SUMMARY

• Business Analyst with over 7+ years of diversified experience and successful implementations in Information Technology involving in - depth understanding of Business Process Flows, Software Development Life Cycle, Process design, Business and functional requirements, Business case preparation, Development and Testing.
• Experience in full Software Development Lifecycle (SDLC) from association with end-users for requirements determination, defining the system scope, system analysis, Business Case Development to Rollout, Production, testing, maintenance and documentation.
• Thorough knowledge of UML, RUP, Waterfall, Agile, RAD methodology and rational tools.
• Strong Knowledge in various domains like Health care, Insurance and Bank Industries
• Proficiency in transforming business requirements into functional specifications focusing on workflow analysis and design, business process reengineering, user interface design, and process flow modeling.
• Lead and organized Requirements gathering sessions and JAD sessions before groups of Subject Matter Experts as needed in order to document decisions regarding future state of business processes.
• Proficient in diverse technology architectures.
• Excellent knowledge of HIPAA standards, EDI (Electronic data interchange) Transaction syntax like ANSI X12, Implementation and Knowledge of HIPAA code sets, ICD-9, ICD-10 coding and HL7.
• Good knowledge of Health Insurance Plans (Medicare Part A, B, C and D), managed care concepts (Medicaid and Medicare) and experienced in determining the membership eligibility, billing experience within life and disability in health plans with thorough understanding of CPT coding, CMS-1500 claim forms and reimbursement forms.
• Proficient in medical terminology and coding outpatient and inpatients diagnosis and procedures using ICD-9, ICD-10 and CPT codes.
• Insurance Claim Processing, ETL processes Main frame legacy system, MS SQL, Oracle, and Facets
• Fair working Knowledge of SOX compliance standards and HIPAA
• Facilitated Joint Application Development (JAD) sessions.
• Extensive experience with process modeling using UML, activity Diagrams with partitions and Use Cases, flow charts and sequence diagrams.
• Business writing skills in writing Business requirements document, Use-Case Specifications, Systems Requirements Specification (SRS)
• Experienced in Systems Testing, Integration Testing, and Software Quality Standards, Training, Documentation and implementation in a business environment.
• Experience in creation of project presentations for progress meetings and other high level discussions.
• Experience in conducting SWOT analysis.
• Experience in writing Test Cases and Test Scripts from the system requirements.
• Familiar with BASEL II, SOX and FDA compliance regulations.
• Understand rules and regulations of HIPAA as imposed during Electronic Data Interchange (EDI).
• Ability to rapidly learn new concepts and good experience in handling global projects.
• Can work individually and in a team, posse’s excellent communication and interpersonal skills.
• Competent problem-solver with exceptional negotiation, verbal and written communication skills.
• Proven ability handling multiple projects simultaneously.
• Proven ability working in high pressure and time crunch situation.
• Ability to create and maintain highly efficient environment with all team members and clients with clear understanding of requirements.
• Strong written and verbal communication skills.

TECHNICAL SKILLS

Operating System: Windows 95/98/200/XP/ME/NT, UNIX, LINUX, DOS

Business Analysis Tools: Rational Rose, UML, Requisite Pro, Visio, Mercury Test Director, JIRA

Software Languages: SQL, PL/SQL, C, C++, HTML, XML, VB, Unix Shell Scripting

RDBMS: Sybase, Oracle 9i/8.x/7x, SQL Server 7.0/2000

Office Tools: MS Word, MS Power Point, MS Excel, MS Access, Outlook

PROFESSIONAL EXPERIENCE

Confidential, La Jolla, CA

Sr. Business Analyst

Responsibilities:

