SUMMARY

• Qualified professional with over 6+ years of extensive experience in the field of System/Business Analyst, working with the technical staff to implement management and staff's business requirements into the software application in Healthcare and Healthcare Insurance Industry.
• Experienced as a Business Systems Analyst in using the iterative software development life cycle principles of Rational Unified Process to manage, develop and test distributed client/server, internet and intranet applications on heterogeneous environments.
• Developed and run periodic global "ITSM monthly Performance metrics report" with scheduled reports in ServiceNow and compared with ITSM Scorecard with focus on strategic KPIs.
• Conducting requirement gathering sessions, feasibility studies and Impact Analysis and organizing the software requirements in a structured way using Rational RequisitePro to track development.
• Served as a point of contact for CMS and trading partners to do the testing for various types of claims and real time transactions like 270/271/276/277 for Medicare and Medicaid programs inFACETS.

TECHNICAL SKILLS

Business Tools: Rational Suite (Requisite Pro, Rose, Clear Quest, Clear Case), MS Visio, MS Project, MS Access, MS Office Suite

Business Skills: Business Definition Requirements, Business Process Analysis, Gap AnalysisMethodologies RUP, OOAD, UML & Business/Data Modeling

Testing Tools: QC, ALM, JIRA

Operating Systems: Windows XP/95/98/NT/2000, Mac OS X, DOS, UNIX, Linux

Databases: Oracle 8i/9i, SQL Server 7, Access 2000, MS SQL Server, DB2

PROFESSIONAL EXPERIENCE

Confidential, NJ

Business Analyst

Responsibilities:

• Wrote PL/SQL statement and stored procedures in Oracle for extracting as well as writing data.
• Created, developed, and administered two complexes custom ServiceNow applications, using application studio and Helsinki - Service Portal.
• Troubleshoot, maintain and resolve difficult ServiceNow issues and enhancements with configuration and/or JavaScript updates, which include Workflow creation, mail scripts and notifications.
• Uses scripting tools and ServiceNow functionality create script to automate routine tasks being done in ServiceNow.
• Executing, Reporting and Tracking the defects using Quality Centre, Clear Quest, JIRA and Bugzilla.
• Strong experience in all phases of Software Development Lifecycle (SDLC) using Waterfall, Agile/Scrum, RUP (Rational Unified Process) and Software Testing Life Cycle (STLC).
• Deployed a change management process on ServiceNow, assess organizational needs and execute plans to ease the organization through technological cultural transformation. Establish division communication and engagement strategy.
• Proficient in using Agile Scrum methodologies, performed roles of Scrum Master following sprint/stand-ups sessions and used Excel extensively to write user stories, analyzed the Iteration Burn Down charts and reviewed defects.
• Coordinate relationships business & technical teams to detail user stories (requirements) to be approved for Sprint & Release plans through ServiceNow SDLC.
• Ensured development opportunities on ServiceNow platform are identified to meet evolving business needs and align with key business strategies.
• Successfully used Agile/Scrum Method for gathering requirements and facilitated user stories workshop. Documented User Stories and facilitated Story Point discussions to analyze the level of effort on project specifications

Confidential, Bridgeville, DE

Business Analyst

Responsibilities:

• Experience with EPIC user and provider record provisioning, including the development of role-based access, security classes, and user profiles.
• Supporting ServiceNow new process to include, standard workflow process, standard group membership build design, catalogue items (workflows, approvals, task sequences).
• Knowledge of update set, import set and transform maps in ServiceNow for data mapping and data transformation from legacy system to ServiceNow.
• Ensured development opportunities on ServiceNow platform are identified to meet evolving business needs and align with key business strategies.
• Partnered with stakeholders to drive faster adoption, greater utilization and higher proficiency of ServiceNow system.
• Formulated Business Requirements usingAgile / Scrummethodologies to decompose requirements into Epics and User Stories iteratively
• Proficiency with Microsoft Office applications (Word, Excel, PowerPoint, and Visio and Project Management Software), and Atlassian (JIRA, and Confluence).
• Monitoring the migration of BMC Remedy with ServiceNow and developing ITSM/ITIL processes, roles, business procedures to support (ITSM) best practices.
• Manage configuration/customization of ServiceNow such as Single-Sign-On, Dashboard, workflow administration, SLA management, Report setup, data imports, Knowledge management tool training as per the need of the business.
• Good understanding of SDLC and STLC methodologies including Waterfall, Iterative, Agile and Scrum methodologies.
• Assigned tasks among development team, monitored and tracked progress of project following Agile methodology
• Extensively involved in mapping data from various sources and formats (flat files, XML files and web services) to the target database.
• Worked with solutions/delivery teams to implement data quality processes during acquisition, ETL, and delivery stages for Business Intelligence solutions and changes to Data Warehouses.

