SUMMARY

• Versatile and result oriented Business Analyst with about 6 years of experience in business requirement gathering and analysis, business process re - engineering, object-oriented design, and project management.
• Interpreted statistical data in identifying risks and opportunities on behalf of the requirement setting, while maintaining data to continuously improve the manner in which that data can benefit project operations.
• Dexterous in documenting Business Requirements Documents (BRDs), Use Cases, Functional Requirement Documents (FRDs), Systems Design Specifications, Systems Requirements
• Proficient in Rational tools including Rational Rose and Requisite Pro. Excellent skills in Business Analysis, Requirement Analysis, Business Process Modeling and Use Case Development.
• Recognized as a hands-on, pro-active troubleshooter, and in implementing new process in diverse environments
• Experienced in conducting Joint Application Development (JAD) and Rapid Application Development (RAD) sessions to converge early towards a design acceptable to the customer.
• In-depth understanding of SDLCs using Waterfall and Agile methodologies.
• Experienced in release and deployment management, preparing and documenting the User Acceptance Test (UAT) plans and obtaining the necessary signoffs using Quality Assurance
• Extensive experience in using MS Visio to create Activity diagrams, Sequence diagrams, Swim Lane diagrams, Process flow and Use case diagrams.
• Hands on experience in mapping and validation of different EDI transaction File formats like 837 (I, P, D) & 835. Processed Medicare enrollment Applications.
• Sound understanding of HIPAA, ICD codes, HL7 and Medicare business areas
• Extensive working experience with various Health care and Insurance companies in the areas of Medicare Part A, B, C, D, Medicaid, Claims Processing/Payer Group, and Pharmacy enrollment. Extensive work experience on CMS mandated projects.

TECHNICAL SKILLS

Utilities: Microsoft Office Word/Excel/PowerPoint/Outlook, Microsoft Project2010/FrontPage

Software: Requisite Pro, Clear Case, Clear Quest, JIRA, Rational Rose, UML, Microsoft Visio, Win Runner, Load Runner

Languages: C, 6.0, SQL, Webmethods

Databases: Microsoft SQL Server2000/Access, Oracle SQL, IBM DB2

Methodology: Scrum, Agile

ERP packages: Adempiere, SAP, Oracle 11g

PROFESSIONAL EXPERIENCE

Confidential, Philadelphia, PA

Business Analyst

Responsibilities:

• Conducted user interviews, gathered requirements, and analyzed the requirements.
• Participated in full project life cycle, including gathering user requirements, screen and report design, in addition to implementation and roll out.
• Worked alongside cross functional teams in order to establish comprehensive business and functional requirements and then translating those requirements into software design specifications.
• Analyzed and prioritized key reports for day to day servicing needs for product monitoring processing and inspection.
• Responsible for developing and managing project plans: system requirements, change management policy standard and procedures.
• A strong emphasis on developing and producing daily, weekly, monthly reports for different departments.
• Documented, reviewed, and verified testing procedures for compliance to Interface Quality Assurance and Development standards.
• Reported to business and reporting manager as necessary with status. Assisted Management Team with necessary updates on projects.
• Applied Business Rules and met with the different pharmaceutical departments in order to understand and obtain necessary regulatory information to construct quality requirement documentation.
• Assisted with User Acceptance Testing (UAT), developing and maintaining quality procedures, and ensuring that appropriate documentation is in place.
• Created client documentation, acceptance tests plan and user procedures.
• Identified and documented issues, risks, gaps and their impact to the project life cycle. Provided recommendations and alternatives.
• Involved in different iterations and phases of the Software Development Life Cycle (SDLC)

Environment: SAP, agile, scrum, Rational Requisite Pro, MS Visio, UML

Confidential, New York, NY

Business Analyst

Responsibilities:

• Conducted user interviews, gathered requirements and analyzed the requirements in RUP framework.
• Using Rational tools such as Rational Rose to model requirements and Rational Requisite Pro to manage the requirements
• Conducted JAD session with Stakeholders, users, vendor and SME's, Project Directors for open and pending issues to develop specifications
• 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 redefining 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 Requisite Pro 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 Center, Test Director, SQL Server 2008

Confidential, Newtown Square, PA

Business Analyst

Responsibilities:

• Performed internal reviews for the team to improve quality and attain higher productivity.
• 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.
• 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, one-on-one interviews/meetings and corresponding through emails with work stream owners to discuss the impact of change request on the project.
• Provided detailed reports to show the status of accounts.
• Assigned work to team based on the client requirements.

Environment: MS Office, SQL Server, Agile, SCRUM, Rational Clear Quest, Rational Clear Case, Rational Requisite Pro, Rational Rose, UML, RUP, .Net

Confidential

Junior Business Analyst

Responsibilities:

• Worked directly with researchers to determine the requirements and specifications for their data analysis systems.
• Understood and analyze the end to endbusinessprocess.
• Worked directly with statisticians to develop and validate mathematical models for analysis of experimental data.
• Gathered requirements frombusinessusers for new application and enhancements to existing applications.
• Analyzed and created workflow diagrams and presented to developers.
• Created use cases and designed use case diagram, and sequence diagrams.
• Responsible for preparing Software Requirements Specification (SRS) taking functional requirements specification as a base.
• Responsible for the Timeline estimation.
• Analyzed and documented non-functional requirements.
• Documented and handed-off the requirements to IT developers and project managers.
• Acted as key spokesperson between thebusinessand the IT departments.
• Designed and created Microsoft Excel spreadsheets to implement mathematical data analysis models and to provide an attractive and functional user interface for the biologists and chemists who use them to analyze the results of their research.

Environment: RUP, Waterfall, Oracle, Test director, win runner, MS Office Suite.