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Business Analyst Resume

Los Angeles, CA

SUMMARY

  • Over 10 years of IT experience as a Business Analyst with extensive knowledge in diverse domains such as Healthcare and Finance.
  • Excellent Business writing skills in writing Business requirements documents, Use Case Specifications, Functional Specifications, Systems Design Specification (SDS), Systems Requirements Specification (SRS) and maintaining Requirement Traceability Matrix (RTM).
  • Strong knowledge of Software Development Life Cycle (SDLC) - Waterfall, Agile (SCRUM), and Rational Unified Process (RUP).
  • Worked closely with Project Stakeholders, Subject Matter Experts (SMEs), and Business Users.
  • Expert knowledge on Pega PRPC tool in creating various roles like Work User,Work Manager, Architect, System Architect.
  • Proficient in developing Use Case Diagrams/Models, Workflow Maps, and Activity diagrams based on UML using Rational Rose and MS Visio.
  • Excellent Working Knowledge of HIPPA, Claims Processing, and FACETS.
  • Extensive experience in producing Wireframes for UI extensive projects and specifying Usability requirements.
  • Used elicitation techniques such as interviews, questionnaires, brainstorming sessions, JAD sessions, observation, and document analysis for requirement gathering.
  • Solid understanding of Gap Analysis and converting requirements into test plans.
  • Experienced in performing Business Process Analysis and creating AS-IS and TO-BE Business Process Models (BPM's).
  • Participated in Change Management Processes and performed Impact Analysis to ensure Changes/ New Requirements are aligned to the Scope and agreements of the project.
  • Proficient in facilitating and performing User Acceptance Test (UAT) by working with internal and external Users / Customers and obtaining delivery approval for the project.
  • Knowledge of Medicare (Part A, B, C, D), Medicaid, and Commercial Insurance.
  • Knowledge of HIPAA ANSI X 12 4010/5010 formats including EDI transactions.
  • Good knowledge of Claims Adjudication Processes.
  • Have profound knowledge in various domains such as Healthcare, Insurance, Trading and Finance.
  • Excellent written and oral communication skills with the ability to communicate appropriately in business and technical situations at all levels.
  • Involved in Quality Assurance (QA - Manual and Automation Testing); Experienced in reviewing test procedures, defining Test cases, reviewing and maintaining test scripts, analyzing bugs, interaction with team members in fixing errors.
  • Extensive knowledge of MS-Excel features and tools like lookup functions, referencing, conditional formatting, creating pivot tables and charts, data analysis, data filtering, macro and form functionalities for reporting and connection to MS-Access database for data extraction.
  • Good understanding of Data Warehousing, OLAP concepts.
  • Highly motivated team player with excellent communication, presentation and interpersonal skills.

TECHNICAL SKILLS

  • MS Visio
  • Rational Rose
  • Paradigm
  • Balsamiq iRise
  • Rational Requisite Pro
  • DOORS
  • SharePoint 2010
  • Pega 6.1/5.5
  • JIRA
  • QC
  • QTP
  • Load Runner
  • MS Excel
  • MS Word
  • MS PowerPoint
  • Cognos
  • Informatica
  • SAP Business Objects.

PROFESSIONAL EXPERIENCE

Confidential, Los Angeles, CA

Business Analyst

Responsibilities:

  • Conducted interview sessions with users and different levels of management so as to extract requirements to understand the functional specifications of the AS IS system.
  • Did the GAP and IMPACT analysis to design the TO BE system.
  • Managed the execution for the project life cycle (SDLC), including requirements gathering, design, testing, implementation, and documentation as required
  • Organized and participated in daily SCRUM meetings in order to resolve issues with developers and the rest of the scrum team.
  • Prepared product backlog working with product owner and other SME (Subject Matter Experts).
  • Facilitated daily stand ups and managed task board with user stories and board.
  • Facilitated smooth completion of project by providing insurance subject matter expertise to the team and utilizing subject matter know-how for quality assurance purposes.
  • Drafted user stories in order to describe the business needs in terms of the main deliverables.
  • Provided issue resolution recommendations by ensuring that there is regular and effective communications of issues and corrective actions between teams.
  • Identified Actors, Activities, Artifacts and Workflows and developed use case diagrams.
  • Assisted clients during UAT Environment.
  • Documented the UAT Plan for the project and worked with the UAT Team.
  • Performed Requirement Analysis and developed Use Cases, Activity Diagrams using Rational Rose.
  • Completed the documentation of Claims Scenarios for the source system.
  • Helped in designing and implementing the deployment process and thus maintaining the application in post deployment process.

