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Technical Analyst (ba) Resume

SUMMARY

  • More than 8 years of cross - functional progressive experience in the capacities of Business SystemsAnalyst, Project Coordinator,TechnicalWriter, Implementation Coordinator/Single Point of Contact (SPOC) for deliverables, and SystemsAnalyst.
  • Expertise in business analysis and planning, documentation, requirement elicitation, requirement management, identification of enterprise business need, business analysis tools and techniques, understanding requirement solution assessment and software development life cycle, including analysis, design, development, testing and implementation of software applications.
  • Expert at interacting with stakeholders, Subject Matter Experts (SMEs) and end-users to understand, analyze, communicate and validate requirements using Joint Application Design (JAD), Joint Application Review (JAR) sessions.
  • Strong experience in developing test plans; build test conditions and test cases, creating test data, analyzing bugs, interacting with development team members to fix defects.
  • Standardized the SDLC process by collaborating with IT partners. Established new requirements for user acceptance testing guidelines, which reduced issues during and after launch.
  • Experience in GAP ANALYSIS between the "AS-IS" model of the legacy system and "TO-BE" model to identify the project gaps.
  • Hands on experience on Real-time Claims Processing on WGS (Wellpoint Group System) and NPS (NASCO Processing System)
  • Log test claims using Real-time WGS and STAR Systems
  • Configuring Edifice’s products to process transactions as well as assisting during implementation
  • Hands on experience in analysis of business processes, and as well as a good technical understanding of Edifices’ solutions and transactions
  • Understanding of EDI transactions including X12 and UN/EDIFACT; HIPAA
  • Gathered and analyzed requirements, development of detailed functional designs and test cases in support of proposed projects and system enhancement requests.
  • Connoisseur in documentingBusinessRequirements Document (BRDs), Functional Requirements Document (FRDs), Non-Functional Requirements Documents, Use Cases, Test Cases and User Interface Prototypes
  • A smart working, motivated, sincere, committed, quick learner, detail-oriented team player with excellent communication, analytical, leadership, interpersonal and problem solving skills.
  • Worked in various Healthcare areas like Enrollment, Benefits, Claims, experience in Healthcare concepts such as HIPAA privacy, ICD-9/ICD10 conversion, patient protection and affordability care act PPACA. Experience as Business/SystemsAnalystwith expertise in Insurance, Healthcare processes, health insurance exchange HIX, meeting federal compliance and regulation, understanding client requirements and providing scalable infrastructure.

PROFESSIONAL EXPERIENCE

Technical Analyst (BA)

Confidential

Responsibilities:

  • Primary responsibility include review, gap analysis, statement of work, and costing for IT work to client requests for proposal (RFP). Evaluate/research business problems and their relationship to technology.
  • Execute change management tasks in systems projects including, but not limited to, communication to key user communities, providing subject matter expertise, providing training and documentation where appropriate.
  • Facets Benefits Configuration/Service ID builds with Facets benefits configuration, Service ID configuration, Product, Class/Plan configuration, and variable components builds
  • Analysis of employee benefit programs, including Health, Life, Dental, Accident and Disability, Medical/Dependent care spending accounts, COBRA, Leave of absence/FMLA, health savings account (HSA), federal savings accounts (FSA) and different retirement plans.
  • Assists with the Implementation of new benefit programs advise management for the changes, arrange and conduct enrollments related presentation.
  • Developed and implemented multi-tiered underwriting guidelines to increase market penetration and maintain profitability.
  • Assisted in obtaining documentation needed to complete Facets configuration with plan design charts, and final CIT designs.
  • Designed and documented, code & test Facets Medical Plan, Product, Provider, Pricing, Subscriber/member, Claims, Utilization Management, Finance, Billing, Accounting, Customer service, workflow, security, etc. application configurations to support new and existing business requirements for migration projects, new implementation and current production
  • Gather and document business requirements to developtechnicaland functional design specifications for new programs or modifications to existing programs per client requirements.
  • Analyzetechnicalrequirements, test plan, training materials and procedure documents.
  • Execute test plans and test case scenarios to ensure requirements are being met.
  • Perform data manipulation, mapping, conversions, and validations utilizing internal systems, external files, Access, and Excel.
  • Configuration Performed in Facets 5.01 environment
  • Create and execute SQL and/or Access queries to determine proper data logic and file structures.
  • Develop and generate carrier files, enrollment counts, payroll files, census files, and billing reports while verifying reports meet quality standards.
  • Assist with Project Management tasks such as scope definition, project plans, issue management, and status updates.
  • Support client implementations, renewals, and other project initiatives as needed.

