PROFESSIONAL SUMMARY

• Expertise in all the phases of the Software Development Life Cycle (SDLC), Agile, Waterfall and RUP methodology.
• Expertise in documenting the Business Requirements Document (BRD), Process Flows, generating the UAT Plan, maintaining the Traceability Matrix and assisting in Post Implementation activities.
• Experienced in gathering and documenting test scenarios and ability to train users to translate technical requirements to a business and have experience in conducting UAT.
• Ability to map current and future system requirements into sufficiently detailed descriptive requirements for development.
• Expertise in translating user requirements into System Specifications and mapping the process design, work flows.
• Ability to elicit, analyzes, gather, document and prioritize requirements for business support system and operational support system using digital capability analysis, workshops, surveys,interviews.
• Experience in facilitating Joint Requirement Planning (JRP) sessions with Business User Groups, conducting Joint Application Development (JAD) sessions with IT Groups (ITG) and Conflict Management with Project team members.
• Strong knowledge of project management, data mapping, data classification, digital technologies and trends.
• Extensive experience in developing Use Cases, conducting Gap Analysis, and Impact Analysis, SWOT analysis and propose changes as per various internal and external requirements gathered for process improvement.
• Expert in creating Use Case Diagrams, Class Diagrams, Sequence Flows using MS Visio and Rational Rose using UML concepts.
• Possess strong analytical and problem solving skills with the ability to adapt to a new environment and meet stringent deadlines.
• Strong knowledge of BABOK (Business Analysis Body of Knowledge).
• Expertise in change management process and process improvement methodology.
• Extensively worked as a liaison between the product management, IT development and QA team. Trace and inform business requirement changes throughout the lifecycle of the project.
• Responsible to Track, Document, Capture, Manage and Communicate the Requirements using Requirement Traceability Matrix (RTM) which helped in controlling numerous artifacts produced by the teams across the deliverables for a project.
• Involved in Test Planning, Test Preparation, Test Execution, Issue Resolution, and Report Generation to assure that all aspects of a Project are in Compliance with the Business Requirements.
• Extensive experience in facilitating user group meetings and gathering system requirements for web application development using Rational Requisite Pro, Rational Clear Case.
• Optimum use of documentation to avoid any form of miscommunication or misinterpretation during the entire software development process.
• Experience in creating and maintaining the Requirements definition documents that included Business requirements and Functional requirements.
• Experience in customer / client interaction, deep understanding of business systems functionality and technicality.
• Conducted requirement analysis techniques such as Business Process Management, Business Process Automation, Business Process Improvement, and Business Process Re - engineering.
• Experience in developing surveys and interview questionnaires for interviewees and selecting the target population segment
• Comprehensive knowledge and experience in all aspects of the Software Development Life Cycle (SDLC) which includes Gathering Requirements, Analysis, Design, Development, Testing and Implementation. Proficient in Object Oriented Analysis, Design and Development.
• Strong knowledge oftechnical risk assessment methodologies.
• Ability to excel and succeed in diverse environment and projects with strong determination, dedication, and inclination towards customer satisfaction.
• Creative, Aggressive and highly motivated team player capable enough to work and lead a team besides being capable to work independently.
• Interface with clients from Operations, Marketing, Sales, Technologies, and Outside Vendors and act as their customer interface point as the lead of the Projects.

TECHNICAL SKILLS

Project Methodologies: SDLC, Agile, Rational Unified Process (RUP), UML

Business Modeling Tools: Rational Rose, MS Visio, UML

Requirement Management Tools: Rational Requisite Pro

Defect Tracking Tools: Rational Clear Quest, Quality Center, Test Director

Operating Systems: Windows NT/XP/2000, UNIX

Database: Oracle, SQL Server, DB2, Tera Data

Quality Assurance: Software Application Testing Life Cycle

Business Applications: Microsoft Office Suite, MS VISIO, MS Project

PROFESSIONAL EXPERIENCE

Confidential, Virginia Beach, VA

Senior Business Analyst

Roles &Responsibilities:

