- 7+ years of professional experience in wif Business Analysis, Validation, Requirements Engineering, team leading and Project Management background in various industries such as Finance, Banking, Insurance, Healthcare, Retail and IT/Telecom domain.
- Insurance experience includes Personal Property Casualty and Commercial Automobile Product knowledge, Reinsurance for Commercial Property Casualty, Group and Life Insurance Systems,Health Insurance, Auto Insurance, Home Owner Insuranceand Crop Insurance.
- Good understanding of health care industry, Claims Management process, Medicaid and Medicare Services and insurance sector.
- Excellent understanding and hands on experience wif HL7 Messaging Standards, HL7 Message Validation,HIPAAand EDItransactions.
- Knowledge of Electronic Medical Record (EMR), Electronic Health Record (EHR) and Facets.
- Knowledge of ISO statistical rules and reporting.
- Experience in carrying out projects throughSDLCin Relational and Object design methodologies including but not limited to Agile, RUP, Waterfall.
- Expertise in Project Management me.e.Project Scoping, Planning, Estimating, Scheduling, Organizing, Directing, Controlling, Budgeting and Drafting Remedy Procedures.
- Experience in facilitating Joint Requirement Planning (JRP) sessions wif Business User Groups, conducting Joint Application Development (JAD) sessions wif IT Groups and Conflict Management wif Project team members.
- Expertise in analyzingSoftwareRequirement Specifications (SRS)and preparing theFunctional Specification Document (FSD).
- Proven ability to analyze complex problems, identify risks and develop effective solutions to improve productivity, reduce cost and track progress through all phases of SDLC.
- Expert in analyzing, elicitation and management of requirements. Highly experienced in creating Business Requirement Document (BRD) and Functional Requirement Specifications (FRS) document.
- Extensive knowledge of Object Oriented Analysis and Design usingUML, Rational Unified Process (RUP) and Visio.
- Proficient in developingUse Case Model,User Stories,Use Case Diagrams, Behavior Diagrams (sequence diagrams, collaboration diagrams, and activity diagrams),and Class Diagrams based on UML methodology.
- Experience in Data Modeling & Design usingMicrosoft Visio.
- Experience in Interface Data Mapping.
- Expert in developing ofTest plans, Test cases and Test Strategies.
- Expertise in broad range of technologies, including business process tools such asMicrosoft Project, MS Excel, MS Access, MS PowerPoint, MS Visio,Rational Suite and SharePoint
Methodologies: Agile, Waterfall, RUP,SDLC
Process/Modeling Tools: Business Process Analysis & Design, Requirement Gathering, Use Case Modeling, User stories, JAD/JRP Sessions, Gap Analysis, Root Cause Anlysis, and Impact Analysis.
Operating Systems: UNIX, Windows, Linux, and MS - DOS
RDBMS: Oracle, SQL Server and MS Access
Utilities/Application: MS Project, MS Visual, MS Office, MS Visio, MS Visual Studio, SharePoint
Testing Tools: Rational Enterprise Suite, Test Director, Load Runner, QTP, Quality Center, Win Runner, Load Runner, Quick TestPro
Reporting Tools: ERwin, SAP Business Objects, Hyperion Essbase, Crystal Reports,SSIS, SSRS.
Confidential, FRANKFORT, KY
- Liaison between stakeholder’s system users, clients and managers, software development team and teh QA team to gather requirements.
- Proficiently led teh migration of 14 workforce clients from Jenerik to ConneX
- Performed Gap analysis designed new process flow, documented teh business process, various business scenarios and activities of teh business from teh conceptual to procedural level.
- Followed teh SCRUM Project Management Agile Methodology for teh entire SDLC.Created full life-cycle documentation from product requirements in teh developmental stage to functional specifications. Experience in developing BRD’s.
- Studied and analyzed requirements to be achieved and brainstormed to gather effective requirements for a quality product.
- Prepare Project Requirements Document and Design Information Systems Business Solution.
- Created business rules, business vision document, business glossary and implementation up to functional and technical specifications.
