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Business Analyst Resume

Madison, WI


  • Over 7+ years of industry experience as Business Analyst, including a strong understanding of Business Process Flows, Case Tools, and Business Analysis.
  • Masters of Science in computer science from one of the top universities of technology. With extensive experience in the development, implementation and integration of processes within a team oriented environment, utilizing quantitative and qualitative analytical skills.
  • Strong Knowledge of SDLC methodology, project life cycle, and project management.
  • Excellent communication and presentation skills. Experience working with business users as well as senior management.
  • Extensive experience to analyze and document business requirements and functional specifications.
  • Experience in writing queries/scripts for Data Analysis and Manipulation in MS Access and MySQL using SQL scripts.
  • Experienced of Agile methodology, UML, RUP, Rational Rose, Visio Pro etc.
  • Proficient in creating Use Cases, Sequence Diagrams, Collaboration Diagrams, Task Diagrams, Flow Charts, Activity Diagrams, Class Diagrams, Business Intelligence Tools etc.
  • Good noledge of Business Process Flows/ Modeling, Case Tools, Business Re - Engineering, Business Intelligence and Data Warehousing.
  • Experience in conducting GAP Analysis, User Acceptance Testing (UAT), SWOT Analysis, Cost Benefit Analysis and ROI Analysis, NPV, conducting feasibility studies, scope.
  • Creative abilities and capable of forming and maintaining positive and productive team environments.
  • Excellent Analytical Skills in Data Mining, Performance Management and Project Management to support strategic planning, goal setting, strengtan accountability, enhance decision making, and improve customer service.
  • Experienced working on data mapping from web services, data exchange and database to user interface.
  • Strong noledge of HL7 Standards, HIX, EHR - Electronic Health Records, EMR - by CouponDropDown">Electronic Medical Records, CMS regulations, Health Care Reform and HMO.
  • Strong Knowledge of Operations Management, Lean Management, Six Sigma and Capability Maturity Models (CMM).
  • Experience with Implementation of ICD 10 codes system transferring from ICD 9 codes system.
  • Experience in conducting Joint Application Development (JAD) sessions for requirement gatherings, analysis, design, SCRUM, and Rapid Application Development (RAD) sessions to converge early toward a design and blue print acceptance to the customer, and to limit a project’s exposure to the forces of change.
  • Good Knowledge of rational Database.
  • Effective time management skills and the consistent ability to meet client deadlines.
  • Experienced in writing complex and technical reports for a varied high caliber audience.


Operating Systems: UNIX, DOS, Win 95/98/NT/2000/XP/7Databases MS SQL Server, MS Access, Lexis Nexis, Bloomberg

Methodology: SCRUM, UML, JAD, RAD, RUP, Waterfall, Agile

Skills: Data Analysis; SPSS, Financial Modeling

Project Mgmt, Design & Case tools: MS Project, Visio Pro, Rational Rose

Quality Management: Six Sigma, CMM, TQM, Lean Management and Operations Management

