SUMMARY

• Business Analyst with 7 years of experience in healthcare industry. Experience and knowledge of various methodologies and phases of the SDLC (Agile/Scrum and Waterfall). Possess strong experience in capturing/analyzing business requirements, solution design, Re - engineering, and project management. Excellent analytical and problem-solving skills, good communication, leadership skills, fast-learner and high degree of creativity and initiative.
• Well experienced in Business analysis and closely work with QA and Developer team in Healthcare and Insurance industry.
• Strong knowledge of the Software Development Life Cycle methodologies (phases and gates) like Agile and Waterfall models.
• Excellent knowledge of HIPAA standards, EDI 834, 835,837 (Electronic data interchange) and Knowledge of HIPAA code sets, ICD-9, ICD-10.
• Good experience working with MMIS, data mapping, and writing SQL queries.
• Worked with Member Enrollment and Eligibility and dealt with audits and claims editing.
• Extensive experience in Business Requirements gathering and writing skills with expertise in developing and documenting Business Requirement Document (BRD), Functional Requirement Document (FRD), Software Requirement Specification (SRS) across the deliverables of a projects.
• Experience in facilitating Joint Application Development (JAD) sessions, conducting user interviews, and acting as a liaison between the customers, development team and testing team.
• Used Analytical, methodical, and resourceful approach to problem solving, identifying root causes and corrective actions to meet short and long-term business, financial, and system requirements.
• Facilitated the review and approval of requirements from all stakeholders
• Facilitated and participated in design discussion and workshops
• Written user stories, conducting grooming sessions and story walkthroughs
• Provided first sign-off on the development post Dev testing
• Given demo to the PO and other stakeholders for final sign-off
• Provide support UAT, SIT (System Integration Testing) and Production
• Preparation of use case diagrams, UMLs, Sequence diagrams
• Coordinated between the business, the customers, and their product related needs on one side, and the Team on the other to make sure everyone meet their expectation.
• Hands on experience in JIRA tool for project scope, a defect tracking system to identify issues and concerns, then worked with development teams to implement necessary functional changes.
• Expensive experience in Agile methodologies like Backlog refinement, Daily Scrum meeting, Sprint planning, Sprint Demo and Retrospective.
• Work closely with the team to define the user-facing and technical requirements, to document the requirements as needed, and to determine the order of their implementation.
• As a Business Analyst I have acted as a liaison between business and technology teams. Excellent verbal and written communication skills, strong analytical abilities, and can perform well both independently and as a team player.
• Proficient in tracking defects and communicating with stakeholders and discussed with developer team and provide solution to Business user.

TECHNICAL SKILLS

Data Warehouse Tools: Oracle SQL developer, MS SQL Server, SQL Server Integration Services (SSIS).

Reporting Services (SSRS), Erwin.:

Business Management Tools: MS Office Suite (Outlook, Excel, Word, PowerPoint, Project, SharePoint, etc.), Tableau, MS Visio, Adobe Acrobat Suite, JIRA, HP Quality Centre.

SDLC: Agile/Scrum, Waterfall, RUP, UML, JAD.

PROFESSIONAL EXPERIENCE

Confidential

Senior Business System Analyst

Responsibilities:

• Conducted sessions with Business SMEs for requirements gathering and documented them in high level documents to effectively communicate the requirements to the technical team.
• Managed on site Scrum meetings for daily work updates and provided status of requirements or any challenges.
• Created User Stories using JIRA based on the collected requirements for the Quality Analysts to base their testing off.
• Served as subject matter expert on projects to answer business questions that impact the strategic business priorities.
• Updated the BRDs based on the changes suggested by the business and received approvals for the same in a timely fashion to avoid delays.
• Assessed & analyze user stories and participated in Sprint planning, Review Sessions & Scrum Meetings and developed Test scenarios, Test cases, Test data, Test procedures, Test reports.
• Collected and documented defects data in a tracker based on the regular updates received from the quality analysts to communicate them effectively and clearly to the business.
• Worked closely with the Development team and the quality analysts to do analysis thus identifying, prioritizing, structuring, and solving complex problems.
• Created software requirements artifacts and deliverables.
• Maintained the requirements traceability matrix throughout the project.
• Updated business requirement documents by Defining software quality attributes, external interfaces, constraints, and other nonfunctional requirements.
• Established and implemented effective requirements practices, such as change control process, etc.
• Prepared status report updates on the progress of assigned tasks and communicated the same to the project manager daily.

Confidential

System/Business Analyst

Responsibilities:

• Gathered requirements from Business Owners and Subject Matter Experts. Followed SDLC processes for maximum quality.
• Organized various meetings for creation of design and development of reports with Business Owners, users, Project Managers, and Project Sponsors.
• Created project documentation including requirements specifications, Use Cases Documented the existing process in technical model format in order to evaluate and define new IT solutions and implementation processes.
• Created additional reports to identify claims impacted by accumulator changes (retro etc.) for 837D.
• Created Access queries which were translated into SQL queries in the back-end Facets database.
• Created Reports on claims adjudication based on Management Requests documentation and user manuals for projects of for low to moderately complex.
• Represented dental on project calls and provided input and feedback regarding dental activities.
• Created reports based on Management Requests. Built queries in Access and Oracle for reporting and helped to find out unpaid claims for adjudication process. Created and edited reports in EXCEL. Responded to data requests from associates needing data from the Facets system.
• Created data mapping for requirements and developed functional requirements as per BRD.
• Documented requirements for different regulatory and operational reports.
• Worked on Ad-hoc files for reports that were urgent and at risk in terms of deadline to state.
• Worked on long term solutions for monthly, quarterly, and annual reports.
• Assigned task to development team and monitored and controlled the overall progress of the task given.
• Audited opened and closed claims to maintain consistent and accurate claims handling and documentation.
• Maintained the Traceability Matrix table to track the business requirements.
• Researched Provider, Member, Claims, Appeals and Grievances data in Facets and used it meaningfully to generate reports.
• Created EDI report as per requirement to deliver facets claims details. Generated EDI claims by using GENESYS Calls.
• Strong functional expertise in the Healthcare Payer Area - Membership claims, benefits, eligibility check, and ICD10.
• Participated in the analysis of existing business rules, processes, and systems to recommend process and system enhancements to improve business performance and maximize the effectiveness of available technology.
• Used Jira to maintain requirements, track status, and maintained defects and bugs and create User Stories.
• Translated business requirements into functional specifications for the IT organizations, manages changes to such specifications, and educated the IT organizations on the direction of the business.
• Gathered information about the organization’s work processes and information flows. Participated in the tracking and management of open issues and assists in planning for resolution for complex projects.
• Reviewed, edited, analyzed and created detailed documentation of business systems and user needs. Responsible for writing all documentation in a clear and well-organized manner.
• Researched and analyzed issues surrounding the processes and systems of an organization.