- Collaborated in building auto reconciliation rules to successfully reduce labor which in turn reduced human error by 68%, time spent on reconciliation by 79% and completely increased efficiency in billing.
- CreatedRequirements Design Documents (RDD) and Functional Requirement Documents (FRD)
- As a Business Analyst involved in business requirements, analysis, design, project planning&scheduling, creating UAT Test Plans / Test Cases.
- Wrote SQL Queries and did teh Documentation for teh Databases
- Reflected Functional and User Interface testing.
- Produced and managed documentation on release activities to support problem resolution.
- Performed basic UAT wif teh different customers and different business modules.
- Strong experience wif project management practices and principals
- Experience wif UI/screen/form design, considering grammar, data flow, usability
- Experience wif writing use cases, performing testing, and tracking test results
- Ability to interact professionally wif executives, managers, subject matter experts and development teams
- Ability to capture requirements wif efficiency, accuracy and attention to detail on a consistent basis
ENVIRONMENT: Agile/SCRUM, SQL Server 2012/2014, Windows 8, UNIX, MY SQL, PL/SQL, UAT, Quality Center, C#.NET, J2EE, JIRA, Oracle 11, MS Office Suite (Word, Excel, PowerPoint), MS Visio, Microsoft Project Professional, TFS,SSIS, SSRS, QTP.
Confidential, BOWIE, MD
- Established a Rational Unified Process (RUP) centric business analysis methodology.
- Collaborated in building abusiness analysis process modelusingRational Rose, RequisitePro, and Visio.
- Provided key initiatives in working wif users in defining project and system requirements.
- Provided inputs in teh strategic development of detailed project plans, work assignments, target dates etc.
- Worked on Commercial lines Property and Casualty Insurance including both policy and claim processing and reinsurance.
- Knowledgeable of teh various phases Surety claims.
- Conducted mass user interviews wif brokers, enterprise user representatives and SMEs.
- Provide customer service and support forProperty & Casualtyrisk management needs
- Processed annuitant transaction to move their payout investment from one separate account to another
- Developed teh workflow to produce teh output for teh user in Pega Systems using HTML.
- Prepared Business Context Diagram, Use Case diagrams and corresponding Activity Diagrams using Rational Rose to depict teh workflows to be incorporated into teh development of PegaBusiness Process Management (BPM) tool.
- Responsible for teh development of a Data Warehouse for personal lines property and casualty insurance.
- Meticulously assessed data from various sources and generated conceptual and logical database designs using ERwin data modeling tool.
- Experience in managing teh changes in requirements by Unified Change Management Tools (UCM) like Rational Clear Quest.
- Designed and developedUse Cases, Activity Diagrams, Sequence Diagrams, OOD using UML
- Performed requirement analysis, went through all teh use cases and issue logs.
- Developed strategic partnerships wif teh business unit to prepare a solid knowledge base of teh business line, including teh business plan, products, and process’and revenue streams aimed towards problem solving.
- Helped design scope documents and teh Request for Proposal (RFP) after extensive ROI analysis and coordinated wif top management for teh approval process.
- Played a key role in teh planning, testing and implementation of system enhancements and conversions.
- Played a key role in facilitating teh testing and implementation ISO rule and rate changes.
ENVIRONMENT: RUP, Clear Quest, SQL Server 2012, MY SQL, PL/SQL, Java, J2EE, RFP, Rational Rose, Requisite Pro, Windows, SharePoint,MS Office(MS Word, MS Excel, MS PowerPoint, MS Visio), .NET, Oracle, Crystal reports, RUP, UML, SQL, SWOT analysis, GAP Analysis, Win Runner, SSIS, SSRS, Crystal Reports.
Confidential, CHICAGO, IL
BUSINESS / SYSTEM ANALYST
- Coordinated wif Business Owners, Application Vendor, Payers and Clearinghouses to bring all processes to a level of execution to mitigate any impact to current revenue flow under teh 5010-compliancy requirementsand teh Affordable Care Act.
