PROFESSIONAL SUMMARY:

• Enthusiastic & Innovative with around 8+ years of BUSINESS/SYSTEM ANALYST experience in IT.
• Excellent understanding of Software Development Life Cycle and its modeling techniques like Waterfall, Agile Programming Methodology (SCRUM), Iterative Models (RUP - Rational Unified Process).
• Comprehensive understanding of Healthcare, Insurance and Finance domain.
• Full working knowledge of Rational Unified Process (RUP) using Rational Rose, Requisite Pro, SilkCentral Test Manager, SOA, UML, GEM, DWH, RFP, SDLC and Object Oriented Analysis (OOA).
• Experience in Business Process Modeling, MS CRM Dynamics, KPI, Activity Diagrams, XML, GUI, database designing, Cost/Benefit analysis, Prototype Models, swim lanes, Process maps, Mock-ups, UAT, Oracle SQL, JAD, PLSQL, QA, MySql5.0, UNIX, Sql server 2005, MS Office.
• Knowledge of health information and health care services regulatory environment, ERISA (Employee Retirement Income Security Act), NPI’s, 21 CFR 11, ICD-9, ICD-10, Medicaid/Medicare, MMIS, HIPAA EDI 4010 & 5010 and XML.
• Good working experience in Claims processing, HIPAA Regulations, HL7 and 270, 834, 835, 837P, 837I, 837D EDI Transactions for health care industries.
• Experience working on MS SharePoint (MOSS 2007/2010) (Content Management System) involved in configuration,
• Proficient in all cycles of test life cycle from test planning to defect tracking and managing defect lifecycle.
• Proficient in creating UML diagrams including Use Case Diagrams, Behavioral Diagrams (Sequence Diagrams, Activity Diagrams and State Chart Diagrams), Class Diagrams, Data Flow Diagrams (DFD), E-R Diagrams using Rational Rose and MS-Visio.
• Proficient in identifying, documenting and analyzing business requirements specifications (BRS), System Design Specifications (SDS) and Software Requirement Specification (SRS).
• Demonstrated experiences of Claim lifecycle: First Notice, Assignment, Evaluation, Settlement, Recovery and File Review with various Auto & Home, Personal Liabilities, Property, Business.
• Experience in identifying and gathering the information from useful sources and also prepared Requirement Traceability Matrix.
• Experience in Property & Casualty, Health, Retirement Plan & Benefits, Pensions, Life Insurance, Personal & Commercial, Workers Compensation, after tax Annuities etc.
• Experience of online payment system like payment systems that can help expedite both transactions conducted on exchanges and those conducted between existing trading partners.
• Extensively involved in providing business and technical support to business users or customers.
• Have vast experience in Project Management, Business Analysis, Business & Data Modeling.
• Analyzed current (as-is) process by creating process mapping, gathered requirement and developed ‘to-be’ process by suggesting and incorporating business process improvement.
• Experience in Rational Requisite Pro and Caliber RM, Requirement Management tool.
• Made process improvement recommendations to management and involved in Business Process Re-engineering (BPR), CMMI and Six Sigma (DMAIC).
• Flexible, innovative and able to thrive in a growth-oriented and time-critical environment.
• Created wire-frame diagrams to facilitate the team to show the layout &structure of website.
• Good experience in Test Case Preparation, Test Case Execution, Bug Reporting and Bug Fixing.
• Ensured Client confidence and prevented slippage of issues by serving as onsite coordinator during critical phases of the project.
• Strong project management and team skills with customer interfacing / consulting experience.
• Ability to communicate effectively and clearly between teams and resolve issues quickly.

TECHNICAL SKILLS:

Operating System: UNIX, Windows 2000/NT/XP/2003

Languages: PL/SQL, SQL, Dot Net 3.5, C, XML, VB, HTML, Data Structure, Pro*c

Databases: Oracle 9i & 10g, Sql server 2005/2008/2010 , Mysql5.0, Ms Access

Software Packages: Ms Word, Power Point, Excel, Visio, Project

Application Products & CRM Tool: Netmind (Telecom Product), TIA, MS Dynamics

Req. management, Testing & Reporting Tools: Rational Requisite Pro, QTP, HP Quality Centre 9.2, SilkCentral Test Manager, Test Director, Load Runner, Caliber RM, MS SharePoint Server 2007 & 2010, Business Objects XI (BI Tool)

Change management Tools: Rational ClearCase, Bugzilla, TeamTrack, Rational ClearQuest

Methodologies/Best Practices: Agile (scrum), Waterfall, RUP (Rational Unified Process), BABOK, CMMI, BPR, Six Sigma (DMAIC)

Healthcare/Medical Applications: Monument Xpress (Tricore), CMS

PROFESSIONAL EXPERIENCE:

