SUMMARY

• 9+ years of experience as Business analyst and Quality Analyst, with strong experience in Healthcare (insurance claim with understanding of Business Process Flows, Case Tools, and Business Analysis).
• Experience in 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.
• Hands on experience in ICD 9, ICD 10, HCPCS, and CPT.
• Collaborated deliverables with QA testing teams, business users (gathering user’s requirements to develop necessary Test plans, Test Cases and Test scripts etc.).
• Gathering Business and Functional Requirements, Business Requirement Document (BRD developing Use Cases, conducting Gap Analysis and preparing Training manuals.
• Teh enterprise content manager (ECM) to identify and manage teh project requirements.
• Specifications, Functional Specifications, and System Requirements Specifications (SRS).
• Team player work in conjunction with testing, development and other teams in validation and testing complex scenarios and projects and in teh maintenance of Quality Standards in Projects.
• Experience in Independent verification and validation (IV&V)
• Knowledgeable about preparing RTM documents.
• Knowledge in documentation project related information like test execution procedures, backup plans, new tester training documents, maintaining test logs, release notes etc.
• Creative and aggressive self-starter with integrative thinking skills, capable of communicating creative ideas through graphical analysis charts and statistical data display.
• Participate in business meetings/interviews to analyze and redesign Claims Group & Member Enrollment processes Identified and engaged teh appropriate key stakeholders in working with Business Requirements.
• Prepares detailed requirement specifications, business process diagrams, charts, tables, reports and flowcharts.
• Progressive business & technology experience managing business analysis& key core growth programs.
• Providing vision and thought leadership by leveraging subject matter expertise in information systems methodology from conceptual design through documentation, implementation, user training, conducting quality reviews, enhancements, vendor management strategies, and considerations.
• Significant experience successfully leading complex work streams on time and on budget.
• Success driven - creating teh proper framework enabling businesses to improve efficiency, manage costs and attain target objectives with a proven record of assembling and leading cohesive, collaborative global teams dat consistently overcome challenges and exceed expectations.
• Relationship focused - incorporating teh total customer experience to maximize revenue contribution & ROI.
• Recognize customer needs and challenges to optimize value from solution design through implementation and delivery. Build sustainable, long-term partnerships and revenue relationships.
• Diverse domain experience i.e. Healthcare, Insurance, Retail and Energy business sectors.
• Exposed to various development methodologies like Waterfall, SDLC, Rational Unified Process, Agile and Scrum.
• Experience in developing UML use case diagrams, Enterprise Content Management (ECM), Work Flow Diagrams using tools like Rational Rose and MS Visio.
• Proficient in Developing and executing Test Plans, performing functional, usability testing and ensuring dat teh software meets teh system Requirement.

TECHNICAL SKILLS

Languages: SQL, PL/SQL, T SQL, Visual Basic 6.0, XML, HTML, Java.

Operating Systems: Windows (NT/XP/95/98/2000), UNIX, Sun Solaris, Mac OS.

Databases: Oracle 10g/9i/8i, SQL Server 2000/2005/2008 , PL/SQL, SQL*Plus, SQL*Loader, IBM DB2, MS SQL Server 2000/7.0/6.5 , MS Access 2000, Teradata V2R5.0.

Microsoft office: Word, Excel, Access, Visio, Outlook, PowerPoint

Project Management Tools: Microsoft Project and other tools.

Project Methodologies: SDLC, Agile, Rational Unified Process (RUP), UML

Requirement Management Tools: Rational Requisite Pro

Defect Tracking Tools: Rational Clear Quest, Quality Center, Test Director

Data Modeling Tools: Erwin, Sybase Power Design Clear quest, Rational Rose, MS Visio, ER Studio, Oracle BPA, SA - System Architect, Toad, EDM (Mapping Tool)

Reporting Tools: Business Objects 5.x / 6.5, Cognos 7.0/6.0, Crystal (6, 8, and 11), OBIEE Business Intelligence Enterprise edition 10.3.4.1.

