SUMMARY

• Senior Business Analyst wif 8+ Years of experience in healthcare - Insurance domain
• A hard-working team player wif extensive noledge 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 wif 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 Mapping & Modeling to support ETL process (data warehousing) including Dimensional Modeling, Data Cleansing, and Data Quality etc.
• Hands on Experience wif Web-Services (SOAP, UDDI) and SOA wif in-depth noledge of N-Tier Architecture.
• Hands on experience wif PL/SQL, T-SQL for scheduled and ad-hoc reports including use of Stored Procedures, Views, Joins and Triggers
• Extensive noledge 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: Windows, AS/400, Solaris, Android, Linux, Unix

PROFESSIONAL EXPERIENCE

Senior Business Analyst / Project Coordinator

Confidential - Newark, NJ

Responsibilities:

• Collaborated wif the SME and interviewed the stakeholders to understand the As-Is and To-Be state of the project
• Conducted several JAD sessions and requirement workshops wif the system architects, business users and development team to perform GAP Analysis
• Created detailed business scenarios and writing master use cases, which covered step-by-step process of interaction between user and system.
• Developed Business Flow diagrams, Entity Relationship diagrams and Sequence diagrams using MS Visio so development team and other stakeholders could understand business process
• Created wireframes usingAxure based on collaboration wif use cases and Visio flows.
• Created a WBS for the project by integrating the features of both Waterfall and Agile Scrum Framework
• Involved in change control and change management and ensured dat changes during the project lifecycle are introduced in a coordinated manner.
• Utilized SharePoint tool effective document management and creating dashboards for the team
• Conducted workshops to understand requirements for Data Warehouse design. Conducted client side validation to study ETL (Extract Transform and Load) operations on database.
• Utilized Informatica to ETL data for business intelligence and reporting. Used Tableau as the reporting tool.
• Participated in mapping documents for transferring data from source to target.
• Assisted QA team in conducting User Acceptance Testing (UAT) and documentation of test cases.
• Organized, documented and tracked changes and defects in HP QC
• Expertise in interacting wif the client and the IT Department and thus acted as a facilitator between both the parties

Environment: Waterfall, Agile Scrum, MS Visio, HP QC, Informatica, Tableau, MS Suite, Axure, SharePoint

Sr. Project Analyst / Business Analyst

Confidential, NY

Responsibilities:

• Gathered Requirements to overcome the problems of existing system, and created a Business Requirement Document.
• Conducted interviews wif the SME and gathered information about Health care Enrollment, Billing and Claims processing.
• The user interface (UI) screens were mocked up in Microsoft Visio and reviewed wif the end users prior to programming to solicit User Acceptance.
• Ensured dat project followed Business Rules and was in compliance wif HIPAA rules to display minimum benefit information and others.
• Worked wif 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.
• Participated in daily standup meetings and owned daily milestones to gather and create reporting specifications.
• Created UAT plans wif several test cases for each project to ensure dat 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 dat those requirements are in alignment wif the expected results.
• Gathered requirements for impacted system and business areas and their needs to embrace the changes.
• Created T-SQL statements, stored procedures to query the custom claims OLAP & OLTP databases.

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

Business Analyst

Confidential, Kennett Square, PA

Responsibilities:

• Gathered Functional Requirements to overcome the problems of existing system, and implemented the rectified changes in the new system.
• Conducted interviews wif 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
• 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 wif the end users prior to programming to solicit User Acceptance.
• Ensured dat project followed Business Rules and was in compliance wif HIPAA rules to display minimum benefit information.
• Worked wif 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 wif several test cases for each project to ensure dat 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 dat those requirements are in alignment wif 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

Business Analyst

Confidential, Sunrise, FL

Responsibilities:

• Assisted in identifying project scope, to conform to the regulatory compliance related to X12 837 (me/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 wif stakeholders, SME’s and business owners to discuss the scope of the conversion.
• Produced for transaction sets 835 and 837 (me/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 wif 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

Business Analyst

Confidential, Queens, NY

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.
• Helped co-business analysts in drawing process flow diagrams using MS Visio.
• Helped project manager wif MS-Project for developing schedules using Gantt charts.
• Extensively worked wif quality analysts to make sure dat the functionality meets requirements.
• Conducted walkthroughs wif development & Test teams and stakeholders.
• Helped Reporting team wif 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)