- Business system analyst with 8+ years of experience in medium to large scale web application services environments with strong focus on Business Analysis, Business modeling, requirements gathering, technical documentation and software validation.
- More than 8 years of successful progressive experience in all phases of software development life cycle (SDLC) and project life cycle (PLC).
- Proven ability to work in dynamic and fast pace work environment under pressure to prioritize and meet deadlines.
- Good understanding of working in collaboration with SME’s, architects, developers and other team members in the overall enhancement of software product quality.
- 8+ years of extensive experience as a business analyst with strong experience in Healthcare domain.
- Strong knowledge of various development methodologies like SDLC, Waterfall, Rational Unified Process, Agile and Scrum.
- Proficient experience in Manual and Automated Testing of GUI and functional aspects of the Client - Server and Web based Applications on multiple levels of SDLC.
- Extensive experience in gathering Business and System Requirements and documenting BRD, FRD, and SRS.
- Experience in developing UML use case diagrams, Work Flow Diagrams using tools like MS Visio.
- Experience working with HIPAA ANSI X12 4010A 270/271, 276/277, 834, 835, 837 for institutional, professional and commercial claims, and up-gradation of ANSI 4010 to ANSI 5010.
- Excellent understanding of ICD 9, ICD 10, HL7, HCPCS, Patient Protection and Affordable Care Act (ACA) and CPT.
- Experience in capturing all HIPAA-related EDI data in the repository using FACETS.
- Proficient in Developing database schema based on logical models and executing Test Plans, performing functional, usability testing and ensuring that the software meets the system Requirement.
- Good knowledge of UI/UX designing.
- Facilitated accelerated process design workshops based on ITIL best- practices for request fulfillment, incident and change management and their respective integration point.
- Utilized Microsoft Team Foundation Server (TFS) to manage the team's software development lifecycle.
- Utilized Rational Clear Quest to organize, document and track changes and defects and used Clear Case to archive the changes.
- Proficient in soliciting client Requirements through interviews, workshops, existing system documentation and organizing JAD sessions.
- Consulted to deploy ITSM processes and promote Continuous Service Improvement.
- Proficient in Technical and Business Writing, Business Process Flow, Business Process Modeling, Business Analysis and Testing various methodologies.
- Competent in Creating Unified Modeling Language (UML) diagrams such as ER diagram, Use Case Diagrams, Activity Diagrams, and Sequence Diagrams.
- Extensive experience in developing Use Cases, creating Screen Mockups, wire frames, conducting Feasibility Analysis, Gap Analysis, Impact Analysis, Cost Benefit Analysis and Risk Analysis.
- Responsible to Track, Document, Capture, Manage and Communicate the Requirements using Requirement Traceability Matrix (RTM) which helped in controlling numerous artifacts produced by the teams across the deliverables for a project.
- Experience in working with QA testing teams, while interacting with business users and gathering user’s requirements to develop necessary Test plans, Test Cases and Test script and participated in UAT.
- Good understanding of BABOK and working towards Business Analyst Certification through IIBA.
Operating Systems: Windows XP, Windows 7, Windows 8, MAC OSX
Databases: MS SQL Server, Oracle 9/9i, Mainframes
MS-Suite: MS-Word, MS Excel, MS outlook, MS Power-point, MS SharePoint, Team Foundation Server
Testing Tools: Rational Requisite Pro, HP Test Director, Win Runner, Load Runner, Rational Clear Quest
Methodologies: Rational Unified Process, Agile, Waterfall, SCRUM, Six Sigma(DMAIC), Business Modeling, Process Modeling and Data Modeling
Design Tools: Microsoft Visio, Rational Rose
Other technologies: XML, MYSQL, SOAP, WSDL, Altova XMLSPY, HTML, CSS
Confidential, Pennington, NJ
Sr. Business Analyst
- Analyzed business requirements and segregated them into high level and low level Use Cases, activity diagrams/Chart Diagrams using UML, defining the Data Process Models.
- Assisted the team as a liaison between the developers and project manager, and was instrumental in resolving conflicts between Testers and development teams.
- Developed ITIL standardization of processes change control and workflow management.
- Development of standard documentation package (Requirements, Specification, Design, Operations, and Quality Testing Plans).
- Derived Business Requirements Document (BRD), Functional Requirement Specifications (FRS) based on User Requirement Specification URS. Understand and articulate business requirements from user interviews and then convert requirements into technical specifications.
- Created test strategies, test plans, wrote and executed positive and negative test cases using testing tools
- Involved in writing Test Cases based on the Functional Specifications, documenting them using Test Director as per HIPAA standards.
- Detailed user-interface prototypes and performed usability testing.
- Involved in HIPPA various levels of testing like Integrity Testing, Requirement Testing and Business Scenario's specific testing.
