SUMMARY

• Over 12 years of work experience which includes over 8 years as a Business Systems Analyst/ Lead Business Analyst.
• Experience spans from conceptualization to implementation in Healthcare industry - Software Development Life Cycle (SDLC), Software Testing Life Cycle (STLC) and Project Management.
• Expert knowledge of Business Analysis methodologies like Rational Unified Process (RUP), Agile - Scrum, Waterfall, etc.
• Proficient in creating Business Requirement Document (BRD), System Requirement Specification(SRS), Functional Requirement Specifications(FRS), Requirements Traceability Matrix(RTM).
• Proficient in conducting Business Process Modeling (BPM), Feasibility Studies, Impact Analysis, Cost/Benefit Analysis, ROI Analysis, Gap Analysis and Risk analysis, SWOT analysis.
• Interacted with different risk management, disaster recovery (DR) and analytic groups to get the requirements for the application.
• Experienced in extracting data from external sources, processing and loading data files (ETL process).
• Conducted Joint Application Development (JAD) sessions as a facilitator to gather requirements from the technical team.
• Performed Manual Testing and Automated Testing. Experience in Analyzing, designing, executing and reviewing new and old Test plans, Test cases, developing and maintaining Test scripts, analyzing bugs etc.
• Facilitated User Acceptance Testing (UAT) with the stakeholders and the business users.
• Proficient in using UML for BusinessProcess Modeling, Use Cases, Activity Diagrams, Entity Relationship Diagrams, Sequence Diagrams, Collaboration Diagrams, Class Diagrams.
• Solid understanding of Cloud or Data Virtualization and Software-As-A-Service (SAAS) technologies.
• Excellent understanding of Data Warehouse lifecycle.
• Experience working in a cross-functional team environment/different geographical locations teams.
• In depth knowledge and experience in areas of Health Benefits, Sec 125, COBRA, New Hire process, Retirement Process, Pricing and Premiums etc.
• Knowledge of CMS Meaningful Use Stage 1 and 2.
• Extensive knowledge Medicaid, Medicaid Information Technology Architecture, Medicare (Part A, B, C, D), Procedural and Diagnostic codes, Claims Process and Medicaid Management Information Systems (MMIS).
• Excellent knowledge of Health insurance claims like Ub04, HCFA.
• Sound knowledge of ICD-9 & ICD-10 codes.
• Experience in planning and defining system requirements, Use Case Scenario and Use Case diagrams for web-based applications based on HIPPA 4010/5010 compliancy.
• Have good knowledge of Business functionalities like Medicare (Part A, B, C, and D), Medicaid, ACA/ObamaCare Commercial claims, AR Reduction, Bulk Billing and Insurance specific trends.
• Worked in claims process and adjudication in the Medicare, Medicaid and Private Insurance Sectors.
• Validated 837 (Healthcare Claims), 835 (Healthcare Claims payment/ Remittance), 270/271 (Eligibility request/Response), 834 (Enrollment/Dis-enrollment to health plan) for Part B and Part A of Medicare health claims.
• Validated codes for billing process which included ICD-9, CPT codes and various modifiers where applicable in compliance with HIPAA 4010.
• Knowledge of the industry standards such as HIPAA, Six Sigma & CMMi.

TECHNICAL SKILLS

Operating Systems: Windows XP/95/98/NT/2000/Vista/8, UNIX

Database / Data Warehouse: MS Access, MySQL, Microsoft SQL Server, Oracle 8i/9i, DB2, NetezzaProgramming and

Scripting Languages: HTML, XML, C, C++, Java, VBA, JavaScript, VBScript

Testing Tools: Mercury interactive- Load runner, win runner, Quick test pro, Test

Business Modeling Tools: Rational Rose, Microsoft Visio

Project Management: MS Project, Rational ClearQuest, Rational RequisitePro

Operating Systems: Windows 95/98/NT/2000/XP/Vista

ETL tools: Informatica

BI Reporting tools: MicroStrategy, Business Objects, Crystal Reports, Cognos

Other Tools: SQL developer, DBVisualizer, MS SharePoint2007/2010/2013

SDLC Methodologies: Agile, RUP, Water Fall

Healthcare: HL7, CMS Meaning Full use Stage 1 and 2, ASCII X12 EDI

Data warehousing Concepts: Data Mart, OLAP, OLTP, Global, Independent and Interconnected Data Warehouses, Slice/Dice, Drill Up/Drill DownAdvanced Excel 2010

functionalities: VBA, Macro, Pivot tables, charts, data tables, general models, financial models with functions such as NPV, PV, FV, DCF, etc. Comfortable with complex/nested functions such as Offset, Match, Index, VLookup, HLookup, text parsing (left, right, mid, len).

