SUMMARY:

• Business Analyst with 7+ years of dynamic professional career reflecting experience and high performance in supporting business solutions and analyzing different business operations and business process re - engineering from inception through implementation.
• Excellent Business writing skills in writing Business Requirements Document, Use Case Specifications, Functional Requirement Documents, Software Design Specification, Software Requirements Specification, Software External Specifications, Software Requirement Document, Data Dictionary, Workflows and Unified Modeling Language Diagrams such as Activity Diagrams, Class Diagrams and Sequence Diagrams.
• In-depth knowledge of Software Development Life Cycle (SDLC) with thorough understanding of various phases like Requirements Analysis, Design, Development and Testing.
• Proficient in Requirement Management including gathering, analyzing, detailing and tracking requirements.
• Analyzed client's business requirements and processes through document analysis, interviews, workshops and workflow analysis.
• Conducted different levels of testing including functional, regression, user acceptance, integration and performance to verify that client's needs are met.
• Well-versed in Data Extraction, Data Compilation, Data Analysis, Data Manipulation and Data Validation using SQL queries in a MS SQL Server environment.
• Communicated client's business requirements by constructing easy-to-understand data and process models.
• Liaised between business and technical personnel to ensure a mutual understanding of processes and applications.
• Translated stakeholder requirements into different tangible deliverables such as functional specifications, user cases, user stories, workflow/process diagrams, data flow/data model diagrams.
• Facilitated monthly meetings with clients to document requirements and explore potential solutions.
• Proficient in design and execution of Test Strategy, Test Plan, Test Scenarios, and Test Cases based on the requirements for the applications.
• Developed strategic plan documents and experienced in conducting sessions for defining business requirements with the clients.
• Created Daily Status Reports, Test Incident Reports and Test Summary Reports.

PROFESSIONAL EXPERIENCE:

Sr. Business Analyst

Confidential, Fremont, CA

Responsibilities:

• Gathered, analyzed, validated and managed all documented requirements.
• Interacted with users for verifying requirements, managing change control process, updating existing documentation.
• Performed business analysis & coordinated with SMEs, users, internal and external stakeholders in order to gather requirements.
• Defined, developed and delivered user stories. Managed communication with development team.
• Reviewed requirements, user stories and acceptance criteria as required in facilitating sprint and release planning.
• Helped define and communicate the product backlog and sprint goals for the team throughout iterations.
• Participated in daily stand-up meetings.
• Participated proactively and continuously in the activities of the team, acted as a fully integrated member of the scrum team.
• Reviewed and accepted the solution delivered by the scrum team. Drove acceptance of the solution amongst the stakeholders.
• Contributed to the end of the sprint demonstration to stakeholders.
• Executed component or integration testing in alignment with sprint delivery cycles.
• Performed continuous process improvement across the product development lifecycle.
• Shared in defining the product vision and roadmap with the business and its stakeholder.
• Understood the concept of technical debt and the importance of its prioritization in the backlog.
• Created, maintained, organized, and communicated the product backlog.

Business Systems Analyst

Confidential, Bel Air, MD

Responsibilities:

• Utilized the guidelines and artifacts of the Agile Methodology to develop a detailed implementation process Guidewire Claim Center Integration during different iterations and phases in Software Development Life Cycle (SDLC).
• Acted as a liaison between Stakeholders, Subject Matter Experts, Business Users, and Development Team to identify the business needs, business rules and business process specification for the implementation.
• Documented policy integration and claims professional assignment details in Template using the Epic and Theme with major user stories in Power Designer.
• Successfully implemented call center CRM solutions related to assessment of loan applications for claim investigation and loan payment tracking.
• Successfully led and conducted JAD sessions to facilitate business process agility and to identify the content flows and processes.
• Gathered Product Backlog on the traditional claims system and newly integrated Claim Center and carefully elaborated application enhancement specifications detailing in scope/out of scope items, as-is/to-be process maps and critical test scenarios.
• Worked with claim specialists in specifying the requirements for Incident Permissions Incidents, Exposures, and Claims Incident Entity and their Subtypes.
• Dispensed automated claim segmentation and assignment, automated triggers and escalations and seamless integration based structured walkthrough to the developers to understand the Use Cases.
• Worked with quality control teams to develop Test Plans, Test Cases and test scripts based on functional performance criteria and usability.
• Garnered technical prowess on Change Management by performing Impact Analysis for Change Requests obtained during Claims processing lifecycle.
• Frequently used Requirements Traceability Matrix (RTM) for identifying and tracing the linkages among Policy Center, Billing Center and Claim Center.
• Conducted policy holder's standpoint based manual application tests.
• Used SQL during the testing phase to verify and validate that the correct information was provided.
• Orchestrated User Acceptance Testing (UAT) to guarantee that all the data model, business rules, workflows and user interface requirements have been fulfilled by the web application.
• Worked closely with PO and Scrum Master during RACI review process and release management for seamless integration.
• Implemented Software Quality Assurance development policies and test procedures. Documented test scripts according to the business specifications and design documents.
• Collaborated with development and testing teams to accomplish timely release objectives.

