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Business Analyst Resume

Newark, NJ

SUMMARY:

  • Business Analyst with a strong experience in Healthcare domain.
  • Conducted Root Cause Analysis, Time studies, Process Mapping exercises, performance and risk matrices etc. using various tool sets.
  • Designed and reviewed various documents including the System Requirement Specifications (SRS), Business requirements document (BRD), Use Cases, Functional Specifications (FSD), Systems Design Specification (SDS), Requirement Traceability Matrix (RTM) and testing documents
  • Performed Gap Analysis to check the compatibility of the existing system infrastructure with the new business requirements.
  • Good understanding of Healthcare Industry standards, Electronic Data Interchange (EDI), HIPAA Code Sets, Regulatory changes including ICD9 - ICD10 conversions
  • Experienced in facilitating Joint Application Development (JAD) sessions, interviews, workshops and requirement elicitation sessions with end-users, clients, stakeholders and development teams
  • Extensive Knowledge of Medicare, Medicaid, procedural and diagnostic codes
  • Experienced in System Integration to deliver main purpose and functionality
  • Experience in Risk and Regulatory Compliance associated with archival and disposal of data
  • Facilitated project meetings, reviews, walkthroughs, and customer interviews to gather requirements and relevant information for Business analysis
  • Experienced in handling Change Management, writing Test Plans and executing Test Cases
  • Experienced as BA analyst in Defect Tracking and extensively involved in User Acceptance Testing
  • Exceptional Problem Solving and Decision-Making capabilities, along with the ability to resolve difficult situations
  • Extensive Knowledge of Medicare, Medicaid, procedural and diagnostic codes
  • Experienced with project management, planning, Issue/Risk management, budget and resource management, Executive reporting
  • Knowledge of Medical Claims Processing, and HIPAA regulations
  • Experience with writing SQL queries as well as designing Business Object reports

TECHNICAL SKILLS:

Domain: Project Management, Healthcare Management

SDLC: Agile (SCRUM), Waterfall

Tools: MS Project, MS VISIO, SharePoint, JIRA, MS Excel, MS Word, MS PowerPoint, MS Visual Studio, QSI-XL

Testing Tools: JIRA (Defect Tracking), Microsoft SQL Server, Toad, Teradata, Denodo

PROFESSIONAL EXPERIENCE:

Confidential, Newark, NJ

Business Analyst

Responsibilities:

  • Perform detailed analysis and investigation on multiple projects, recommend potential business solutions and ensure successful implementations
  • Manage the quality of the HEDIS data in an effective manner to achieve all the business goals.
  • Perform HEDIS rates analysis for several measures of each population to manage the quality of the data.
  • Work in collaboration with different Line of Business (LOB) such as Medicare, Medicaid and Marketplace
  • Follow HIPAA security and privacy rules in order to maintain compliance and prevent unauthorized access to PHI
  • Elicit and gather user and business requirements through open ended discussions, brainstorming and prototyping
  • Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems
  • Work in an Agile environment with development team to deliver products in an effective manner
  • Run SQL Queries through Microsoft SQL Server, Toad and Teradata in order to pull data from database and to provide that data to the business team for their analysis
  • Export data from QSI-XL tool, analyze that big data and prepare reports for detailed investigation
  • Import big data through Microsoft Visual Studio and prepare Monthly Reports for the business team and other teams of the organization.
  • Perform Impact Analysis on the business due to implementation of a new process or any kind of changes in the system
  • Work on preparing new products and services in line with Healthcare regulations
  • Track all issues through Jira tool, prioritize work and ensure that each task meets the requirements and is accomplished in a timely manner.
  • Perform various analysis and interpretation to connect business requirements and objectives for assigned function
  • Involve with the coders in evaluation of CPT and ICD-9 codes to ensure that the diagnosis meets medical necessity for the specific CPT code.
  • Develop Business Requirement Document and Use Case Specification Document for Use Cases
  • Responsible for converting the business requirements into functional and non-functional requirements.
  • Conduct JAD sessions for communicating with all project directors and stakeholders and created process workflows, functional specifications and project initiation artifacts.
  • Analyze Business Requirements and segregate them into high level and low-level Use Cases and Activity Diagrams
  • Work on preparing new products and services in line with Healthcare regulations
  • Diagnose problems and identify opportunities for process redesign and improvement
  • Perform extensive requirement analysis including Data analysis and Gap analysis.
  • Define Functional Test Cases, documented them, executed test scripts
  • Develop, share, and in corporate organizational best practices into business applications
  • Successfully conduct JAD sessions, which helped synchronize the different stakeholders on their objectives and helped the developers to have a clear picture of the project.
  • Identify ways to enhance performance management and operational reports related to new business implementation processes
  • Conduct presentations of the Q/A test results with analysis to the stakeholders and users and documented modifications and requirements.
  • Coordinate with various business units and departments in the development and delivery of training programs
  • Assign tasks among development team, monitored and tracked progress of project following Agile methodology.
  • Create Process Flow diagrams, Use Case Diagrams, Class Diagrams and Interaction Diagrams using Microsoft Visio
  • Formulate and update departmental policies and procedures

