SUMMARY:

• Almost 7 year’s industry experience as a Business Analyst with solid understanding of Business Requirement gathering, Business Process flow, Business Process Modeling and Business Analysis. Expertise in working with Business Analysis, Business Processes, Business Process Models, Business Flow Diagrams and Business Requirement Documents.
• Expertise in Business Systems Analysis and Requirements Management.
• Direct responsibilities include experience with requirements gathering, planning, organizing, and Change Management.
• Excellent Analytical skills, Technical skills to understand the Business process and Functionality requirements and to translate them to system requirement specifications.
• In Depth Knowledge of all phases of SDLC methodologies like Waterfall, Scrum and Agile (RUP).
• Experience in developing and writing functional business requirement and process flows.
• Experience in conducting JAD sessions for project definition involving analyzing requirements, creating prototypes, and user interface documents.
• Experience in Business Process definition, Risk Analysis, and Use case Analysis.
• Experience in Business Analysis using tools such as Functional Flow charts, Workshops and Brainstorming Sessions and extensive exposure to UML diagrams using MS VISIO.
• Good knowledge of Medicaid, Medicare, ICD Procedural as well as Diagnostic codes.
• Good experience in medical HIPAA 5010, EDI - 837, 834, 835, 270/271, 276/277 Claims Process.
• Expertise in implementation of HIPAA 4010 and 5010, HL7standards and regulations to protect the privacy of the employee insured under any policy.
• Worked with pharmaceutical data processing and have excellent knowledge of user activity data handling.
• Good experience working as QA (Quality Assurance) reviewing test plans and Test Scripts to make sure that all the requirements will be covered in scripts and tested properly
• Experience of doing GAP analysis, User Acceptance Testing (UAT), SWOT analysis, Risk analysis, and ROI analysis
• Team player, result-oriented, fast learner, excellent communication skills with strong research capability.
• Expertise in all aspects of accounting, including accounts payables, accounts receivables, financial reporting, payroll administration, bank reconciliation, and tax accounting.
• Detail oriented and organized employee, with strong problem solving skills and exemplary attention to details. Proficient with a variety of computer programs. A respected team player willing to do whatever is necessary to get the job done.

TECHNICAL SKILLS:

Application: Microsoft project, Microsoft Visio, Rational Rose, MS Office 2003/2000/XP: MS Word, MS Excel, And PowerPoint, SSH Client.

Process Modeling: Unified Modeling Language (UML), Rational Rose, BPMN Business process Modeling notation, BRML Business Rule Markup language.

Standards &Methodologies: HIPAA, EDI, CMM, SDLC, RUP, Agile, and ICD-9/10 Coding, CMS forms, Analysis & Design, E/R Design, Waterfall prototype

Operating Systems: Window 7, Window Vista/2003/2000/NT XP/98/95, DOS, UNIX, Linux

Modeling Tools: Rational Clear case, MS Visio 2000/2003/2007, MS Project 2000/2003, Mega Modeling Suite.

Quality Management: Six Sigma, TQM, Lean Manufacturing and Erwin

Database: SQL Server, Oracle Server, Microsoft Access

Project Mgmt, Design & Case tools: MS Project, Visio, Rational Rose, RequisitePro, Clearcase, Clearquest Microsoft Office 2010 (Project, Word, Excel PowerPoint, Access, Visio)

Standard Skills: HIPAA, ISO, Six Sigma, Research Analysis, SOX and CMM

Test Tools: Test Director, Quality Centre, Quick Test Pro(QTP), Win Runner, HP Quality Centre

PROFESSIONAL EXPERIENCE:

Confidential, NJ

Sr.Business Analyst

Responsibilities:

• Assisted in Billing and Transition phases of the project and to review project deliverables for completeness, quality and compliance.
• Conducted detailed and comprehensive business analysis by working with the Stakeholders, End Users, System Analyst, Developers and Management Staff in order to identify system, operational requirements and improvements.
• Converted user requirements into business requirements and technical specifications for designers and developers to understand the business process.
• Creating artifacts for Rational Unified Process (RUP) - system architecture document, supplemental requirements document, desk procedure manual, architecture diagrams; designing and executing performance tests.
• Gathered health plan and dependent business requirements so that members can access rmation, claim histories and enroll for coverage in KP Health Connect.
• Involved with KPHC in adding a new Benefit Plan, new provider and updating the current existing Benefit Plan.
• Involved in Medicare, ICD Procedural as well as Diagnostic codes
• Involved with the following list of HIPAA-EDI Transaction Code Sets:
• 837 - Claims and Encounter
• 834 - Benefit Enrollment and Maintenance
• 835 - Claim Payment/Advice
• 270/271 - Eligibility Benefit Inquiry and Response
• 276/277 - Claim Status Request / Response
• Documented Health Insurance Claims processing Test Plans, Test Cases and performed data validation using specification documents
• Created data flow diagrams, system Use cases and UML models to depict required functionality.
• Managed the change request in Clear Quest and analyzed the impact of the change request on the application in regards to Project Plan, Project Scope and Project Schedule.

Environment: MS Access, MS Visio, MS Project, MS Office, HTML, SQL, Windows XP/2000, Mercury Quality Center.