- Analyzed the pre-edits against Client Profile and the input EDI files. Loops and segments were checked on the EDI files for the data sent for different fields.
- Recommended implementation of application using Service Oriented Architecture (SOA).
- Performed data mapping and data field mapping to map the application server, web server and database server.
- Involved in writing business requirements, test plan, and defects in test director.
- Involved in designing data base schema.
- Worked with FDA guidelines, HIPAA and EDI transactions.
- Developed test cases based on business and functional requirement
- Performed functional, Regression, System, Compatibility, User Acceptance Testing, for verifying application functionality.
- Worked on Pharmacovigilance through Argus Insight and Safety
- Actively involved in walkthroughs and meetings with development team to discuss related issues.
- Developed SQL queries to conduct front end and backend testing
- Developed & Automated Data Validation Test Cases to test the application.
- Enhanced Test cases in Test director as per the new functional requirements.
- Performed data driven tests with positive and negative data sets using flat file and data tables.
- All the issues that came up during this process were logged in Test Director as defects.
- Maintained status reports and communicated with the Management on progress of work.
Environment: Win runner, Test Director, HIPAA, Pharmacovigilance, ITIL, Rational rose, Rational requisite Pro, ASP, SQL SERVER, XML, SOA, MS Office suite, UML .
Confidential, Quincy, MA
Business System Analyst
- Conducted interview sessions with users and different levels of management so as to extract requirements to understand the functional specifications of the AS IS system.
- Did the GAP and IMPACT analysis to design the TO BE system.
- Responsible for the execution for the project life cycle (SDLC), including requirements gathering, design, testing, implementation and documentation, as required.
- Facilitated smooth completion of project by providing insurance subject matter expertise to the team and utilizing subject matter know-how for quality assurance purposes.
- Gathered and documented business requirements and system requirements in order to describe the business needs in terms of the main deliverables.
- Actively involved in creating/updating Work Breakdown Structure (WBS), preparing deliverable tasks in the project plan.
- Provided issue resolution recommendations by ensuring that there is regular and effective communications of issues and corrective actions between teams.
- Identified Actors, Activities, Artifacts and Workflows and developed use case diagrams.
- Involved in Service Oriented Architecture (SOA) of the claims processing system.
- Assisted clients during UAT Environment.
- Performed Requirement Analysis and developed Use Cases, Activity Diagrams using Rational Rose.
- Completed the documentation of Claims Scenarios for the source system.
- Helped in designing and implementing deployment process, and thus maintaining the application in post deployment process.
Environment: Environment: Quality Center, Java, Oracle, Toad, Web logic, Windows XP, MS Office, Rational Requisite Pro, Rational Rose, XML, SOA, MS SQL, MS Share Point.
Confidential, Jacksonville, FL
Sr. Business Analyst
- Worked as a liaison among stakeholders in order to elicit, analyze, communicate and validate requirements for changes to business processes, policies and information systems.
- Interacted with the Business users, SME’s, Developers, PMs and QA teams to better understand the business processes and application knowledge.
- Contributed in implementation of transition in accordance with HIPAA standards.
- Accepted inbound transactions from multiple sources using FACETS.
- Supported integrated EDI batch processing and real-time EDI using FACETS.
- Analyzed and prioritized HL7 V3.
- Recommended and Conducted a JAD session for technical capability and feasibility analysis of implementing the SOA with technical leads and architects.
- Met with Supervisors and business users and defined the scope of the project, gathered business requirements, and conducted gap analysis
- Created Business Requirement Documents (BRDs), Use-Case Narratives including business process workflow diagrams and Requirements Traceability based on any of the projects need.
- Conducted Requirements Walk-Thru JAD Sessions and resolved all issues/findings.
- Successfully received Sign-Offs by utilizing Clear Quest tool for all projects on time after resolving all open questions.
- Lead & Facilitated numerous meetings to help answer any question on requirements during Design, Development, Testing and Implementation phase.
- Communicated with all the key stakeholders, business teams, contributors, operations and technical experts to ensure help and involvement in completing the assigned task.
- Responsible for mapping documents, creation of test plan, test cases for unit, system and system integration testing.
- Worked on multiple complex client side and server side validation tools.
- Wrote and tested multiple XML based web services and web methods using SOAP and WSDL.
- Conducted data mapping, data migration and multiple ETL transactions using prior SQL knowledge and conducting meetings with database administrators of both internal as well as external databases.
- Organized brainstorming and JAD sessions with stake holders, business users, technical teams, testing team to analyze and validate the business requirements, system life cycle and explained the key performance indicators and documented the specifications.
- Coordinated with users and QA team in doing UAT and conducted UAT testing.