Palisade suite: Decision trees (PrecisionTree), Risk Analysis and simulation, built complex simulation models in Risk software. Tornado Charts

PROFESSIONAL EXPERIENCE

Confidential, Brea, CA

Business Systems Analyst

Responsibilities:

• Worked on several IT Service Requests/Enhancements and Defects that impacted Enterprise Data Warehouse. Source Systems are in Oracle and DB2 while staging and target tables are in Netezza Netezza is very similar to Teradata .
• Owned the entire accountability of delivering a project right from Analysis Phase to Post Production Validation.
• Performed analysis of the defects to find the root cause of the problem and how that can be resolved.
• Both the Enhancement and Defects required diving deep into the source system tables and all the intermediate tables of staging through the Target table. Some defects have over 8 tables in the staging that is between the source system and target table.
• Used DBVisualizer for querying the database and Informatica (ETL) to understand the mapping of the columns. These two tools are used over 80% of the time in a day. Made complex queries joining multiple tables across different schema in snow flake schema design.
• I was responsible for looking into the Source Qualifier to understand the mapping in Informatica.
• Deliverables included Functional Requirements and Solutions Architecture Requirements Document, Impact Analysis, Gap Analysis, Requirements Traceability Matrix, Mapping Document, Test Plan, Test Scripts, etc.
• Prepared System Design Document with the help of developers.
• Did code review and also participated in Unit Testing with the developer.
• Also wore the hat of QA to perform testing which included Regression Testing, Referential Integrity Testing, System Integration Testing, etc.
• Prepared environment for UAT and guided the business users to do the UAT.
• Used Microstrategy to make customized reports for the user.
• Performed post-production validation
• Used tools such as HP ALM and WIDB to log in defects and status of tasks.
• Acquired deep knowledge of Property Insurance industry especially around Written Premium, Earned Premium, Incurred Losses, Claims, Driver and Vehicle related.
• Interacted with different Business Users and Subject Matter Experts to understand the business requirements and the underlying Databases and the implication.

Environment: Hybrid Methodology (Agile SCRUM and Waterfall), DBVisualizer, ETL - Informatica, MicroStrategy, MS SharePoint 2013, HP ALM, Databases - Oracle, DB2 and Netezza.

Confidential, Virginia Beach, VA

Lead Business Analyst

Responsibilities:

