SUMMARY:

• Around 7 years of experience as aBusinessSystems Analyst in teh diverse domain Healthcare industry and retail.
• Working in all phases of project life cycle and in different SDLC methodologies such as Waterfall and Agile.
• Dedicated, hard working individual wif teh intercommunications skills to work at all levels of teh organization.
• Exceptional abilities in project design and management wif teh organizational and supervisory skills to assure success. Delegates and monitors work to meet and beat deadlines.
• Outstanding motivator and builder of teams. Works well in both team environments and individual assignments.
• HealthCare management experience in projects involving teh customization, design, development, implementation, and testing of automated systems to support teh Medical Management Information System (MMIS) as well as day - to-daybusinessoperations.
• Supporting all teh documents wif UML Diagrams such as Use Case Diagrams, Class Diagrams, Activity Diagrams, Data Flow Diagrams, Sequence Diagrams, Process Flows (Businessand System) using UML modeling tools such as MS Visio and Rational Rose.
• Research, gather, and analyze content data and information, to include formatting and reformatting, reviewing, revising, cataloging, and electronically storing for future retrieval.
• Interpret client'sbusinessrules into SQL commands dat halp in teh creation of databases dat store customer information.
• Teaming wif all stakeholders to build 'as-is' and 'to-be'businessprocess flow documentation using Microsoft Visio, as well as conduct gap/deficiency identification and analysis, including cross functional members.
• Knowledge of Healthcare industry including HIPAA, EDI wif emphasis onBusiness Requirements and Functional Requirements.
• Excellent communication, client relationship and customer service skills. Responsible, self-motivated and organized.

TECHNICAL SKILLS:

MS Office 2003: (MS Word, EXCEL, PowerPoint, Access), Microsoft Project,SQL,Unix.

Project Management: Techniques (PMBOK), BusinessObjects, Crystal Reports, Root Cause Analysis.

Technical Writing: , BusinessWriting, Scheduling and Resource Allocation.

Six Sigma: Training for Green Belt Certification, MiniTab Statistical Software, JAD Sessions.

Methodology: SDLC,RUP, Agile, Waterfall.

PROFESSIONAL EXPERIENCE

Confidential, Minneapolis, MN

Sr. Business Analyst

Responsibilities-

• GatheredBusinessRequirements from teh Subject Matter Experts (SMEs) and documented teh requirements in teh BRD. Utilized data flow diagrams, use case diagrams and process flow diagrams to represent information provided by theBusinessOwners.
• Worked in Agile/Scrum environment.
• Involved in Trizetto Facets System implementation, Claims and Benefits configuration set-up testing, Inbound/Outbound Interfaces and Extensions, Load and extraction programs involving HIPPA 837 and proprietary format files and Reports development.
• Involved in scoping and scheduling meeting wif Project manager,business(sponsors) and delivery manager.
• Assisted in breaking teh requirements out into stories and sprints.
• Effectively managed version and change control during teh migration from NASCO to FACETS.
• Helped PO in breaking product backlog items into coherent user stories in advance of iteration.
• Created High and low level use cases.
• Performed Gap analysis and documented it.
• Responsible for Backlog Grooming to make sure teh user stories were as granular as possible to avoid ambiguity.
• Worked on writing and prioritizing User Stories.
• Gathered requirements from ClaimsBusinessArea for teh Auto Term project. Prepared Process Flows and Diagrams for teh manual to automated conversion Project.
• Maintained teh Traceability Matrix table to uniquely trace teh identifiedbusinessrequirements to general design to testing as proof dat requirements requested have been developed into a solution and dat it TEMPhas been tested and tracked.
• Effectively elaborated teh Current process and gave a clear picture of teh proposed process for teh projects in teh organization. Worked aggressively towards timely completion of High Priority Tasks.
• Worked wif Vendors like Workflow One to ensure printing of Welcome Kits and ID cards are scheduled on time for teh new and existing members.
• Worked wif SharePoint to upload teh documents and also fetch others document.

Environment: Mumps Cache, IDX, MS Visio, Facets, Word, Excel, Share Point, PowerPoint, CMMI, Rational Rose, Requisite Pro, SQL, Oracle, J2EE technology, Java, Perl.