• Interacted with clients to assess needs, identify key challenges, and define project scope and deliverables.
• Experienced in documenting requirements on cost modeling.
• Analyzed and documented the cost of the overall system.
• Responsible for performance analysis and utilization reporting.
• Interacted with Business users and Technical team in providing clear solutions to requirements.
• Analyzing the Facets Requirements and thus conducting gap analysis.
• Developed business process models in RUP to document existing and future business process
• Followed the UML methodology to generate Activity Diagrams, Sequence Diagrams, and Class Diagrams and Collaboration Diagrams using MS Visio.
• Led the Installation of internal CRM system to streamline customer support and sale.
• Used MS Visio for flow-charting, process model and architectural design of the application
• Used Test Director for preparing the test plans and manual test scripts.
• Redesigned project plan with in depth detail of all UAT. Review resources and create timelines and guidelines for all deliverables.
• Automation of HIM process.
• Requirements gathering in compliance with HIPAA.
• Extensively used SQL statements to query the SQL Database for Data Validation and Data Integrity.
• Extensively worked with HIPAA 837, 834 and 835 files.
• Defined test cases to satisfy each business requirement for the application being tested.
• Created the Input Form for HIPPA 837P, 837D and 837Iclaims to help business people built test cases on live scenarios.
• Responsible for creating and execution of automated test scripts using QTP.
• Performed back-end testing by extensively using SQL commands to verify the database integrity
• Inserted Check Points to check the broken links, Text and standard properties of an object using QTP.
• Created test files for Regression, Integration and UAT test cases, map failure tests for data validation
• Performed complete Functional, System and Integration testing.
• Involved in Data Selection for testing the EDI Load Process: backend process for loading and processing the data received through EDI and manual process as per Business Rules.
• Executed the EDI Load Process to verify that Claims are validated as per Business Rules and good claims are successfully loaded for the adjudication

Environment: Windows XP/2000, JAVA, SQL, UML, QTP, SQL, MS-Visio, DB2, Rational Rose, HIM

Confidential, Mason, OH

Senior Business Analyst

Roles & Responsibilities:

• Reviewed existing process and involved in creating the future process.
• Extensively worked on Pharmacy claims data.
• Created business requirements communicating with Project manager and other stakeholders.
• Identified impacted areas, Use Cases, Activity diagrams, Activity Nodes and documented them in a matrix document.
• Created Mapping document for ICD 10 impacted process and created mapping document to capture for AS IS and To Be process after ICD 10 code implementation.
• Collected the data for various system and applications to develop data warehouse.
• Assisted in data mitigation and data reconciliation.
• Created Short term and Long term Swim lane diagrams to depict the Business requirements.
• Contributed to the other Projects such as ERISA 5500 and 0$ Margin.
• Work extensively with cross functional teams such as Accounting and finance
• Identify and address areas of discontinuity between ICD 9 and 10 so as to avoid unnecessary mappings.
• Help in preparing the training material of the providers and insurance companies using the software supporting ICD 10.
• Created Daily, Weekly and Monthly pharmacy reports for Pharmacy business team.
• Identified the requirements for accommodating HIPAA 5010 standards for 837P transactions and captured these requirements to develop new mapping document.
• Developed SQL queries to generate report for cross functional team.
• Extracted data and analyze based on the user requirements.
• Managed Exception pricing Project Share point site.
• Worked as a project coordinator to assist Project manager by coordinating meetings, leading meetings, and creating meeting minutes.
• Followed up on the Actions Items for team members, created issue log and updated them in SP site accordingly.
• Created Report book for the Long term process.
• Developed template for the WLP and ESI validation report.
• Created pricing data format to send data to ESI for short term process.
• Involved in creating Bill Code Event to Group Matrix to be used by the Project for long term.
• Participated in weekly Project team status meeting, Joint status Meeting with the client to present status and incorporate any digressions from the original scope.
• Conducted and Participated in bi weekly Joint Issue touch base meeting with the client.
• Created and maintained RACIA matrix (contact).
• Conducted and Participated in Business requirement gathering and work thru.
• Performed Data verification and validation against the user requirements.
• Performed Gap Analysis of short term business requirements with long term business requirements and reported the GAP to the management.
• Used Teradata SQL assistance to write SQL queries for data extraction.
• Created and provided Ad hoc data request to the users with quick time around.
• Assisted other team member extract data from the data ware house and any data related issues.

