- Business System 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.
- 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 835/837/834/270/271/277/997 (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
Modeling tools: MS Visio, MS Project
Methodologies: Agile, SDLC, Waterfall, JIRA.
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: C, C++, .Net, Visual Basic, SQL
Reporting tools: Power BI, Tableau
Sr. Business Analyst
- Have done project tracking, product management, configurable dashboards and documnetation using JIRA.
- Utilized Rational Unified Process (RUP) to configure and develop process, standards and procedures.
- Implemented and provide support for HIPAA ANSI X12 standard transactions 270, 271, 276, 277 and 278. Maintain and support 834, 835 and 837 HIPAA EDI transactions. Analyzed and documented system release/deployment issues according to version management, backward compatibility, load balancing of components in production environment.
- Did impact analysis for changing requirements and coordinated with business users for prioritizing the testing/release of the changes.
- Performed complex ad hoc SQL queries from BAs in Teradata SQL Assistant.
- Maintained a very close interaction between business users and developers to avoid any gaps in understanding or implementation of requirements.
- Did data analysis, created data mapping and data interface documents and kept the documents updated with changes in requirements and functional specifications.
- Performed Risk Analysis based on defect severity and priority.
- Tested User Interface inconsistency and application functionality.
- Developed Reports and Graphs to present the Stress Test results to the management.
- Wrote VB script for automated testing in QTP.
- Prepared the business requirement document (BRD) and system requirement document (SRD).
- Involved in documenting the procedural flow of Hospital/Insurance claim (270/271, 837, 997, 276,277, 835) to make sure application is transferring data accordingly.
- Facilitated Provider Enrollment, Setting up Provider profile & Trading Partner Agreement.
- Set up Provider's Access to the System. (Security Setup).
- Helped creating Provider Reports i.e. Financial, Claims processing.
- Prepared the Business requirement Document for the enhancement of the existing services.
- Wrote FRDs for the defects and enhancements and got approval from business for the developers.
- Worked on Technical design documentation (TDD) of the claims processing system.
- Performed task estimations and documentation of procedures.
- Used SSIS as an ETL tool to load data from flat files and databases into SQL Server and Teradata environments
- Quality Center administrator and used Quality Center for defect tracking and reporting
- Designed, prepared and implemented test cases for system testing as well as for User Acceptance testing.
- Involved in the testing of web portal of New MMIS system.
- Conducted integration testing and regression testing with developers in development and QA, also conducted user acceptance testing with UAT team. Safety reporting on system-based projects, acted as a liaison, writing documentation and increased project coordination.
- Created Summary Use Cases for next phase of Forward Engineering
- Extensive used of UML to draw Business Process Flow, Use Cases Modeling, Sequence, Sequential Diagram and Activity Diagrams
- Created BPR charts for AS IS and TO BE processes of different business functionalities
Confidential, Durham, NC
Business Systems Analyst
- Managed software system development and integration projects through all phases of project life cycle - analysis, design, development, testing, implementation, and post-production support.
- Interacted with stakeholders to get a better understanding of client business processes and gathered requirements.
- Designed reports using SQL Server Reporting Services (SSRS).
- Tracked stakeholder requested enhancements and changes using Requirement Traceability Matrix (RTM).
- Involved with the following list of HIPPA-EDI Transaction Code sets: 837, 835, 270/271,277/275 and 276/277
- Involved with the Quality Assurance Team to develop and design test plan and test cases.
- Project documentation using JIRA for Agile project management.
- Created user stories, user documentation using JIRA.
- Conducted User Acceptance Testing (UAT) of the application with the QA team.
- Executed SQL statements to check if the data integrity has been maintained.
- Used Mercury Quality Center for logging defects and managing defect history.
- Performed testing of the health benefit claims receiving and processing system to ensure that the system adheres to project standards, performance criteria, and functional specifications
- Implemented Standardized and Unified process throughout the Software Development Life Cycle (SDLC).
- Responsible for gathering the functional requirements for the health benefit claims receiving and processing system.
- Develop business requirements for new projects involving federal and state government initiatives regarding Health Insurance Exchange
- Conducted requirement gathering sessions with the purpose of creating and defining the Business Requirement Document (BRD) and the Functional Requirement Document (FRD) using Rational Requisite Pro.
