PROFESSIONAL SUMMARY:

• A progressive Business Analyst commensurate with over 6 years of experience in business process analysis/modeling, business requirements in HealthCare, Insurance, Banking, and Pharmaceutical based Industries
• Strong experiencein documenting theBusiness Requirements Document (BRD), developing theUAT Plan, maintainingtheTraceability Matrix and assisting inpost implementation.
• Acted as the primary liaison between the clients and the Information systems and interactedwith internal as well as external clients, to collect requirements and business process information.
• Extensive experience in working in SDLC with various methodologies included RUP, Agile, waterfall and other methodologies
• Expert in translating business requirements & user expectations into detailed Functional Requirements Specifications (FRS) by employing Unified Modeling Language (UML)
• Highly experienced in performingFeasibility Studies,Impact analysis,GAP analysis and Risk Analysis.
• Expertise in creatingUse Cases, Use Case Diagrams,ClassDiagrams, Sequence Flows usingMS Visioand UML concepts.
• Experience with insurance administration systems included Actuarial, Policy Application, Eligibility, Enrollment, Underwriting, Claims, Billing, and Payments.
• Knowledge on Electronic data interchange (EDI) transaction, Electronic Health Record (EHR) and Health Information Technology (HIT)
• Strong testing experience in HIPAA X - 12 EDI Insurance/Health Series (INS) such as 270/271, 274, 276/277, 278, 820, 834, 835, 837, and Version 5010 of this transactions.
• Performed Gap Analysis to check the compatibility of the existing system infrastructure with the new business requirements.
• Creative and aggressive self-starter with integrative thinking skills, capable of forming and maintaining positive and productive working relationships in internal, external, independent, and team environments.
• Excellent verbal and written communication skills and the ability to interact professionally and confidently with a diverse group, executives, managers, and subject matter experts.
• Strong analytical, decision-making and problem solving skills to interpret customer business needs and translate them into application and operational requirements.
• Strong facilitation skills and proven experience at driving consensus across multiple stakeholders.
• Good presentation and leadership skills.
• Must be flexible and willing to undertake a wide variety of challenging tasks.
• Process-driven analysis skills and a background in various requirements elicitation methods.
• Team player who can establish excellent working relationships with peers and other teams.
• Ability to work on multiple projects as team member.
• Utilize application development environments, tools and methodologies across multiple platforms.
• Experience using Microsoft Office Applications.

TECHNICAL SKILLS:

• HIPAA ANSI X 12, CMMI, Six Sigma, MMIS
• SDLC, RUP, Agile Methodology,,, CPT and ICD-10 Coding
• FACETS, AMISYS, NASCO, ANSI X12, Rational Rose, Requisite Pro
• MicrosoftVisio,, SAS, SAS/SQL, .NET, Cobol, Microsoft Project
• Microsoft Office, Erwin, Clinical Data Management Systems ARGUS
• Crystal Report, MS SQL Server-2005/2008, MS-Access, MS Windows 7/98/XP.

PROFESSIONAL EXPERIENCE:

Confidential

Business Analyst

Responsibilities:

• Functioned as the primary liaison between the business line, operations, and the technical areas throughout the project cycle.
• Involved in defining scope of the project along with vision statement.
• Created User stories for defining business requirements.
• Involved in identifying Functional and Non-Functional requirements and created the Functional System Design document (FSD).
• Accumulated customer requirements from various end users through surveys, interviews and JAD sessions.
• Involved in GAP analysis in the identification of business rules, business and system process flows, requirements and assumptions.
• Analyzed “AS IS” and “TO BE” scenarios, designed new process flows and documented the business process and various business scenarios.
• Gathered requirements and document the proposed processes to the existing system.
• Modules included: Medical Claims Processing files and HIPPA guidelines adherence across the company.
• Enhanced applicationsassociated withClaim Numbersso that duplicate Claim Numbers could be eliminated in the system.
• Updated theElectronic Claims, Patient Screen and Sales Administration processes.
• Claim Transactions and Billing Transactions - Created flows for adequate matching of Claims.Matched Billing FileandEDI Claim Filerecords uponreceipt.
• Duplicated Claim Number Project - Enhanced three different applications - EDI Feedsand Patient Screen Appto remove duplicate claim numbers.
• Validated the following: 837 (Health Care Claims or Encounters), 835 (Health Care Claims payment/ Remittance), 270/271 (Eligibility request/Response), 834 (Enrollment / Dis-enrollment to a health plan)
• ConductedJRP sessions and JAD sessionswith the management, users and other stakeholders for open and pending issues to develop specifications
• Assisted the Project Manager in setting realistic project expectations, in evaluating the impact of changes on the organization and plans accordingly, and conducted project related presentations
• Testing -DevelopedTest ScriptsusingTest Director/Quality Centerand coordinated with developers to quickly resolve the defects associated with them.
• Participated insystem testing and user acceptance testingworked with System Test Review team and developers to resolve system test issues and re-test.
• Facilitated Change Control Board and Governance Board meetings and acted as a liaison between parties impacted by the change requests
• Used HTML prototypes for users to explain the intended systems Interface design and sign-off documents.
• Conducted User Acceptance Testing (UAT) and verified performance, reliability and fault tolerance issues.
• Performed A/B tests, reporting/analysis standards.Created test plans and scripts, and tested strategies with developers and testers.
• During construction iterations identified new stories, split existing stories.
• Acted as a liaison between the business, data and the technical teams throughout the project lifecycle.
• Actively interacted with other corporate departments, including executive, legal and information services as well as vendor relationships.