• Adapted step by step SDLC methodology in order to accomplish the end system needs.
• Lead JAD sessions in order to understand the business process and sent Minutes of Meetings to the attendees.
• Analyzed the security risk of data consumption and suggested ways to implement data level security at various stages.
• Extensive gathering of Business/Functional user requirements, creating Use Cases, diagrams such as Activity, Class, and Sequence diagrams.
• Supported tactical and strategic goals of the IT Production Support Team. Ensured compliance with structured Project Delivery Process.
• Created “As Is” and “To Be” diagram in order to understand the current system and conducted GAP analysis to accomplish the end system needs.
• Attended daily defect SCRUM meeting in order to identify the defects encountered in the current release and worked with the development team for resolution.
• Created UI screens to illustrate the requirements and aligned around the project scope using MS Visio.
• Worked well under pressure on multiple projects in order to meet the project timelines.
• Raised defects using Rational Requisite Pro and assigned it the appropriate developer.
• Defined data elements of the reports, data mapping, data element definition and report layout.
• Monitoring of loads running and Scheduling Workloads in accordance with the SLA and scheduled based on the dependencies of job and jobsets.
• Handled and corrected Teradata queries running with high Partition Join Index.
• Used Teradata loading utilities (BTEQ, Fastload, Multi Load) to extract data from external sources and transform and load into data warehouse.
• Extensively used Explain to fine-tune the Teradata tables and improve system performance.
• Developed and supported the extraction, transformation and load process (ETL) for the Data.
• Developed and scheduled workflows using Informatica workflow designer.
• Organizing and participating in IM review & code review meetings and coordinating with the development team to assign priorities during releases.
• Designed Excel sheets and Pivot tables to update the running job statuses to the higher Executive management till date.
• Developed a methodology to support the creation of HL7 standards from the HL7 Reference Information Model (RIM). HL7 was used to transmit ORM, ADT and ORU messages.
• Well versed with HIPAA, Facets, STAR CHIP claim adjustments, claim processing from point of entry to finalizing, claim review, identifying claims processing problems, their source and providing corresponding solutions.
• Involved in implementation of HIPAA EDI Transactions (835,837) and facilitated Electronic Data Interchange.
• Performed GAP Analysis for HIPAA 4010 and 5010 transactions and used EDI tools to verify mapping to X12 format.
• Created and Supported ICD-9 to ICD 10 Code conversion application and deployed on browser based version.
• 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 ANSI.
• Analyzed HIPAA EDI transactions in X12 responses and of 837, 835, 277CA and 999 and checked for defects.
• Responsible for Gap Analysis (GAP), User Acceptance Testing (UAT), and System Integration testing (SIT), Regression Testing (RT) and SWOT analysis at various stages of the project.
• Coordinated with the QA Team for testing activities across multiple systems and managed Conversion test execution.
• Ensured effective and efficient delivery of ITIL processes such as Change, Problem, Incident Management and Production Readiness.
• Ensured that Technical Analysts/developers are using accepted processes and methods which include ITIL best practices and ITSM disciplines.

Environment: Hybrid Methodology (Agile SCRUM and RUP), Windows XP/2000, MS SharePoint 2010/2013, JAVA, J2EE Environment, XML, Cognos 10

Confidential, Rocky Hill, CT

Business Systems Analyst

Roles and Responsibilities:

• Gathered, analyzed, and documented Systems Requirement Documents (SRD), Functional Design Document (FDD) and all the affiliate artifacts like UML diagrams (Use Case, Activity, and Sequence Diagrams).
• Planned and supervised target meetings with SMEs, direct interview sessions, conference calls and produced detailed artifacts such as Surveys/Questionnaires and minutes of meetings.
• Conduced GAP Analysis, Risk Analysis, Data Analysis between current system and new requirements to be implemented, thereby mapping the business requirements of the application.
• Effectively managed project risks by creating and managing a Risk Register which identifies, prioritizes and measures risk, risk drivers and expected loss.
• Assisted the Project Manager in developing, tracking and managing the project’s triple constraints - time, resources (money, labor) and scope using MS Project.
• Involved in daily Scrums to determine the status of the project and impediments if any.
• Worked on Error Analysis of the failed Transactions coming from different Vendors System.
• Identified and documented Business Rules, created detailed Use Cases.
• Used Rational Requisite Pro for overall requirements management and to build the Requirements Traceability matrix.
• Developed several Unified Modeling Language (UML) Diagrams using MS Visio to help developers and stakeholders understand the 'AS IS' and 'To BE' systems.
• Effectively managed change by deploying change management techniques such as Change Assessment and Impact Analysis.
• Verify and validate all the build or release related issues and resolve them through discussion with the business analystsafter approval from the users.
• Develop the Requirement management Plan and disseminating the Plan to theProject Manager
• Facilitated the design and development of Business Rules Engine(BRE) to support SOA architecture and web services.
• The Business Rules Engine (BRE) was used for making decision about aggregating federated information in real time to resolve sourcing system conflict and coordinate data visibility with data quality rules in the in-house application.
• Worked closely with System Architect to implement Service Oriented Architecture (SOA), Client side validations, and Server side validations.
• Assisted in the design and validation processes by performing explanatory Data Mapping.
• Carried out all the processes in compliance with HIPAA.
• Participated in Test Cases review and UAT testing.

