SUMMARY

• A Business Analyst with 7 years of experience with complete knowledge in various methodologies including Business Analysis, Requirement gathering, focusing on the Healthcare Insurance domain.
• Proficient in creating business use case documentation, leading business and technical analysis sessions, supporting development and testing teams throughout the Software Development Life Cycle (SDLC).
• Possess excellent client interaction and communication skills.
• Experience working in complex and geographically dispersed team environments.
• Seeking a fast paced dynamic environment to apply my professional skills in the field of Business Analysis.
• I believe I can contribute effective solutions to the organization needs.
• Professional Business Analyst having extensive experience with Health Care clients.
• Extensive experience in creating Business Requirement Documents (BRD), Use Cases, Functional Requirement documents, Project Plans, Test Plans, Training Manuals and Requirements Traceability Matrix (RTM) throughout the Life Cycle of a project.
• Strong knowledge of the Software Development Life Cycle methodologies like RUP and Waterfall models.
• In - depth knowledge of RUP (Rational Unified Process) methodology and its application to health care industry process management.
• Worked on different EDI healthcare transactions like 834-Enrollment and Maintenance, 835-Claim Payment/Remittance Advise, 270/271-Eligibility Benefit Inquiry/Response.
• Experience in Conversion of HIPAA X12 4010 codes to X12 5010 codes & ICD 9 to ICD 10 codes.
• Developed Use Case UML modeling using modeling tools like Rational Rose/MS Visio.
• Experienced in Joint Application Development (JAD) sessions, interviews, workshops and requirement elicitation sessions with end-users, clients, stakeholders and development team.
• Conducted GAP analysis so as to analyze the variance between the system capabilities and business requirements.
• Experienced in using UML and tools like Rational Rose, Visio, and Requisite Pro.
• Experience in working with Microsoft Office Suite (Word, Excel, Power Point, Access, Visio, and Project) for documentation, analysis and presentation.
• Good organization & time management skills.
• Certified White belt holder for EPMO standards.
• Proven track record of delivering projects (quality documents/ deliverables) on time.
• Excellent verbal/written Communication skills and strong Analytical abilities to perform well both independently and as a team player.

TECHNICAL SKILLS

Operating Systems: Windows 95/98 /NT/XP/Vista

Languages: SQL, HTML, XML

Database: SQL Server, MS - Access

Testing: Quality center/ ALM, NASCO- claim Processing system, Qcare- claim processing system, maxMC- clinical management system, PEP- Web medical management system, Rational tools, Clear Quest

Project Methodologies: Joint Application Development (JAD), Rational Unified Process (RUP), Unified Modeling Language (UML), System Development Life Cycle (SDLC)

Documentation Tools: MS - Office Suite (Word/Excel/Power Point).

Business modeling tools: Rational Rose, MS Visio, MS Project

PROFESSIONAL EXPERIENCE

Confidential, New York

Sr. Business Analyst

Responsibilities:

• Work with team in developing Business Requirement Documents for multiple system change requests and participate in system testing.
• Identify and validated business rules and data elements with Business owners.
• Create UML Diagrams like Use Case and data flow diagrams using MS-Visio.
• Facilitate meetings with the technical team and client team to analyze the current process and gather requirements for the proposed process.
• Supervised a team of 3 as a lead BA for documenting process and conducting UATP.
• Created Requirements Traceability Matrix by mapping test scenarios & cases to the business requirements.
• Ensure test outcome meets expectations and validate that modification to existing systems and procedures are yielding the anticipated result.
• Conducted UAT (User Acceptance testing) with client and getting signed off on testing.
• Create monthly/weekly status reports to update the project schedules & deliverable plan.
• Prepared Training Manual for better understanding of the application by its end users
• Developed Test Cases, Test plans and strategies with Quality Assurance group to implement them.
• Update the ICD 10 Reports and create Pivot tables and charts for the teams Clinical and Operational on daily basis.
• Logged defects into Quality Center/ Application Lifecycle Management while doing Functional Testing and followed through the process until the defects were closed.
• Interacted with the users and logged any defects, enhancements from the UAT.
• Reviewed the Defects entered by the QA team and prioritized the defects and assigned them to the development team
• Working closely with developers and QA team.
• Prioritize and working on different responsibilities in given time.

