SUMMARY:

• Business Analyst with over 7 years of experience in the domains of Health Care, Banking, Financial, Insurance, Mortgage and Pharmaceutical applications.
• Strong understanding of Business Requirement Gathering, Business Process Flows, Business Process Modeling, Case Tools, and Business Analysis.
• Extensive experience in business analysis, requirement elicitation and gathering, use case modeling using UML, data analysis, modeling and data mapping.
• Worked with project teams and information architects to develop business process models.
• Generated models to depict business processes and information flows. Provided production assistance after project implementation
• Participated in all phases of the Software Development Life Cycle (SDLC) - from project scoping, planning and requirements definition to issues resolution, testing, training and implementation.
• Strong facilitation skills and experience in leading Joint Application Development (JAD) formal/informal sessions, use case walkthroughs and functional Rapid Application Development (RAD).
• Involved in generating business requirements, functional specifications, detailed design specifications, use cases and UML diagrams to communicate the intended system functionality and execution to developers
• Documented the Business Requirement Document (BRD), Functional Requirement Document, Non- Functional Requirement Document.
• Designed and documented Operators Guides Minutes of the meeting, Flow charts, Installation Guides- Standard operating procedures, Training Manuals and Management Presentations.
• Excellent in performing Gap Analysis, to check the compatibility of the existing system infrastructure with the new business requirements, SWOT analysis, Cost benefit analysis and ROI analysis.
• Expertise in developing QA Test Plan, Test Conditions, and Test Cases reports for Automated and manual testing; ensuring adequate testing of software both before and after completion; conducting and documenting UAT.
• Expertise in the management of User Request Change, and handle User Conflicts.
• Ability to organize, document and track changes and defects by Traceability Matrix, using Rational Unified Process (RUP), Rational Requisite Pro, Clear Quest, Clear Case.
• Extensively used Microsoft Excel, Project, Visio, PowerPoint, Word and MS Office products for data Analysis, Project Schedules, Business process modeling, Requirement/issues documentation and Customer training.
• Knowledge of health care services regulatory environment in compliance with HIPAA, ICD, MITA, MMIS and EDI.
• Knowledge of Business Objects, Business Warehouse (BW) and Data Warehousing and Supply Change Business concepts.
• Effective in executing multiple tasks and assignments ahead of schedule.
• Team player, result-oriented, fast learner, excellent communication skills with strong research capability.
• Strong knowledge of Business Intelligence, Data Warehousing and Business Architecture.
• Excellent Presentation skills. Experience working with business users as well as senior management.
• Reputation for dedicated teamwork, high energy, work ethics and commitment with capability to handle new technologies and situations.

TECHNICAL SKILLS:

Methodologies: SDLC, Agile, Scrum, Waterfall, Rational Unified Process (RUP)

Business Modeling Tools: UML, MS Visio, Rational Rose

Databases: SQL Server 2000, MS Access, SQL, Oracle

Operating System: Windows 2003 Server, Windows XP/2000, UNIX

Programming Languages: SQL, Oracle, C, C++, VB, VBA, Java

Applications: MS Office, MS Excel, MS Word, MS-Project, MS Power Point, Rational Requisite Pro, OOAD.

Quality Management: Concept and Tools of Quality Management Test Director and Win Runner, ISO Concepts, Six Sigma Techniques

PROFESSIONAL EXPERIENCE:

Confidential, Phoenix, AZ

Sr.Business Analyst

Responsibilities:

• Process claims for all lines of business including but not limited to HMO, PPO, POS, TPA and Medicaid/Medicare.
• Audit claims for accuracy as it relates to State Medicaid and appeal denials as needed.
• Work all pending holds according to plan benefits to ensure timely and proper payment.
• Create and implement workflows to use for claims processing.
• Assist in all trainings and meetings related to claims processing and implementations.
• Educate providers on benefits and eligibility related to member utilized health services.
• Collaborate with the health improvement department to create and implement health related activities.
• Performed the requirement analysis, impact analysis and documented Business Requirements Document (BRD) and Functional Specification Document (FSD) using Rational Requisite Pro.
• Prioritized deliverables, identified gaps, tracked defects, defined software requirements, created artifacts for testing and development.
• Gathered knowledge on HL7, HIPAA rules and regulations.
• Mapped HIPAA compliant EDI transactions for 837: healthcare claims and 835: payment advice transactions
• QNXT, Care Advance, CWS, Facets and a host of 3rd party software suites are included with the build outs of the environments.
• Collaborated efforts with technical staff and subject matter experts to establish the technical vision of product and analyze triple constraint tradeoffs.
• Analyzed business processes, requirements, and data necessary to provide detailed logic for ETL development.
• Created UML diagrams- Use Case Diagrams, Activity Diagrams, Sequence Diagrams and ER Diagrams in MS Visio.
• Documented the Traceability Matrix for tracing the Test Cases and requirements related to them.
• Conducted GAP Analysis of current state (As-Is) ICD 9 and proposed state (To-Be) ICD 10 situations and represented the same on MS Visio.
• Supported development of UAT cycle test scripts, Review User Acceptance Test Plan (UATP).
• Recommended changes for system design, methods, procedures, policies and workflows affecting Medicare/Medicaid claims processing in compliance with government compliant processes like HIPAA/ EDI formats and accredited standards like ANSI.
• Managed the planning / test process for Medicare Part D Pharmacy Claims (PBM).
• Analyzed, maintained and updated FAQ knowledge base in SharePoint for better data accuracy and better timely data availability.