Confidential, FL

Business Analyst

Responsibilities:

• Performed and conducted independent research such as company background checks, comparative industry analysis, trending analysis and demographic data using SQL
• Identified potential risk concerns within the Accounts Receivable portfolio and efficiently provided a risk assessment for the monthly Credit Watch report.
• Created, reviewed, and modified the Risk Assessment Criteria model predicated upon characteristic changes in the industry and the Accounts Receivable portfolio.
• Performed and conducted written analysis outlining key performance indicators and key risk indicators.
• Monitored and examined roll rate and performed related analysis.
• Provided support in the design and implementation of ad hoc requests for Credit-Related Portfolio Data.
• Optimize the risk and reward balance by applying and assessing the NPV performance across the various portfolio segments
• Liaise with senior management in key business areas impacted by strategy changes.
• Perform business analysis and report to understand financial performance by risk and key channel and partner sub-sectors that will be used to inform future investment decisions.
• Analyzed bank's market position and ran figures through complex modeling techniques to find value at risk (VAR) measurements
• Translated the business needs into system requirements, communicating with the business on a broader scale and with an in-depth view too.
• Performed extensive requirement analysis including data analysis and gap analysis.

Environment: Windows, MS Office (MS Word, MS Excel, MS Access, MS PowerPoint, MS Visio), RUP, UML, SQL, SWOT analysis, GAP Analysis

Confidential - Ankeny, IA

Business System Analyst

Responsibilities:

• Performed Feasibility Study, Project Planning, Requirements Analysis, and Prototype Development
• Followed Agile SDLC methodology from requirement analysis through deployment, using Agile methodology
• Gathered Business requirements and documented them and translated them into system specifications and business process flow for internal and B2B web services.
• Researched various steps in project lifecycle and constructed system in a way that the high-risk material would be easily identified and monitored.
• Facilitated Joint Application Development (JAD) for communicating and managing expectations to discuss ways of integration of rational tools with current system
• Developed test plans, test conditions and test cases to be used in testing based on Business requirements
• Proficient in creating UML Diagrams including Use Cases Diagrams, Activity Diagrams using Rational Rose and MS Visio
• Prepared comprehensive Use Case Specifications document by identifying the use cases from the collected business gathering document.
• Managed the change request and analyzed the impact of the change request on the application in regards to Project Plan, Project Scope and Project Schedule.
• Worked with development and testing teams to accomplish timely release.
• Worked closely with QA to develop Test Plans and Test Cases as per the requirements using Mercury Quality Center.
• Reviewed and processed Test Plans, Test Cases, Test Case Execution and performed data validation using specification documents and Quality Centre.
• Involved in User Manual designing, knowledge transition seminars, and conducted benchmarking activities to identify best practices in the industry

Environment: MS Office, RUP, UML, t, Clear Case.

Confidential - Philadelphia, PA

Business Analyst

Responsibilities:

• Interacted with stakeholders and end users in order to define the purpose and scope of application and gather User Requirements.
• Created Requirement Specification Documents after conducting Interviews with End Users, JAD Sessions and analyzed their current systems.
• Involved in Medicare, Medicaid and also in International Classification Disease (ICD).
• Involved in gathering requirements that comply with HIPAA 5010, HL7 and ANSI X 12 format regulations to protect the privacy of the employee insured under any policy.
• Conducted and involved in functional requirement reviews and walkthrough with the designers, developers and stakeholders.
• Monitoring Defect Tracking using Rational Clear Quest to ensure that testing effort is progressing with the development team.
• Involved in GUI Design sessions with the Usability Team and testing Browser compatibility and navigation.
• Actively involved in analyzing the As-Is process and designing to-be process as a part of business process re-engineering module, using TQM as a tool to handle various problems encountered during the effort to improve the process continuously.
• Managed the change request and analyzed the impact of the change request on the application in regards to Project Plan, Project Scope and Project Schedule.
• Interacted with users using existing Mainframe system for better understanding of business flow and implementation.
• Clarified QA team issues and reviewed test plans and test scripts developed by QA team to make sure that all requirements will be covered in scripts and tested properly.
• Organized meetings to discuss outstanding issues with QA team and developers

Environment: HTML, SQL, Rational Clear Quest, Windows XP/2000, MS Project, MS Visio, MS Outlook and MS Office.

Confidential

Business Analyst

Responsibilities:

• Interacted closely with the Subject matter experts (SME) for the functional requirements gathering.
• Facilitated JAD sessions, conducted interviews, Q and A sessions with business users to solicit business requirements relative to proposed functionality and created Functional and Non-functional requirements.
• Worked closely with the development team to clarify and understand functionality, resolve issues and provided feedback from the UML diagrams.
• Created Use Cases and Business Use Cases model after accessing the scope and status of the project and understanding the business processes form USER perspective.
• Analyzed, collected and prepared user requirements, definitions, scope and expectations for deliverable plans and delivered system documents, processes, diagrams.
• Defined business processes, identified gaps, evaluated requirements and change requests, managed scope and transferred knowledge.
• Developed and managed all the work plans, acted as the key client contact, handled all kinds of scheduling, ran all status meetings and compiled various reports.

Environment: UML, Use Case Analysis, MS Visio, Enterprise Architect, MS Office