- Extensive work experience in all the stages of SDLC as well as QA Life Cycle.
- Experience in developing both client-server and web-based applications.
- In depth knowledge and implementation experience of RUP towards Software Development Life Cycle (SDLC) and QA processes. Can work independently, lead or work within a team environment.
- Excellent organizational and communication skills, both oral and written
- Understanding of User Requirements through extensive interactions with users, developers, and other stakeholders.
- Converting User Requirements into Business Requirements and User and Functional Requirement Specification.
- Understanding of Business Rules and implementing them into Business Process Flow.
- Understanding of ETL, Data warehousing
- Medical Claims experience in Analysis and Implementation in 835/837IPD/834/270/271/277/997(X12 Standards) processes of Medical Claims Industry from the Payer side.
- HIPAA4010 5010Changes documentedchangesforEDI ClaimsTransactionsaccording totheHIPAA5010standards.
- Used expert knowledge of HIPAA, X12, EDI, and CLAREDI on a See Beyond team to test for HIPAA compliance.
- Knowledge of FACETS, Working knowledge of EDIFECS SPECBUILDER FOR 4010-5010 MIGRATION.
- Using UML/Rational Rose for overall System Modeling.
- Experience in conducting Joint Application Development (JAD) sessions.
- Refining Standards and Procedures required in organization in accordance with CMM, ISO and RUP and putting forward Suggestions for streamlining the QA Process to suit the business requirements.
- Interacted with client regarding project status and feedback on UAT anddiscussed the information with the development team.
- Creating Functional and User Acceptance Test Plans, Test Strategies Test Cases, and Test Scenarios to measure requirements and provide a Head Start for the QA Team.
- Using MS Project for scheduling deadlines, resources, and facilities.
- Acting as Liaison between user and stakeholders to resolve conflicts, and building exceptionally well client relationships.
- Ability to quickly master new concepts, applications.
- Good Documentation and Process Management skills with an ability to effectively understand the business requirements to develop a quality product.
- Strongly self-motivated, willing to assume responsibilities.
- Extensive experience to analyze and document business requirements and system functional specifications including Use Cases.
Requirement Tracking: Rational RequisitePro, Mercury’s Test Director
Automation Testing Tools: WinRunner, LoadRunner, Quick Test pro
Management Tools: Rational ClearQuest,Test Director,Quality Center, Crystal Reports
Performance Testing Tools: Rational Suite Performance Studio, LoadRunner
Data Modeling Tools: Erwin ,IBM Rational
Languages: C, C++, Java, J2EE, SQL, XML, XSLT,XPath.
Operating Systems: MS Windows NT/98/2000/XP, UNIX
Web/Design Tools: HTsML, MS Front Page, Flash, Adobe Photoshop, MS Paint, HTML, XML
Databases: Oracle, MS Access, Toad,
Office Tools: MS Word, Excel, MS Project, MS Outlook
Methodologies: SDLC, RUP, UML, RAD, JAD
- Business Requirements Documents.
- Data Dictionaries and Data Models
- Applications Help (Web Pages)
- Maintenance Methodologies
- Systems Design Documents
- Use Cases
- Functional Requirements Specification
- Data Dictionaries and Data Models
- Technical Presentations
- Technical Training Materials
Confidential, Mar 11 - Present
Business Systems/EDI Analyst
Project: Facets Integration
Roles & Responsibilities:
- Interacted with SMEs and technical experts to understand the “As Is” process and gather requirements for next release.
- Worked on documenting the changes that were to be made in the current payment platform.
- Worked with the business to understand the overpayment rules and their effect on release 2.
- Performed Trader Partner Testing.
- Gathered requirements for changes in the void/stop payment process, intake and prepayment process, downstream applications which were being updated by the new payment platform and the post-payment process.
- Understood and translated the requirements for reporting systems and treasury reports in the new release.
- Performed gap analysis to understand the “As Is” situation and identify the requirements for next release.
- Participated in daily meetings with BA lead to make sure that the project timelines are being met.
- Involved in preparing Business Requirement Matrix for the downstream process.
- Gathered Requirements through interviews and JAD sessions with business owners.
- Worked closely with the development team to ensure that the requirements documented are properly understood as well as participated in status meetings to ensure that the system developed met those requirements in timely manner
- Coordinated with team members in different locations to make sure that all the requirements were gathered and documented correctly.
- Worked as a liaison between the business and technical side to convey the business needs to the system architects.
- Participated in weekly status meetings to present status and incorporate any digressions from the original scope.
- Designed Use Cases using UML and managed the entire functional requirements life cycle using SDLC.
- Performed UAT testing of EOBs and 835 EDI transactions.
- Used TOAD and Ultra Edit to perform validation of EOBs and 835 EDI transactions.
- Used Test Director to run the scripts manually and to log the defects.