Environment: JIRA, MS Office (MS Word, MS Excel, MS Power point, MS Visio), Microsoft Sharepoint, SQL, Toad

Sr. Business Systems Analyst

Confidential

Responsibilities:

  • Uses a variety of information gathering techniques (e.g., interviews, brainstorming, focus groups, facilitated sessions) to determine business, system requirements and technology needs.
  • Leads requirements gathering sessions, requirement analysis, planning, tracking and delivery.
  • Responsible for the delivery of Business Requirements Document (BRD) within project timelines.
  • Analyzed user problems, including automated and manual business processes and identified, researched, investigated, defined and documented business processes.
  • Designed and developed User stories, Use Cases and created process flow diagrams using MS Visio.
  • Create and maintain queries using SQL in Oracle and Teradata for enrollmentand Plan product lines
  • Expert knowledge of SharePoint site design, templates, web parts, workflows, navigation features and access groups, roles and permissions.
  • Monitors SharePoint and Teamcenter Community Group Mailbox and User Support Phone.
  • Supports internal IT Brokerage customers maintaining their SharePoint sites and other business applications, such as, Microsoft Access and Excel using VBA code to help automate their processes.
  • Documenting new or updated procedures, job aids and or training materials
  • Experienced using SharePoint Designer to create custom Web Parts and Workflows.
  • Customer Support for new users of SharePoint and Teamcenter Community.
  • Modeled the detailed design of the process using UML, Use Case Diagrams, Activity diagrams and State Chart diagrams.
  • Perform Testing (positive, negative and/or regression tests)
  • Created user interface design or coordinates activities with design team. Writes use case documents and requirements.
  • Identified, researched, investigated, analyzed, defined and documented business processes and Use Case Scenarios.
  • Support bug fix remediation through the project defined warranty period
  • Provide operational support for daily automated enrollmenterror reporting system.
  • Created and updated project status in MS Project and shared it with Stakeholders, business process owners, subject matter experts.
  • Maps work flows of internal client. Ensures project addresses business needs and IT issues, such as security requirements and regulations.
  • Elicits identification of business assumptions and risks. Communicatestechnicalissues at appropriate level for audience.
  • Translates business needs into system and software requirements and writes requirements documents.
  • Manage the use of a proprietary MS access database design for productionenrollmentsupport.
  • Participates in Change Control Board activities to ensure system specifications are met, and to identify the risks and interface issues that may result from approval or rejection of changes. Coordinates submission of change management requests and verifies record assignment, tracking, and closure.
  • Created Reporting, Query, pulling data and performed reconciliation reviews on EnrollmentFiles
  • Collaborate with various project team members (Data Conversion Architects, Software Engineers and business users) to create, modify and validate data conversion rules.
  • Assist in the testing of new web-based tool to generate Enrollmentmaterials.
  • Track the rules by maintaining a data mapping document in Excel, which contains data elements from legacy system to new system.
  • Analyze existing system, new system and data to understand the relationships between multiple databases and processes by utilizing Entity Relationship Diagram Models (ERD), Business Design Documents (BRDs), Functional Design Documents and system process flows.
  • Created SQL queries, MS Access and MS Excel to drill down and analyze large data sets, mining business data to identify trends, patterns and insight among the various data elements.
  • Assist developers in creation of online Enrollmentweb site and consolidated billing system.

Environment: Agile, Visio, MS Project,BusinessIntelligence Tools - Tableau, MS Office, TOAD, IBM DataStage, JIRA, SQL server.

Business Analyst Consultant

Confidential

Responsibilities:

  • Strong business analysis and requirements gathering experience including; leading JAD sessions and SME interviews, use case andtechnicalspecification development, wireframe, storyboarding and test script creation.
  • Processing all employee exits each month while meeting the monthly payroll timelines Compensation and HRIS:
  • Managed HRIS of employees - personal and work lifecycle changes
  • Assisted with surveys, payroll and other compensation related activities in line with corporate philosophy
  • Lead all aspects of benefits programs, strategize, develop, organize and implement employee benefits in support of organizational strategy.
  • Analyze compensation of faculty & staff to implement Mass. equity pay law.
  • Implemented HIPAA/ EDI X 12 4010/5010 healthcare-related file formats including 834/835, 837, 270/271, 276/ 277, 278, 999 for acknowledgements.
  • Knowledge of claims, enrollment, eligibility and business processes in a commercial, Medicare/Medicaid health plan. Fluent with commonly used EDI concepts, practices and procedures within the heath-care industry.
  • Formulates and defines scope and objective based on user needs and thorough understanding of business processes.
  • Performs JAD sessions and requirement elicitation, gathers and documents system requirements from users for software selection and development projects.
  • Work with stakeholders on process improvement projects designed to improve results, and will lead business process re-engineering efforts.
  • Gather and analyze key data and provides recommendations to address and resolve root causes.
  • Develop business process scripts, use cases, etc. used for configuring software to meet the Responsible for gap analysis, planning, coordination, requirements direction, and scheduling of new software feature development to support migration of numerous classic software application systems to most current product service applications.
  • Identifies process, technology and organizational role changes necessary to support business goals and objectives.
  • Perform data analysis on the claims data, enrollment data by utilizing T-SQL on the SQL Server 2003.
  • Write SQL queries for the reporting, data analysis, code set analysis, identify gaps in the data, financial reconciliation and the data consistency.
  • Maintain and ensure adherence to existing access control policies and procedures
  • Worked on various methodologies including Waterfall, Agile, and Scrum methodologies. Good understanding of business strategy and development techniques.