Environment: MS-Visio, Share Point, Windows XP, Teradata, SQL, Landing Zone, EDW, MS Office.

Confidential Care, San Diego, CA

Business Analyst

Roles and Responsibilities:

• Acted as a primary contact in all the phases of Software Development Life Cycle SDLC, including Quality Assurance Testing, Performance & User Acceptance testing.
• Performed GAP analysis for ICD - 9 and EDI 5010 X12 Message Structure with the 4010 Structure.
• Developed End-to-End Business Process Flows for HIPAA 4010 EDI transactions including 834 (Benefit Enrollment and Maintenance), 835 (ERN-Electronic Remittance Notification) and 837 (Claims Submission) Transactions.
• ICD 9 Conversion Project - Worked in the analysis of the ICD 9 conversion Project. Expertise in GEM processes and concepts.
• Drug Card Project - Worked in a project involving Miami Systems to create Drug Cards.
• Created Test File to be sent to the Drug Card Vendors for approval. Worked on a Paid without prejudice project for various States.
• User Acceptance Testing (UAT) - Performed UAT tests using the MORAE Usability Testing Tool using the Observer and the Manager Mode.
• Testing - Developed Test Scripts using Test Director/Quality Center and coordinated with developers to quickly resolve the defects associated with them.
• Conducted JAD sessions with the management, users and other stakeholders for open and pending issues to develop specifications.
• Analyzed and evaluated User Interface Designs, Technical Design Documents and Quality Assurance Test Conditions the performance of the application from various dimensions.
• 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

Environment: MS Mumps Cache, IDX, MS Visio, Word, Excel, PowerPoint, CMMI, Rational Rose, Requisite Pro, Clear Case, Clear Quest, SQL, Oracle, J2EE technology, Java, Perl.

Confidential, Bloomfield, CT

Business Analyst

Roles and Responsibilities:

• Performed stakeholder analysis to identify key players for project success
• Identified and involved all key stakeholders, contributors, business, operations and technical resources that must participate in a project and ensured that contributors are motivated to complete assigned tasks within the parameters of the project plan
• Played an active and lead role in gathering, analyzing, and writing business requirements.
• Followed the RUP and UML methodology throughout the SDLC.
• Collected and documented business processes as well as business rules. Provided key input in working with users in defining project and system requirements.
• Utilized corporation developed Agile SDLC methodology. Used Scrum Work Pro and Microsoft Office software to perform required job functions
• Translated the business needs into functional requirements and communicated with the business users on a non-technical level
• Analyzed and worked with HIPAA specific EDI transactions for claims, member enrollment, billing transactions. Worked specifically with 837, 835, 834, 270/271, 276/277
• Worked on Transaction Set (835) which is used to make a payment, send an Explanation of Benefits (EOB).
• Worked on EDI Health Care Claim Transaction set (837)
• Established, documented, and maintained EDI procedures. Tasks include identifying errors and taking corrective action, reconciling EDI transactions through coordinating information with internal and external customers, and working closely with internal departments and external vendors to maintain EDI integrity
• Worked on modules related to Claims, Providers, & Contracts and worked with Claims attributes, Provider attributes, enabling EOB & Remit rules associated with Provider configuration process
• Documented the System Specifications Document.
• Created and maintained the Requirements Traceability Matrix (RTM).
• Created use cases and Use case diagrams.
• Interacted with other teams through walkthroughs, teleconferences, meetings, etc. to resolve various issues.
• Conducted JAD sessions when needed.
• Ensured Use-Cases were consistent and covered all aspects of the Requirements document.
• Designed and developed scenarios based on business requirements.
• Prepared UML activity, collaboration and sequence diagrams for detailed analysis of business objects
• Created and managed project templates and used case project templates.
• Used Quality Center for manual testing.
• Gathered Business Requirements from the Subject Matter Experts (SMEs) and documented the requirements in the BRD. Utilized data flow diagrams, use case diagrams and process flow diagrams to represent information provided by the Business Owners.
• Developed User Requirements for proposed HIPAA 4010 EDI transactions 837 (Claims Submission)
• Conducted UAT (user acceptance testing).