Environment: MS Windows, MS Visio, MS Project, MS Office (PowerPoint, MS Word, MS EXCEL), SQL, Oracle
Confidential, Tampa FL Aug 10 to Mar 11
Business Systems Analyst/EDI Specialist.
Roles and Responsibilities:
- The current Encounters process was complex, expensive and prone to errors so reengineering of E2E Encounters was an integral issue. This was necessary to ensure that Encounters can be accurately reported in a timely manner without requiring “heroic” day-to-day efforts.
- I was involved in elimination of association errors between Peradigm and Encounters.
- Worked to improve validity of data in the Encounters repository, data that is found to be erroneous during the adjudication process which will never make it to the Encounters repository.
- ICD 9 ICD 10ConversionProject Worked in the analysis of theICD 9 10 codesconversionProject. Worked with GEM processes and concepts.
- HIPAA4010 5010ConversionAnalysis Involved in the documentation of HIPAA5010changes toEDI 837, 834, 835, 276, 277 Transactions.
- Eliminated need to pull and reconcile Encounter data with Peradigm data during processing, the repackaging of the data will ensure all data required is necessary to process the Encounter
- Gathered requirements from Claims Business Area for the Auto Term project. Prepared Process Flows and Diagrams for the manual to automatedconversionProject.
- Organized meetings and led JAD sessions to ensure legal and compliance deadlines of CMS (Centers for Medicare and Medicaid Services) are met.
- HIPAA4010 5010ConversionAnalysis Involved in the documentation of HIPAA5010changes to EDI 837, 834, 835, 276, 277 Transactions.
- Analyze 837I, 837P and 837D compliance, 837 DB2 Repository, and flow of X12 and proprietary data.
- Worked on 4010-5010 transition, performing Gap Analysis.
- Worked as a translator to elicit, analyze, validate and document Business, Organizational and operational requirements.
- Prepare Business Requirements Document (BRD) for current issues pertaining to errors between Peradigm and Encounters.
- Involved in Eliciting requirements for new line of business (Ohio, NY and Hawaii )
- Analyze the existing issue and prepare an estimation of the task based on the effort needed for this process
- Identify the Wellcare code/logic responsible for issue and determine the root cause.
- Prepare high level change details to be implemented for issue correction determine if the proposed logic is going to be new or updates to existing components.
- Identifying the component impacting the process change, determined whether the solution is generic across all the states or state specific.
- Based on the type of requirement, determined the appropriate requirement document template to address the solutions like I prepared BRD in case of long term or effort intensive solution, Prepared Spring BRD in case of short term/ Emergency fix and if any changes to BRD(approved) then I implemented it as a PCR
- Worked extensively on PL/SQL Developer for analyzing the expected results to the current results.
ENVIRONMENT: PL/SQL Developer, Oracle 10i, UltraEdit 32 Professional, SharePoint, HTML, Windows XP, Requisite Pro ,SQL, MS Visio, MS Office Suite.
Confidential, Richmond VA Jun 10 Aug 10
Sr. Business Systems Analyst
Roles and Responsibilities:
- Based on the business requirements and conceptual data model created, As a BSA I was responsible for initial creation of a data mapping document. I worked with Business SME to create the initial data mapping.
- After the Creation of Data Mapping Documents It was later updated by Data Architect to update more technical details.
- StudiedOracle11i data elements and provide amapping from the existing legacy system
- I was responsible for the initial creation of data mapping document working with the Data Architect
- I was responsible for providing answers to any data mapping related questions or clarification needed from the Design and / or Test teams.
- Used the data dictionary to ensure all data element-level requirements are accounted for and insure that the definitions match those that were accepted and signed off by business.
- Manually performed UAT by writing numerous SQL test cases and executing them to validate the results .
- Used SQL to validate data stored and retrieved in the database.
- Wrote complex SQL queries to perform the backend testing of the database.
- Created and added tables to the SQL database when required.
- Worked with business SMEs and other planners to assess current capabilities and identify high-level customer requirements.
- Participated in model reviews to ensure understanding of the data model and how to manage the mapping document(s).
- Facilitated and Lead Mapping Meetings to insure completion of data mapping document(s).
- Translated business need and source system data to the physical model to manage the mapping document(s).
- Possessed and delivered ability to decipher and pull put relevant / key information from business subject matter experts to complete data mapping document(s).
ENVIRONMENT: SQL, MS Visio, MS Office Suite, Teradata SQL Share Point, HTML, Oracle and Windows NT, Visio, Requisite Pro
Confidential, Philadelphia, PA Jun 08 Jun 10
Sr. Business Analyst
- Created documents that incorporated both the technical and functional details.
- Involved in standardizing the documents to meet the HIPAA Compliance Standards.
- Involved in creating documents and diagrams for Membership Enrollment according to the HIPAA 834 Compliance Standards for Membership Enrollment.
