OBJECTIVE:

• Experienced Business Analyst with over 8 years of hands - on experience in identifying business needs and determining solutions to business problems for complex software projects, including system development component, business process improvement, strategic planning and policy development.

SUMMARY

• Experience in all phases of Software Development Life Cycle (SDLC).
• Experience in software development methodologies like - Agile (such as Scrum) and Waterfall.
• Expertise in Business Analysis, GAP Analysis, Data Analysis, Business Rules and developing and creating business process documents.
• Proficient in preparing Business Requirement Document (BRD), Software Requirement Specification (SRS), Functional Specifications, Use Cases, and User Manuals.
• Good knowledge of important and frequently used UML diagrams such as Use Case Diagrams, Activity Diagrams and Sequence Diagrams.
• Experience in using Joint Requirement Planning (JRP) and Joint Application Development (JAD) sessions for gathering requirements and brainstorming ideas.
• Strong background in developing data mapping, data profiling and identifying bottlenecks of sources, mappings, and targets.
• Sound knowledge of HIPAA migration and ICD 9 to ICD 10 codes conversions and mapping.
• Knowledge of different modules within Healthcare Claims Adjudication Process (Membership process, Billing process and enrollment & Claims process).
• Excellent experience in EDI 837 - Claims processing and Encounters, EDI 834 - Benefit Enrollment and Maintenance, EDI 835 - Claim Payment/Advice.
• Strong understanding of data quality assurance processes and procedures.
• Created data flow diagrams, data mapping from Source to Stage and Stage to Target mapping documents.
• Analyzing and validating data from different data sources using various SQL queries.
• Firm understanding of HIPAA regulations and experienced working in all phases of healthcare insurance processing like defining Membership Eligibility and Enrollment and various Medical Claims processing.
• Good knowledge of SQL Server Database and developing SQL queries in IBM AS400 for data driven test and back-end testing of the project.
• Created Test cases and Test scripts for System Integration Testing (SIT), User Acceptance Testing (UAT).
• Experience in using Quick test Professional (QTP) testing for Client /Server, Web and Database Applications.
• Skilled in using change control and bug tracking tools like TFS and Quality Center for identifying, analyzing, assigning and documenting defects including version and change control.
• Experience with handling User Acceptance Tests (UAT).
• Attention to details and ability to prioritize tasks along with excellent project management and problem solving skills.
• Skilled at learning new concepts quickly, can work well under pressure and able to communicate ideas clearly and effectively.
• Excellent team player with an ability to perform individually, good interpersonal and analytical skills.

TECHNICAL SKILLS

Project Methodologies: Waterfall, Agile, Rational Unified Process (RUP)

Business Modeling Tools: Rational Rose, MS Visio, UML

Operating Systems: Windows 2000, Windows XP, Windows 7, UNIX

Databases: Oracle, MS SQL Server, DB2

Languages: C, JAVA, Visual Basic, SQL

Defect Tracking Tools: HP Quality Center, TFS

Test Tools: Quick Test Pro (QTP)

Quality Assurance: Software Application Testing Life Cycle

Project Management Tools: MS Project

PROFESSIONAL EXPERIENCE

Confidential, Tampa, FL

Sr. Business Analyst

Responsibilities:

• Assisted project managers with the development of project schedules.
• Performed scope analysis, impact analysis and GAP analysis
• Conducted user interviews, gathered requirements, and analyzed the requirements.
• Worked with all levels of client staff in solution definition.
• Performed risk analysis of the requirements to identify key business areas for the project.
• Developed the requirements document and a preliminary design for the HIX web portal.
• Managed scope and change throughout the life cycle of the product.
• Analyzed set behavior and contribution to business performance, critical business metrics and tracking underlying business trends.
• Participated in the logical and physical design sessions and assisted in the development of design documents.
• Designed new process flows for the existing system as well as for the enhanced portal.
• Conducted and led status report meetings with the business and the IT team on a weekly basis.
• Worked on Electronic health record system as a CRM web based application.
• Performed Content Management using MS SharePoint.
• Documented test cases during requirements gathering, analysis and design phases.
• Provided technical and procedural support for User Acceptance Testing (UAT)
• Prioritized and communicated open issues and project risk/mitigation plans to UAT teams.
• Assisted the QA team to develop testing strategies and prepare detailed test cases by analyzing technical requirements.
• Contributed to improvise training sessions for effective use ofEHRfeatures.