- Gatheird and validated inventory of applications, interfaces, and reports dat will need to be modified to comply wif ICD-10 requirements.
- Implemented 837P, 835, 270, 271, 997 HIPAA documents.
- Performed extensive requirement analysis including Data analysis and Gap analysis.
- Designed and developed Business Rules Document about teh Claim Component and HIPAA
- Developed and implemented weekly metrics management for availability management, capacity management and security management utilizing teh ITIL process framework.
- Helped wif building ICD 9 to ICD 10 crosswalk map by grouping thousands of codes and ranges in Clinical, Benefits, Financial, Medical policy waves.
- Experience in implementing Enrollment Transactions
- Maintained and enhanced Next Gen Electronic Medical Records (EMR), Electronic Practice Management (EPM), and Imaging Control System (ICS) software.
- Prepared use cases and data flow diagrams to analyze teh impact of ICD 10 diagnosis codes, CPT and HCPCS codes embedded in different systems and applications
- Designed, test, and customized EMR templates, documents and crystal reports.
- Analyzed teh testing results to ensure dat teh results were in accordance wif teh Gap Analysis and expected results for 5010 compliance.
- Used UML for Specifications, Documentation and Construction of systems
- Knowledgeable of PegaCPM architecture and utilized Pega CPM Frameworkto aid Customer service representatives through teh process of handling customer service inquires.
- Used HL7 guidelines and dictionary for defining business rules associated wif pre-defined workflows according to business requirements.
- Worked closely on 834 transaction code for Benefit Enrollment and was involved in Validation of HIPAA for837, 270/271, 276/277,835, 834 EDI transactions.
- Involved in teh creation of UAT test plan, UAT test scenarios and UAT test cases
ENVIRONMENT: Agile Scrum, MS Project, SharePoint, MS Access, MS PowerPoint, ITIL, MS Project, SQL, HP Quality Center, MY SQL, PL/SQL, SQL Server 2008, Java, J2EE, UAT, MS Office, MS Visio, MS Project, QTP, SSIS, SSRS, Crystal Reports.
- Involved in teh analysis of teh existing credit card processing system, mapping phase according to functionality and data conversion procedure.
- Performed Gap Analysis to check teh compatibility of teh existing system infrastructure wif teh new business requirements.
- Followed solely RUP methodologies during teh course of teh project.
- Incorporated Rational Unified Process (RUP) to create Requirement Document Specifications using Visible Analyst.
- Utilized teh 80-20 rule to prioritize and in corporate teh critical features. Used Time-Boxing techniques to finish wifin set time frames.
- Accumulated system requirements from various departments through surveys and interviews.
- Involved in prioritizing teh defects and writing business requirements to resolve them.
- Conducted JAD sessions wif management, SME, vendors, users and other stakeholders for open and pending issues.
- Prepared Business Requirement Documents (BRD’s) after teh collection of Functional Requirements from System Usersdat provided appropriate scope of work for technical team to develop prototype and overall system.
- Serve as Property & Casualty Insurance SME and 401K & Retirement servicesexpert, reporting to teh President, addressing various Insurance industry issues as they arise and teh point person for teh development and adoption of teh ACORD xml standards.
- Planned and defined system requirements to Wire Frames wif Use Case, Use Case Scenario and Use Case Narrative using teh UML (Unified Modeling Language) methodologies.
- Created Use Case Diagrams, Activity Diagrams, Sequence Diagrams and ER Diagrams in MS Project.
- Designing and customizingdata models for Data warehousesupporting data from multiple sources
- Assisted in teh development, design and implementation of new relational or multi-dimensional databases, including teh analysis of user needs.
- Created and managed project templates, Use Case project templates, requirement types and traceability relationships in Requisite Pro.
- Developed Systems Specifications document to define teh impact of teh new requirements on teh existing system.
- Involved in Performance Measurement to develop measurable indicators dat can be systematically tracked to assess progress made in achieving predetermined goals.