Confidential, Des Moines, IA

Sr. Business Systems Analyst

Responsibilities:

• Conducting interviews with key business users and the technical team to collect requirement and business process information.
• Documenting Detailed Business Requirements as per the business users and the application requirement and converted them in to Functional Requirements.
• Responsible for finalizing the data elements for the new application as per the business and technical requirements in synchronization with the current process.
• Interacting with the M&O team members regarding the customization of the application as per the requirements.
• Working on the different interfaces used for commission, mailing and trade review.
• Involved in the migration of the client data from different applications to new application.
• Using HP Quality Centre for test planning, test cases and for fixing of defects.
• Conducting Joint Application Development (JAD) sessions to develop and agree upon a system that focuses on a Business Requirement.
• Working with the data architecture and data analyst team in designing the model and in creation of the data mapping documents.
• Experience working on waterfall and agile software development methodology.
• Presenting the walkthroughs and review sessions to the business folks and technical architects.
• Provided leadership to requirement teams, serving as a central point of contact through mentoring and motivating other business analysts in a positive manner.
• Creating the process maps, UML diagrams, swim lanes, data flow diagrams etc with the help of MS Visio and also involved in developing the project plan.
• Developing data mapping documents with the help of ING technical team and the M&O team members.
• Developing use cases, test cases and also doing the testing of the broker dealer application.

Environment: MS Office, MS Visio. BPM Agile Scrum, waterfall, Clarity, MS Project, BPR, UML, XML, UAT, Sql Server 2010, Quality Center 9.2, MS One Note, Queries, Test Cases, Use Cases, SIT, STP .

Confidential, Des Moines, IOWA

Sr. Business System Analyst

Responsibilities:

• Interacting with different departments like claim, FEP, Blue Card, & Enrollment, Medical and customer service regarding the finalization of data elements required to build the new data mart.
• Conducting interviews with key business users to collect requirement and business process information.
• Documenting High Level Requirements as per the business users and converted them in to Detailed Business Requirements.
• Responsible for creating a new data mart for reporting and analytics and also finalized the new data elements.
• Provided leadership to requirement teams, serving as a central point of contact through mentoring and motivating other business system analysts in a positive manner.
• Responsible for getting the approvals of the new data mart elements from the users of various departments.
• Worked with the underwriters & Actuarial team in identifying the pricing elements for calculation of the provider charge and provider saving account for UA claims.
• Worked with the data architecture and data analyst team in designing the model and in creation of the data mapping documents.
• Creating the Information Delivery Requirement document for finalizing the folder names for the data elements in BO universe and defining the security permissions.
• Working on MS CRM Dynamics for handling the customer claim inquiries, Validation and case creation.
• Part of the ICD 10 implementation team and worked on the Expansion and files programs and EDI transactions forms.
• Helped the business analyst in generating the reports with Business objects XI (BI).
• Worked on the Mixed Code Claims and Description issues related to the ICD-9 & ICD-10.
• Also interacted with the stakeholders and the IT Department in finalizing the requirements according to the HIPAA Regulations.
• Build Use Case diagrams, Behavior Diagrams, Sequence Diagrams based on UML methodology using MS Visio.
• Wrote SQL queries as per the project requirements.
• Developing the Test Plan, use cases, Test Cases and Test Scenarios to be used in testing based on Business Requirements, technical specifications and/or product knowledge.
• Participating in UAT and worked with SilkCentral Test manager for testing the application defects and which is effective in agile development based projects.
• Use to create Swim lanes, Business Flows, Process maps and Work Flows Diagrams for effective plans.

Environment: MS Office, MS Visio. HIPAA 4010, 5010, ICD 9, ICD 10, MS CRM Dynamics, Business Objects XI (Business Intelligence Tool), EDI, SilkCentral Test manager, Data Warehouse, BPM, Agile Scrum, BPR, UML, XML, UAT, Sql Server 2010, Dot Net 3.5 framework, GEM, Queries, Test Cases, Use Cases, SIT, STP .

Confidential, Medford, MA

Sr. Business/System Analyst

Responsibilities:

