PROFESSIONAL SUMMARY:

• Business Data Analyst with Nearly 7+ years of experience including an understanding of Business Process Flows, Case Tools, and Business Analysis.
• Managing reporting, analysis and decision - making for a change request using tools like ClearQuest and Excel.
• Build and maintain strong relationships with business partners, customers, technology teams and Data Management team to build Business Intelligence solutions.
• Involved in testing EDI Transactions, mainly focusing on Eligibility system 270/271 transaction, based on HIPAA 5010 compliance
• Experience in writing SQL queries/scripts for data analysis.
• Experience in conducting Joint application development (JAD) sessions for gathering requirements, and Rapid application development (RAD) sessions to converge early toward a design acceptable to customer.
• Maintained project documentation and coordinated team efforts to successfully complete projects.
• Documented specifications based on user scenarios, requirements and input from business, wrote functional specifications for software applications.
• Used SharePoint outlook express for office assistance, time and schedule management
• Profound Knowledge of Rational Unified Process (RUP) methodology, Use Cases, Object Oriented Analysis and Design (OOAD).
• Extensive experience in gathering business requirements, business processes, identifying risks, GAP analysis and UML modeling.
• Worked on Informatica Utilities Source Analyzer, warehouse Designer, Mapping Designer, Mapplet Designer and Transformation Developer for defining Source and Target, and coded the process from source system to data warehouse.
• Strong understanding of various SDLC methodologies such as RUP, Waterfall and Agile with hands on experience in all of them.
• Developed expertise in claims processing and direct clearinghouse for claim processing and billing to insurances companies nationwide all on a SQL backend.
• Medical Claims experience in Process Documentation, Analysis and Implementation in 835/837/834/270/271/ (X12 Standards) processes of Medical Claims Industry from the Provider/Payer side
• Deployed and uploaded the SSRS reports to SharePoint Server for the end users and involved in enhancements and modifications.
• Knowledge of health information and health care services regulatory environment including HIPAA, Medicaid/Medicare, CCHIT, EDI and XML
• Experience with data manipulation, conversion, transformation and generation of reports.
• Skilled and quick to adapt to new environments with strong problem solving and trouble shooting skills.
• Have knowledge on packages like SSRS, SSIS.

TECHNICAL SKILLS:

Modeling tools: MS Visio, MS Project, Rational rose

Methodologies: Agile, SDLC, Waterfall, Iterative, RUP, SCRUM, RAD, JAD, SWOT

Management Tool: Rational Requisite Pro

Office Automation Tools: MS Office, Project outlook

Operating Systems: Windows 95/98/XP/2000/NT, MS-DOS, UNIX

DBMS: MS Access, SQL server, Oracle

Packages: SSIS, SSRS

Language: Java, C, C++, .Net, Visual Basic, SQL

Reporting tools: Power BI, Tableau

PROFESSIONAL EXPERIENCE:

Confidential, Columbia, SC

Sr. Data Analyst

RESPONSIBILITIES:

• Acted as a liaison between client and payer/intermediary.
• Data Analysis using MS ACCESS and Statistical Analytical Software (SAS).
• Gathered requirement on FACETS EDI 834 Benefit Enrollment and Maintenance subsystems
• Designed workflows using Informatica Power Center to perform ETL on the data from the staging area to the transaction enrichment data store and to the compensation data marts.
• Conducted gap analysis and impact analysis of transition from HIPAA 5010 on EDI transactions 837 (I, P & D) 1, 834, and 835.
• Performed complex ad hoc SQL queries from BAs in Teradata SQL Assistant.
• Performed ETL data validation using MS Excel and Informatica
• Worked on Data Mapping to map Facets data to outbound eligibility extracts.
• Involved in FACETS Implementation, involved end-to-end testing of FACETS Billing, Enrollment, Claim Processing and Subscriber/Member module.
• Created Ad-Hoc Reports, Summary Reports, Sub Reports, and Drill-down Reports using SSRS.
• Worked on FACETS claims processing, payment adjustments, claims inquiry, benefits,
• Conducted different session with business owners from Claim, eligibility, enrollment.
• Medical Claims experience in Process Documentation, Analysis and Implementation in 835/837/834/270/271/277 (X12 Standards) processes of Medical Claims Industry from the Provider/Payer side.
• Perform BA validation process for all the reports before dispatching to QA environment
• Analyzed Health plan Enrollment and Maintenance (ANSI X12 834) file specifications under HIPAA framework
• Prepared implementation plan and negotiated agreement on EDI file specifications with Trading Partners and vendors in accordance with HIPAA guidelines
• Assisted for the business requirements, ETL Analysis, ETL test and design of the flow and the logic for the Data warehouse project.
• Interfaced with technical staff, trading partners, Clearinghouses and internal staff including programmers on all HIPAA related information and changes
• Modeled expenses incurred using SAS. For the same found the expense trend and compared the same with the productivity/deliverables.
• Teamed up with Senior Managers in managing System (EDI and data processing) requirements, System design and Architecture, develop and test EDI Portal Redesign applications and transactions. Worked on EDI Portal from its inception to completion and then support it
• Delivered ad hoc reports using SSRS, SAS, and standard SQL queries
• Facets support systems were used to enable inbound/outbound HIPAA EDI transaction in support of HIPAA 834, 835 /271 transactions.
• Facets support systems were used to enable inbound/outbound HIPAA EDI transaction in support of HIPAA 834, 835 /271 transactions.
• Designed reports using SQL Server Reporting Services (SSRS).
• Extensively tested EDI X12 Transaction sets like EDI 837 (Health Care Claim).
• Teamed up with various e-Business areas in their overall efforts to make EDI infrastructure X12 5010 compliant. Involved in Gap Analysis and Risk Analysis
• Worked on FACETS claims processing, payment adjustments, claims inquiry, benefits,
• Reviewed, analyzed and modified programming systems including encoding, testing, debugging to support organization's Web systems. Consulted with users to identify current operating procedures and clarify program objectives. Planed and direct activities of assigned projects to ensure the goals and objectives of the project are accomplished on time and within budget
• Medical Claims experience in Process Documentation, Analysis and Implementation in 835/837/834/270/271/ (X12 Standards) processes of Medical Claims Industry from the Provider/Payer side
• Used SQL queries to analyze incoming customer information against IBC system data to validate expected test results