Environment: Windows, MS SharePoint, MS Office, MS Project, MS Visio, MS SQL Server.

Confidential, Philadelphia, PA

Business System Analyst

Responsibilities:

• Participated in all aspects of the standard project life cycle to ensure a smooth transition of projects to production support.
• Created a High level Vision and Scope (HLVS) document that helped identify the overall scope of the project and provide a guideline.
• Worked with business users to define Business, Process, and Data Models to understand the overall business.
• Conducted Impact analysis of the project to identify affected teams, help them integrate the new process in existing processes and resolve/mitigate any issues or risks.
• Conducted meetings, interviews and JAD sessions with appropriate business/technical stakeholders to gather functional system requirements from Process Owners.
• Developed and documented functional specifications for application enhancements and database updates.
• Conferred with Business Users to gather requirements for the design and development teams.
• Analyzed Business Requirements to produce System Requirements for the technical team
• Worked with development / technical team members to ensure that the enhancements would meet the defined business requirements.
• Identified business processes involved in the INSINQ project and documented them in UML Use Cases with Use Case diagrams.
• Wrote both high level and low-level system requirements for the project.
• Worked closely with the business team, the development team and the quality assurance team to ensure that requirements are as intended in order to achieve the desired output.
• Analyzed “AS IS” and “TO BE” scenarios by designing and documenting process flows.
• Documented the business process and various business scenarios related to the “Service Now to INSINQ Integration” project.
• Wrote Use Cases with relevant UML diagrams such as Use Case diagrams, Activity diagrams and Sequence diagrams using MS Visio.
• Worked with developers to test the iterations of the System under development (SUD) to ensure it met the user’s needs: conducted User Acceptance Tests (UAT).
• Reviewed Test cases as needed and interacted with and assisted the entire team on the testing tools and procedures.

Environment: Windows, XP, MS -Visio, SharePoint, Clarity PPM, MS Office, MS Excel, MS Project, XML, HTML.

Confidential, PA

Business Analyst

Responsibilities:

• Helped in defining Change Management Process for Release Management Team.
• Mapped process flow; assess as-is a process through user interviews, data collection and analysis, design and evaluation of to-be process solutions.
• Prepared Business Object / Business Process Models that included modeling of all the activities of business from conceptual to procedural level.
• Consulted with healthcare insurance company to develop conversion specifications for other insurance Coordination of Benefits (including Medicare).
• Involved in TRIZETTO Facets System implementation, Claims and Benefits configuration set-up testing, Inbound/Outbound Interfaces and Extensions, Load and extraction programs involving HIPPA 837 and proprietary format files and Reports development.
• Developed data conversion programs for membership, claims, and benefit accumulator data - converted thirteen corporate acquisitions. Developed data field mappings. Provided programming and support for claims processing functions and auto-adjudication.
• 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)
• Identified gaps in the business process.
• Defined roles and responsibilities of participants in the business process.
• Developed and maintain information and documentation related to developing and modifying business processes and systems.
• Recommend system/process solution approaches to minimize risk and workflow impacts while capitalize strategic goals.
• Assisted process owners in process training and implementation.
• Streamlined the Restatement Financial Data Warehouse access review Process.
• Gathered requirements from users of the Clear Quest (CQ) tool for any Enhancements or change requests for any defects.
• Involved in Six Sigma process analysis.
• Planned and defined system requirements to Wire Frame with Use Case, Use Case Scenario and Use Case Narrative using the UML (Unified Modeling Language) methodologies.
• Led and conducted JAD sessions for requirements gathering, analysis and design of the system.
• Created context and workflow models, information and business rule models, Use Case and Object Models during the analysis using rational tools.
• Designed and developed project document templates based on SDLC methodology
• Established RUP (Rational Unified Process) methodology and provided assistance in developing Use cases and project plans.
• Analyze business requirements and segregated them into Use Case Diagrams, Activity Diagrams, Sequence Diagrams, and OOD using Borland Together according to UML methodology thus defining the Data Process Models.
• Documented Requirements for Management Reporting out of Clear Quest using Crystal Reports.
• Worked as a CQ administrator by assisting customer with any issues and by running queries for ad-hoc reports for management team.
• Facilitated Change Control Board and Governance Board meetings and acted as a liaison between parties impacted by the change requests.
• Provided training on new features within CQ and prepared training materials like Quick Reference Guides and Job aids.
• Environment: SQL, MS Office, UML, Visio, Clear Quest

