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Business Analyst Resume

SUMMARY

  • Experience in all phases of software development life cycle (SDLC), Optimized waterfall, Agile, Scrum including Requirement gathering and documentation, Use Case Documentation, Business Case Study/Analysis and user stories.
  • Experience in developing and writing functional business requirement, Scope documents, Gap and Risk analysis documents,
  • Expertise in generating various reports to assist with validating Reconciliation reports for claims and also Daily Outstanding Reports
  • Experience in working on multi - channel cross-platform web applications, supporting implementation of new and existing products, ensuring requirements delivery on budget, time and quality for the agreed upon scope.
  • Experience in Software Quality Assurance with excellent understanding of Software Testing Life Cycle (STLC), Change Control management, Defect Tracking, and reporting.
  • Experience in conducting JAD sessions for project definition involving analyzing requirements, creating user interface (UI) prototypes.
  • Excellent knowledge of Health Insurance Portability and Accountability Act (HIPAA) transaction and code set rules such as EDI 837,834,835.
  • Extensive knowledge, and experience on Medicaid, and Medicare Part A, Part B, Part C, and Part D, and Medicare advantage plans.
  • Experience in implementation of HIPAA 4010 and HIPAA 5010 changes in the existing claim processing integrated system.
  • Good understanding of ICD 9, ICD 10, HCPCS, and CPT.
  • Highly experienced with requirements gathering, planning, organizing, and Change Management.
  • Experience with Rational Tools including Rational Requisite Pro, Rational Rose.
  • Extensive exposure to SDLC Methodologies like Rational Unified Process (RUP) Agile, Waterfall, Spiral.
  • Experienced in GAP Analysis, Traceability Matrices, SWOT and Cost Benefit Analysis.
  • Experience with User Acceptance Testing (UAT), Unit Testing, application testing, integration testing, Black box testing.
  • Designed and implemented basic SQL queries for QA testing and report / data validation.
  • Experience with PL/SQL and MS Access database and MS office.
  • Developed Process flows, use case diagrams, class diagrams, sequence diagrams, collaboration diagrams, state diagrams and activity diagrams using UML to make users and developers understand the system.
  • Practical understanding of the Data modeling (Dimensional & Relational) concepts like Star-Schema Modeling, Snowflake Schema Modeling, Fact and Dimension tables.
  • Experience in extracting, transforming and loading (ETL) data from spreadsheets, database tables and other sources using Datastage.
  • Understanding the Business Architecture and Business Processes of technology network like insurance, banking, finance, and investment industry.

TECHNICAL SKILLS

Process/Model Tools: MS Word, Excel, PowerPoint, Visio, Toad, Agile Methodology, Scrum, Rational Unified Process (RUP), Rational Rose, Rational RequisitePro, Rational Clear Case, UML, Use Case Diagrams, Sequence Diagrams, Excel VBA, Activity Diagrams, MS Office, Google Analytics.

Reporting Tools: Crystal Reports, OBIE.

Test Tools: ALM (Application Lifecycle Management), Bugzilla, Jira

Operating System: Unix, Windows NT/2000, Windows XP, IBM Mainframe

Languages and tools: C programming, IBM mainframes, DataStage.

Databases: Oracle, SQL Server 2000, 2005, 9g, 10g, My SQL.

PROFESSIONAL EXPERIENCE

Confidential

Business Analyst

Responsibilities:

  • Engage business stakeholders to gather software requirements/business rules, and ensure alignment with development teams.
  • Translate Business needs into functional requirements, use cases, user stories, workflow/process diagrams.
  • Identify system and data requirements for the project and engage appropriate stakeholders to ensure those needs are met.
  • Support all levels of testing including functional, regression, user acceptance, system integration and performance to verify the client’s needs are met.
  • Identify risks related to requirements implementation and ensure project management is kept up to date on assigned tasks, issues, risks and key decisions.
  • Facilitate meetings to discuss complex situations with business stakeholders and external vendors and explore potential solutions.
  • Monitor and report defects, review open issues with stakeholders to set priority and ensure speedy resolution.
  • Prepare presentations for business, give demo to sales and marketing team for assigned products.
  • Participate actively in focus groups and process improvement meetings.

Confidential

SDO Tech Business Analyst

Responsibilities:

  • Responsible for making and maintaining necessary changes for claims finalization tasks using Confidential -chip (core enrollment and adjudication system).
  • Responsible for cost containment for investigating the eligibility of Institutional inpatient hospital stays and specific Institutional outpatient diagnostic procedures
  • Develop business analysis using requirements such as scope, processes, and risks assessment.
  • Worked on Healthcare experience management rules cleanup and DCDD updates.
  • Establish requirements with using ALM to ensure it is written for the business needs.
  • Gathered requirements from Business Partners, Business Managers, Stakeholders, and SME’s.
  • Conducted Joint Application Development (JAD) sessions with stakeholders.
  • Involved in walkthroughs and meetings with development team to discuss related issues.
  • Maintained Requirement Traceability Matrix (RTM).
  • Involved in the creation and maintenance of the Workflow plans and artifacts.
  • Modified existing workflow to accommodate change request from the client.
  • Updated Impact and Trace Matrix.
  • Participated in functional and technical reviews.
  • Worked with QA team to design test strategy and test cases for User Acceptance Testing (UAT).
  • Resolve and process different types of claim audits.

Environment: BlueChip, CLAIMS GUI, PREMIER, Agile, Waterfall, ALM, ARIS, JIRA, SharePoint, Super Scrubber, Splunk, UML, Use Case Analysis, MS Visio, MS Project, MS Office, One Note, BAM.

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