General: MS Word, Excel, PowerPoint, Outlook, One Note, Access, MS Project


Confidential, Madison, WI

Business Analyst


  • Gatheird requirements Primary source: Interoperability - Oregon Health Authority ( Oregon immunization Program/Alert IIS)
  • Worked for the state of Oregon project.
  • Heavily involved in all the discussions with stakeholders (Oregon Health Authority) and finalizing requirements.
  • Provided weekly status updates to project stakeholders on the progress of project development.
  • Worked on HL7 Standards, HIX, EHR - Electronic Health Records, EMR - by CouponDropDown">Electronic Medical Records, CMS regulations, Health Care Reform, EMTALA, PPO, POS and HMO.
  • Involved in testing and reporting issues, as well as defining resolutions.
  • Conducted JAD sessions for gathering requirements for the project.
  • Analyzed the business requirement using various business requirement gathering techniques.
  • Experience of working in Agile Methodology environment.
  • Designed the estimate for the initial stage of enhancements. Also, presented the estimate with the enhancements to HPE red- team to get it approved.
  • Prepared Project requirements, User Specification documents, and UML diagrams to present detailed design of the system.
  • Designed various mock ups using Ms Visio.
  • Worked on Data exchange enhancements such as adding the filters to Job monitor and Check status
  • Created High - level requirement document and various functional designed document.
  • Performed data analysis while working on data exchange project.
  • Worked on report generation for Internal and external partners.
  • Involved in translating business requirements into detailed system specification.
  • Created a Report available through the reports menu to external users which includes adding filters by timeframe, user- defined parameters, drill down capacity that provides output for sending org level, owing org level, patient level.
  • Worked on summary details on HL7 issues.
  • Worked on HL7 2.5.1, 2.4.1 with an implementation of CDC guidelines.
  • Finalized the inputs of core data elements in the report for report generation.
  • Worked on Model automated reporting that captures data quality metrics on required fields and strongly recommended fields (i.e., CDC core data elements), at the provider org level.
  • Worked on Vaccine tracking requirement for a client where they wanted to update the tables for Trade Name of Vaccine group in the Oregon Health Authority Immunization Registry.
  • Contributed noledge and support to QA and UAT teams throughout the process of testing the applications workflow and functionality.
  • Executed SQL queries to test data entry into the database and worked with the QA team to execute test cases.
  • Involved in Regression testing, UAT testing on address retention.
  • Worked on design of a new U.I for patients to be inactivated.
  • Performed project estimation with team members and other financial authorities involved.
  • Involved in mapping data from web services using soap U.I.
  • Created Reports, worked on report generation, suggested the inputs for internal and external reports.

Environment: Soap U.I, MS Office, MS Spreadsheet, MS Office (Word, Excel, PowerPoint, Outlook, Visio, Share Point, Project, One Note), SQL, Windows 7, SCRUM, JAD, RUP, Agile, Remote access, Lync 2015, Skype for business.

Sr. Business Analyst

Confidential, Linthicum Heights, MD


  • Participating in reverse engineering method, comprising of documenting a FSD (Functional Specification Document), which outlines the Workflows, Use Case diagrams, Reports and Technical Requirements explaining the HIX application and portal for following needs from Business Units: functionality and its benefits; features and attributes; integration; Business Rules; processing new application, health plans and claims; frontend and backend interfaces.
  • Gathering data and performing analysis on frontend and backend interfaces of HIX Web application/portal.
  • Retiring MD21 legacy application and replacing it HIX Web Portal.
  • Engaging in analysis and testing of ‘as-Is’ State of Payments data exchanged between MD 21 MMARS (Middleware) and MD 21, in comparison to ‘To-Be’ State of similar Payments processing flow in MD HIX.
  • Organizing and evaluating data in regards to migration of data comprising of claims, payments and remittance from MD 21 to HIX.
  • Analyzing and designing Integration workflow displaying HIX interaction with other systems consisting of MMIS (Medicaid Management Information System), Medicare Claims Processing Systems and other Healthcare Systems at State, Federal level as well as Third Party Companies.
  • Proposed strategies to implement HIPAA in the new MMIS system and worked on planning and documentation.
  • Involved in EDI HIPAA Project to convert EDI X12 Healthcare 4010 transactions into 5010 Complaint transactions
  • Interacting with EDI and ICD operations team and technologists in monitoring the conversion of these protocols and standards for HIPAA .
  • Conducted Analysis and Design of existing transaction sets, and modification of these transaction sets to ensure HIPAA compliance.
  • Performed data analysis, created data mapping and data interface documents and kept the documents updated with changes in requirements and functional specifications.
  • Worked on developing the business requirements and use cases for automating the billing entity and commission process.
  • Coordinated the upgrade of Transaction Sets 837 HIPAA compliance.
  • Documented gap analysis for HIPAA P Transactions and HIPAA P Transactions.
  • Involved in impact analysis of HIPAA and 837P Transaction sets on different systems
  • Created mapping table for the Transactions accepted by the Sybase translator move into an Interface Database for 837 Transactions.
  • Wrote SQL queries related to NPI and Data migration from ICD 9 to ICD 10.
  • Worked on streamlining SharePoint to meet project policies and processes.
  • Collaborated with Business Units regarding different Work streams including: Infrastructure of Contact Center, Call Center and IVR; Enrollment and Eligibility; Contractual Policies; CRM; and Health Plan Policies.
  • Writing Test Cases/Test Scripts for System, System Integration and UAT concerning HIX and its communication with other Systems.
  • Experienced in Rally onboarding releases.
  • Worked with QA and checked in the requirements in HP ALM

Environment: MS Office; MS Visio; ICD-10 and ICD-9; GUI; Quality Center; Agile Scrum; XML; UAT; and SQL Server, HIX, MMIS, MMARS, ACA.

