Business Analyst Resume
Durhman, NC
SUMMARY:
- 7+ years of experience as HEALTHCARE BUSINESS ANALYST and has extensively worked oncomputerized healthcare systems.
- Worked on EMR systems. Posses good knowledge of EDI transactions for claim process,
- Well versed with HIPAA compliance, software testing techniques, Agile/SCRUM, SDLC/STLC, CPT, ICD - 9/
- ICD 10 coding, EDI/X12.
- Detail-oriented, excellent analytical and communication skills.
- Expertise in ICD-9 to ICD 10 Conversion and have good knowledge of healthcare domain.
- Highly skilled in identifying system and client needs. Strengths include developing and presenting innovative solutions.
- Experience in system conversions (Mapping, Migrating, Enhancement) such as HIPAA X12 4010 codes to
- X12 5010 codes and ICD-9-CM codes to ICD 10-CM & PCS codes in Medicaid, Medicare, Procedural and
- Diagnostic codes and Claims processes.
- Able to manage multiple projects and bring them through to completion. Regarded as a determined troubleshooter in areas where problems are not clearly defined.
- Developed Test Plans, Test Requirements, Test Cases, Test Reports, and detect tracking as required by the project.
- Experienced in manual testing, recreating errors and provide support to programmers to correct defects in the system. Facilitated UAT with the stakeholders and the business users.
- Facilitate JRP sessions and JAD sessions with business owners, IT team & Users to drive out detailed business requirements, experienced in Systems Testing, Integration Testing, and Software Quality Standards,
- , Documentation and implementation in a business environment.
- Versatile team player with excellent communication and interpersonal skills. Exceptional ability to quickly master new concepts and technologies.
- Managed Projects with Proof of Concept and help the team for the Functional Specification write ups
- Worked with Tech Lead to Prototype systems with the business
- Extensive experience in Content Mgmt/Publishing, Use Cases, Web Based Project background
- Extensive Understanding of Physician Data
- Functioned as Subject Matter Expert and Managed both onsite and offshore teams.
- Hosted change control meetings and Involved in change management coordination.
- Provided innovative solutions for client's requirements, pla nned & executed of any upgrades on existingproducts.
- Handled operations in-coordination with client to maximize the resources efficiency.
- Proven command on ICD/CPT coding on multispecialty e.g. Interventional Radiology, surgery, radiology, E/
- M, and medicine.
- Clarify client requirements, business needs and project objectives, via feedback sessions and client meetings, in collaboration with all stakeholders.
- Collaborated with third-party technology distributors to facilitate communication for successful project completion.
- Experience working on database-centric projects (Data Warehousing, data mapping, data migration)
- Conducted business analysis, project assessment and feasibility determination. Analyses of data feed requirements for news product.
- Creating and updating user guides for different software and applications.
- Knowledge of ISO, Six Sigma and CMM standards.
TECHNICAL SKILLS:
SDLC Methodologies: RUP, CMM, Waterfall, Agile.
Testing Tools: Rational Enterprise Suite, Mercury Test Director, WinRunner, Load Runner
Business Modeling Tools: Rational Rose, DOORS, Microsoft Visio, Erwin
Version Control: Systems Rational Clear Case, PVCS, Documentation
Project Management Requirements: Management MS Project, Confidential, Tele logic DOORS
Test Management Tools: Rational Clear Quest, HP Quality Center
Programming Languages: SQL, PL\SQL, Visual Basic, HTML, C, C++
Databases: MS Access, SQL Server, Oracle 10g/11g, DB2
Operating Systems: Windows 2000/XP/Vista, UNIX, MS Dos, Mac OS
Web Technologies & General Microsoft: Front Page, Macromedia Dreamweaver 8, XMLMS Office (WordExcel, PowerPoint), MS Project, Lotus Notes
WORK EXPERIENCE:
Business Analyst
Confidential - Durhman, NC
Responsibilities:
- Performed Impact analysis for readiness of ICD 10 conversion.
- Documented High Level Logical Data Models and BRD supporting documents containing the essential business elements, detailed definitions, and descriptions of the relationships between the actors to analyze and document business data requirements
- Assisted Project Management in developing Scope/ Vision Documentation and Project Plan, tracking project process, and developed Risk Mitigation Plan.
