponding EDI transactions.
- Extensive experience in Healthcare/Claims adjudication with knowledge of industry compliance standards like HIPAA and EDI X12 transactions (834, 837, 835, 270/271, 276/277).
- Strong experience in all phases of Software Development Lifecycle (SDLC) using Waterfall, Agile/Scrum, RUP (Rational Unified Process) and Software Testing Life Cycle (STLC).
- Proven ability to support multiple complex projects under tight deadlines, often with competing priorities
- Experience in Change Management and Conflict Resolution at various stages of the project life cycle
- Experience in developing test plans, building Test Conditions and Test Cases, creating test data, analyzing bugs, and interacting with development team members to fix errors.
- SQL background, including data validation and system testing using SQL.
- Highly motivated and organized leader with excellent client relationship, communication, and delivery skills.
Microsoft Technologies: MS Project, Visio, Excel, Word, Outlook, PowerPoint
Requirements Management Tools: Jira, Rational Requisite Pro, Rational Rose, MS Visio, HP ALMOperating Systems: Windows 2000/7/XP
Languages/Standards: SQL, XML, HTML
Defect management Tools: Jira, HP Quality Center
Methodologies: Agile, Waterfall
Confidential, Garland, TX
Business System Analyst
- Interviewed international user community to gather requirements for a document management system used by the legal division of a large Pharmaceutical company;
- Work with business customers and technical teams to elicit requirements and use cases for systems used by partners and retailers. This includes creating new requirements, identifying existing requirements, and negotiating business needs with technical constraints.
- Hosted requirements gathering sessions with the business users by preparing documentation and conducting application demonstrations. Authored the Requirements Specification Document;
- Ensured requirements mapping through all stages of the SDLC.
- Designed and developed wireframes based on the Functional Requirements;
- Presented wireframes at Requirements Workshops to gather additional feedback from the user community and to gain buy in from the stakeholders;
- Established strategy for critical function and User Acceptance Testing (UAT). Performed critical function testing and facilitated the UAT planning and testing process with business users and IT service providers.
- Prioritized outstanding defects and system problems, ensuring accuracy and deadlines were met.
- Created documentation, presentations, and materials for and Help Desk teams.
Confidential, Baton Rouge, LA
Business Analyst / QA Analyst
- Implemented SDLC which included Waterfall-SCRUM hybrid agile methodology with requirements, specifications phase and development phase in iterative time boxed sprint cycles, incorporating a rigorous definition of done.
- Gathered functional and non-functional requirements and involved in development and documentation of Business Requirement Document (BRD), and Software Requirements Specification (SRS) using agile methodology.
- Developed implementation guides for Partners EDI X12 transactions such as 834, 835,837,270, 271 and 274.
- Assisted the Project Manager in defining the project plan, project charter, scope, vision, and timelines. Handled requests for proposals (RFP), making presentations to customers, and negotiating project timelines and deliverables.
- Performed Gap Analysis by identifying current technology, policies, procedures, documenting the enhancements for the requirements, and analyzing new HIPAA 5010 compliance and developed an action plan for the migration process.
- Prepared Business Process Models (BPM) and UML diagrams like workflow diagrams, activity diagrams, sequence diagrams, use case diagrams, by using MS Visio, for visual representation to explain various steps involved in business.
- Responsible for the development and implementation of HIPAA EDI Data Mapping artifacts 270, 271, 274, 276, 277, 820, 834, 835, 837 and 5010.
- Performed User Acceptance Testing for the ANSI X12 Version 5010 / EDI transactions (HIPAA) for Claims Status and Eligibility (270, 271, 276, 277, 834, 837P, 837I, 837D, 835 remittances and NCPDP Claims).
- Developed HL7 messaging for bi-directional case and disease report exchange, in HTML and XML formats, in accordance with HL7 specifications.
- Developed XSD Schemas and wrote XML test files for backwards compatibility testing.
- Developed and executed detailed Use Case to describe the functionality of the system including claims transactions.
- Involved in creating and executing test cases, test plans and test scripts for EDI 837 Claims (I & P) Transactions.
- Performed Data mapping to validate and customize Claims daily load into FACETS for processing the transactions.
- Performed Data profiling through careful range and pattern analysis and checked for data integrity by looking for various data anomalies and doing data normalization and data verification using Informatica Data Quality Center.
- Build Data Dictionary for various designers, developers, users, and administration with information on contents, data-type, and data element in various tables, columns and rows, and data modelling through star and snowflake schema.
- Responsible for developing Traceability Matrix, worked on developing test plans, writing test cases, generated test scripts Involved in developing the test strategy.
- Extensively used Rational Clear Case for test planning and test management.
- Developed QA Test plans for Functional, Regression and User Acceptance Testing (UAT).
- Regression Testing is performed and the additional scripts are generated for each version.
- Develop Data Driven tests to handle the scenarios requiring multiples sets of data and parameterize the scripts to input varying data from MS EXCEL.