Confidential, Group, CA

Data Business Analyst

RESPONSIBILITIES:

• Reviewed design documents & business requirements to learn the function and scope of the application.
• Gathered analyzed, documented business and technical requirements from both formal and informal sessions and validate the needs of the business stakeholders.
• System analysis, design, development, testing, Implementation and maintenance
• Performed Data mapping on the extracted data, logical data modeling, created class diagrams and ER diagrams and used SQL queries to filter data.
• Effectively managed version and change control during the migration from to FACETS
• Designed and developed Use Cases and Use Case scenarios, Activity Diagrams, Sequence Diagrams, High Level and Low Level Process Flow Diagrams, OOAD using UML and Business Process Modeling.
• Conduct impact analysis for Facet Migration
• Worked on Complex SSRS Reports, Sub Reports, Graphing, Data Drill-Down, and Data sorting/grouping, SSRS Reports Design.
• Responsible for requirements analysis, design and developing technical requirements.
• Extensively used SQL queries and procedures for data validation in both source system and target system.
• Conducted walk through sessions for Business Requirement Document (BRD) and Use Cases to discuss certain issues with stake holders, Architectures and Design & development teams and also did GAP Analysis.
• Worked on MS-Visio and Excel for defining business use cases and activity diagrams for FACET migration
• Conducted user interviews and JAD sessions to get an understanding of client's business process.
• Create and execute claims test cases for the FACETS upgrade and ICD 10 testing
• Monitored workflow of the data, Resolution/Adjustment Unit, delegate tasks accordingly, and ensure that quality, quantity, and efficiency standards are met or exceeded.
• Conducted Functional, System, Regression, Smoke, End to End and UAT testing
• Involved in claim adjudication process of FACETS application and FACETS data model
• Responsible for creating test case scenarios, creating test data plan and writing test scripts for the UAT using testing tool and defect management for Policy Management Systems, Payables/Receivables and Claims processing.
• Gathered requirements on FACETS EDI 834 Benefit Enrollment and Maintenance subsystems
• Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Health Insurance Claims. Worked on HIPAA Standard/ EDI standard transactions: 270, 271, 276, 277, 278, 834, 835, and 837 (P.I.D), 997 and 999 to identify key data set elements for designated record set. Interacted with Claims, Payments and Enrollment hence analyzing and documenting related business processes.
• Author and execute Test cases for Claims and Customer Service Workflow by manually.
• Tested the EDI 820,834, 835 and 837 interfaces, developed test cases and test scripts for all 835, 837 Institutional and Professional HIPPA Transactions
• Deployed and uploaded the SSRS reports to SharePoint Server for the end users and involved in enhancements and modifications.
• Created the test scenarios best on the new business requirement for the UAT
• Conducted surveys, interviews, and JRP, JAR and JAD sessions and translated them into system Requirements. Suggested measures and recommendations to improve the current application performance of the system.
• Used RUP to create use cases, activity, class diagrams and workflow process diagrams.
• Responsible for executing SQL Queries for checking duplication in records.
• Authorized Test Cases for HIPAA EDI transactions specifically 837.
• Assisted the team members to develop Service Oriented Architecture (SOA), and data warehouse system (EDW) to utilize data mining for data analysis.

