SUMMARY

• Senior Business Analyst with 8 Years of experience in healthcare - Insurance domain
• A hard-working team player with extensive knowledge of Unified Modeling Language (UML), Software Development Life Cycle (SDLC), Object Oriented Analysis and Design (OOAD), Business Process Re-engineering (BPR), Testing Lifecycle, Data Modeling, Service Oriented Architecture (SOA), GAP analysis, risk analysis, cost-benefit analysis, conducting Joint Application Development Sessions (JAD) and various methodologies including Waterfall, Agile and SCRUM, Prototyping, Six Sigma (DMAIC), Rapid Application Development (RAD) and Rational Unified Process (RUP).
• Skillfully documented Business Requirements, Use Case Specification, Functional and Non-Functional specification, UML diagrams including Use Case diagram, Activity diagram, Class diagram, Sequence diagram, Data Flow diagram (DFD), Entity-Relationship diagram (ERD), Requirement Traceability Matrix (RTM), Change-Version Control, Training and User Manuals.
• Experience with Agile (KANBAN & SCRUM) including Sprint Planning, Backlog Management, User stories & Epics, Story Points & Velocity Calculation, Mockup and Testing & Defect Management.
• Adept in creating Mockups for Widgets especially for Dashboards targeting both web & Mobile platforms.
• Experience and Knowledge of Data Architect, Data Mapping & Modeling to support ETL process (data warehousing) including Dimensional Modeling, Data Cleansing, and Data Quality etc.
• Hands on Experience with Web-Services (SOAP, UDDI) and SOA with in-depth knowledge of N-Tier Architecture.
• Hands on experience with PL/SQL, T-SQL for scheduled and ad-hoc reports including use of Stored Procedures, Views, Joins and Triggers
• Extensive knowledge of Medical Management Information Systems (MMIS), Health Insurance Portability and Accountability Act (HIPAA) standards, Electronic Data Interchange (EDI) and implementation of HIPAA code sets, ICD-9, ICD-10 and HL7.
• Experience in White Box, Black Box, Unit, Functional, Integration, Back End and System Level Load and Stress Testing.

TECHNICAL SKILLS

Business Skills: Business Process Analysis & Design, Gap Analysis, Impact Analysis, JAD/JRP Sessions, Requirement Management, Technical Specifications, UAT, Defect Management, Test Plan & Test Cases.

Models & Artifacts: BRD(Functional & Technical), SRS, Use Case Modeling, ER & EER Modeling, Dimensional Modeling, DFD, Change-Version Control, Traceability Matrices, Project Charter, Context Diagram, STLC

Methodologies: Agile, Scrum, RUP, CMM, CMMI, Six-Sigma, Prototyping and Waterfall

Languages: COBOL, C#.NET, JAVA, T-SQL, PL/SQL, HTML and XML

Tools: MS Visio, Balsamiq Mockup, IBM Rational Rose, Requisite Pro, ClearQuest, ClearCase, HP Quality Center, Win Runner, Microsoft office Suite, MS SharePoint, MS Lync, JIRA, TFSDatabase Oracle, DB2, MS SQL Server, SSMS, SQL Developer, ERWin, Toad

Environment: s: Windows, AS/400, Solaris, Android, Linux, Unix

PROFESSIONAL EXPERIENCE

Confidential, Chicago IL

Sr. Business Analyst / Project Analyst

Responsibilities:

