SUMMARY:

• Sr. Business System Analyst/Data Analyst with a Healthcare, Finance and Retail consulting background with 9+ experience in creating, managing, and maintaining accountability for all aspects and artifacts of project management for the design, development and execution of small and large - scale IT systems and projects.
• Gathering/validate requirements, Functional Documentation, Business Processes, Procedures, Technical Documentation, Testing Methodologies, Test Case & Change Control Process Documents.
• Proficient in interacting with key stakeholder, SME’s, development team, and end users gathering business requirements through interviews, JAD sessions, brainstorming sessions, questionnaires, surveys, and meetings, involved in facilitating communication flow between all parties involved throughout the project Life Cycle.
• Expertise in Project Planning, Project Design, creating functional specifications and data flow diagrams.
• Experienced in business process flows, business process modeling, case tools, business analysis, gap analysis and organizational change management.
• Experienced in conducting sessions and worked with executives, developers, and end-users to define the exact requirements.
• Solid understanding of, Claims Processing, Billing, Benefit/ Eligibility, Authorization/ Referrals, COB, and have experience in HIPAA standards and corresponding EDI transactions (837, 834 and 835).
• Knowledge of health care services regulatory environment in compliance with HIPAA, ICD, MITA, MMIS.
• Knowledge on Affordable Care Act (ACA), Medicare, Medicaid, HIPAA EDI transactions 270,271,276,277, 834, 835, 837, ICD-9, ICD-10, HMO, PPO, ANSI X12 Procedural and Diagnosis codes.
• Adequate knowledge in Health Administration - Claims processing (adjudication), COB, EOB,EOP,HIPAA, enrolment, EDI, Medicare, Medicaid.
• Ability to develop business rules, context data flow diagram, entity relationship diagram, workflow diagramming, prototyping and document current state, gaps and future state processes.
• Experience in multi-tasking such as managing numerous simultaneous projects with great attention to detail.
• Experience in solution assessment, validation and applying critical thinking for problem solving approach.
• Experience in Requirements elicitation techniques like conducting user interviews, document analysis, JAD sessions and managing the requirements.
• Comprehensive knowledge of Software Development methodologies (SDLC) such as Waterfall, Agile, Spiral and Scrum.
• Create various documents like the Software Requirement Specifications (SRS), Business requirements document (BRD), Use Case Specifications, Functional Specifications (FSD), Systems Design Specification (SDS).
• Efficient in writing Business Requirement Document (BRD), Functional Specification Document (FSD), Use Cases, User Interface Specifications (UIS), System Requirement Specification (SRS) and Report Specifications Documents.
• Sound proficiency in analyzing and creating, Use Case Diagrams, Sequence Diagram, Activity Diagram, Data Flow Diagrams, Business Flow Diagrams, Wire Frames and Mock-ups using MS Visio and Rational Rose to communicate business and functional requirements to clients and developers.
• Performed AS-IS and TO-BE business process flow for clear translation of Functional to system requirement specification.
• Extensively worked on JQuery, Angular JS, JSON, HTML5, CSS3 and Ajax frameworks.
• Strong Understanding of J2EE technologies, including Servlets, JSP, J2SE, JDBC, RMI, JNDI, EJB, MDB, JMS, and MQ.
• Experience on Struts Spring frameworks.
• Experience in writing simple and complex SQL queries
• Experience in various RDBMS including DB2, Oracle, SQL Server, and MySQL.
• Experience in developing enterprise applications using IDE tools like RAD, IntelliJ Idea, NetBeans, and Eclipse.
• Design, Development of web-based Applications Using different App servers like WebSphere, WebLogic and web server like Apache Tomcat.
• Experience on various version control tools such as GIT.
• Very good experience on continuous integrations (CI) & deployments (CD) using Jenkins.
• Very good experience on Build tools such as ANT, Maven.
• Support the Test Team and the rest of the Development Team in compliance related issues while working with them in the development phases of the projects.
• Business Analyst with solid understanding of Business Requirements Gathering, Business Process Flow and Business Process Modeling and Data Mapping.
• Expertise in developing Process mapping documents to describe the data flow between various systems in the organization.
• Expertise in Waterfall and iterative methodologies such as Rational Unified Process (RUP) methodology, and Agile.
• Expertise in Creating Unified Modeling Language (UML) diagrams such as Use Case diagrams, Activity diagrams, Class diagrams and Sequence diagrams using Rational Rose according to UML methodology.
• Understanding of database objects such as tables,views, stored procedures, Triggers etc
• Created the POC and prototype Tableau reports and dashboards with the keymetrics.
• Worked on Enrolment, Claims, Medicaid, Medicare, Benefits Affected by the ICD conversion and HIPAA complaint security issues
• Experience in testing API/Web Services Testing across REST and SOAP.