Confidential

Business Analyst

Responsibilities:

• Conducted user interviews, gathered Requirements, analyzed the Requirements and managed changes. Participated with leads to develop the prototypes and improvise the user interface with the system.
• This project comprised of providing a software solution with various functionalities such as patient admission, lab investigation and diagnosis, patient billing, patient discharge, summary and doctor consultation billing.
• This project comprised of providing a software solution with various functionalities such as patient admission, lab investigation and diagnosis, patient billing, patient discharge, summary and doctor consultation billing.
• Configured, analyzed, and tested Epic Resolute Hospital, Home Health, and Hospice Billing applications based on end user workflows, state and federal regulations, and patient needs.
• Worked and supported on Professional, Inpatient, Outpatient, pharmacy claims and dental claims Errors.
• Usedagile methodologyand used 15 day iterations for completion of projects and conducted dailySCRUM/Stand-up meetings to track the progress of the Team on a day to day basis.
• Responsible for executingEpic workflow / flow sheet analysis, system setup andconfiguringEpicambulatory and inpatient templatesaccording to the specialty clinic patient order sets.
• Good understanding of SQL Database and data warehouse design principles (e.g. facts, dimensions).
• Facilitate all agile ceremonies including daily stand-ups, weekly grooming, retrospective, and review and planning session.
• Participated in frequent agile team meetings (Scrum planning, daily stand-ups, retrospectives) to provide guidance to an agile product development process.
• PerformedDefect TrackingandProject TrackingusingJira - Change Notification Request (CNR).

Confidential, Louisville, KY

Business Analyst

Responsibilities:

• Worked with a cross functional and diverse team of business users and developers to enable accurate communication of requirements and ensure consensus for BRD and FRD and business docs.
• Coordinated with the developers and IT architects to design the interface of the new system according to the X12 (270, 276, 278, 834, 837 (I, P, D) and 820) standards.
• Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Eligibility.
• Ability to analyze engineering product support issues described within a bug-tracking system (JIRA) and provide guidance to other Client Services members in an advisory capacity, focusing on the quick resolution of the production issue and using this as a training opportunity for other team members
• Worked on HIPAA Standard transactions: 270, 271, 276, 277, 278, 834, 835, and 837 (P.I.D), 997 and 999 to identify key data set elements for designated record set. Interacted with Eligibility, Payments and Enrolment hence analyzing and documenting related business processes.
• Responsible for conducting the overall System Testing to verify operations of key FACETS modules involved in the processing of claims (including benefits), providers and members.
• Worked on developing the business requirement and use cases for FACETS batch process, automating the billing entities and commission process.
• Worked on the existing mainframe system to understand the code written in CBOR, documented the system requirements from the CBOR code and came up with Use Cases from the analysis.
• Performed Migration and Validation per SDLC standards. Interacted with the Test Team and reviewed Test Plans and Cases.
• Using SQL query to produce data for270 EDI X12file, and create 270 files and submit to MEVSNET to check dual snip member for Medicaid benefits.
• Worked on writing complex SQL queries using joins, sub queries and correlated sub queries to manipulate and validate data.
• Worked on Data mapping, logical data modelling used SQL queries to filter data within the Oracle database tables.
• Worked on Audit/Edits reconciliation for claims codes to correct any configuration and documentation inaccuracies and updated Audit, Edit and Claim Check Manuals as required.
• Designed and created SQL Databases tables, indexes, and views, User Defined Functions, Stored Procedures and Triggers based on user requirements.