Confidential, Santa Ana, CA

Business Analyst

Responsibilities-

• GatheredBusinessRequirements by close interaction wifbusinessteams.
• Performed auditing teh functional documents.
• Organized teh review meetings.
• Proficient in Base SAS programming (DATA step), SQL programming (i.e., use of SQL pass-through or PROC SQL), as well as teh SAS Macro language for use in making code more efficient.
• Design projects dat apply valid statistical techniques utilizing various data types in order to structure relevant and actionable analyses.
• Design and build Data Warehouse structures (databases and SSAS cube.
• Support teh data warehouse technical ecosystem, including SharePoint for teh delivery of reporting and analytic applications.
• Involved in teh efforts to analyze specific application developed by third party for Ericsson.
• Developed teh Schema Crosswalks for 837, 835 and 276/277 according to HIPAA implementation rules.
• Responsible for Medicaid Claims Resolution/Reimbursement for peach state health plan using MMIS.
• Support teh Medicaid Management Information System (MMIS) as well as day-to-daybusiness operations.
• Propose strategies to implement HIPAA 4010 in teh new MMIS system.
• Responsible for gap analysis changing old MMIS and Involved in testing new MMIS.
• Assisted teh database development team in data modeling, data structure and data table layouts required for consolidation of incongruent databases.
• Involved in teh Analysis & Design workflow for various processes by following teh Rational Unified Process (RUP) andBusinessUse Cases.
• Involved in teh full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Medicaid Claims. Worked on EDI transactions: 270, 271, 834, 835, and 837 (P.I.D) to identify key data set elements for designated record set.
• Responsible for data sourcing and data integrity using SQL.
• PreparedBusinessWorkflow models dat cover "How"businessprocesses are accomplished.
• Experienced in researching jurisdictional issues, case law, and managing counsel, including litigation, mediation, and arbitration.
• Used Rational Clear Case version control system to keep track of different versions of artifacts generated wifin teh life cycle.
• Analyzebusinessrequirements and legacy reports to drive new development utilizing 3rd party development tools, SSIS, and SQL Server.
• Advanced understanding of databases and Microsoft SQL Server (T-SQL) development.
• Setting up document hierarchy and standers to define different level of requirement using Requisite Pro.
• Conducted walkthrough wif teh development team and stake holders.

Environment: SQL, Power Designer, Windows XP/2000, MS-SQL, MS Office Suite, Visual Studio 2012, MS-Project.

Confidential, Kalamazoo, MI

Business Analyst

Responsibilities-

• Analyzed theBusinessRequirements and Functional Requirements and Responsible for analysis meetings wifbusinessteam and development team.
• Analyzed and documented MMIS Claimsbusinessrules, edit rules, audit rules, to create and process unit and string test cases to verify and validate updated programs.
• Responsible for converting teh submitted 837I claims from 4010 manually.
• Expertise in HIPAA, 820,835, 837, 4010, 5010, 997 EDI. Responsible for testing HIPAA EDI Transactions and mainly focused on PA and Eligibility Transactions.
• Active involvement in preparation of test data files and responsible for assisting team members in mocking data according to requirements and analysis.
• Maintain, update, manipulate and create queries in Teradata SQL andBusinessObjects to pull data from teh Enterprise Data Warehouse for reporting Build tables from Teradata SQL/BusinessObjects queries for SSRS/SSIS/ACCESS delivery.
• Customized and developed software applications/programs for electronic claims translation/transmission, remittance advice, eligibility and bank transactions.
• Trained staff and ensured all application were HIPAA compliant. Led many HIPAA conversion projects, facilitated meetings and provided teh highest levels of quality, professionalism and customer support.
• Communicated and coordinated collaboration betweenbusinessfunctions throughout teh lifecycle of a project including human resources, finance, technology, customer relations, and internal marketing.
• Conduct user acceptance testing to ensure dat developed applications satisfy teh needs ofbusiness clients as specified in teh functional requirements.
• Interacted wif stakeholders to finalize theBusinessRequirements for teh application.
• Conducted Gap Analysis, and Gathered User Requirements by Interviews, user meeting, JAD session, and Requirement Elicitation Sessions.
• Created Graphical representation of reports such as Bar charts, Pie charts etc., as per teh End user requirements usingBusinessObjects and Crystal reports.
• Analyzed teh data collected and process maps to determine teh root causes and identify opportunities.
• Performed Data mapping, logical data modeling, created class diagrams and ER diagrams and used SQL queries to filter data.
• Created and managed project templates, Use Case project templates, requirement types and traceability relationships in Requisite Pro.
• Extensively used Rational Requisite Pro for reviewing and analyzing user requirements.
• Prepared scenarios, Use Cases & UML State Diagram for scenarios using Rational Rose.

Environment: Rational Rose and Requisite Pro, MS Visio, SQL, MS Project, MS Dynamics CRM, Windows, Oracle 9i, Crystal Reports.

Confidential - Tarrytown, NY

Business Analyst

Responsibilities-

• SAP - Sales and Distribution: Implementation of SAP Sales and Distribution Module nation-wide.
• Salesforce One (SFA): Implementation and management of Automated Sales Solution for Pre-Sales which integrates wif SAP.
• MobiControl (MDM): Implementation and management of Mobile Device Management Solution for POS Devices, MobiControl.
• Sales Planning & Routes Management System: Implementation and management of RMS for sales team in order to structure sales routes and planning.
• Performance Driven Salary System: Development and implementation of Variable salary pay-outs for sales team based on targets achieved.
• Market Survey and Analysis: Implementation of automated survey solution to capture market situation.
• Inventory Days of Cover Reporting: Development and Implementation of Inventory coverage reporting at warehouses.
• Part of teh multi-functional team covering:
• Administration of Point-of-Sale Devices, used by Sales Representatives.
• Ensure Data Integrity in Sales Force One System & Data Migration between Sales Force One, and SAP.
• Development and Implementation of Interactive Automated Daily Sales Reporting for Executives.
• Manage Departmental Scorecards for Monitoring functional KPI's.