TECHNICAL SKILLS:

BPMN Tools: Enterprise Architect

Diagramming tool: MS Visio,Gliffy,Draw.io

Testing Automation tools: UFT, Selenium Web Driver, Load Runner, Performance Center

Test Management Tools: ALM, Jira, TFS

Build tools: Maven, Jenkins

Version Control tools: Git, SVN.

Programming Languages: C, C#, .Net,JavaOperating Systems Windows, Linux

CM & CI Tool: Ansible, Chef, Puppet, Jenkins and Hudson

Version Control Tool: Git, GitHub, GitLab, Bitbucket, ClearCase, Gerrit, Valgrind

Build Tool: Ant, Maven

Application Servers: Nginx, Tomcat Apache, WebLogic, IIS and WebSphere

Databases: Oracle DB, SQL Server, MySQL, Mongo DB,HBase

Scripting Languages: Python, Perl, Shell Scripting

Data Modeling Tool: Erwin

BI Tools: Power Center,IDQ,ABInito,Tableau,Cognos,Talend

Agile: SAFe practitioner

PROFESSIONAL EXPERIENCE:

Confidential, Indianapolis, IN

Sr. System Analyst

Responsibilities:

• Understanding the Legacy application and trying to extract as-is business process for the claims adjudication.
• Developed the project management plan documenting the actions necessary to define, prepare, integrate and coordinate all subsidiary plans.
• Used gap analysis framework to identify AS-IS processes of claims transactions and TO-BE processes.
• Performed Gap Analysis to identify the deficiencies of the current system and to identify the requirements for the change in the proposed system
• Interacted with business stakeholders during the initiation, design, execution and release phases of the business projects, understanding product roadmap, monitoring customer expectations, project performance, and key deliverables.
• Defined the detailed project schedule based on the WBS formulating a Gantt chart using MS Project, defining key project milestones, dependencies, and resource utilizations.
• Track project/program progress, identifying and escalating issues and identifying resources to provide solutions to ensure that program tasks are completed according to established timelines.
• Conducted walkthroughs at various stages of development with stakeholders.
• Managed and coordinated communications across all stakeholders, acting as the primary POC, mediating JAD sessions, brain storming sessions, scope negotiations, Release planning meeting, stakeholder meeting, project status review, and customer feedback meetings.
• Identified project stakeholders, analyzed their interest, influence and impact on the project, and accordingly developed a communication strategy.
• Facilitated Sprint Planning, Release Planning, Daily Stand-Ups, Stakeholder Demos and Sprint Retrospectives.
• Developed project schedule by analyzing the project activity sequences, durations, requirements and constrains.
• Managed and forecasted budgets for project resources.
• Scrum Master for Information Technology services web application development team, leading Daily Stand-ups, Sprint Planning, Sprint Reviews and Sprint Retrospectives utilizing Version One.
• Facilitated Iteration Planning meetings and coordination of release management activities for deployments.
• Closely tracked iteration progress reporting velocity and managing capacity.
• Developed and implemented repeatable processes related to production and fostered an environment of continuous improvement.
• Research the data in enterprise data warehouse and create and provide the SQL for accessing the data per the business user request.
• Analyze and research on the data issues reported by the business users and Conduct or participates in meetings with key system owners to understand current data and systems environments to resolve source data issues and refine transformation rules.
• Work with technical and business representatives to determine strategies for handling data anomalies identified during the data analysis.
• Provide assistance in Data Model preparation & Design ETL processes and create source to target data mappings & data dictionary.
• Facilitating Release planning, Agile estimation (story points), SPRINT planning, Daily SCRUM, SPRINT review and Retrospective meeting to track progress, eliminate project impediments and setting strategies.
• Inviting active participation from customer in user acceptance testing for every SPRINT delivery and focusing on pro-active customer collaboration rather than customer negotiation.
• Created various reports (summary reports, matrix reports, pie charts, dashboards) and setup report folders to authenticate users based on their profiles (permissions).
• Representing the PMO group/Steering Committee for project portfolio tracking, Metrics, cost-benefit analysis, Risk Management, issue resolutions etc. Verifying project results with management expectations.
• Responsible for creating and maintaining testing documentation on department policies and procedures towards CMMI (Capability Maturity Model Integration).
• Define Business details for provider handling, subscriber claim processing rules, other payer logic and diagnosis procedure code. expertise in HIPAA regulations, EDI and ICD-9, ICD-10.
• End to end understanding on Claims Adjudication process.
• Developed the business crosswalks for 837 (P, I, D), 835, 834, 270, 271 and 276/277 according to HIPAA implementation rules With EDITS.
• Understanding of the External System communicating in the whole business Process
• Understand the Legacy system and try to extract Business Rules.
• Managing process changes and leads process redesign workshops
• Identified/documented data sources and transformation rules required to populate and maintain data warehouse content.
• Have extensive experience in writing SQL Queries to Retrieve data.
• J2EE Design patterns were used in the design and development of the project.
• Create projects on Jira and assigned Jira Agile boards such as Scrum.
• Validated Java Code and validation of CRUD Operations.
• Customizing dashboards and reports and searches using JQL (JIRA Query Language).
• Create team specific agile process flow in JIRA to move tasks from one activity to another.
• Validated tableau dashboards with combination of chart.