- Developing Use Case Models, Entity Relationship Diagrams (ERD), Activity Diagrams, State Diagrams and Data Flow Diagrams (DFD)
- Use SQL server management studio for data analysis and SSIS tool for ETL on a daily basis.
- Involved in Requirement Scoping and analyzing high priority requirement. Conducted sign-off meetings with IT teams to lock down the requirements.
- Created high-level Use Cases from Business Requirements and created UML diagrams like Use Case and Activity diagrams using MS-Visio.
- Experienced in Full life cycle Manual Testing in a Web-based Applications (JAVA, .NET etc), Client/Server Applications.
- Involved in FACETS Implementation, involved end-to-end testing of FACETS Billing, Claim Processing and Subscriber/Member module.
Confidential, Concord, NH
- Responsible for defining the scope and implementing business rules of the project, gathering business requirements and documentation.
- Assigned tasks among development team monitored and tracked progress of project following agile methodology.
- Assisted JAD sessions to identify the business flows and determine whether the EDI X12 Transaction, Code set and Identifier aspects of HIPAA, impacts any current or proposed systems.
- Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Medicaid Claims.
- Responsible for writing Functional Requirement Specifications (FRS) and User Requirement Specification (URS).
- Delivered ad hoc reports using SSRS, SAS, and standard SQL queries.
- Used MS-Team Foundation Server (TFS) for categorizing business requirements and testing documents.
- Responsible for setting up data for NH Medicaid and Welfare eligibility claims.
- Tested Web services as response to the welfare eligibility.
- Involved in testing EDI Transactions, mainly focusing on Eligibility system 270/271 transaction, based on HIPAA compliance.
- Responsible for architecting integrated HIPAA, Medicare solutions.
- Involved in Service Oriented Architecture (SOA) of the claims processing system
- Thorough understanding of Software Development with various programming languages such as, C, Java, HTML, XML, etc
- Used the Functional testing tool SOAPUI, to perform Web Service Testing.
- Analyzed Business Requirements and segregated them into high level and low level Use Cases, Activity Diagrams / State Chart Diagrams using Rational Rose according to UML methodology thus defining the Data Process Models.
- Tested Web Services, XML, WSDL using SOAPUI tool. Modified end points when the work was performed on different servers and different versions of Web Services.
- Performed Integration Testing and System Testing
- Automated Teradata utility scripts using UNIX Demonstrated expertise utilizing ETL tools, including SQL Server Integration Services (SSIS), Data Transformation Services (DTS) and ETL package design, and RDBM systems like SQL Servers, Oracle, and DB2.
- Created Process Flow diagrams, Use Case Diagrams, Class Diagrams and Interaction Diagrams using Microsoft Visio and Rational Rose. Worked on EDI transactions: 270, 271, 834, 835, and 837 (P.I.D) to identify key data set elements for designated record set. Interacted with Claims, Payments and Enrollment hence analyzing and documenting related business processes.
Confidential, Boston MA
- Gathering functional and non-functional requirements in collaboration with end clients and internal project managers as well as SME(s).
- Creating detailed business scenarios and writing master use cases which covered step by step process of interaction between user and system.
- Designing granular Visio diagrams to show the flow of events as well as BPM documents for benefit of offshore developers.
- Designing detailed storyboards based on the client template.
- Hands on experience on various SQL Server Services like Integration Services (SSIS), Analysis Services (SSAS), and Reporting Services (SSRS).
- Following the project progress and make sure that everything is going to be done on time by creating various trackers and keeping it updated based on daily Agile stand up meetings.
- Conducting GAP analysis to find out what needs to be done for the next step
- Communicating with the project’s PMO to make sure all deliverable are consistent with the clients’ templates and expectations.
- Analyzed the mainframe reports for member/eligibility/claims and mapped the fields with FACETS batch jobs and reports.
- Review the clients’ comments and feedbacks for each deliverables and try to resubmit the documents on time and get them signed off.
- Used SAS as an ETL tool to load data from flat files and databases into SQL Server and Teradata environments
- Assigning action items within each JAD sessions and war rooms and following up with the client to get the right response.
- Reviewed and worked on JIRA Tickets
- Was leading the Healthcare Handbook project.
Business System Analyst
- 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.
- 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.
- 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.
- 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.
- 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.