Environment: Microsoft Office Suite (Word, Excel, Power Point, Visio, Project), UAT, maxMC-clinical system, ALM, Qcare- claim processing system and PEP- web system.

Confidential, NJ

Sr. Business Analyst

Responsibilities:

• Identify and validate business rules and data elements with Business owners.
• Document identified activities to research, prioritized the assigned activities to ensure deadlines are met, elevated issues and concerns, coordinated with the project team on the activity status and documented activity resolution.
• Played an active and lead role in requirements gathering, design analysis, requirements management, business modeling and validation according to the Rational Unified Process (RUP).
• Work with AIE2E team in developing Business Requirement Documents for multiple Groups and subgroups added for ID card production.
• Assisted in the development of the Functional Specifications for the ID card process including groups and their details templates.
• Create UML Diagrams like Use Case and data flow diagrams using MS-Visio.
• Supervised a team of 6 as a lead BA for documenting processes and UATP for Member ID cards.
• Performed Data mapping for Prime Project.
• Created MS Access DB for daily reports for the Account Implementation department.
• Facilitate meetings with the vendor team and AIE2E team to analyze the current process and gather requirements for the proposed process and hence documenting SIPOC.
• Used MS Project for project planning, also involved creating an Access database to log the defects
• Conducting daily defect call meeting with the vendor company (Fiserv) to address daily defects with help of defect tracker.
• Documented Communication document (Brochure) and checklist for Horizon AIE2E team to understand the new process of ID cards.
• Documented Operational support documents for Operational Support team and supporting them in resolving issues with the help of Business SME’s.
• Day to day Enrollment checking on major and complicated groups, ordering checkout list on NASCO
• Extensively worked on Elixir software to modify benefits, logo information etc. on the card. Triggered ID Card’s, generated ID card reports on NASCO
• Use Clear Quest for testing requirements, test cases, reporting bugs, work completion status.
• Use Lotus notes for internal communication and data management in the company.
• Create monthly/weekly status reports to update the project schedules & deliverable plan.
• Participated in UAT (User Acceptance testing) with AIE2E team and getting signed off on various documents.
• Present every month Planning Approximation for various work orders to SDG review board of Horizon.
• Coordinated with project manager to facilitate NASCO training for all new employees in the company.

Environment: Microsoft Office Suite (Word, Excel, Power Point, Visio, Project), MS Access, UAT,NASCO, Clear Quest

Confidential, MI

Business Analyst

Responsibilities:

• Conduct Review Requirements meetings to identify missing or incomplete requirements and to identify potential test cases as well as to ensure testing functionality complies with user requirement.
• Responsible to demonstrate that system changes are made from a benefit perspective using Test Mart to locate claim, test change and then validate accurate outcomes.
• Experience testing on the NASCO-claim processing platform and working on other applications in the NPS System - HIQK, HEHK etc.
• Performed Testing along with all the screen shots of the test claims which are prior and after to the benefit changes to verify the current system and expected results.
• Developed Test Cases, Test plans and strategies with Quality Assurance group to implement them.
• Performed Quality reviews of Test grids
• Using Microsoft Access as the tracking tool for managing the Groups and packages of different Analysts.
• Use Quality center to develop the test case / test claims based on our scenarios for the ER and Preventive health Services.
• Monitoring Defect Tracking using Mercury Quality Center to ensure that testing effort is progressing with the development team.
• Created Requirements Traceability Matrix by mapping test scenarios & cases to the business requirements.
• Conducted UAT (User Acceptance testing) with client and getting signed off on testing.
• Create monthly/weekly status reports to update the project schedules & deliverable plan.
• Prepared Training Manual for better understanding of the application by its end users.
• Knowledge on HEHK - for claims testing and work the claims and release the claims for Authorization process.
• Knowledge on HIQK- Application for subscriber selection, Claims Inquiry.