Web Development Tools: Macromedia Dream Weaver4.0, Flash 5.0, Adobe Photoshop

ETL Tools: Informatica Power Center 7.1/6.2, Teradata SQL Assistant 7.2

PROFESSIONAL EXPERIENCE

Confidential, Richardson, TX

Sr. Business Analyst

Responsibilities:

• Participate in business meetings/interviews to analyze and redesign Claims, Group & Member Enrollment processes
• Prepares detailed requirement specifications, business process diagrams, charts, tables, reports and flowcharts.
• Provide support to teh enterprise content manager (ECM) to identify and manage teh project requirements.
• Ensure dat teh enterprise content is secured and accessible across all levels.
• Analyzes and documents business processes and work flows. Analyzes and documents requests for Information Systems services to determine scope and order of magnitude.
• Analyzes web applications and conducts web usability studies.
• Participate in daily scrum/standup meetings to produce artifacts- product backlog, sprint backlog in agile methodology and document teh meeting minutes in MS Word and send them out for confirmation.
• Write Requirement and Design document for Master Data Entities( Corporate Modeler)
• Analyzed different source systems in order to come up with Source system, which was generating teh data.
• Converted Data from legacy system to teh new system (Data Conversion)
• Prepared BRDs (Business Requirement Documents) supporting documents containing teh essential business elements, detailed definitions, and descriptions of teh relationships between teh actors to analyze and document business data requirements.
• Help in designing teh data warehouse and core Database for teh system including tables, Stored.
• Perform Data Profiling and Data Quality Analysis to analyze and to support data quality controls
• Closely worked with Data Modeler and development team in creating Enterprise Data Warehouse
• Planned and documented procedures for data processing and prepared data flow diagrams for teh application.
• Experience working with Team velocity tool for creating stories
• Assist in performing Functional Testing and User Acceptance testing (UAT) and documented detailed results.

Environment: Agile, Microsoft SQL Server,ECM, Data Explorer Windows NT, MS Excel, MS Visio, Rational Rose, Requisite Pro, Rational Clear Quest, Rational, Clear Case, MS Access, CSV files, XML files, Data Stage, Clear Case

Confidential, Bowie, MD

Sr. Business Analyst/ Data Analyst

Responsibilities:

• Responsible to lead teh Unit as lead to reach teh project timelines TEMPeffectively.
• Identified stakeholders' requirements and validated them with implementation and Quality-of-Service requirements.
• Gather teh requirements for Medicare, Medicaid products.
• Responsible for conducting daily standup meetings as a Scrum Master.
• Responsible for creating weekly/monthly/quarterly extracts and transmitted to a third party vendor.
• Responsible for architecting integrated HIPAA, Medicare solutions, Facets.
• Gatheird Requirements, AS-IS and TO-BE for migrating teh data source for HIPAA Eligibility Systems from current source systems to New Source System
• Identify Member, Provider, Coverage, Medicare, and Medicaid.
• Claims Processing and Claims Scrubbing in HMO, PPO, Medicaid and Medicare
• Verification and validation (IV&V) as Full Life Cycle Assessments, Point-in-Time, Assessments, Technical Domain Assessments, Data Quality Assessments, Organizational, Software Quality Assurance (SQA) Assessments and Quality Assurance (QA) Assessments.
• Generated Data Mapping documents to define mapping sourcing from data warehouse.
• Working in Agile methodology, prepared tasks and stories for sprints, prepared Retro’s and were responsible for preparing Show cases
• Coordinated with End users/clients about teh File target location process.
• Resolving teh data type inconsistencies between teh source systems and teh target system using teh mapping documents.

Environment: Oracle 11g, Clear Case, Putty, Session log files, Flat files, XML, XSD, XSLT, HP Quality Center, Web Services, Soap UI, SQL Server 2008, and TOAD.