Environment: MS SQL server, XML, SOAP, WSDL, HL7, MS Office Suite (Word, Excel, Access, PowerPoint & Outlook), Facets front end and back end, Vendor Table, WebEx, Share Point.
Confidential, Irvine, CA
- Gathered Business Requirements from the Business users, Subject Matter Experts (SMEs) and document the requirements in the BRD.
- Utilized data flow diagrams, use case diagrams and process flow diagrams to represent information provided by the Business Owners.
- Responsible for understanding, articulating, extracting, and refining user requirements by conducting JAD sessions.
- Facilitated meetings & interviews with Business Units and Technical Supports & Development team, identifying the business flows and process flows, conducting detailed and comprehensive business, functional & system analysis.
- Maintained the Issue Log and Kept track of the Action Items.
- Met with AmeriHealth Caritas Fraud and Abuse department team on a regular basis for requirements and edits.
- Created a detailed project plan with emphasis on deliverables using MS Project.
- Created different Standard Operating Procedures (SOPs), policies and workflows.
- Created test cases and test scripts and participated in UAT.
- Created outbound file template and loaded in ACE system.
- Worked on Prospective and Retrospective payment integrity project.
- Used MS Share point to store all Project Artifacts.
- Documented the Requirement Traceability Matrix (RTM) for tracing the Test Cases and requirements in MS Excel.
- Worked on various procedure codes that leaded for Fraud and Waste cases.
- Helped client recover millions of dollars by identifying fraud claims.
- Met the state and federal standards and worked on coding standard to meet the HIPAA compliances.
- Assisted EDI team with the testing of maps for HIPAA transactions 835 and 837.
Environment: MS Visio, MS Project Professional, MS Project, WebEx, and Microsoft Office package, MS Share point, ACE, Blueprint, Oracle, SQL, Clear Quest, HP Quality Center.
- Responsible for requirements gathering, analysis & design, and preparing artifacts.
- Responsible for planning timelines, schedules and dates for multiple releases and upgrades that are delivered to Service/Channel stake holders.
- Facilitated JAD sessions to identify, understand and document requirements and operated as a liaison between the technical team and the businessusers.
- Created use case diagram, use case document, activity diagram and businessprocess flows.
- Elicited requirements for Agile projects by documenting User stories, Product Backlogs and Acceptance Criteria.
- Participated in User Story Estimation, User Story Prioritization, Sprints, User Story Testing, and Project Documentation.
- Developed businessrequirements, user requirements and functional requirements, and documented the same by creating businessrequirement document, use case document and functional requirement document.
- Documented workflow and results of businessanalysis done and obtained sign-off from client on specifications.
- Communicated with multiple stakeholders, including cross-functional vendors and offshore.
- Conducted gap analysis and documented the gap analysis document using Excel.
- Documented all the artifacts in Microsoft SharePoint for version controlling and common point accessibility purpose.
- Resolved issues and improvised the process to ensure a stable and accurate solution.
- Created test plans, test cases, test scripts and testing traceability matrix. Developed test strategies for User Acceptance Testing (UAT). Used HP Quality center for loading the test scripts and logging the defects.
- Conducted application demos and functional reviews with developers and stakeholders.Retrieved and processed data by writing
- Prepared the production certification scripts and performed the production certification.
- Communicated the project status and ensured the team stays on track to satisfy the businessneeds.
- Provided daily status and prepared weekly project status reports.
Environment: Agile/Scrum, MS Visio, MS Access, XML, HP Quality Center, MS Office, Windows 2000/XP.
- Performed quality review and cleanup of old account receivables utilizing the SMS Invision. Patient Accounting System and SSI Billing and Claims Transmission software for correct claims administration.
- Prepared Workflow diagrams analyzed AS IS and TO BE scenarios, designed new process flows and documented the business process and various business scenarios.
- Facilitated Joint Application Development (JAD) sessions with all IT group members for communicating & managing expectations and to discuss various means for integrations with current system using an adoption through execution strategy.
- Identified all necessary Business and System Use Cases from requirements, created UML diagrams including Use Case Diagrams, Activity Diagrams, and Sequence Diagrams.
- Performed trouble shooting on SSI, SMS, charge master, claims administration and system related issues as warranted.
- Identified major electronic claims transmission problem causing claims transmission failure.
- Assisted in developing test scenarios, test scripts and test data to support unit and system integration testing.
- Corrective action resulted in substantial cost savings.
- Wrote SQL scripts for creating performance evaluation reports.
- Maintained Traceability Matrix throughout the project.
- Advised charge master analyst of changes in Medicaid/Medicare codes to update billing system.
Environment: Waterfall, MS Visio, Java, HP Quality Center, MS Office, Windows2000/ XP, MS Access
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