Environment: Facets, Windows, MS office, Oracle, MS-Visio, Microsoft Project, Clarity, Mercury Quality Center

Confidential, Northbrook, IL

Business Analyst

Roles and Responsibilities:

• Implemented an integrated RUP solution with complete line of traceability for all the artifacts of web development projects.
• Involved in requirement gathering including interviews, brainstorms and meetings with stakeholders and created requirement specification artifact.
• Involved in the creation and maintenance of the workflow plans and artifacts.
• Involved in the preparation of functional specification and supplementary requirement document for the annuity cost calculator.
• Involved in creation of Prototypes; evaluation of development and technology options and feasibility analysis for the insurance policies, claims, and customer profile.
• Prepared Business Process Models that includes modeling of all the activities of the business from the conceptual to procedural level. Followed top down leveled technique for building Business Process Models.
• Created Use Case Models using Rational Rose to depict Actors and Use-Cases in various Business Processes and identification of Basic/Alternative flows and definition of preconditions of the system.
• Worked with UI team to create the User Interface screenshots to be presented to the end-users and stakeholders.
• Conducted interactive JAD session along with the stakeholders and developing teams for better understanding of their requirements, constraints, and evolution of new ideas for suitable remedies for the problems.
• Performed Gap analysis for the modules in production, conducted feasibility study and performed impact analysis for proposed enhancements.
• Verified the functional aspects as per the Business Process and validated the interfaces with the other systems and data conversion from the legacy system.
• Used Rational Clear Case, and Configuration Management tool, to maintain different builds of the application with descriptions about all changes and versions.

Environment: Windows 98 / NT, SQL, MS Visio, MS Project, HTML, MS-FrontPage, Clear Quest, WinRunner, and Clear Case.

Confidential, Columbus, OH

Junior Business Analyst

Roles and Responsibilities:

• Facilitated JAD sessions to collect requirements from system users and prepared business requirement document (BRD) that provided appropriate scope of work for technical team to develop prototype and overall system.
• Identified processes for developing and documenting detailed business requirements. Data was collected from end-users, and analysts.
• Created Use-Cases and Requirements documents to document business needs and involved in Writing use case based on HIPAA standards.
• Created and maintained the Requirements Traceability Matrix (RTM).
• Ensured Use-Cases were consistent and covered all aspects of the Requirements document.
• Refined the requirements (use-cases) and Business Process Modesto detailed level appropriate for technical analysis and system design.
• Extensive Analysis of HIPPA rules to incorporate in the Development of Utility applications which are not HIPAA compliant.
• Was responsible for tracking issues that are detected and updating the status of existing issues based on the daily meetings with the off-shore team.
• Identified and analyzed the data requirements for the various site teams and made sure that the required data is available in the testing environment.
• Worked Facets Data Models and their relationship between all functional areas.
• Designed and developed new Interfaces based on business requirements and system’s needs.
• Developed requirements integrating E-R diagrams and designed the testing process flows.
• Followed agile methodology for the entire SDLC.
• Was involved in Functional System Testing, Integration Testing, Regression Testing, and User Acceptance Test using the test cases given by the client before releasing the application.
• Interacted with other teams through walkthroughs, teleconferences, meetings, etc. to resolve various issues.
• Involved in project status meetings, QA review meeting, and System Test meeting.
• Wrote test cases and test scripts for the User Acceptance testing.

Environment: RUP, UML, MS office suite, DB2,Rational ClearQuest, Rational Clear Case, Rational Requisite Pro, HTML, MS Visio, Windows XP/2000,MS Project, DOORS