Environment: Microsoft Office Suite (Word, Excel, Power Point, Visio, Project), MS Access, Quality Center, UAT,NASCO

Confidential, Nebraska

Business Analyst

Responsibilities:

• Involved profoundly in theGAP Analysisof thetransitionfromHIPAA and Impact Analysis focusing on how current transactions and system was going to be effected by the new5010compliance.
• Documented identified activities to research, prioritized the assigned activities to ensure deadlines are met, elevated issues and concerns, coordinated with the project team on the activity status and documented activity resolution
• Worked with legacy team in developing Business Requirement Documents for multiple system change requests and participated in system testing.
• Reviewing Functional Specifications for the target physical database
• Participated in JAD sessions for Requirement Validation with Confidential to gather requirements for the new MMIS.
• Analyze EDI data elements captured by the existing system to validate it against the data elements required for new system.
• Created UML Diagrams like Use Case, Activity and data flow diagrams using MS-Visio.
• Analyze different data cross-walks, complicated logic & look ups required by different fields for the source to target transformations.
• Facilitated meetings with the technical team and client team to analyze the current process and gather requirements for the proposed process.
• Involved in the analysis of HIPAA compliance and EDI transaction sets and actively participated in the designing of the EDI transactions using the new HIPAA 5010 utilizing the ICD-10 codes.
• Propose strategies to implement HIPAA 4010 in the new MMIS system& eventually move to HIPAA 5010.
• Used Microsoft SharePoint as the version tracking tool for managing the requirements documentation.
• Create monthly/weekly status reports to update the project schedules & deliverable plan.
• Participated in developing test plan, test scripts, and test scenarios and designed user documentation.
• UsedMercury Quality Centerfor loggingdefectsand managing defect history.
• Conducted UAT (User Acceptance testing) with client and getting signed off on various documents.

Environment: MS Office, Windows 2000, MS Visio, MS SharePoint, Quality Center, MS Project, SQL.

Confidential, Detroit, MI

Business Analyst

Responsibilities:

• Assisted in designing policies and procedures to protect the privacy of Electronic Protected Health Information to ensure data integrity as per HIPAA guidelines.
• Involved in creating the business case and project plan.
• Played an active and lead role in requirements gathering, design analysis, requirements management, business modeling and validation according to the Rational Unified Process (RUP).
• Created and managed project templates, use case project templates, requirement types and traceability relationships in Requisite Pro.
• Conducted GAP analysis and assessed the status of the organization to determine the scope of the application.
• Assisted in building a business analysis process model using Visio.
• Designed and developed Use case diagrams, Activity diagrams, and Sequence diagrams using UML.
• Documented the Functional Specifications Document.
• Developed Test Cases, test plans and strategies with Quality Assurance group to implement them.
• Reviewed detailed test cases with in-depth description of each test scenario of the system according to HIPAA guidelines.
• Facilitated JAD sessions with stake holders, developers, systems analyst and testers to collaborate resource allocation and project completion using MS Project.
• Was responsible for data mapping of HIPAA 5010 format into relational database.
• Identified and involved all key stakeholders, contributors, business, operations and technical resources that must participate in a project and ensured that contributors are motivated to complete assigned tasks within the parameters of the project plan.
• Conducted interviews with client to ensure developed functionality complied with user requirements.
• Collected and documented business processes as well as business rules.
• Experience with User Acceptance Testing (UAT), System testing.
• Used Clear Quest for testing requirements, test cases, reporting bugs, work completion status.
• Analyzed, organized, and updated database using SQL.

Environment: Rational Requisite Pro, Clear Quest, Microsoft Office Suite (Word, Excel, Power Point, Visio, Project), Windows XP, SQL.