• Communicated with business owners and system users for gathering requirements using face to face meetings, telecom and e-mails. Couple of projects required communicating with customers at different countries like UK and Belgium.
• Followed company’s Template for documenting the requirements in particular format after dividing all the requirements into like Business Requirements, User Requirements, Functional Requirements and Non-Functional Requirements.
• Designed Work Flow Diagram and other different UML Diagrams like Sequence Diagram, Activity Diagram and Use Case Diagram for the better understanding of the whole process.
• Bridging gap between the Business needs and the Technical solutions
• Defining the Business Process Model and Data Process Model
• Followed HIPAA compliance to safe guard patient information
• Coordinated with Project Managers to resolve risk issues and ensure compliance of Security System-Related to the HIPAA.
• Performed Gap analysis pertaining to conversion to accommodate the ICD-10-CM and ICD-10-PCS code sets.
• Gathered AS-IS and TO-BE information about work processes and information flows (Claims process, Membership, Enrollment) and conceptualized using activity diagrams
• Managed and developed EDI specifications, gap analysis, and applications structures for data feeds and mappings for integration between various systems, including XML, to follow ICD 10 Code set, ANSI X12 4010 formats including 270 Eligibility/Benefit Inquiry, 271 Eligibility/Benefit Information, 276 Claim Status Request, 277 Claim Status Response, 700 Attachment Request, 701 Attachment Response, 810 Invoice, 820 Payment Order/Remittance Advice, 834 Benefit Enrollment, 835 Remittance Advice, 837 Claims and Encounter, and 997 File Transmission Acknowledgement, to meet and exceed HIPAA requirements set forth by the federal government.
• Developed use cases, and traceability matrices to better assist software development.
• Developed training material for understanding the newly developed application.
• Wrote technical documentation for root cause analysis on customer support issues.
• Part of the team assisting in documentation such as proposal writing, evaluation criteria, proposal approval, design document, project plan, project scheduling and project report.
• Prepared business requirement document (BRD) and functional requirement document (FRD) to provide details of each business and functional requirement, development and implementation plan of these requirements, timelines, owners, etc.
• Prepared the efforts and cost estimation of the project and worked towards obtaining approvals from all the stakeholders
• Designed Context Diagram to explain which other different system our system would interact and how the information would be exchanged between them.
• Scheduled and organized requirements review workshop with all the customers and business owners. Went through each and every requirements line to line and got approval from the customers and give developers ‘go’ to start building the application.
• Worked with customers and designed different screen’s prototype to explain the developers how customers exactly want to view their screen.
• Conducted weekly team meetings with developers for discussing the status and issues.
• Prepared reference material for all the users of the system using screen shots to guide them through different functionalities of the system.
• Worked with tester in developing test scripts for all user roles and determining who will execute each script.
• Created and maintained the Requirement Traceability Matrix between the requirements and other products such as design documents and test plans.
• Attended UAT and assisted users in executing each script and got customer signoffs.

Environment: J2EE, MS Word, MS Visio, MS Excel, SharePoint, HTML, UML, SQL, Oracle9, Mercury Load Runner, Mercury Quality Center, COGNOS, OSCAR, BDR

Confidential, Minneapolis, MN

Business Analyst

Responsibilities:

• Involved in preparing the project scope and objectives.
• Prepared business requirements documents by conducting client group interviews, focused groups, workshops and online surveys.
• Prepared and maintained the Requirement Traceability Matrix (RTM) to record the business, functional and non-functional requirement.
• Prepared business requirement document (BRD) and functional requirement document (FRD) to provide details of each business and functional requirement, development and implementation plan of these requirements, timelines, owners, etc.
• Prepared the efforts and cost estimation of the project and worked towards obtaining approvals from all the stakeholders
• Participated in prioritize the requirements to better manage the project.
• Performed comparative analysis and gap analysis to meet HIPAA standards pertaining to conversion to accommodate the ICD-10-CM and ICD-10-PCS code sets.
• Ensured that the ICD-9-CM diagnosis and procedure codes & CPT codes requirements are thoroughly understood by all the stakeholders to in corporate appropriate changes in the recording system
• Conducted use case analysis to identify the possible scenarios in the project
• Prepared use case diagrams and description documentation based on the analysis, and obtained approvals from the clients
• Prepared activity diagrams and sequence diagrams on MS Visio to better understand the flow of activities along with the timelines of each actors
• Used Rapid Application Development (RAD) model to in corporate all required features as per the HIPAA guidelines in the patient’s ID
• Coordinated with project stakeholders to track the progress of the project, update status and lead review meeting to ensure that schedules and deliverables are met
• Coordinated and controlled change request for the clients by conducting impact and cost analysis, prioritizing and mitigating changes
• Prepared change request form to provide details of the changes requests, and obtained approvals from the appropriate stakeholders
• Prepared test plan and test cases
• Supported the testing team during the testing stage by conducting user acceptance testing (UAT)