Environment: Scrum,Java,Jira, Pega, Oracle 12C, Mainframes, Cobol, AS/400, VSAM, DB2, SQL Developer, Tableau,sql Loader,SOAP UI, SQL Queries,PowerCenter.MS VISIO,CSS, HTML, JavaScript, JQuery, React.js, AJAX,Oracle Claims Pricing,Oracle Revenue management and Billing.Teradata,MS Visio,Teradata

Confidential - Tampa, FL

Systems Analyst

Responsibilities:

• Played an active and lead role in gathering, analyzing, and writing business requirements.
• Project was implemented in phases, enabling system to deliver as many business requirements as early as possible.
• Involved in Requirement Scoping and analysis of high priority requirements for implementation.
• Worked on Transaction-835 claims payments and remittance advice, which deals the payment from payer to provider.
• Involved in HIPAA EDI transactions such as 270, 271, 837 (P, D, I), 276, 277, 834, 820, 278, 999/TA1, and 277 CA.
• Evaluated Medicare requirements and benefits in Medicare Health Plans for member enrollment and management.
• Coordinated, implemented and provided on-going support of the Quality Performer as outlined in the Specifications Manual for Well Care Inpatient Quality Measures Centers for Medicare & Medicaid Services (CMS).
• Used HP Quality Center for writing Test plans and Test Cases.
• Working knowledge of implementing software development projects using methodologies such as Waterfall, RUP, and Agile Scrum.
• Used HIPAA guidelines and regulations to keep track of Healthcare transactions like Eligibility Request/ Response, Request and Response for Claims Status, Prior Authorization, Claims Vision and Claims Payment.
• Worked closely with business team, and identified, analyzed the core requirements and key features of the ongoing project. Extracted, discussed, and refined business requirements and developed comprehensive business requirement document (BRD).
• Developed Software Requirement Specification (SRS) document using Visio and MS Office.
• Loaded the defects on to HP Quality Center and maintained a track record of the updates on the defects from the development team.
• Executed Test Cases Manually once the application is stable and documented the successful or unsuccessful completion of each test case in HP Quality Center (QC) for End-to-End Scenario based testing.
• Worked on Agile SDLC during the project phase, performed the role of Product Owner and Team member in Scrum Meetings.
• Participated in agile process - planned iterations, created tasks, assigned tasks to quality assurance team based on the priorities and estimated capabilities of quality assurance team for every iteration.
• Involved in Testing Out-Bound Transactions (835 Health care claims Payment, 277 Claim Status Response).
• Consulted with healthcare third-party administrator company to develop conversion specifications for member, enrollment, and authorizations.
• Created workflows to track issues and tasks usingSharePointDesigner
• Enhance JIRA application to customize as required.
• Used JIRA for Creation of Tasks.
• Involved in Scrum development process and prepared Sprint burn down chart, product catalog and sprint backlog contain Business Requirements and supporting documents that contain the essential business elements and definitions as well as the tasks to be completed.
• Analyzed and studied the technical, structural and data content changes for EDI transaction sets 834 (Enrollment and Maintenance), 837 (Professional, Institutional and Dental Claims) and 835 (Claim Payment/ Advice).

Environment: Agile,Jira,MS Office, Quality Center, MS Project, MS Outlook, MS Visio, Linux, XML, Mainframes, MS SQL Server, MS Access, SQL Developer, UML,Oracle 11g, Informatica. CSS, HTML, JavaScript, JQuery, React.js, AJAX &JSON,Hadoop (CDH),Mongo DB,HBase, SharePoint.