Business Analyst

Confidential, Bloomfield, CT

Responsibilities:

• Documented Trading Partner Migration Process Flow from HIPAA 4010A to 5010; created process flow diagrams and presentation materials; and monitored production and release events.
• Interpreted Systems Architect and Logical Diagrams to business users and other stakeholders; and assisted with change requirements elicitation.
• Assisted in writing business requirements and system specification documents.
• Extensively worked on EDI transactions 834, 835, 837I, 837P, 820, 270/271, 276/277, and 999.
• Responsible for interpreting ASC X12 Original and Errata version documents such as X12 220, 221A1, 222A2, 222, & 224A2 to business and technical users including the developers.
• Researched, tracked, parsed and interpreted EDI files 999, Transaction Acknowledgement Records, and enrollment and claims files in EDIFECS data repository and UNIX server and analyzed them according to the request.
• Conducted operational and implementation assessment of project tasks and prepared budget estimate documents for change request using standard templates.
• Conducted ICD-9/ICD-10 conversion analysis through ICD-9 and ICD-10 proposed mapping documents and HIPAA 5010 system capabilities of EDIFECS tools.
• Updated mapping documents as required for version upgrade and change requests.
• Monitored various files transfer events and repository records for claims, enrollment, remittance and status inquiry records in Trading Partner Gateway (HIPAA Gateway), transactional, operational and mainframe data repositories.
• Performed AS-IS and TO-BE analysis for EDIFECS Standards - HIPAA 5010 Database Setup for new version releases. Documented proposed changes and coordinated development, testing and production release environments, including end-to-end testing.
• Validated the Log Files (999, X12) for 834/820, 277CA, 837IB and 835 Transactions in UNIX and HTM (Healthcare Transaction Manager).
• Responsible for preparing and presenting technical reports and documents to stakeholders in client facing environments.
• Extensively used Quality Center to manage defects, change request and pre-uploaded requirements and mapping documents.
• Produced wireframe and User Interface Mockups.
• Conducted sessions over MITA and practiced it. Worked over Companion guide.

Business Systems Analyst

Confidential, Philadelphia PA

Responsibilities:

• Gathered requirements from Subject Matter Experts and documented the BRDs.
• Communicated risks/contingencies to project managers and consulted with technical development staff to clarify business requirements from the business users.
• Interviewed Business Users and SMEs to elicit requirements. Worked on developing the functional requirement documents (FRD) and Use Cases for FACETS batch process; automating the billing entity, commission process and Medicare enrollment.
• Conducted HIPAA 4010 to 5010 Conversion Analysis. Contributed in the documentation of HIPAA 5010 changes to EDI 837, 834, 835, 276, 277 transactions sets.
• Performed Analysis of ICD-9 Procedure and Diagnosis Codes in accordance with ICD-10 CM and ICD-10 PCS Conversion Compliances using GEM.
• Performed GAP Analysis to assess "AS-IS" and "TO-BE" scenarios between HIPAA 4010 and HIPAA 5010 and conversions of codes from ICD-9 to ICD-10.
• Worked in FACETS Configuration, Data Element Definition and Usage, and completed configuring FACETS Applications such as Related Entity, Parent Group, Group, Subgroup, and Member/Subscriber.
• Formulated system design, methods, procedures, policies and workflows affecting Medicare/Medicaid claims processing in compliance with government compliant processes such as HIPAA/EDI formats and accredited standards.
• Extensively worked in customization and configuration of Claims Processing applications in FACETS 4.71. Involved in reconfiguration of FACETS in functional areas including Membership, Claims, Provider, Enrollment and Service Modules.
• Coordinated the upgrade of EDI Transaction Sets 837, 835 and 834 to HIPAA compliance. Worked on EDI 834 file load in Facets through MMS (Membership Maintenance Sub-System).
• Worked as a facilitator and point of contact person for Testing Efforts and New Requirements between the Healthcare Company and its various Vendors.
• Maintained the Traceability Matrix to ensure accuracy and consistency of project success. Dealt with data mapping issues between various source systems, staging area and data marts.
• Worked with the UAT and QA teams to conduct an assessment and determine how effective UAT and QA guidelines can help the company achieve timely completion of projects.
• Analyzed data and created reports using SQL queries for all issued action Items.

Business Analyst

Confidential, Columbus, OH

Responsibilities:

• Interviewed Business Users to gather requirements and analyzed the feasibility of their needs by coordinating with the project manager and technical lead.
• Performed GAP Analysis to identify the deficiencies of the current system and to identify the requirements for the change in the proposed system.
• Prepared Business Requirement Documents (BRDs) after the collection of Functional Requirements from System Users that provided appropriate scope of work for technical team to develop prototype and overall system.
• Facilitated Joint Application Development (JAD) Sessions for communicating and managing expectations, and to discuss the different ways and means for the integration of rational tools with the current system.
• Created and managed project templates, Use Case Project templates, requirement types and traceability relationships in Rational Requisite Pro.
• Collaborated with development architect and the business to develop both high-level and detailed application architecture to meet the business needs.
• Developed and documented timelines for Project Delivery, and managed Projects and Resources to successful completion.
• Worked extensively with the QA team for designing Test Plan and Test Cases for the User Acceptance testing (UAT).
• Conducted walkthroughs with business and development teams.

TOOLS: & METHODS: MS Visio, MS Office Suite, Rational Rose, SQL, Oracle, FACETS 4.71, Requisite Pro, BizTalk Server, Oracle, JAVA, XML, Quality Center, Caliber RM, Enterprise Manager, Wireframe, UNIX, C++, SharePoint, Rational Requisite Pro, MetaVance, HP Virtual Room, Agile, Power Designer, Silk Central.