Environment: MS PowerPoint, Requisite Pro, XML, MS Visio, Dreamweaver, UI, MS Excel, MS Access, Oracle, Waterfall SDLC.

Confidential

Senior Business Analyst

Responsibilities:

• Interacted with business users, understood their business processes and gathered requirements for business definition.
• Involved throughout the System Development Life Cycle (SDLC) and performed a primary liaison between the business and the technical areas.
• Created Planning documents.
• Responsible to interact and liaison with Business partners and other technical teams to facilitate joint application development (JAD) sessions and document the business requirements.
• Conducted JAD sessions during the various stages of upgrading the matching system and discuss the current system preference.
• Regularly scheduled meetings to review the project status/plan with senior technology staff.
• Performed GAP Analysis for the modules in new system and conducted feasibility study for the proposed enhancements
• Followed Agile as the software development methodology and used story boards to gather requirements.
• Conducted user interviews, gathering business requirements, and analyze requirements to write system specifications documents. Extensively worked on Business processes and workflow sessions.
• Translate all Business Requirements into detailed Use Cases.
• Studied simple Fixed Income securities (Bond) to more complex structured products like MBS (Mortgage Based Securities) and ABS ( Asset Based Securities).
• Prepared Detail Business requirements documents (BRD) and assessment of current OTC derivatives Equity SWAP’S, Interest Rate Derivatives, Interest Rate SWAP’S.
• Extensively used ER (entity relationship) diagrams.
• Worked with Information Architect to create wire-frames / prototypes of the web based application.
• Ensured CIP requirements, customer due diligence and Enhanced Due Diligence policies are being followed based on KYC norms for specific countries.
• Documented technical compatibility by gathering adequate requirements to mimic client's platform requirements for Actimize AML as a part of CDD/ECDD.
• Used Requisite Pro to maintain the requirements and prepare the documents.
• Identified the requirements of the new algorithms that powered the database search engine, designed and prototyped.
• Integrated the distributed data in several locations to serve the purpose of the project.
• Created the Data Flow Diagrams (DFD). Compiled the business requirements and used them as guidelines to create a test plan to test the new application.
• Reviewed System Test Plans.
• Prepared project initiation and closure report.
• Involved in System testing and User Acceptance testing. Wrote Test plans, Test scripts and implemented them.
• Worked closely with other team members to monitor progress, and the deliverables for the project.
• Involved in defect tracking and bug management.
• Responsible for creating a report on a weekly basis, listing committed dates, risks that impact project schedules and status information.

Environment: Rational Requisite Pro, RUP, UML, Rational Rose, MS-Visio, MS-Project, Rational ClearQuest, SQL Server and Windows.

Confidential, Louisville, KY

Business Analyst

Responsibilities:

• Participated for the creation of Business Process Workflow Diagrams with Stakeholders.
• Involved throughout the business solution Development Life Cycle (SDLC).
• Conducted meetings with business users and SMEs to identify and gather various functional and non-functional requirements.
• Conducted GAP analysis of the different reports that are being presented to clients to accommodate their requirements.
• Utilized Rational Unified Process (RUP) to configure and develop process, standards, and procedures to create a Business requirement Document (BRD).
• Created artifacts such as Use Cases, Activity Diagrams, and Sequence Diagrams using MS Visio.
• Participated in team meetings to improve overall implementation process.
• Strong knowledge of HIPAA 4010A rules to store the transactions.
• Monitored all the HIPAA transactions through the gateway.
• Played a key role in planning, testing, and implementing system enhancement requests.
• Adopt Rational Unified Process (RUP) methodology with emphasis on its six best practices for iterative and incremental development.
• Planned all the RUP iterations and documented the artifacts throughout various phases. Conduct analyses of Business requirements and System specifications.
• Conducted JAD sessions during the various stages of upgrading the matching system and discuss the current system preference.
• Helped identifying reports for decision support system and interacted with database designers and architect for gathering the requirements for reporting.
• Worked closely with the Lead Business Analyst to monitor progress, and the deliverables for the project.
• Reviewed System Test Plans, wrote test scripts and worked with business folks to validate and execute the test scripts.
• Functioned as the primary liaison between the business line, operations, and the technical areas throughout the project cycle.