Confidential, Baltimore, MD

Sr. Business Analyst

Responsibilities:

• Partner with a variety of business teams to elicit and analyze business requirements through interview, workshops, and work flow analysis.
• Perform As-Is analysis of existing business processes.
• Conduct data mining, data modeling, statistical analysis, business intelligence gathering, trending and benchmarking.
• Conduct GAP analysis of business process flows to identify deficiencies and recommend improvements.
• Collaborate with Quality Assurance team to develop test cases and acceptance criteria.
• Wrote and executed SQL Statements to retrieve data from back-end to verify the result set.
• Create, update and maintain sprint issues and product backlog items in JIRA.
• Collaborate and share information with the teams using Confluence.
• Communicate the progress to senior management using Burndown Charts and status reports.
• Identify and manage risks and issues. Escalate unresolved issues to upper management.
• Educate and reinforce scrum methodology and agile framework to the team and stakeholders.
• Gather, interpret and analyze customer needs into functional and non-functional requirements and determine opportunities to automate processes and functions - translate them into User Stories.
• Performed Data Analysis and Data validation by writing complex SQL queries.
• Create wireframes/mock-ups in PowerPoint.
• Designed the business requirement collection approach based on the project scope and SDLC methodology.
• Developing workflows for system entities, parameter driven processing, data and functional entitlements.
• Responsible for user and developing documentation for raining guides.

Environment: SQL,Java,J2EE,Agile, MS Office, Quality Center, MS Project, MS Outlook, MS Visio, Linux, XML,Oracle DB, SQL Developer, UML,CSS, HTML, JavaScript, JSON.

Confidential, San Francisco, CA

System Analyst

Responsibilities:

• Interact with application developers, application BAs and PMs, other portfolios, Vendors, SOA PMs, Architects, Developers, and QA testers for the full life cycle of a project.Determined user/business/functional requirements
• Ensuring solutions meet business needs and requirements
• Created vision, scope, and use case documents; business process models, use case diagrams, activity diagrams, and state chart diagrams.
• Validate technical designs created by IT developers against functional specifications.
• Worked with QA team to design test plan and test cases for User Acceptance Testing (UAT)
• Managing the developing project as well as performance
• Acting as a liaison between the stakeholders and users
• Coordinated work plans between project manager and client using MS Project.
• Developed use cases, workflow, screen mock-ups, and conversion requirements.
• Allocating resources and maintain budget resulting cost efficiency
• Maintained UML models and promoted the creation of repeatable models
• Created business processes for existing manual workflows within the organization and enhanced the processes into textual use cases.
• Prioritized outstanding defects and system problems, ensuring accuracy and deadlines were met.
• Ensured all artifacts complied with corporate SDLC Policies and guidelines.
• Applied change requests, versions, and addendums.
• Prepared business process models; used Visio to create use case diagrams.
• Created documentation for and Help Desk teams.
• Worked with QA team to design test plan and test cases for User Acceptance Testing (UAT).
• Essentially a specialist in Service-Oriented Analysis that coordinates and leads architects and Business Analysts throughout all process steps.
• Used SQL queries to extract data from different databases including testing and production for data validation and data analysis. Participated in testing software by conducting User Acceptance Testing (UAT).

Environment: C,C++,.Net,Sqlserver,Windows,SSIS,SSRS, MS VISIO.MS Office

Confidential

Quality Analyst

Responsibilities:

• Maintained test schedules, test plan, test strategy, test assignment documentsfor various testing activities.
• Created and modified test plans and Test outlines.
• Collaborated with product management and engineering teams, in an agile environment, to develop a comprehensive set of tests for web-based applications.
• CreatedManualand Automated test cases according to the business standards in Quality Center and Excel.
• Performed extensive functional, integration, security, UItestingand RegressionTesting.
• Executed test cases manually and maintained, re-tested failed test cases after bug fixes.
• Collaborate with Devs/engineers to validate bugs and get them fixed.
• Assisted QA and Release Leads in preparing implementation timelines.
• Ran test suites, Identify software defects, verify fixes, and updated bugs in HP QC/ALM.
• Worked with business analysts to ensure business requirements are adequate.
• Updated requirement traceability, test cases, test sets and defects according to QA standards.
• Participated on continuous improvement efforts within the QA organization.
• Supported and provided constructive feedback on existing processes and standards.
• Evaluated and recommended process or technical changes to partner organizations.
• Provided guidance around automation strategies, working with the QA Architect and App/Dev
• Ran automation scripts for smoketestingand sanitytestingon builds.
• Used VuGen in LoadRunner and created Vuser Scripts for LoadTesting.
• Carried out Servertesting/LoadTesting, Volume and StressTestingusing Load Runner.
• Used Controller to Perform and monitor Load Test and Stress Test.
• Used LoadRunner Analysis, generated various graphs and reports for higher management.
• Documented bug reports, test execution status reports and test summary reports.
• Participated in all aspects of SDLC planning and of release deliverables.