Confidential, Parsippany, NJ

Business Analyst

Responsibilities:

• Performed Gap analysis, requirements gathering and for enhancements to existing systems and processes.
• Worked with Investigator Brochures, NDA periodic Reports, PSUR, and e-CTD.
• Worked with Regulatory Report Authoring & Publishing management Systems (e.g. Dossier, Aliquant Insight) and Documentum.
• Worked with the Documentum Query Language and Documentum wrapper.
• Prepared use case models based on Business Requirement documentation gathered through interaction with users and the stakeholders.
• Implemented RUP, which included requirements, specifications, design and analysis.
• Created and maintained the Requirements Traceability Matrix (RTM).
• Worked with the Project Manager on various Project Management activities like keeping track of Project Status, Deadlines, Environment Request, and Compliance Issues.
• Ensured Use-Cases were consistent and covered all aspects of the Requirements document.
• Identified and analyzed the data requirements for the various site teams and made sure that the required data is available in the testing environment.
• Worked directly with development teams to ensure clear communications on requirements and defect reports.
• Designed and developed scenarios based on business requirements.
• Was involved in Functional System Testing, Integration Testing, Regression Testing, and User Acceptance Test before releasing the application.
• Validated the scripts to make sure they have been executed correctly and meets the scenario description.
• Involved in project status meetings, QA review meeting, and System Test meeting.
• Exposure to GIS-based information technology projects.
• Experience in Working knowledge of HTML, SQL, and database design.

Environment: Web Interface Definition Language, JSP, Oracle database, HTML, XML, XSL, Rational Rose, Rational ClearQuest, Rational ClearCase, Robot, Requisite Pro, MS Visio, RUP methodology, MS Project, Crystal Reports, RUP

Confidential, TX

Business Analyst

Responsibilities:

• Prepared graphical depictions of User stories, State Diagrams, Activity Diagrams, Sequence Diagrams, Component Based Diagrams, and Collateral Diagrams usingMS Visio.
• Worked throughout the SDLC, which included requirements, specifications, design, analysis and testing utilizing RUP methodology.
• Performed Gap Analysis to check the compatibility of the existing system infrastructure with the new business requirements.
• Involved in creating and enhancing requirements, analysis and design using Rational Tools (Rational Rose, Rational Requisite Pro, Rational Clear Case, and Clear Quest).
• Creating user requirements document for companywide reports by interacting with end users and developers.
• Interact with the developers and defined the needs to update the design of the Graphical User Interface.
• Helped QA team in testing SQL scripts and validated the enhancement of the project by creating test cases which were developed for Development team. A major responsibility included interacting with the users and business relationship managers and implementing changes on the database in order to ensure UAT approval.
• Experience with web-based applications, database query tools, and Microsoft Office products.

Environment: Rational Requisite Pro, Rational Clear Quest, Rational Clear Case, Rational Rose, MS Visio, SharePoint 2009, MS Visio and MS Excel

Confidential

Associate Business Analyst

Responsibilities:

• Involved in writing theBusiness Requirements for different functionalitiesof the web based application, including creation of an account online.
• Diligent in writing the Data Dictionary for different processes and their file layouts
• Mentored the effort to develop artifacts with an emphasis on the Rational Suite including: Vision, User requirements specifications, Functional specification quality assurance plan, product Acceptance plan, and test plan, test case.
• Wrote high-level use case and generatedUMLuse case diagrams using Rational Rose.
• Designed prototypes for development and maintenance processes to explore the feasibility of ideas.
• Participated inJADworkshops, refined prototypes and use cases.
• Wrote requirements management plan document using Rational Requisite Pro.
• Extensively used RUPmethodology in all phases of the project.
• UsedClear Case and Clear Questfor data management and defect tracking.
• Assisted insystem testing and user acceptance testingworked with System Test Review team and developers to resolve system test issues and re-test.
• Developed timelines for project delivery, and managed projects and resources to successful completion.
• Assisted in development of materials for new technology and process improvement.
• Working experience with legacy mainframe integration and system improvement projects.

Environment: Agile Methodology, MS Project, MS Visio, Visual Basic, Crystal Report, Win Runner, HTML, MS Office, SQL.