- Generated Data Driven scripts that access the backend database, Performed Both Positive and Negative Testing.
- Performed the tests and documented the results and bugs by using Rational Clear Quest.
- Used Quality Center to invoke the scripts and initially performed the baseline testing and organized all the scripts systematically and generated reports.
- Develop SQL Queries for checking the Data Transaction and Database Integrity.
- Verified the loaded data in oracle and compared the extracted data from Legacy system
- Performed queries in the database using 'SQL' to check successful transaction using TOAD
- Checked the logs were written for each process that runs.
- Developed SQL Queries to perform Database testing.
- Participated in Validating ETL process by creating various simple and complex SQL queries.
- Created test cases for the premium calculations and Claims limits and deductibles (Claims calculations).
- Wrote SQL queries to match the results with the actual BI report.
- For User Acceptance Testing (UAT) created ad hoc BI reports using Tableau
Confidential, Grand Rapids, MI
- Gather requirements and document the proposed processes to the existing system. Modules included: Claims Processing Files and HIPAA Guidelines adherence across the company.
- Assist in designing, planning and managing the data migration process.
- Perform source system data analysis and gap analysis to manage source to target data mapping.
- Perform migration and testing of static data and transaction data from one core system to another.
- Worked on claims, Claim adjudication, and Eligibility.
- Claim Transactions and Billing Transactions - Created flows for adequate matching of Claims. Matched Billing File and EDI Claim File records upon receipt.
- Responsible for system integration testing of 837 claim files, 834 eligibility files and 270/271 interface files to ensure required interactions are met during the SDLC process.
- Performed Data mapping to validate and customize Claims daily load into QNXT for processing the transactions.
- Validated Inbound and outbound 837 transactions, including but not limited to the loading and correcting any errors with the process of EDI inbound and outbound files
- Validated outbound 835 transactions including but not limited with vendor on QNXT mapping and system configuration.
- Testing - Developed Test Scripts using Quality Center and coordinated with developers to quickly resolve the defects associated with them.
- Analyzed and evaluated User Interface Designs, Technical Design Documents and Quality Assurance Test Conditions the performance of the application from various dimensions.
- Helped create the 'Business Glossary' to facilitate efficient understanding of the business process amongst the other teams.
- Planned the entire Data Warehousing initiative from requirements gathering, analysis, design, identifying and analyzing the source systems, to data quality, to ETL, and to the end user data access.
Confidential, Los Angeles, CA
- Coordinated IT projects and ensures company resources are utilized appropriately.
- Compiled project status reports, coordinates project schedules, manages project meetings, and identifies and resolves technical problems.
- Identified and analyzes systems requirements and defines project scope, requirements, and deliverables.
- Coordinated project activities and ensures all project phases are documented appropriately
- Conducted Requirements Clarification Sessions with concerned project members to clarify requirements.
- Worked on Policy Submissions, Policy Changes, Policy Renewals, Rewrites and Reinstatements Functionalities
- Scheduled and conducted JAD (Joint Application Development) sessions for analyzing and documenting requirements.
- Used the guidelines and artifacts of the Rational Unified Process (RUP) to strategize the Implementation of Rational Unified Process effort in different iterations and phases of the Software Development Life Cycle.
- Carried out AS-IS and TO-BE Analysis to showcase the improvements in business processes.
- Worked as an interface between the users and the different teams involved in the application development for better understanding of the business and IT processes.
- Followed the UML based Methods using Rational Rose to create Activity Diagrams, Sequence Diagrams, and Collaboration Diagrams.
- Used Requisite pro to input all the data elements, Use cases, and UI specifications.
- Prepared Business Process Models that includes modelling of all the activities of the business from the conceptual to procedural view.
- Aided management in standardizing web applications by preparing GUI standards and recommending alternative strategic solutions incorporated in a phased and iterative manner.
- Involved in project status meetings, QA review meeting, and Defect Status Meeting.
- Prepared Test Strategy and Test plan documents.
- Worked for multiple Sprints in Agile Methodology.
- Written Test conditions based on Requirements.
- Created positive and negative Functional Integration test cases by analyzing requirements and test conditions.
- Worked on Test Data Setup, created data as per test case requirements.
- Interacted with Business Partners in Reviews and User Acceptance Testing.
- Created and Reporting Bugs, involved in every phase of Bug Life Cycle.
- Escalation of Critical problems / issues during Testing and reporting them in JIRA.
- Prepared Final Test reports containing test steps and snapshots of execution
Corporate Legal Advisor
- Thorough comprehensive review assessed legalities of auditor’s performance in Internal Audit Section along with legality of documents issued by the Cameroon Ports Authority.
- Devised contracts and reviewed external contracts to determine if they were in accordance with the law before their final issuances.
- Communicated and counseled the board of the Directors during staff meetings.
- Edited motion papers for court submission, performed legal research, assisted attorneys with various aspects of pretrial discovery, and maintained case information and deposition databases.