professional objective

Seeking a new challenging position as a Business Analyst in a strong and growing company within the healthcare industry, where relevant education, experience, analytical, client service, follow-up and problem-solving skills will be utilized and advanced

Summary

• 6 years of professional experience as a Business Analyst in logistic and Healthcare Industry.
• Strong knowledge of SDLC methodologies particularly RUP, AGILE-SCRUM, Waterfall.
• Expertise in conducting Rapid Application Development RAD, Joint Requirement Planning JRP and Joint by CouponDropDown >Application Development JAD sessions, interviews, workshops and requirement gathering sessions with business users, stakeholders and development team.
• Extensive experience in gathering requirements and authoring Business Requirement Documents BRD , Software Requirement Specification SRS , Functional Requirement Document FRD and maintaining Requirement Traceability Matrix.
• Strong knowledge of Rational Unified Process RUP risk engineering, data modeling and mapping, and design using Unified Modeling Language UML and Visio.
• Experienced in creating Use Cases, Sequence Diagrams, Activity Diagrams, Collaboration Diagrams and Class Diagrams using Rational tools and Microsoft Visio.
• Experienced in conducting SWOT Analysis, Business Analysis, Risk Analysis and Gap Analysis.
• Broad knowledge of Test plans, Test cases and test scripts.
• Excellent communication and presentation skills.
• Excellent Client relationship management, analytical, and conflict resolving skills.
• Exposed to using ICD 9/ICD 10.
• Excellent knowledge of HIPAA Health Insurance Portability and Accountability Act transaction codes such as 270/271 Eligibility Benefit Inquiry/Response , 276/277 Claim Status , 835 Payment or remittance Advice , and 837 Health Care Claim .
• Strong knowledge of Medicaid, Medicare Part A, B, C, D , Procedural and Diagnostic codes and Claims Process.
• Expertise in EDI HIPAA 4010 - 5010 Project to convert EDI X12 Healthcare 4010 transactions into 5010 Complaint transactions.
• Strong knowledge of HL7 Standards, HIX, EHR - Electronic Health Records, EMR - by CouponDropDown >Electronic Medical Records, CMS regulations, Health Care Reform, EMTALA, PPO, POS and HMO.
• Working knowledge of Medical Management Information Systems MMIS
• Good knowledge of PPACA Patient Protection and Affordable Care Act .
• Strong knowledge of the Trizetto Facets
• Experienced in preparing User Manuals documentation, and Conducting training and support to the users and other stakeholders.
• Good control on MS Office suite, MS Visio and MS Project
• Determined, highly motivated, and team player.
• Good knowledge of Oracle and SQL.
• Solid Change Management experience.
• Skilled in validation and testing complex scenarios for the maintenance of quality standards in projects.

Technical Skills

Confidential

Business Analyst

Responsibilities

• Developed various use cases to come up with the front end application design.
• Performed GAP analysis and analyzed EDI 837 Health Care Claim transaction from 4010 to 5010.
• Developed crosswalk between ICD-10 and ICD-9 to assist with transitioning to ICD-10 and identify the differences between the two versions.
• Conducted JAD sessions involving SME's, business users, data administrators, system architects, managers and development team in order to create a good business process model.
• Identified the project scope, business objective, feasibilities and risks based on Scope/Vision documents.
• Used Requisite Pro to organize and catalog requirements.
• Created Data Flow Diagrams and process diagram using MS Visio
• Developed Business flow diagrams, use cases and activity diagram assisted developers in creating sequence diagrams and collaboration diagrams.
• Generated Functional Requirement specifications FRS and User Requirements Specifications URS that helped to guide the design of the application
• Maintained Requirement Traceability matrix throughout the project.
• Reviewed test plans and test scripts developed by development team and QA team to make sure all requirements have been covered in scripts and tested properly.
• Functional testing of the application was performed as per the ICD10 changes.
• Identified bugs during the test phase and reported them using ALM.
• Helped in conducting User Acceptance Testing UAT , Unit and System Integration testing SIT .

Environment: - MS SQL, RUP, MS VISIO, MS PROJECT, ALM, Windows.

Confidential

Business Analyst

Responsibilities:

• Conducted the JAD Sessions with stakeholders and developers to have a clear picture of the project.
• Prepared the Functional Specification Document FSD and Software Requirement Specifications SRS as per SEI CMM standards.
• Worked on improvement of Claims Reimbursement User Interface for a better experience and incorporate changes as per HIPAA guidelines using the gap analysis.
• Developed test cases and test plans on the basis of requirements and also did manual testing of the functionality of the application to ensure that the application is able to handle a lot of data.
• Used UML to create use case diagrams, sequence diagrams and activity diagrams.
• Developed flowchart and process diagram using MS Visio.
• Conducted interviews with clients to analyze their data and gather requirements.
• Provided assistance in building EDI's 270, 271, 276, 277, 835, 837 and 834 transactions.
• Clarified QA team issues and reviewed test plans and test scripts developed by development team and QA team to make sure all requirements have been covered in scripts and tested properly.
• Identified bugs during the test phase and reported them using ALM.
• Maintained Traceability Matrix throughout the project.
• Used the Rational Unified Process RUP to build the different phases of Software Development Life Cycle SDLC .
• Collected the information related to ongoing application upgrade and their impact on ICD-10 implementation and created awareness within the departments regarding the need, impact, benefits and risks of ICD-10 code application.

Environment: - RUP, SQL, MS Visio, MS Office, UML Use Cases, Rational test Manger.

Confidential

Business Analyst

Responsibilities:

• Utilized the RUP Software Development Methodology for the creation of the new operations system.
• Actively participated in all phases of SDLC, which is used as our practice-based methodology to effectively model the system.
• Used Rational Requisite Pro to collect requirements.
• Prepared Project requirements, User Specification documents, and UML diagrams to present detailed design of the system.
• Conducted JAD sessions for gathering requirements for the project.
• Followed standards according to Medicare A, B, C, D and Medicaid, HIPAA compliance and ANSI X12 837 formats.
• Created business and technical requirements, functional specs, gather and translate functional requirements into technical requirements and provide analytical support to the management team as needed.
• Proposed strategies to implement HIPAA in the new MMIS system and worked on planning and documentation
• Heavily involved in testing and reporting issues, as well as defining resolutions.
• Managed defect tracking and helped in the verification of the developed test cases.
• Generated traceability matrices for QA and test teams.
• Conducted risk analysis to analyze potential risk that could affect patients as a result of new functionality introduced into the system.
• Performed defect tracking and maintaining trailing history of bugs.
• Executed SQL queries to test data entry into the database and worked with the QA team to execute test cases.
• Contributed knowledge and support to QA and UAT teams throughout the process of testing the applications workflow and functionality.
• Provided weekly status updates to project stakeholders on the progress of project development.

Environment: Rational Suite RUP, Requisite Pro, Test Manager, Clear Quest , HTML, Oracle, MS Visio, MS Project, UML.