Environment: - MS Projects, MS Visio, MS Word, MS Excel, MS PowerPoint, MS Outlook, UML, Rational Application Development (RAD) SDLC model, Rational Requisite Pro, Windows XP, Issue Tracker

Confidential, Minneapolis, MN

Business Analyst

Responsibilities:

• Analyzing the old database and understanding its short comings.
• Arranges JAD sessions with the employees to understand their needs.
• Conducted detailed walkthrough of Business requirement and functional requirement.
• Developed Project Plan around RAD (Rapid Application Development).
• Chalked out the scope, timeframe, risk analysis, cost and maintenance procedure
• Researched and established the points of improvement in the software and the possible implementation of security standards
• Used Microsoft project to develop the project plan
• Microsoft Visio was used to create various documents such as Use Cases and Activity Diagrams in a format that can be reviewed and understood by both business and technical people.
• Played the key role in planning, developing, implementing. User accepted testing and maintenance
• Used SQL to manage data and data queries.

Environment: - Windows, SQL, Microsoft Excel, Microsoft word, Microsoft Access, Power Point, Agile Methodology, Windows 2000/XP

Confidential, NJ

Business Analyst

Responsibilities:

• Responsible for the coordination and completion of projects across various functional areas.
• Provided subject matter expertise in areas including project management, project scope definition, risk identification, project methodology, resource allocation, facilitation, and other areas of expertise based on professional knowledge and background.
• Conducted presentations to management on project updates, project cycle, and expected results.
• Created process flows and conducted walk-through of the process flows for the vendor’s team and the client’s team
• Created multiple SharePoint InfoPath based collaboration rules interfaces to convert different formats of data formats to interact with the internal system and external client systems.
• Successfully executed the BA process such as Entity Relationship diagram (ERD’s), Gap analysis, Process evaluation and SDLC.
• Used basic SQL queries for testing.
• Created UI mockups (prototypes) using Excel and traditional whiteboards
• Involved in authoring the Project Standards, Project Charter, Project Scope document
• Migrate the ICD 9 documentation from documents repository to the central share point site.
• Authored System Implementation Documents (Technical Specifications) (which includes creating mockups and screens) using functional requirements.
• Developed test requirements by decomposing the functional requirements
• Performed functional, regression and user acceptance testing on GUI
• Updated, maintained, and promoted Test Plans, Scripts and cases
• Designed detailed workflows using MS Visio.
• Worked with SciQuest tool in managing the procurement process to gather the product resources and contracts.
• Design, create and Provide training program for the new project members on the SharePoint structure, ICD 9 and the claim processing system.
• Drafted high-level Test Plan with assistance of QA lead to define a roadmap for testing at different phases
• Assisted QA in generating test scripts and test cases for functional requirement (FR) validation and performed user acceptance testing (UAT) to validate user requirements and expectations.

Environment: - Share point, Html, MS Visio, RUP, MS OFFICE, Windows XP, Rational Requisite Pro, Oracle Clinical Database, SQL

Confidential

Business Analyst

Responsibilities:

• Understand the need of the company. Organize workshops and interaction session with the employees and the management of the company.
• Understand the supply chain of the company.
• Analyze and understand the shortcoming of the present database and supply chain management system.
• Document the requirements for the developers.
• Develop the Project Plan and implement using RAD methodology.
• Develop Use cases, Use Case Models, Activity diagrams, Requirement traceability matrix using Microsoft Visio and other IT tools.
• Testing and implementing the software.
• Involved in training and software maintenance.

Environment: - Microsoft Office, SQL, Windows 2000, HTML and PHP, SDLC, RAD