SUMMARY

• Over 8+ years’ experience in IT with focus on US Healthcare with experience in business analysis, requirements management, application development and testing.
• Over 5+ years of experience as a Business Analyst performing business requirements modeling, risk analysis, software validation and development of Web Based, and Client/Server applications in diverse business domains.
• Excellent understanding of US healthcare industry with specific focus on payer and provider businesses. Certified in Healthcare IT (AHM250 and AHM510) through Academy for Healthcare Management (AHIP)
• Extensive experience with Enrollment, Claims/Billing. Experience in EDI automated first - pass claim adjudication. Expertise in Claims, Subscriber/Member, Eligibility and Claims and Patient Experience, CAQH on Provider side of business.
• Good knowledge of various standards including American national standard institute's (ANSI), accredited standard committee (ASC) and X12 Standards.
• Extensive knowledge about the various types of health insurance programs such as: Medicaid, Medicare (Part A, B, C and D), PPO (Preferred provider organization) and HMO (Health maintenance organization).
• Worked on HL7 message validations, Electronic Health Records, Electronic Medical RecordsHIPAA transaction codes specifically on EDI 837 (medical claims), 835 (medical claim payments), 276 (claim status), 277 (claim status response), and 834 (premium payments) to in corporate enhancements to existing efforts on capturing and mapping.
• Experienced in managing various aspects of the software development lifecycle (SDLC) including requirements gathering, design, development, testing, deployment and support.
• Professional experience as a Cognos Business Intelligence Developer-Analyst with key activities such as support, analysis, designing and testing Cognos BI solutions across multiple industries.
• Strong Business Analysis Skills including In-depth knowledge of Software Development Life Cycle (SDLC), having thorough understanding of various phases like Requirements, Analysis/Design, Development and Testing and Practical knowledge of Rational Unified Process (RUP)
• In Depth understanding of the AS-IS and TO-BE business processes and experience in converting these requirements into technical specifications for preparing test plans.
• Experience in conducting GAP analysis, User Acceptance Testing (UAT), SWOT analysis, Cost benefit analysis, Portfolio Analysis and ROI analysis.
• Understanding of SQL, PL/SQL and Relational Database queries in ORACLE to analyze data and troubleshoot issues.
• Worked on stored procedures and User Define Scalar Functions to be used in theSSISpackages and SQL scripts.
• Experience in conducting Joint Application Development (JAD) sessions with end-users, SMEs' and development team for project meetings, walkthroughs and customer interviews.
• Work in close coordination with technical teams in developing use cases, test plans and test cases from functional and business requirements.
• Expert communicator and facilitator with great interpersonal skills - effective in interactions with business and technology professionals as well as executive management.

TECHNICAL SKILLS

Development Approach: Waterfall and Agile

Programming Languages: React JS, Node JS, HTML, SQL, ETL

Java/J2EE Technologies: JDBC, Web Services, RESTFUL

Web Development: Angular, JavaScript, Node.JS, JQuery, HTML5

Web Service Protocols: SOAP, REST

Databases: Oracle, SQL, T- SQL Server, IBM DB2, MySQL, NoSQL, and Hadoop, HBase, Neo4J

ETL/Reporting Tools: Cognos Data Manager, Informatica, Cognos BI

Operating Systems: Mainframe, Linux, Windows

PM Tools: HP ALM, Rally, JIRA, Confluence and IBM Rational Suite

BI Reporting Tools: Power BI, Tableau

Other Tools: MS-Office (Word, Excel, PowerPoint, Outlook, Access,Visio)

Healthcare Functional: EDI - HIPPA 277, 834, 835, 837I and 837P

PROFESSIONAL EXPERIENCE

Confidential

Business Analyst

Responsibilities:

• Solicit functional requirement from key stakeholders, provide impact analysis and solutions and document them in the Liaison between the IT Function and the Business.
• Converted business requirement into functional requirements. Prepared detailed business specifications for development of systems.
• Develop Use Cases as well as process mapping in line with detailed functional specifications for Sponsor validation
• Tracked project related data/issues and report it to project management. Regular collaboration with PMO on project management, project delivery, issue resolution, scope management and process governance
• Used MS Word and Visio to document data flow of the AS-IS process and TO-BE process.
• Worked with the scrum development to understand buildingJava micro servicesinMicrosoft Azure cloud.
• Developed Requirements Traceability Matrix to record the requirements through each stage of requirements gathering process.
• IntegratedAzure AD(Active Directory),ADB2CwithSalesforceto ease the customer sign in and identification process.
• UsedData loader for insert, update and bulk import or export of data from SalesforceS-Objects used it to read, extract and load data from a comma-separated value (CSV) file.
• Used Microsoft SharePoint as the version tracking tool for managing the requirements documentation.

Confidential

Business Analyst

Responsibilities:

• Designed wireframes for Angular & Tableau dashboards.
• Solicit functional requirement from key stakeholders, provide impact analysis and solutions and document them in the Liaison between the IT Function and the Business.
• Worked closely with business users to define reporting requirements and documenting the requirements in order to design, develop and maintain, and secure Cognos reports.
• Closely worked with ETL team to design Data Marts by understanding user requirements and increasing the reporting efficiency.
• Performed data analysis, testing and validation using SQL queries and data-driven testing methodologies to create reusable tests that leverage source to target validation
• Designed and validated Power BI visualization of Dashboards & Scorecards (KPI).
• Develop Use Cases as well as process mapping in line with detailed functional specifications for Sponsor validation.
• Extensive experience writing SQL Verification scripts against complex ERD’s as well as testing SQL Objects. Including tables, views, schema changes, ETL Scripts, Ad Hoc SQL statements, and Stored Procedures for data accuracy and consistency through multiple layers of an application.
• Provide knowledge transfer and Specification walkthrough for the Testing team and Support business user in UAT

Environment: - Angular, NodeJS, Azure SQK, Redis and Azure Cloud

Confidential

Business Analyst

Responsibilities:

• Converted business requirement into functional requirements. Prepared detailed business specifications for development of systems.
• Tracked project related data/issues and report it to project management. Regular collaboration with PMO on project management, project delivery, issue resolution, scope management and process governance
• Used MS Word and Visio to document data flow of the AS-IS process and TO-BE process.
• Developed Requirements Traceability Matrix to record the requirements through each stage of requirements gathering process.
• Used Microsoft SharePoint as the version tracking tool for managing the requirements documentation.

Confidential 

Developer & Business Analyst

Responsibilities:

• Converted business requirement into functional requirements. Prepared detailed business specifications for development of systems.
• As a part of the project worked on Claims processing module. The claims processing module involved Receipt and Verification of Claim Forms (837) and Claims Attachments (275), Claims Enquiry and Response (276/277), Adjudication,HealthcareClaim Payment (835) as per HIPAA guidelines.
• Extensively worked on EDI transaction like 837, 835,834, 820, 270, 271, 276, 277 and 278.
• Tracked project related data/issues and report it to project management. Regular collaboration with PMO on project management, project delivery, issue resolution, scope management and process governance
• Used MS Word and Visio to document data flow of the AS-IS process and TO-BE process.
• Developed Requirements Traceability Matrix to record the requirements through each stage of requirements gathering process.
• Used Microsoft SharePoint as the version tracking tool for managing the requirements documentation.