• Created Business Requirement Document (BRD) and Functional Requirement Document (FRD)
• Created Use cases, Use case diagram, Activity diagram, and other flow charts to define the business process
• Experienced in facilitating of Joint Application Development (JAD) sessions with end user, expert team, business intelligence team, SME’s, QA team, Walk Through and Signoff with Stakeholders as required
• Extensively used tools like Microsoft Excel, Access, Share point, MS Visio and in-house Optimal Trace tool
• Facilitated Joint Application Development sessions (JAD) to resolve issues relating to difference between business requirements and technical design
• Extensively used Optimal Trace (Home grown system) to document BRDs & FRDs
• Supported change control of projects that comes in during or after the project being implemented
• Created Use Cases to make developers understand the requirements in more easy way
• Experienced in RUP and Agile PLM Business Modeling process, complete UML artifacts related to Business Modeling and Requirements, including MS Visio and Rational Rose
• Worked with client organizations to help define and improve application development and maintenance processes using the Capability Maturity Model Integration (CMMI) models
• Translated Business requirements and functional specifications into Scenarios to make developers understand the requirements in more easy way
• Captured process flows by preparing activity and sequence diagrams, pre- and post-conditions, performance requirements, impacted areas, high-level business rules, issues, areas in scope and out of scope, assumptions.
• Worked with SCRUM Methodology
• Worked on Sprint Methodology, using for new projects like Custom Faxing, Auto faxing elaborating Epic stories and Acceptance Criteria to create flow
• Reviewed Technical Specification Documents, TSD, with development team, resolves issues and provide Sign Off
• Reviewed QA test case outputs for all projects undertaken

Environment: SharePoint, RUP, Rational Requisite Pro, IBM Rational Clear case, Optimal Trace, MS Office Suite, MS TFS, MS Visio

Confidential, NJ

Business Analyst / Project Coordinator

Responsibilities:

• Gathered Functional Requirements to overcome the problems of existing system, and implemented the rectified changes in the new system.
• Conducted interviews with the SME and gathered information about Health care Enrolment, Billing and Claims processing.
• Developed Knowledge of HIPAA guidelines and compliance, HIPAA & ANSI X-12 EDI (Electronic Data Interchange) series such as 270/271, 276/277, 835, 837
• Research and resolve disputes filed by HCP after review of CIA/CMS data postings
• Conducted GAP analysis to identify and document gaps between existing 4010 compliant system and proposed 5010 compliant system.
• The user interface (UI) screens were mocked up in Microsoft Visio and reviewed with the end users prior to programming to solicit User Acceptance.
• Ensured that project followed Business Rules and was in compliance with HIPAA rules to display minimum benefit information.
• Worked with end users to define business design solutions (e.g. new workflows, systems, programs, reports).
• Created Report Mockups and Sample Mapping documents for the Error Reporting.
• Created flow charts describing how to use the new system.
• Worked on SCRUM for the Reporting requirements. Participated in daily standup meetings and owned daily milestones to gather and create reporting specifications.
• Created UAT plans with several test cases for each project to ensure that the system runs smoothly after the proposed enhancements.
• Coordinated between business line, operations and the technical team throughout the project.
• Facilitated and scribed JAD sessions, user meetings, and interviews to extract business requirements to confirm that those requirements are in alignment with the expected results.
• Gathered requirements for impacted system and business areas for ICD-10 and their needs to embrace the changes.
• Thorough use of MS Visio to develop Activity Diagrams, Sequence Diagrams
• Identified, researched, investigated, analyzed and documented business processes and use case scenarios.

Environment: Rational RequisitePro, HP Quality Center, RUP, SCRUM, UML, HTML, MS Project 2000, MS Visio

Confidential, Sunrise, FL

Business Analyst

Responsibilities:

• Assisted in identifying project scope, to conform to the regulatory compliance related to X12 837 (I/P), 835, 834, 270, 271, etc.
• Responsible for soliciting and eliciting requirements for 4010A-5010 conversions.
• Carried out Risk Assessment, GAP analysis and Impact Analysis for the 4010A-5010 conversion project.
• Involved in one-to-one interview sessions and JAD sessions with stakeholders, SME’s and business owners to discuss the scope of the conversion.
• Produced for transaction sets 835 and 837 (I/P) a full gap analysis 4010 vs. 5010 against the documented application 5010 enhancements ensuring the upgraded application included the required changes and additions for 5010 compliance..
• Worked as a liaison among stakeholders both business and IT side in order to elicit, analyze, communicate and validate requirements for changes to business processes.
• Involved in creating Reports and Documents like Requirements Documents, and Management Plan, Issue/Alternatives documents, Project Summary and Plans
• Prepared UML diagrams (Activity diagrams, Sequence Diagrams, Use case diagrams)
• Played a key role in project planning activities, User Acceptance testing, and implementation of the system enhancements and conversions.
• Involved with reviewing defects reported from UAT efforts and analyzed for root cause and took actions based on the findings.

