SUMMARY

• Over 6 years of proficient experience in the Business Analysis, Business Modeling, Requirement Gathering, Documenting Requirements (BRDs/FSDs/Use Cases), Design, Development, Implementation and Software Validation.
• Strong business analysis skills and experience in the Software Development Life Cycle (SDLC) and used methodologies such as Waterfall Model, Rational Unified Process (RUP), Agile Methodology.
• Strong experience in Scrum/Agile methodology and proficient in writing user stories of core business systems.
• Involved in Sprint Planning, Daily Scrum Stand Up, and Sprint Retrospective meetings.
• Expertise in successfully creating diagrams and graphs using Business Process Model and Notation (BPMN) to facilitate an understanding of performance and processes
• Extensive experience in using Microsoft Visio for Proto typing System requirements particularly in creating Activity diagrams and class diagrams and also writing Use cases, Business Process, Work Flows, Process Flows and documentation.
• Hold excellent communication and documentation skills with good process management and interpersonal skills to gather requirements to bring out quality end product.
• Experienced in performing Gap Analysis to ensure the compatibility of the existing system with the new business requirements.
• Data Mapping and delivering capabilities in the user friendly GUI.
• Highly logical in developing the methods and procedures to meet requirements and solve concerns that arise during the project.
• Understanding customer/ client requirement specifications as well as business systems functionality and technicality.
• Expertise in using QA Methodology to ensure strong functionality.
• Carefully worked with MS Office, MS Excel, MS PowerPoint and MS Visio on multiple projects.
• Conducted User Acceptance Testing (UAT) on newly developed applications.
• Ensured that issues logged into defect and incident reporting and tracking tool (Team Foundation Server) are accurate, complete, and ensure there is no existing ticket on the same issue.
• Used Quality Center and Rational Clear Quest for any possible error reporting.
• Experienced in writing SQL queries to generate reports.
• Strong communication and interpersonal skills when working with project managers, subject - matter experts, developers, stakeholders and application end-users to adapt new/existing environment.
• Extensive experience in organizing Joint Application Development (JAD) sessions with various groups.
• Excellent analytical and problem solving skills with the ability to handle multiple tasks effectively and quickly master new concepts and subjects.

TECHNICAL SKILLS

Project Methodologies: SDCL, Agile, Scrum

Business Applications: MS Visio, MS Word, MS Excel, Outlook, MS PowerPoint, MS SQL Server, DB2, RDBMS, Rational Rose, Rational Requisite Pro, Rational Clear Quest, MS Project, MS SharePoint, .Net, FileNet, JIRA, CMMI, TOAD

Operating Systems: Windows NT, Windows 2000, Windows XP, Windows 2007, Oracle, Unix.

Defect Tracking Tools: Quality Center, Test Director, CMS

Web Browser: Internet Explorer, Mozilla Fire Fox, Google Chrome

PROFESSIONAL EXPERIENCE

Confidential, KS

Sr. Business Analyst

Responsibilities:

• As Business analyst Iinvolve indeveloping and documenting Product Test Plans, using Agile/Scrum Methodology for Software Development Life cycle.
• Trained the team on JIRA tool for Agile/ Scrum Methodologies.
• Facilitated various meaningful scrum meetings
• Helped create the 'Business Glossary' to facilitate efficient understanding of the business process amongst the other teams. Assisted in creation of the Functional Design Document from the Business Requirements Document which was used as the reference by the development team while preparing the design and held the responsibility of the required data setup for unit testing.
• Performed end-to-endSystem Integrationtesting which covered the entire business process flow from the initial point of sales through to all thedownstream systems and XML output files, including apps/interfaces.
• Responsible for creating Mockup screens using Wireframes for Mobile and Web Portal.
• Worked on creating UI and process flow for new mobile application for member portal.
• Implemented automated COB processing of Medicare claims into Facets
• Created and maintained requirement documents for Facets for the different modules like Billing, Member enrollment and Claim adjudication.
• Performed numerous data extraction requests using SQL scripts to prepare ad hoc reports
• Strong experience in conducting Functional Testing, Regression Testing, User Acceptance Testing (UAT), and System Integration testing (SIT).
• Performed numerous data extraction requests using SQL scripts to prepare ad hoc reports
• Providedthe required test data for the developers in order to fix the defects
• Extensively worked with ANSI X12 HIPAA EDI Transactions 270, 271, 276, 277, 837, 835 and 997
• MonitoredEDIEligibility/Inquiry/Response (270/271) transactionsvia reports generated by the developers.
• Worked on solving the errors of EDI 834 load to Facets through MMS.
• Checked the data flow through the frontend to backend and usedSQL Queries to extract the data from the database.
• Mapped documents from/to various formats including but not limited to x12, EDIFACT, XML, SQL and text utilizing ODBC and other connectivity methods
• Involved in writing extensiveSQL Queriesforback end testing oracle database.
• Retrieved files usingSQL statementsandUNIX commands.
• Created and maintainedSQL Queries for back-end testing.
• Involved in EDIFACT electronic transmission.
• Performedmanual back-end testingusingPL/SQL to connectto an Oracle 9i database.
• Established and maintained test cases and test data in ALM.
• Assisted in writing efficient and effective Master Test Plan, Test Strategy, System Testing, End-to-End Test and User Acceptance Test Plan.
• Worked in both traditional EDI integration in X12 & EDIFACT data formats
• Involved in making Use Case Diagrams, User Interface (UI) design, Activity Diagrams, and using analysis and design models tools like MS Visio, Rational Rose through Agile and Waterfall Model
• Logged the defects in ALM and maintained track of the defect throughout its lifecycle
• Participated inQAteam meeting and defect tracking meetings.