Confidential, NY

Sr. Business System Analyst

Responsibilities:

• Performed extensive Data validation by writing several SQL queries, back-end testing and worked to resolve data quality issues.
• Worked with cutting edge technologies, like Adobe Marketing Cloud (AEM, Campaign, and Analytics).
• Gathered Business Requirements from different business owners such as Claim, enrollment, cost containment, marketing, customer service etc.
• Performed Data Mappings based on the specified data requirements and to check for data uniformity and to modify /update the data fields.
• Verified Source to Target mapping and data validation.
• Strong experience in Data warehouse concepts.
• Successfully used Agile/Scrum Method for gathering requirements and facilitated user stores workshop. Documented User stories and facilitated Story Point discussions to analyze the level of effort on project specifications.
• Helped design and implement processes for deploying, upgrading, managing, archiving and extracting data for reporting.
• Managed the Metadata associated with ETL processes used to populate the data warehouse.
• Analyzed the state requirements and mapped the state requirements with business requirements.
• Job operated within a very agile environment, employing 2-4 week sprints, daily scrum meetings, burn-down charts, task weighting, pair programming, refactoring, presentations and review.
• Conducted and automated the ETL operations to Extract data from multiple data sources, transform inconsistent and missing data to consistent and reliable data and finally load it into the Multi-dimensional data warehouse.
• Created business requirement documents as well as system requirement specification after the JAD session.
• Executed queries using multiple aggregate and OLAP/OLTP functions and joins.
• Used SQL to test various reports and ETL load jobs in development, QA and production environment.
• Designed ETL Process Models, Systems Diagram, Workflow, Activity Diagrams, Use Cases (UML) and Business Rules using MS Visio.
• Experience in designing and developing Data Warehouse applications using ETL and Business Intelligence tools like Informatica Power Center, Datastage, Mainframes, OLTP, OLAP, Business Objects.
• Extensively involved in Data warehousing administration and metadata management responsibilities
• Wrote the SQL queries on data staging tables and data warehouse tables to validate the data results.
• Incremental development and testing of Enterprise Data Warehouse.
• Intensive use of SQL within the Teradata platform. Performed the Back-end testing manually by writing and executing SQL statements on Oracle Database in UNIX environment to query the database for Data validation, identifying, cleaning/scrubbing.
• Created non-data warehouse ETL system for outbound files going to cloud provider using Informatica’s SFTP
• Extensively involved in Data warehousing administration and metadata management responsibilities
• Conducted different session with business owners from Claim, eligibility, enrollment.
• Perform BA validation process for all the reports before dispatching to QA environment
• Participated in weekly base team meetings to discuss team progress, problems.
• Extensively used team track for the documentation as well as track the version for each documents
• Using Agile SDLC Methodology, I organized and facilitated daily scrum meetings, Sprints planning meeting and sprint review meeting.
• Tested and validated the database tables using SQL queries and Stored Procedures and performed Data Validation and Data Integration.
• Conducted Data integrity and Data validation test manually.

Confidential, Dallas, TX

Business System Analyst

Responsibilities:

• Performed Data Mappings based on the specified data requirements and to check for data uniformity and to modify /update the data fields.
• Verified Source to Target mapping and data validation.
• Strong experience in Data warehouse concepts.
• Successfully used Agile/Scrum Method for gathering requirements and facilitated user stores workshop. Documented User stories and facilitated Story Point discussions to analyze the level of effort on project specifications.
• Helped design and implement processes for deploying, upgrading, managing, archiving and extracting data for reporting.
• Built models containing query subjects, query items, and namespaces from scratch as well as from imported metadata.
• Worked with innovative technologies, like Adobe Marketing Cloud (AEM, Campaign, and Analytics).
• Gathered Business Requirements from different business owners such as Claim, enrollment, cost containment, marketing, customer service etc.
• Analyzed the state requirements and mapped the state requirements with business requirements.
• Job operated within a very agile environment, employing 2-4 week sprints, daily scrum meetings, burn-down charts, task weighting, pair programming, refactoring, presentations and review.
• Conducted and automated the ETL operations to Extract data from multiple data sources, transform inconsistent and missing data to consistent and reliable data and finally load it into the Multi-dimensional data warehouse.
• Created business requirement documents as well as system requirement specification after the JAD session.
• Executed queries using multiple aggregate and OLAP/OLTP functions and joins.
• Used SQL to test various reports and ETL load jobs in development, QA and production environment.
• Designed ETL Process Models, Systems Diagram, Workflow, Activity Diagrams, Use Cases (UML) and Business Rules using MS Visio.
• Worked closely with users’ business analyst on dashboard requirements followed by performing the data modeling and creating source-to-target specifications for Informatica team member
• Wrote the SQL queries on data staging tables and data warehouse tables to validate the data results.
• Incremental development and testing of Enterprise Data Warehouse.
• Intensive use of SQL within the Teradata platform. Performed the Back-end testing manually by writing and executing SQL statements on Oracle Database in UNIX environment to query the database for Data validation, identifying, cleaning/scrubbing.
• Responsibilities included designing and developing complex informatica mappings including Type-II slowly changing dimensions.
• Managed the Metadata associated with ETL processes used to populate the data warehouse
• Conducted different session with business owners from Claim, eligibility, enrollment.
• Perform BA validation process for all the reports before dispatching to QA environment
• Participated in weekly base team meetings to discuss team progress, problems.
• Extensively used team track for the documentation as well as track the version for each documents
• Using Agile SDLC Methodology, I organized and facilitated daily scrum meetings, Sprints planning meeting and sprint review meeting.
• Tested and validated the database tables using SQL queries and Stored Procedures and performed Data Validation and Data Integration.
• Conducted Data integrity and Data validation test manually.