Environment: Hybrid Methodology (Water Fall and Agile SCRUM), RUP Tools (Requisite Pro), Oracle, Crystal Reports, HP Quality Centre, SharePoint 2010, Visio Professional 2003

Confidential, Montgomery, AL

Business Systems Analyst

Roles and Responsibilities:

• Used Water Fall methodology for Data Migration from Sybase Adaptive Server to Oracle.
• Liaisoned with key business users and the IT stakeholders to understand the various requirements of the new system and the challenges associated with the migration.
• Created Business Requirement Document (BRD), System Requirement Specification (SRS), and Functional Requirement Specifications (FRS).
• Analyzed the data warehouses to identify the data for migration
• Interacted with the business users and IT support teams to understand both data and reporting requirements
• Perform classification / trending analysis by understanding the source data
• Assisted in design & development of reconciliation report for tracking the data during conversions
• Developed source to target mapping documents for multiple subject area
• Worked closely with the ETL team to extract data from data warehouse and coordinate data mapping during code development
• Responsible for coordinating with multiple teams to perform both unit and integration testing
• Responsible for loading production scrubbed data into multiple development and QA environments
• Responsible for performing both logical and physical data quality scans
• Responsible for coordinating data cleanup to fix the errors identified during data quality scans
• Developed data validation plan to assist business readiness and legal compliance team for signoff
• Responsible for providing sensitive credit data to the business readiness team, to support data migration from legacy to target systems.
• Provided production support to resolve the defects identified during the conversion process.
• Responsible for coordinating with DBA’s for rebuilding indexes and collecting stats
• Responsible for generating daily / weekly performance and incident reports for senior IT leadership
• Responsible for tracking data defects in Quality Center and provide resolutions to fix the defects.

Environment: Waterfall methodology, Oracle 10g, Oracle MDM, Teradata, SQL, UNIX, HP Quality Center 10, ClearCase, Microsoft Excel, Microsoft SharePoint 2007/2010, HP Business Availability Center

Confidential

Business Systems Analyst

Responsibilities:

• Created SDLC documentation for massive worldwide SCM system for our client. Functioned as part of a large team in the implementation of multi-million dollar project.
• Participated in JAD sessions with business users and IT team to design systems.
• Created Business Requirement Document (BRD), System Requirement Specification (SRS), and Functional Requirement Specifications (FRS) for challenging business requirements and leveraged standard Oracle functionality in the latest releases of Oracle eBusiness Suite.
• Managed requirements and maintained traceability matrix using Rational Requisite Pro.
• Created system design manuals documenting custom PL/SQL and Prospero (RAD) programs that integrated worldwide sales and operation data. Collaborated modules for global supply chain management.
• Assisted in building a business analysis process model using Rational Rose, Requisite Pro and Visio.
• Created UML diagrams such as Use Cases, Activity Diagrams, Sequence Diagrams and Class Diagrams.
• Assisted in the data conversion efforts for migrating legacy applications to Oracle applications
• Created mappings using PL/SQL packages to implement business rules while loading data.
• Involved in migration of mappings / workflows from Development to Testing and to production.
• Worked with SQL queries for data manipulations.
• Conducted Data analysis including loading data in tables and accessing databases and writing sequel to analyze the data using MS Access and TOAD
• Created Reports using different Analytics Views (Pivot Table, Chart, Column Selector, Table).
• Acted as a change agent for business processes through developing strong business partnerships and defining technical solutions to business problems
• Managed and led delivery of technical components and coordinate and communicate status, issues and delivery plan
• Drove the resolution & troubleshooting of issues during development and post production support.
• Worked on functions such as Change Control and Request, and managed complaints to ensure customer satisfaction.
• Assisted Test Lead and Testers understand business process and help them successfully complete Unit Testing and System Integration Testing (SIT).
• Analyzed UAT Test scripts and scenarios for functional testing of new development, reports and issues resolution and created training material for users and QA group.
• Conducted JAD sessions with key business users to make them understand the project scope and deliverables and to check the feasibility of the project.
• Worked extensively on Quality Center all the way from requirements loading, creating/updating test cases and tying them back to requirements, test execution and defect logging/tracking.
• Sold staffing (contractual), projects and Application Management Services (AMS). AMS included both offshore (India) and US based support.
• Assisted SAP’s Gold Partners sell their spot consulting services.
• Formulated Go-To-Market strategy with the Sales and Practice Directors.
• Prepared white papers and brochures for SAP Business Intelligence, CRM and ERP.
• Used various CRM tools like SalesForce, Act to track Sales activities, leads, opportunities, customer follow up, etc.
• Used SalesForce to prepare dash boards and reports on individual performance.
• Participated in multiple sales campaigns focusing on SAP BI and CRM.