Confidential, San Francisco, CA

Business Analyst


  • Gathering, elicitating and analyzing requirements using Use case design documents, flow charts and class diagrams.
  • Responsible for defining the scope of the Renewal project and implementing business rules for the project involving both Medicaid and Medicare..
  • Played a vital role in translating BRD into functional specifications and test plans
  • With the Agile/Waterfall hybrid environment, organized and coordinated project management activities to some extent.
  • Worked extensively on both the Case worker and Citizen Portals for creating cases in the New Eligibility System (NES)
  • Reported Application tool defect during making of Test cases in ATST and STST regions.
  • Helped write JIRAs(defects) and PMOs(change requests) with the Eligibility/Enrollment Team so that the defects could be fixed and theirby enhance the use the IBM application tool.
  • Responsible for escalating implementation and helped in assigning issues to appropriate persons or groups for faster resolution
  • Reviewed, analyzed, and evaluated the business data systems that provide data to various data sources like SSA, IRS, Equifax and Fed Hub
  • Created several test cases in Case worker and Citizen portals using various scenarios related to health programs like MA/BHP/PTC/QHP and Medicare part A through D.
  • Worked with QA and development teams to write requirements and during development for various system functionalities.
  • Experience in MS SQL server MS Access, SQL
  • Report cases that have not gone through with the team so that the issue could be esculated and JIRAs could be written.

Business System Analyst

Confidential, Trenton, NJ


  • Responsible for the development and implementation of HIPAA EDI 834, 270.
  • Wide understanding on Healthcare products, HIPAA standards, EDI formats, plans, benefits and coverage.
  • Created a Functional specification Document for Eligibility Benefit Enquiry (EDI 270/271) service flow.
  • Involved in Agile grooming session, scrum meetings, tracked User stories and tasks using Rally software.
  • Worked on EOB report generation and Provider Remittance Advice generation using Crystal Reports.
  • Involved in the scope defining process of ICD 9-10 conversion.
  • Worked with in the areas of Clinical, Corporate and Finance, Pharmacy, Sales, Provider Network and identified the use of ICD 9 codes and prepared documents for the conversion of ICD 9-10 and vice versa.
  • Gatheird requirements and developed Use Cases by interacting with different Functional Groups for ICD 9-10 Conversion.
  • Performed impact analysis for deadliness of ICD-10 conversion.
  • Assist coders to be competent in using ICD-10-CMS/PCS
  • Created UI specification document for the business users to feed data into healthcare web application.
  • Conducted analysis of HIPAA compliance and took part in discussions for designing the healthcare transactions to be HIPAA 5010 compliant
  • Analyzed the impact of new HIPAA standards on targeted systems, processes, and business-associate relationships
  • Defined Functional Test Cases, documented, Executed test script in Facets system.
  • Performed Data Analysis by analyzing inbound data and data in backend system.
  • Implemented ETL process for Eligibility, Claims and benefits loads using SSIS package through TWS jobs.
  • Designed a new database for the system and mapped data elements to tables in backend database.
  • Responsible for implementing BizTalk orchestrations, services and publishing messages to extract EDI 834 file, transforming, implement business logic and loading it into Database.
  • Conducted JAD sessions, attended meetings and involved in weekly deliverables for IT approval.
  • Involved in creating test plans, test data for EDI 270/271 service transactions.
  • Extensive experience in Oracle 10g/9i, MS SQL server, MS Access, SQL.

Environment: MS Office (Word, Excel, PowerPoint, Outlook, Visio, Share Point, Project, One Note), SCRUM, SQL, Six Sigma, SWOT, Gap Analysis, Lean Management, UML JAD, RUP, Agile, SDLC.

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