- Created Use - Case diagrams, Sequence Diagrams and Activity Diagrams after accessing the scope of the
- Project and understanding the business processes.
- Modeled the AS-IS system and performed GAP Analysis for the existing system in order to map it to the
- To-Be system.
- Involved in providing Logic and mapping for ICD10 fields
- Involved in redefing the business rules for claims processing.
- Provided Mapping and transformation rules for Professional, Facility and Denied Claims processes including the conversion of ICD10 fields.
- Worked closely with the UI team to model the screens, which met user defined requirements, organizational and regulatory standards.
- Create tasks and update tasks in the MS Project and Project Management Directory for the senior management reviews.
- Reviewed test cases written by QA team and made changes for better execution of test cases.
- Documented Requirement Traceability matrix in Confidential for traceability of requirements through test cases.
- Coordinated with the PMO group in defining timelines & schedules for the project.
- Maintained and monitored Project progress status using MS Project.
- Communicated status of efforts to management and business partners on a regular basis to ensure that all stakeholders have accurate and current information throughout the process
- Conducted User Acceptance Testing (UAT) with the stakeholders and business users, fixed the discovered errors and verified it through regression testing
- Assisted end users and IT staff in the use of data to satisfy informational and reporting requirements
- Well versed in writing SQL queries.
- Served as the primary point of contact between business and technical staff at all levels
Environment: .Net, UML, SQL, Windows Server 2003, Excel, Visio, MS Project, Power Point, Mercury Quality
Confidential
Business Analyst
Responsibilities:
- This project is involved in gathering business requirements of a client with writing Business requirement document & a High Level Design document for CHE specific projects with the help of flow charts and component modeling& the same is then used by developers to make them understand the business in system logic and help the system testers to derive the test cases from it.
- Performed internal reviews for the team to improve quality and attain higher productivity
- Provided analytical inputs for improving cash collection and reducing the assigned AR
- Took initiatives to design new work strategies that helped in reducing claim resolution time
- Generated multiple automated reports and strategies for smooth process flow
- Provide solutions on Claim Processing Application for the implementation of HIPAA mainly used for AR
- (Accounts Receivable) claims
- Involved in EHR applications, HIPAA 4010 - HIPAA 5010 and ICD9 - ICD10 conversions.
- Researched and understood the claims adjudication and reimbursement systems based on HIPAA X12 4010 standards.
- Ensured that images are mapped, indexed and made online for real-time availability
- Quality and error analysis for inputs to the process gap analysis study
- Providing team with all useful findings in US Healthcare which expedite claim processing Automation of
- In depth analysis on web scraping output to reduce manual intervention
- Analyze the business functionality of CMS
- Identified many Denial & Carrier specific trends
- Directed and managed the Change Control process for the project as a whole by facilitating group meetings, ne-on-one interviews/meetings and corresponding through emails with work stream owners to discuss the impact of change request on the project
- Providing detailed reports to show the status of accounts
- Assigning work to team based on the client requirements
Environment: MS Office, SQL Server, Agile, SCRUM, Rational Clear Quest, Rational Clear Case, Rational
Confidential
Business Analyst
Responsibilities:
- Involved in requirement gathering and created user requirements, managing change control processupdating existing documentation
- Created Data Flow Diagram for the Drug Distribution Application
- Extensive interactions with the client and the management teams to understand the business needs.
- Involved in designing Use Case Diagram, Class Diagram, Sequence Diagram for project documentation
- Analyzed user statement of requirements to develop new reports
- Wrote standard and complex SQL Queries to perform Data Validation to make sure test results matched back to expected results based on the user needs.
- Participated in User Acceptance Testing (UAT)
- Analyzed user requirements, attended Change Request meetings to document changes and implemented procedures to test changes using Rational Clear Quest.
- Performed GAP Analysis to derive requirements for existing systems enhancements.
- Functioned as the primary liaison between the business line, operations and the technical areas throughout the project cycle
Environment: Windows XP, Confidential 7.1, RUP, UML 2.0, MS Visio 2007, Cognos, Oracle Business