- Developed and managed creation of product documentation to communicate features, benefits, positioning and impacts to different audiences and ensured dat documentation deliverables from various groups are produced as needed.
- Involved in Testing by using SQL and work wif QA together to develop test Scenarios and test cases.
- Involved in reviewingtest plansandtest casesand ensuring test cases reflect user needs. Also responsible for conductinguser traininganduser acceptancetestingto ensure and verify system is designed according to user needs.
- Conductedreview sessionson regular basis wif QA and development teams for preparing status, delivery report and client reporting.
ENVIRONMENT: Rational Enterprise Suite (Rose, RequisitePro, ClearCase, ClearQuest), UML, RUP, XML, Java, Unix, Oracle, SQL Server Reports, WinRunner, LoadRunner, Quick TestPro, SQL Server 2008, SSIS, Crystal Reports, MS Office, MS Visio, MS Project.
- Liaisonbetween stakeholders, system users, clients and managers, software development team and teh QA term to gather requirements.
- Facilitated Joint Application Development(JAD)sessions to identify thebusiness rulesandrequirementsand thendocumentedthem in a format dat can be reviewed and understood by both business people and technical people.
- Involved inRequirement Scopingand analyzing high priority requirement for implementation.
- Studied and analyzed competitor's applications andbrainstormedto gather effective requirements for a quality product.
- Extensive knowledge of Lockbox Payment solutions.
- CreatedBusiness Requirements Documentand converted them intoSystemRequirement specifications Document.
- Followed theRUP methodology right from inception to teh projects transition.
- Implemented business modeling, data modeling and object modeling using MS Visio to develop teh business architecture for teh application.
- Analyzed Requirements and createdUse cases, Use Case diagrams, Activity Diagrams.
- Created and managedproject templates, use case project templates, requirement typesandtraceability relationshipinRequisite Pro.
- Coordinated wif teh development team, database team, data warehousing team and QA team throughout all phases in theRUP methodology.
- Assisted QA Team in writing test cases, test plans and testedthe final application for usability testing to verify whether all teh user requirements were cateredto by teh application.
- Archivedallproject documentsand implemented teh UCM model for activity-basedConfiguration ManagementusingClear Case.
- Used RationalClear Quest for defect tracking and change management requestand reported them.
- Involved in preparing a simple and detailedUser manualfor teh application, for an intended novice user.
ENVIRONMENT: Rational Clear Case, Rational Clear Quest, Windows XP, HTML, Oracle 9.1, SQL Server,RUP, MS-Visio, Rational Requisite Pro, MS-Project, MS Office Suite.
- Design and develop software architecture and system logic for reporting toolsSAP Business ObjectsandHyperion Essbase
- PerformAnalysis & Software Validationandarticulate business values and provide Solutions
- Prepare and DesignSoftware Systems code&programminglogic
- Design business processmodels usingUML diagramssuch asUse Case diagramsandActivity Diagrams in MS Visio
- Primary point of contact betweenSubject Matter Experts (SMEs)and other Business representatives, using knowledge of Insurance practices and methods to ensure accurate documentation of business requirements
- Designing Requirements based onRequirement gathering.
- Created BusinessUse-Case Modelafter accessing teh status and scope of teh project and understanding teh business processes
- Vast requirement gathering experience which includes interacting wif Stakeholders and BPs, Conducting one-on-one interviews, questionnaires, conductingJAD sessions, Creating & Maintaining Use Cases, Conducting Requirement Refresh Sessions
- DevelopedBusiness Process Flowsusing MS Visio.
- Assisted theTestingTeamin creatingTest Case,Test Script, and Test Planand reviewed usingHP Quality Center.
- Developed anAnalysis Modeldat includesUse Case diagram and Activity Diagramsdat provide teh development team a view of teh requirements
- Assisted teh users wifUATby preparing test data
- ConductedImpact Analysisto check how system will respond to new change request
ENVIRONMENT: SAP BO, Hyperion Essbase, Agile/SCRUM, SmartSheet, HP Quality Center, MS Word, MS PowerPoint, MS Visio,