Environment: Agile, QSI-XL, QSHR, Microsoft SQL Server, Toad, Teradata, MS Excel, MS Word, MS PowerPoint, MS Visio, MS Visual Studio, Denodo

Confidential, Saint Louis, MO

Business Analyst

Responsibilities:

  • Elicited and gathered user and business requirements through open ended discussions, brainstorming and prototyping
  • Manage the quality of the HEDIS data in an effective manner to achieve all the business goals.
  • Followed HIPAA security and privacy rules in order to maintain compliance and prevent unauthorized access to PHI
  • Worked in waterfall and Agile environment with development team to deliver products in an effective manner
  • Perform HEDIS rates analysis for several measures of each population to manage the quality of the data.
  • Worked in collaboration with different Line of Business (LOB) such as Medicare, Medicaid and Marketplace
  • Run SQL Queries through Microsoft SQL Server to pull data from database and to provide that data to the business team for their analysis
  • Imported big data through Microsoft Visual Studio and prepare Monthly Reports for the business team and other teams of the organization.
  • Exported data from QSI-XL tool, analyze that big data and prepare reports for detailed investigation
  • Used Jira tool to track issues, prioritize work and ensure that each task meets the requirements and is accomplished in a timely manner.
  • Analyzed Business Requirements and segregate them into high level and low-level Use Cases and Activity Diagram
  • Worked on converting the business requirements into functional and non-functional requirements.
  • Conducted JAD sessions for communicating with all project directors and stakeholders and created process workflows, functional specifications and project initiation artifacts.
  • Identified ways to enhance performance management and operational reports related to new business implementation processes

Environment: Agile, Microsoft SQL Server, Toad, Teradata, MS Excel, MS Word, MS PowerPoint, MS Visio, MS Visual Studio, Denodo, QSI-XL

Confidential, East Brunswick, NJ

Business Analyst

Responsibilities:

  • Gathered business requirements and user requirements through open ended discussions, brainstorming and prototyping.
  • Prepared Business Requirement Document and Functional Requirement Document for the stakeholders and clients
  • Performed GAP analysis to compare the existing system with the proposed system and documented new requirements and features.
  • Developed straightforward DBMS queries for managing the databases
  • Prepared an effective BRDs by converting the business requirements into functional and non-functional requirements.
  • Developed Functional Requirement Specifications (FRS) and User Requirement Specification in an efficient manner
  • Extensive analysis on claim processing system allowing the user to inexpensively capture information regarding patient, summary of medical history, symptoms.
  • Performed extensive requirement analysis including Data analysis and Gap analysis.
  • Created Process Flow diagrams, Use Case Diagrams, Class Diagrams and Interaction Diagrams using Microsoft Visio
  • Wrote Test Cases and performed User Acceptance Testing, documented the in-detail defects using the Defect Tracking report.
  • Coordinated between Technical, Business and QA teams for verification of information and facilitate communication
  • Involved in compatibility testing with other software programs, hardware, Operating systems and network environments.

Environment: Agile, SQL, HTML, EDI, UML, Microsoft Excel, Microsoft Word, Microsoft Power Point, Microsoft Visio, Microsoft Project, Microsoft Visual Studio

Confidential

Team Leader

Responsibilities:

  • Delegated tasks to the team, set deadlines for the project, plan and organize team’s work
  • Set team goals and assist team members achieving their goals in an effective manner
  • Provided resources and requirements to team members in order to accomplish their tasks effectively
  • Oversaw day-to-day operation and performance of team members
  • Conducted meetings and facilitate presentation to stakeholders, clients and team members
  • Managed client’s data and stored it effectively in a Database.
  • Created a system project proposal, business requirement document and find multiple solutions for any issues.
  • Created UML diagrams such as use case diagram, activity diagrams and sequence diagram
  • Worked on Database Development by creating Entity Tables and Entity Relationship Diagram
  • Resolved issues, conflicts and provide proper guidance to team members

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