Environment: Rational RequisitePro, Rational ClearCase, RUP, UML, HTML, MS Project 2000, MS Visio

Confidential, Queens, NY

Business Analyst

Responsibilities:

• Managed the project as aBusiness Analystto update the current insurance system specifically focusing on long term-care plans.
• Analyzed and collected business requirements, identified system interfaces and created the requirements specification document.
• Documented use case specifications on the basis of requirements gathered from stakeholders.
• Prepared vision document for defining the scope of the project and the various functional and non- functional requirements involved in it.
• Responsible for design, information architecture and user experience of newly proposed websites portals and web-based applications.
• Created new user-interface designs, mock-ups, wire frames and prototypes.
• Developed Requirement specifications and process diagrams including context diagram and dataflow diagram.
• Used questionnaire, surveys, JAD sessions and Brainstorming sessions as requirement elicitation techniques.
• Framed a detailed agenda and facilitated JAD sessions. Took aggressive efforts towards completion and finalization of documentation towards the end of JAD sessions.
• Analyzed requirement document by identifying ambiguous, incomplete and incorrect requirements.
• Helped in developing attribute matrix and functionality traceability matrix.
• Experienced to developing Bus Matrix and concept of Data Models
• Helped co-business analysts in drawing process flow diagrams using MS Visio.
• Helped project manager with MS-Project for developing schedules using Gantt charts.
• Extensively worked with quality analysts to make sure that the functionality meets requirements.
• Conducted walkthroughs with development & Test teams and stakeholders.
• Helped Reporting team with SQL query building for efficient reporting.
• Transformed documents to UAT Test Plan, UAT Test Case, and UAT Defect Log.
• Involved in creating Manual test cases for HP QC as well as EDI level 2 testing

Environment: SQL Server, Windows XP, Rational Rose, Rational Requisite Pro, QTP, UML, MS Visio, MS Project, MS Office (MS Word, MS Excel, MS PowerPoint)

Confidential, San Francisco, CA

Jr. Business Analyst

Responsibilities:

• Gathered requirements and performed Fit/Gap analysis to find customization and Integration Requirements and created and maintained Business Requirement Document and backlogs.
• Interviewed subject matter expert SME on product development team working with the team to document functional requirements and break them down into clearer user stories for the team to deliver
• Work with the product development team to ensure that the acceptance criteria are met and the software meets project objectives/customer expectations as defined by the product owner
• Work with the product development team to document system and user interface requirements, data requirements and report formats for a mission critical enterprise application with integration points into 15+ sub-systems that included AS-400 based legacy billing system as well.
• Created Mockups using MS Visio to finalize UI design and create Specification documents.
• Created reporting requirements as well as visualization requirements utilizing SSRS.
• Created Ad-hoc and scheduled reports as requested by the management.
• Extensive experience identifying data sources to include production of source to target mapping documentation allowing development teams to readily reference database names, database URL, table names, column names, data types, valid values and invalid values for data points to be presented to TWC frontline personnel
• Assist the operations support team in understanding business impacts of enhancements, defects & issues by developing release-centric production support documentation & via coordination of release-centric functional demonstrations
• SharePoint management of project documentation and approval workflows
• Extensive use of advanced SQL queries and constructs to create reports and test for data quality.
• Weekly project reporting following PMO structure for project deliverables

Environment: MS SharePoint, MS SQL Server, MS Project, MS Visio, MS office, T-SQL, DTS, MySQL, .NET