Environment: Windows, Agile, MS Office, MS Outlook, MS Visio, MS SharePoint, MS SQL, MS-Access

Confidential

Sr. Business Analyst

Responsibilities:

  • Worked with functional teams in an Agile environment.
  • Worked with business representatives to understand requirements and priorities and ensure that software development work is appropriately aligned.
  • Organized and participated in daily SCRUM meetings, in order to resolve issues with developers and product architects.
  • Performed GAP analysis to meet the end state requirements.
  • Collaborated with the developers and technical content writers on a daily basis to update the test documents.
  • Created AS-IS and TO-BE business process flow diagrams Integrated process flow diagrams to show end-to-end business model and processed mapping exercise including swim lanes.
  • Involved in reviewing and enhancing the codes for applications.
  • Involved in decision making to launch new builds.
  • Prepared Test Plans and Test Cases based on the functional requirements and HIPAA regulations like 834, 837, 835 etc.
  • Involved in FACETS Implementation, involved end to end testing of FACETS Billing, Claim Processing and Subscriber/Member module.
  • Drafted test cases for Endorsements, Cancellations and Reinstatements.
  • Performed Manual Testing to check the usability of the application.
  • Executed Configuration Testing to check if the application was compatible in a different environment for each module of the application.
  • Developed WinRunner Automation Test Scripts to perform Functionality, Security, UAT and Regression Testing for 4 different modules of Confidential web application.
  • Managed a team for testing FACETS Accumulators.
  • Conducted result analysis and interacted with developers to resolve bugs.
  • Interacted with developers, business analysts and discussed technical problems and reported bugs.

Environment: Agile, Windows, Oracle, UNIX, FACETS, HIPAA regulations, Manual Testing, MS Office Suite

Confidential

Sr. Business Analyst

Responsibilities:

  • Participated in the initial Impact Analysis (ICD-10) for all the critical functions, i.e., Membership & Enrollment, Claims Processing, Utilization Management, Medical Policy, Reporting, Vendor Management, etc.
  • Worked with an internal team to build out of a high level roadmap and timeline to achieve compliance.
  • Performed impact analysis on 5010 upgrades and ICD-10 conversions.
  • Developed Workflows and Activities, Rule based Business Process Management using Pega Rules Process Commander (PRPC).
  • Participated in ICD 9 to ICD 10 codes conversion requirement gathering sessions and created high level business requirements documents (BRD).
  • Prepared product backlog working with product owner and other SME (Subject Matter Experts).
  • Facilitated daily stand ups and managed task board with user stories and board.
  • Prepared and tracked burn down charts and velocity charts for timely delivery of projects.
  • Utilized corporation developed Agile SDLC methodology used Scrum Work Pro and Microsoft Office software to perform required job functions.
  • Designed and defined User Interface Requirements (UIR) and visual patterns by creating wire frames, screen mockups and storyboards.
  • Prepared 5010 GAP documents involved with 837 and 835 transactions in collaboration with other team members.
  • Defined ICD-9 to ICD-10 mapping process using GEM (General Equivalence Mapping) crosswalk file.
  • Created custom mapping between ICD-9 and ICD-10 codes.
  • Extracted data from several databases to create a master list of the ICD-9 codes.
  • Executed reports using Excel and Business Objects to compare and verify data.
  • Conducted Business Requirements walkthrough with the business owners as well as the Technical Stakeholders.
  • Changed Control Process (CCP) - Led the Change Control Process for changes submitted for the BRD once the document was submitted to the IT department.
  • Documented the UAT Plan for the project and worked with the UAT Team to ensure every acceptance criteria for the requirements has been included in the UAT task plan.
  • Drafted Use Cases and developed a Business Rules document for the implementation of Workflows in Pega PRPC.
  • Maintained the Traceability Matrix table to uniquely trace the identified business requirements to general design to testing as proof that requirements requested have been developed into a solution and that it has been tested and tracked.