• Interacted with different departments like claim and customer service regarding the performance issues related to claim processing system (Tricore Monument Xpress System).
• Conducting interviews with key business users to collect requirement and business process information.
• Involved in data analysis & generated reports with Business objects.
• Involved in implementation of 5010 and part of the ICD-10 implementation team.
• Also involved in analysis for the conversion of ICD-9 to ICD-10 and also worked with the Data management team for data mapping and data analysis.
• Extensively interacted with the stakeholders and the IT Department in finalizing the requirements according to the HIPAA Regulations.
• Wrote SQL queries as per the project requirements.
• Validated the following: 835 (Health Care Claims Payment), 837I, 837P, 837D transaction files.
• Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Medicaid Claims.
• Documenting Functional Requirements for business level components, UI and system security.
• Experience in Business Process Re-engineering (BPR), to make current process more effective.
• Developing the Test Plan, use cases, Test Cases and Test Scenarios to be used in testing based on Business Requirements, technical specifications and/or product knowledge.
• Created the Business Requirement Specifications and helped convert them to system functionality documents and managed them in Rational Requisite Pro.
• Participating in UAT and worked with Mercury Quality Center for bug and defect tracking.
• Defining Core Business Rules and Core Business Validations for the entire application.
• Analyzed the technical specifications and business requirements.
• Use to create swim lanes, Business Flows and Work Flows Diagrams for effective plans.
• Documented and delivered Functional Specification Document to the project team.

Environment: MS Office, MS Visio, Tricore Monument Xpress v3.9, CCMS (McKesson’s CCMS), Rational Requisite Pro, ICD-10, ICD-9, HIPAA 4010, 5010, GUI, Business Objects XI, Test Director, Agile Scrum, BPR, XML, UAT, TeamTrack, GEM, Sql Server 2008, Dot Net 3.5 framework, Queries.

Confidential, Warren, NJ

Sr. Business Analyst

Responsibilities:

• Preparing Business Requirement Documents and Functional Requirement Specifications.
• Regularly updated project plans, project report and also monitored the execution of the project.
• Involved in and policy administration activities like acquiring business, underwriting business, Renew, Risk management and changes in the existing policy methods (Add, remove, modify).
• Acted as a Liaison between the technical team and business users.
• Part of the customer care team also for capturing the claim data from the customers regarding the loss of property through the First Notice of Loss (FNOL) service which helped the company to maintain excellent relationship with the customers.
• Implemented SharePoint 2010 for document management, collaboration and automation of business processes using workflow.
• Wrote SQL queries to check the integrity of the data and generated the reports after data analysis.
• Conducted session with business users to analyze existing business processes and Process flow.
• Responsible for defining the Business rules with the underwriters, scope of the project, gathering business requirements and documenting them using Rational Requisite Pro.
• Created virtual user scripts and test scenarios, executed and monitored that scenario and analyzed the test result using Load Runner.
• Conducted Joint Application Development (JAD) sessions to develop and agree upon a system that focuses on a Business Requirement.
• Involved in planning of the UAT and ensure that defect fixes must be included in that.
• Used agile methodology to analyze and develop solutions, performed the role of Scrum master and wrote user stories.
• Documented the complex business problems and interacted with the team members.
• Interacted with the Business Representatives/Stakeholder’s regarding the business process.
• Involved in data mapping, data analysis (Business analytics) for measuring the performance of the business and then worked on Business Process Re-engineering (BPR) activities for the improvement of the existing process in order to achieve maximum performance.
• Involved in Mentoring team members and users regarding the insurance application and Rational RequisitePro and also involved in the user interface design mock ups and ’s..
• Analyzed current (as-is) process by creating process mapping, gathered requirement and developed ‘to-be’ process by suggesting and incorporating business process improvement.
• Created Use Case Models, Wireframes & Mock-ups,, Analysis Models, Design Models, Use Case Diagrams, Behavior Diagrams (sequence diagrams, activity diagrams) based on UML methodology using MS Visio.
• Wrote process flow and business case documents of existing process.
• Used Mercury Quality Centre for test planning, test cases and for fixing of defects.

Environment: Win XP, MS Office, Dot Net, PLSQL, KPI, BPR, MS SharePoint Server 2010, Activity Diagrams, MS Project, Mercury Quality Centre, DWH, UAT, Rational RequisitePro, Test Plan, Use Cases, SQL, UML, Test Cases, Wireframes, GUI, Queries, Agile, Data modeling (Visio).

Confidential, Hartford, CT

Business Analyst

Responsibilities:

• Led requirement gathering efforts in an aggressive agile environment.
• Convened JAD (Joint Application Design) & SME (Subject Matter Expert) sessions to capture system requirements and business rules that define the overall scope of the system.
• Involved in policy administration, Business process mapping & defining process flow charts.
• Analyzed and documented the existing (as-is) process and gathered requirement and developed ‘to-be’ process by suggesting and incorporating business process improvement
• Drafting, cost/Benefit analysis, Executing and Documenting risk Areas, Wireframes & Mock-ups.
• Involved in sales of the policies and ATA (after tax annuities) with agents at distributed locations.
• Wrote test plan and executed various levels of testing using test cases to prove that the system conform to specifications of business and quality requirements.
• Gathered and Analyzes Business Requirements by conducting interviews with business users.
• Worked on Requisite Pro for capturing the ongoing project requirements and maintained a centralized repository for the project requirements.
• Worked on improvements of the existing business process through Business Process Re-engineering (BPR).
• Performed functional, regression and performance testing in user acceptance test (UAT) environment and approval of the application.
• Helped underwriters in setting the business rules, manage risk analysis and mitigation plans, status reports, and client presentations.
• Used MS Visio and UML for generating class diagrams and activity diagrams.
• Suggested measures and recommendations to improve the current application performance with the aid of SCRs (Small Change Requests) and done data analysis for generation of ad-hoc reports.
• Conducted interviews, Joint Resource Planning & translated them into System Requirement.
• Worked with the FNOL (First Notice of Loss) team for capturing the claim notification regarding any loss of property from the policy holders and also interacted with the agents.
• Prepared Business Requirement Documents (BRD) and Functional Req. Specifications (FRS).
• Mapped requirements to each business process flows/diagrams to provide a visual and clear understanding to the user of technical and functional requirements.
• Conduct and participate in status meetings to collect data from business users.

Environment: Win 2003, MS Office, JAD, Use Cases, SQL, BPR, UAT, Quality Centre, Requisite Pro, MS Project, Activity Diagrams, UML, Wireframes, swim lanes, UI, Test Cases, Agile, Data modeling (Visio).

Confidential

Business System Analyst

Responsibilities:

• Gathering and Analyzing Business Requirements by conduction interviews with business users/Stakeholder.
• Performed User Acceptance Testing (UAT) and wrote SQL queries.
• Extensively used Rational Requisite Pro to maintain the project requirements and to improve the software development process.
• Build a software development process with RUP which consist tells what to produce and how to produce with minimum efforts.
• Handled B2B (Global Trade Transactions) between Firms and Companies with the help of FRA site, for that we have used EBPP: Electronic Billing Presentment and Payment system.
• Provided extensive technical and business support to business customers and also supported developers in website designing.
• Design and development of MS SharePoint for project status, documentation and communications tools. Also documented the material for MS SharePoint.
• Worked on the DMAIC (Six Sigma Method) used to improve the existing business process of the organization. It also works on cost reduction and profit increment.
• Worked with the automation testing team and used QTP, developed test scripts.
• Conducted surveys, interviews and JRP (Joint Resource Planning) and JAD sessions and translated them into System Requirements.
• Suggested measures and recommendations to improve the current application performance and documented the existing process as well.
• Performed Functional Testing, Unit Testing, Regression Testing and documented the outcomes.
• Involved in various status meetings with the team members regarding the issues and client requirements and also in analysis and designing of the wireframes, Mock-ups and prototypes.
• Prepared Business Requirement Document (BRD) and then converted business requirement into Functional Requirements Specifications (FRS).

Environment: Unix, MS Office, Rational Requisite Pro, E commerce, QTP, Clear Quest, MS SharePoint Server 2007, SOX act, Wireframes, XML, UAT, use cases, test cases, Six Sigma, RUP, Sql Server 2005, oracle9i, Dot Net, DWH, Windows 2003, GUI, MS Project, swim lanes, Queries.

Confidential

Business Consultant/Technical Associate

Responsibilities:

• Wrote test plan and executed various levels of Unit, Integration, User Acceptance and Operational Acceptance testing using test cases to prove that the system conform to specifications of business and quality requirements.
• Involved in Functional and Regression testing of the application using QTP.
• Used GIS to extract the exact location of the telephone exchanges for exporting the cables.
• Scheduled jobs for compressing the database after adding the new data and then gather stats after that and escalated that report to the onsite team.
• Worked on improvements of the existing business process through Business Process Re-engineering (BPR).
• Bug fixing on dev. and production environment and involved in the deployment on production.
• Work with business users and user group managers to define requirements and document existing and new business process work flow and business processes
• Thoroughly documented existing business process for improvement purpose..
• Conducted and participated in status meetings to collect data from business users.
• Implement business modeling using MS Visio to develop screen for the applications.

Environment: Oracle9i, UNIX, SQL, Clarify, MS Office, UML, Visio, BPR, QTP, UAT, Sub Queries

Confidential

Business System Analyst/Developer

Responsibilities:

• Conducted Gap Analysis during the review of the Compliance items for improved future audits.
• Involved in the JAD sessions with the Team members.
• Worked with the FNOL (First Notice of Loss) teams for capturing the claims notifications.
• Analyzed and documented Business requirements, Functional Requirement and Business Process Models for better understanding of the business process.
• Conducted and participated in walkthroughs to discuss certain issues with the development and business team and worked on the improvement of the business process through CMMI practices.
• Prepared unit test cases and UML use cases for the application.

Environment: UNIX, MS Word, MS Access, CMMI, UML, HTML, BRD, Test Cases.