Environment: MS Office (MS Word, MS Excel, MS PowerPoint, MS Visio), MS-Project, Windows 2000, SWOT analysis, Clear Case, Clear Quest.

Confidential, New York, NY

Responsibilities:

• Conferred periodically with both business unit and technical unit throughout the lifecycle of the project in order to track progress, identify changes and ensure changes are communicated to both the business unit and technical unit.
• Customized the RUP framework for the project and executed it all through the lifecycle.
• Gathered requirements from clients/user groups and analyzed workflows.
• Conducted user interviews with critical users and arranged JAD sessions at both domestic and client locations.
• Collected, documented, and managed business requirements using RequisitePro.
• Analyzed UI documents and verified them with the user groups.
• Conducted Gap analysis to derive requirements for existing systems enhancements.
• Involved in driving technical decisions and providing rationale for these decisions. Identified and documented different significant architectural aspects/views of the system.
• Conducted iterations and communicated results and milestone achievements to stakeholders while keeping the developers directly updated on all documented modifications.
• Created test plans and Test Cases iteratively to guarantee application meets the requirements.
• Performed GUI testing on various screens and verified functionality of objects on various screens.
• Organizing, and managing tasks and resources, allocating tasks and estimating timelines, feedback and control using but not limited to tools such as MS Project.
• Conducted User Acceptance Testing (UAT) and verified performance, reliability and fault tolerance issues.
• Interacted daily with the project team resolved issues to make enhancements based on the change requests.
• Involved in weekly walkthroughs and assessment meetings to verify the status of testing effort and the project as a whole.
• Scheduled meetings with developers, SA’s (System Analyst) and testers to collaborate resource allocation and project completion. Regularly worked with the CMA (Content Management Application) and CDA (Content Display Management) teams.
• Collaborated with Quality Assurance Analyst in Rational Clear Quest to track defects and used Rational Robot to maintain consistency in the builds.
• Suggested measures and recommendations by request tickets to Marketing Department to improve the visibility of the new Broker Portal for immediate deployment.

Environment: Requisite Pro, J2EE, Oracle, SQL Server, OOAD, Rational Unified Process (RUP) using Rational Rose, MS Word, MS Access, MS Excel and MS Project, Test Director.

Confidential

Business Analyst

Responsibilities:

• Analyzed business needs, created and developed new functionality to meet real time data integration that facilitated decision making.
• Conducted JAD sessions to gather and document requirements.
• Used Requisite Pro for gathering requirements and use case management to improve communication of project goals, facilitate collaborative development, mitigate project risk and increase quality of application before deployment.
• Assisted in designing prototypes for user interface components.
• Assisted project manager, business analyst and team lead in project planning and scheduling activities and designing the system.
• Designed and developed use cases, activity diagrams and sequence diagrams using UML.
• Served as a member of the change control board and managed changes all through the business process.
• Involved with the Software Quality Assurance (SQA) team to develop test plans.
• Involved in preparing Release Schedule for all projects to help ensure delivery audits.
• Analyzed results of UAT according to severity and based on the severity of defect forwarded those defects to developers for fixing.

Environment:: Requisite Pro, Java, OOAD, Rational Unified Process (RUP) using Rational Rose, MS Word, MS Visio, MS Access, MS Excel and MS Project .

Confidential

Business Analyst

Responsibilities:

• Developed Data Flow Diagram & System Flow Diagram.
• Involved in gathering requirements, analyzing them, designing the architecture, estimating and developing the project.
• Involved in the analysis, design and development of software using Visual Basic 6.0 (front-end) and Access (database).
• Created the database for the project using MS Access.
• Involved in designing the user interface and coding.
• Provided User Acceptance Testing support.

Environment: MS office Suite, Flow charts, Data Flow diagrams, QuickTestPro