Environment: Agile, Pega 5.5, MS Visio, Word, Excel, PowerPoint, SQL, SharePoint 2010, MS Project

Confidential, Galveston, TX

Sr. Business Analyst

Responsibilities:

  • Interacted with various users like data analysts, customers, claim settlement experts and service providers to identify the system, operational requirements, and proposed enhancements.
  • Used Prototype to demonstrate and verify the behavior of the system.
  • Directed and supported other Business Analysts.
  • Worked on projects in the claims department of Claims Repricing, Claims Processing.
  • Gathered Business Requirements and converted them into system requirements.
  • Involved in developing the business model for expediting the claim settlement process, Documented Use Cases and Use Case Models using Microsoft Word.
  • Identified all necessary Business and System Use Cases from requirements, created UML diagrams in Microsoft Visio including use Case Diagrams, Activity Diagrams, Entity Relationship Diagram and Sequence Diagrams.
  • Conducted JAD sessions to gain consensus on various issues related to the project. Acted as a facilitator and also as a scribe on different occasions.
  • Used Rational RequisitePro for managing the requirements and MS Project and MS Excel for scheduling and resource allocation.
  • Maintained conceptual, logical and physical data modeling activities in both a relational and multidimensional environment.
  • Understood the Business logic, User requirements and developed design and User interface specifications.
  • Designed and implemented basic SQL Queries for QA testing and Report/Data Validation.
  • Worked closely with the project managers to monitor progress and the deliverables for the project.
  • Interacted with developers & various members of the team to discuss and resolve defects and their priorities.
  • Assisted in developing test scenarios, test scripts & test data to support system integration testing, regression testing and Performance testing.
  • Performed UAT test with the clients for the Quality of Software meets the requirements.

Environment: 837, 835, 276, 277, 270, 271, NCPDP 5.1, HIPAA, EDI, DB2, Agile, Rational RequisitePro 7.0.1, MS Office 2007, Java, J2EE, Rational ClearQuest

Confidential, Minnetonka, MN

Business Analyst

Responsibilities:

  • Worked with functional teams in a RUP environment.
  • Acted as a liaison between the Business and Technical teams to deliver requirements deliverables - beginning with assisting Senior Business Analysts.
  • Involved in all four phases of the requirements development including Elicitation, Analysis, Specification and Quality Validation.
  • Conducted GAP analysis and Impact Analysis to identify customer channel usage trends and interactions focusing on likelihood to buy product recommendations and reduce customer attrition.
  • Conducted Joint Application Development (JAD) sessions with SMEs from Market Research Group, Hospital Survey Group and Web Management Stem to gather Business and Functional requirements including Use Cases and UML Models for the CRMS project.
  • Involved in finding and documenting requirements where the new data capture solution would be compatible with existing Customer Interface Control Systems (CICS).
  • Developed Screen Mock-ups / Prototypes to provide demonstration to the Business teams.
  • Supported Design and Development activities, by providing walkthroughs and feedback.
  • Ensured that the clients adhere to the Change Management Notification (CMN) process.
  • Responsible for managing the Change RequestLog and RTM.
  • Involved in writing and executing Test Cases and User Acceptance Testing (UAT).
  • Assisted in developing end-user training material and training sessions.

Environment: RUP, Microsoft Office, Visio, Microsoft Project, SQL server, UML.

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