- Involved in updating and/or reworking previous documentation on their Membership Enrollment System for Florida to get them in sync and up to date with their current new system in place.
- Involved in bi-weekly workgroup sessions to complete various sections in the functional specification document like Business Rules Definitions, Processing Rules, Pre-Edit Errors, etc. and weekly status meetings for updates.
- Involved in manually testing the application from the backend to carry out data validation.
- Extensively used SQL queries and PL/SQL statements for Data Validation and to check data integrity.
- I was involved indesign and configuration of business rules for 4010 to5010migration in CareFirst.
- As thefirst step of the5010migrationexercise I was involved in multiple brainstorming sessions with Business Analysts on the CareFirstend togatherbusinessscenarios for4010to5010Configurationfor 837 Institutional and Professional claims.
- Attended Joint Application Mapping (JAM) Sessions with my team to map the business needs.
- Used requirement elicitation techniques such as JAD Sessions and Document Analysis to gather information regarding the application from the KMHP SME and EDS along with the State of Florida people.
- Involved in bi-monthly Technical and Operational Issues (T&O) Conference Calls with AHCA, EDS and various providers who worked with AHCA to answer and resolve issues pertaining to a smooth transition from AHCA’s previous fiscal agent ACS to EDS.
- Maintained open and clear communication with the team on change requests.
- Co-authored and reviewed Operational Guidance Documents along with Design Documents and Deployment Plan Documents.
- Set-up, co-ordinate & conduct system & UAT testing.
- Provided assistance in other concurrent projects, especially in Regression Testing, in order for the team to gain time, before the clients could proceed to the system’s User Acceptance Testing (UAT)
- Bug Reporting and Tracking using Test Director and Mercury Quality Center (MQC)
- Used MQC for requirement management, planning, execution, defects tracking and reporting.
- Executed tests in individual / batch mode on local & remote machines and the results were sent to MQC.
- Maintain Traceability Matrix with help of MQC.
- Maintains Test Requirements, Test cases via MQC
- Extensively involved in multiple teleconference calls on a weekly basis with NaviMedix to resolve all the open issues so that the Business Requirements Documents, Functional Specification Documents, Technical Specification Documents, Operational Guides, etc. could be completed, approved and sent for a successful sign off in order to be able to build the application and deploy it.
- Created UI Documents as supporting documents for the Business Requirements Documents.
- Involved in Data Flow/Business Process Diagrams to illustrate the flow, input and output of data.
Environments : SQL, MS Visio, MS Office Suite, Quality Center, limited experience with UNIX, PL SQL, MS BizTalk Server 2004, Share Point, HTML, Oracle and Windows NT, Visio, Requisite Pro
Confidential, Pune, MH, India.
Business Analyst (Full time) Nov 2005 - Sep 2007
Roles and Responsibilities:
- Responsible for defining the scope and business rules of the project, gathering business requirements, and document them textually or using models.
- Interacted with cross functional teams to facilitate gathering of business requirements.
- Responsible for writing Functional Requirement Specifications (FRS) and User Requirement Specification (URS).
- Analyzed Business Requirements, performed gap analysis and segregated them into high level and low level Use Cases, Activity Diagrams/State Chart Diagrams and Robustness Diagram using Rational Rose.
- Handling DB2 SQL query as per the requirement
- Involved in designing new DB2 tables that held new client data.
- Involved in Change Management Configuration using Rational Clear-Quest.
- Worked with the Business Users through interviews and (Joint Application Development) JAD sessions.
- Performed UAT testing of the requirements. Testing for checking the data flow of the application using SQL.
- Involved in preparing flow diagrams for the decision logic using Visio tool.
- Involved with regular walkthroughs and meeting to discuss bottlenecks in the system and possible solutions with the development team.
- RUP process model was used for the different phases of the application development of the Software Development Life Cycle
- Conduct daily build validation and report status to product and QA team.
- Designed the application using UML
- Recommended and coordinated development efforts and enhancements
- Generation of the UML Collaboration and Sequence Diagrams for specifying the call flow.
- Analyzed user requirements, attended Change Request meetings to document changes and implemented procedures to test changes using the Rational Clear Quest.
- Planned, scheduled, and controlled projects based on plans and requirements outlined by the business
- Interacted with developers to report software bugs and re-tested the fixed issues.
- Interpreted Use Case diagram, Sequence diagram and Class diagram with Rational Rose
- Gave valuable input in terms of Modification Requests and Enhancement Requests.
- Responsible for weekly status
Environment: Microsoft Visio, RUP (FDM), Rational Tools, Clear Quest, SQL, DB2, Microsoft Excel, Microsoft Word, Microsoft Access, Windows 2000 Professional.EDUCATION
Master, Computer and Information Science
Bachelor, Information Technology