Confidential, Bloomington, IL

Sr. Business Analyst/Quality Analyst

Responsibilities:

• Participated in Business Modeling by understanding teh needs of teh business, and also documenting.
• Business Use Cases as well as System Use Cases.
• Gatheird Requirements and documented teh proposed additional extension to teh existing HIPAA application.
• Facilitated Joint Application Development (JAD) sessions with teh Management, Mainframe and HIPAA team to make sure everyone are in sync with teh business requirement processes.
• Involved in HIPAA 5010 gap analysis of ANSI X12 4010 and ICD 10 initiatives.
• Used MS Visio to create Use Cases and Sequence Diagrams.
• Managed claims management process, Knowledge of Medicaid and Medicare Services. CMS, Health Assessment Systems,Hl7 Standards, HIPAA, PPACA(Patient Protection and Affordable Care Act), Compliance issues, LO INC and SNOMED Mapping, HL7 Message Validation, ICD 9, Electronic Health Records, Electronic Medical Records.
• Excellent understanding of HIPAA standards (4010 and 5010), HIPAA code sets ICD-9, ICD 10 and HL7.
• Accomplished experience through whole SDLC from requirement analysis till deployment, using highly efficient RUP process of Software development.
• Created and Maintained teh Requirement Traceability Matrix (RTM).
• Conducted User Acceptance Testing (UAT) sessions with business users and prepared document for enhancements and bug fixes.
• Used Test Director and Mercury Quality Center to report any bugs found and communicate to teh developers and product support team.
• Analyzed and evaluated User Interface Designs, Technical Design Documents and Quality Assurance Test condition teh performance of teh application from various dimensions.

Environment: MS Visio, MS Project, Windows XP, HIPAA, Microsoft Office Suite, Quality center, Rational Unified Process (RUP), UML.

Confidential, Mooresville, NC

Business Analyst

Responsibilities:

• Designed and Created test plan, test scenarios and test cases for Data warehouse and ETL testing.
• Responsible to translate business requirements into quality assurance test cases
• Developed test scripts using SQL queries to validate data.
• Used Data Stage Director to validate, run and monitor teh Data Stage jobs.
• Prepared Regression Test Plans, Requirements Traceability Metrics (RTM), positive and negative test scenarios, detailed oriented Test Scripts, Test Kickoff documents, Test Scorecard for test progress status, Test Results, Release Check list, Lessons Learned documents and Regression Test Suite for future use.
• Have tested SSIS packages according to business requirements and data mapping requirement documents.
• Leverage Rational Clear Questto track defects and managed them.
• Tested several reports detailing price/volume trends and expense variance over previous periods by using financial reporting and through teh Interactive Reporting.
• Tested several Business Objects Reports for data quality, fonts, headers, footers, and cosmetics.
• Involved in testing theETLprocess of data sources, SAP, PeopleSoft, Teradata, SQL Server, Oracle, flat files into teh target Teradata, Oracle database as per teh data models.
• Executed automated test scripts using QTP for Regression testing.
• Responsible for in-depth noledge of data, processes or applications in their specific area of responsibilities
• Reviewing teh test activities through daily Agile Software development stand-up meetings.

Environment: Data Stage, Quality Center, Business Objects, TFM,TOAD, QTP, Java, Oracle 10g/9i, SQL Server 2005, PL/SQL, Linux, Win XP

Confidential, Charlotte, NC

Business Analyst

Responsibilities:

• Analyzed business requirements and module-specific functionalities to identify test requirements and formulate an TEMPeffective master test plan.
• Responsible for review of Functional Requirement Specification and System Design Specification documents for testing
• TestedETLmappings to extract and load data from different databases such as Oracle, SQL Server and flat files and loaded them in to Oracle.
• Design and Development of QA documentation like Test Cases and Test scenarios from business and functional requirements.
• Involved in testing teh ETL mappings, by validating whether teh mapping adhere to teh development standards and naming conventions; whether teh mapping do wat teh technical design says it should do; whether teh mapping work correctly in relation to other processes in you're data logistical flow.
• Tested Informatica mappings for various ETL functions.

Environment: Oracle 9i, SQL Server 2005, Informatica, Micro Strategy, SQL, PL/SQL, Autosys, Rapid SQL, Mainframes, Toad, IBM AIX, MS Access, Web Services, Unix, Quality Center