Environment: Windows XP, SQL Server, MS ACCESS, Clear Quest, Facets, MS Office, MS Visio, .Net, SDLC, Agile.

Confidential, Richmond, VA

Business Analyst

Responsibilities:

• Responsible for managing requirements in bothwaterfall/ agile methodology, including elaboration of epics into detailed user stories, management of product backlog, release backlogs, burn-down charts and scrum team velocities.
• Coordinated with the developers and ITarchitectsto design the interface of the new system according to the X12 (270, 276, 278, 834, 835, 837 (I, P, D) and 820) standards.
• Conducted JAD sessions withbusinessunits and stakeholders to define project scope, to identify the businessflows and determine whether any current or proposed systems are impacted by the new development efforts.
• Participated in the recording and analysisofthebusinessrequirements for theCOBproject.
• Understanding and assessment of the current EDI Transactions used.
• Participated in customization of vendor provided solution to accommodate requirement specific to the business.
• While working on requirements of the 835 HIPAA project, jumped half way in the 820 report project, continued working on 835, 834, 276 / 277, 278, 997/999 and HIPAA EDI Transactions across enterprise
• Track and follow-up on all Medicare, Medicaid, and government programs, commercial and contractedpayerissues; concentration on root cause analysis and resolution.
• Assist with project planning and the development of the systemconfigurationactivities associated with the project schedule
• Businessrequirements for 834 Enrollments.Businessrequirements for 820 Payment/Remittance Advice from Federal and State Exchanges.
• UsedFileNetto increase document modification and traceability.
• Created Process Work flows, Functional Specifications, and responsible for preparing Software Requirement Specifications (SRS), Functional Specification Document (FSD).
• Performed Data Mapping to map the EDI 834 data to XML.
• Worked on Agile environment to develop CRM Service Requests and CRM sales Analytics Dashboard.
• Recommend tactic to implement HIPAA ( EDI X12 837,834,278,270, 278, 997,999) in the new System
• Involved in impact analysis of HIPAA EDI 835 and 837P transaction sets on different systems.
• Collaborated with External Auditors and documented SOX compliance requirements and resolved data issues.
• Maintained Disaster Recovery procedures by using FileNet to ensure data backup on cloud servers
• Involved inFileNetContent EngineData Modeling.
• Acted as a liaison between system users, client managers and software development team to gather requirements and document workflows and results of Financial Analysis into the Business Requirement Document (BRD).
• Analyzing User and Functional requirements to point out gaps between usedSQLqueries to extract the data from the database.
• ConductedBusinessRequirements walkthrough with thebusinessowners as well as the Technical Stakeholders.
• Participated in the monthly steering committee meetings to update theBusinessSponsors on the project schedule and financials.
• Handle adhoc reporting request for eligibility 270 & 271 transactions,COBSmart reporting, data quality, and payer request.
• Designed and developed Project document templates based onSDLCmethodology.
• Utilized Informatica to ETL data forbusinessintelligence and reporting. UsedTableauas the reporting tool.
• Established Traceability Matrix using Rational Requisite Pro to trace completeness of requirements in different SDLC stages.

Confidential, Chicago, IL

Business Analyst

Responsibilities:

• Worked as a liaison between the business client and development team for the in compliance with HIPAA standards.
• Identified the business functions and processes, and prepared system scope and objectives based on user needs and industry regulations.
• Defined terms, conducted stakeholder analysis, elicited business needs, conducted business process modeling, and facilitated JAD sessions. Elicited, documented requirements and use cases. Analyzed, validated & prioritized requirements; traced requirements to related project documentation (process models, designs, test scenarios & scripts).
• Responsible for architecting integrated HIPAA, Medicare solutions, Facets.
• Documented the Requirements and circulated them to Business & Technical teams for Signoffs.
• Participated and led daily stand-up meetings in line with Agile Scrum methodology.
• Usedagilemethodology for gathering requirements and testing them.
• Involved in creating the UI design for the mobile applications for member portal.
• Created User Interface for displaying various information related to providers and claims.
• Created 837 I & 837 P claims using macro enabled claim spreadsheets.
• Order Process Management - Designed techniques to implement a new Billing and Inventory Management Tool to better track the expanding business' products.
• Processed EDI 837P, 837I, 834 and 837D transactions, verified 837 transactions were converted correctly to XML file format and verified the claims data loaded to Facets for further processing.
• Worked on analysis of FACETS claims processing system and gathered requirements to comply with HIPAA
• Conduct JAD sessions to gather and document requirements that enhance a wide range of functionalities including claims processing, eligibility and enrollment, provider networks, and electronic data interchange for our Facets core application.
• Created a new project using SoapUI and run request with input XML to receive a response XML for the request sent
• Identified testing scenarios and defined Test Cases for detailed functional testing and UAT.
• Facilitated claims processing while passing 837 claims for a compliance check and running through load processing.
• Worked with ANSI X12 HIPAA EDI Transactions 270, 271, 276, 277, 837, 835 and 997
• Created and maintained data mapping document(s) in reference to the HIPAA transactions: 270/271, 276/277, 837, and 835.
• Developed a Schedule and identified project milestones.
• Reported project progress to the team, senior management and all stakeholders periodically.
• 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
• Identified risk and project impact and performed risk assessment and mitigation.

Environment: SQL, MS Access, Software/Tools Micro-Strategy, Visio, agile, Rational Rose, Quality Center, MS Project.

Confidential - New York, NY

Business Analyst

Responsibilities:

• Followed a structured approach to organize requirements into logical groupings of essential business processes, business rules, and information needs, and ensured that critical requirements are not missed.
• Followed the UML based methods using MS Visio to create Use Case Diagrams, State Chart Diagrams and Sequence Diagrams
• Worked on FACETS claims processing, payment adjustments, claims inquiry, benefits,
• Enhanced test cases and scripts by adding the required functionality as per the new business requirements.
• Was responsible for Defect Tracking and Bug Reporting, which was performed in HP Quality Center.
• Verified data outputs and transformations between systems remained true and were not compromised as systems were integrated.
• Developed process flows diagrams, DFD in accordance with Medicare and Medicaid rules and regulations pertaining to the Facets configuration and evaluated the impact of proposed changes.
• Responsible fortestingMedicaidClaims using MMIS.
• Prepared detailed reports and presentations using SQL and MS Access
• Participated in various meetings and discussed enhancements and modifications request to resolve issues and expand capability of the systems.
• Interacted with stakeholders to get a better understanding of client business processes and gathered requirements.
• Wrote complex SQL queries to perform the backend testing of the Oracle database using PL/SQL developer and UNIX shell commands
• Experience in conducting scrum meetings and sprint planning.
• Executed PL/SQL statements to check if the data integrity has been maintained.
• Collaborating with business partners and cross-functional teams and supporting system documentation.
• Enrolled members and provider in the Facets system.
• Created and modified queries utilizing Facets data tables.
• Responsible for checking member eligibility, provider enrollment, member enrollment for Medicaid and Medicare claims.
• Performed manual back-end testing using PL/SQL to connect to an Oracle 9i database on a UNIX server
• Experience with COB (coordination of benefits) application with in facets, testing of claims status for selected subscribers.
• Involved working with HIPPA-EDI ANSI X12 Transaction Code sets EDI 834, 835 and EDI 837.
• Involved in Testing (271, 277, 820, 834, 835 & 837) Transactions.
• Developed understanding of various transactions involved in transition from HIPAA 4010 to HIPAA 5010 like eligibility, benefit, claim submission transactions in Facets tables.
• Generated on-demand and scheduled reports for business analysis or management decision using SQL Server
• Organized and facilitated meetings with the management and development teams.
• Performed UAT, regression testing on EDI 835 and 837 X12formats in Facets.
• 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.

Confidential, Raleigh, NC

Business System Analyst

Responsibilities:

• Responsible for the requirement-gathering phase and project plan.
• Responsible for the full HIPAA compliance lifecycle from gap analysis, mapping, implementation and testing for processing of Medicaid Claims.
• Used HIPAA 4010 transactions to support the analysis of current business processes and work with management to improve and implement enterprise solutions to ensure compliance and involved in designing future state processes for HIPAA 5010 transaction processing EDI’s 837, 835, and 834.
• Created Use Cases diagram and Activity diagram to depict the interaction between the various actors and the system in Rational Rose for the Business Use Case and System Use Case. face
• Tested the changes for the front-end screens in FACETS related to following modules, test the FACETS batches (membership, Billing, Provider, etc.).
• Interacted with database developers for formulating the ER diagrams and data flow diagrams.
• Worked with a QA lead in validating Test Plan and Test Scenarios.
• Assisted Business User during deployment in formulating User Acceptance Testing (UAT) for customized application and getting confirmation for product Release

Environment: SQL, MS Visio, MS Office Suite, MS BizTalk Rules Engine Deployment Wizard,, Oracle and Windows NT, Visio, Requisite Pro