Environment: Oracle 6/ 7.x/ 8i/ 9i, SQL server, Oracle- TOAD, MS VISIO, Rational rose, UML, MS Word, MS Power point, MS Project, MS Visual studio, EDI, Share point 2007.

Business Analyst

Confidential

Responsibilities:

  • Ensure the ongoing integration of information security with business strategies and requirements.
  • Define business details for provider handling, subscriber claim processing rules, other payer logic, and diagnosis procedure codes. Ensure consolidation of information security with business plans and necessities.
  • Gathered, defined and communicated business needs associated with operations, rating, underwriting, billing and the integration of third party products to technology group.
  • Evaluate recommendations from underwriting team
  • Work with different stakeholders, outside business teams and other third parties to improve information security within the organization.
  • Processed each application submitted ensuring completeness and accuracy prior to submission to carrier to expedite underwriting.
  • Performs application reviews, accurately documents, and maintains underwriting files, and ensures the effective use of procedures in accordance with business practices.
  • Communicates effectively with brokers, agencies, and other sources concerning outstanding requirements, underwriting decisions, reviews of potential applicants.
  • Implemented, managed, and enforced information security directives as mandated by HIPAA. Provide architectural advice to management for HIPAA claims.
  • Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies also reviewed security plans.
  • Involved in implementation of HIPAA EDI Transactions (835, 837, 820,276)
  • Facilitated Electronic Data Interchange and performed GAP Analysis for HIPAA 4010 and 5010 transactions.
  • Recommended changes for system design, methods, procedures, policies and workflows affecting Medicare/Medicaid claims processing in compliance with government compliant processes like HIPAA/ EDI formats.
  • Analyzed HIPAA EDI transactions in XML and X12 responses and of 270 and 276 and looked for defects for amendment. Develop applications which accept different claims like Medical claims, Dental claims, and vision claims from different vendors.
  • Have worked in Waterfall, Agile methodologies. Create, define and maintain data life cycle documentation representing data elements across multiple upstream and downstream systems.

Environment: MS Visio, MS Office, MS Project, MS Word, Power Point, SQL server, Oracle 8.0, EDI, Windows XP, Windows 95/98.

Business Analyst

Confidential

Responsibilities:

  • Developed and implemented processes and tools for requirements gathering, analysis, planning, tracking and delivery.
  • Responsible for the delivery of Business Requirements Document (BRD) within the project timelines.
  • Analyzed user problems, including automated and manual business processes and identified, researched, investigated, defined and documented business processes
  • Designed and developed User stories, Use Cases and created diagrams using Visio
  • Modeled the detailed design of the system using UML and Rational Rose, Use Case diagrams, Activity diagrams and State Chart diagrams
  • Identified, researched, investigated, analyzed, defined and documented business processes and Use Case Scenarios.
  • Created traceability matrix to ensure that all Functional Requirements are addressed at the Use Case Level as well as the Test Case Level.
  • Created and updated project status in MS Project and shared it with stakeholders.
  • Performed Functional and GUI Testing to ensure that the user acceptance criteria are being met.
  • Co-coordinated the UAT with the SME's to make sure that all the Business Requirements are addressed in the application.

Environment: MS Visio, MS Office, MS Project, MS Word, Power Point, SQL server, Oracle 8.0, EDI, Windows XP, Windows 95/98.

Business Analyst

Confidential

Responsibilities:

  • Identify Project needs, Affected Business functions, gathering business requirements
  • Create Scope document related with Account Acquisition, Card-Receipt-Verification, collection efficiency, expansive data capture, speed to market business function.
  • Define Business needs using Requisite Pro, Conduct and participate in JAD sessions
  • Involved in creating the Use Cases Diagrams, flow charts, Activity diagrams and process models Identify test case and log it in the Clear Quest.
  • Developed and adapted existing governance and organizational structures to meet the needs of an evolving program.
  • Reviewed the developed product with Development before the release cycle and worked with development to fix issues
  • Developed test scenarios/scripts, test plans, prepared User Acceptance Testing (UAT) cases, UAT issue log for tracking the defects in JIRA and collaborated with system users to conduct UAT.

Environment: UML, XML, Windows XP, NT/2000, HTML, J2EE (JSP1.2), XML, XSL, XSLT, HTML, Oracle 9i.

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