Confidential, South San Francisco, CA

Quality/Business Analyst

Responsibilities:

• Conducted meetings with business process owners, SME (subject matter experts) and Trading Partners for requirement gathering.
• Participated in JAD sessions to understand the detailed requirements.
• Created and reviewed functional and technical design documents such as BRD, FRD, Use cases, data models and data flow diagrams, Wireframes using Visio etc.
• Acted as a primary contact in all the phases of Software Development Life Cycle (SDLC).
• Worked on Agile SDLC approach implementation for the complete project life cycle.
• Interacted with Client to accommodate any new change in the requirements as well to discuss the project status.
• Attended daily scrum meetings to update status to the Team.
• Responsible for frequent team meetings to resolve any outstanding issues during the sprint and establish a plan of action for the continuation of the sprint.
• Worked on digital patient record module for testing the Tif files related to Amendments Module.
• Performed GAP analysis for ICD9 and ICD10 by creating crosswalk table conversion.
• Involved in the testing of ICD 9 to ICD 10 code conversion by using GEM (General Equivalence Mapping) tools for forward and backward mappings of ICD 9 - ICD 10 codes.
• Assisted business users in defining test plans and UAT test cases.
• Created Test Plan and Test cases for Regression testing and User Acceptance Testing (UAT).
• Created Test Scripts by referring to Acceptance Criteria in User Stories in MS Team foundation Server (TFS).
• Maintained Requirement Traceability Matrix (RTM) to make sure that all the requirements were properly translated to test cases.
• Performed Smoke, Functional, and white box testing and written SQL queries for Backend testing.
• Participated in the retrospective meeting after the end of each sprint and release retrospective at the end of each release.
• Presented the work completed during each sprint in the Sprint Demo session
• Assisted in User Acceptance Testing (UAT), developing and maintaining quality procedures, and ensuring that appropriate documentation is in place.
• Responsible for collecting and analyzing the functional test results and prepared a test summary document that contains Summary and Measure reports.

Environment: Windows, XP, IBM - AS 400, MS -TFS, SQL, Java, SharePoint, HLI server, DB2, MS Office, MS Excel, XML, HTML, UNIX.

Confidential

QA Tester/Business Analyst

Responsibilities:

• Analyzed Business Requirements (BRD) and Functional Requirement Documents (FRD) and attended walkthrough meetings with Business Analysts.
• Actively Responsible for documenting Test Plan and developed scenarios for writing Test Cases and Test Scripts.
• Wrote Test cases for all functions of the application in Test Plan module of HP ALM Quality Center 11.0.
• Responsible for Smoke, Black box and White-box and Functional testing manually.
• Conducted Black Box Testing on the application and validated the dataflow in the application.
• Actively participated during Integration, Load & Stress and User Acceptance Testing (UAT).
• Documented UAT Test Plan and Test cases to conduct User acceptance testing (UAT).
• Facilitated Electronic Data Interchange (EDI) and was responsible for implementation of HIPAA while testing EDI transactions.
• Involved in the Up-gradation of HIPAA X12 4010 transactions to HIPAA X12 5010 and ICD-9-CM to ICD-10.
• Responsible for testing ICD 9 to ICD 10 codes conversion transactions and performed GAP Analysis for the same.
• Extensively tested EDI X12 Transaction sets like EDI 837 (Health Care Claim).
• Analyzed HIPAA EDI 837 transactions in XML and looked for defects for amendment.
• Developedand executed SQL queries to verify the proper insertion, deletion andupdates into the data Warehouse supporting tables.
• Verified claims, payments, and status with back-office database.
• Logged the Defects in Quality Center and maintained track of the defects throughout the Software Testing Life Cycle (STLC).
• Monitored entire defect tracking process, trouble shooting and was responsible for generating customized graphs and reports for the client and stakeholders.
• Maintained the test plan status and facilitated both weekly and daily reporting metrics to team leads and management.
• Created problem tickets and followed up on fixes and resolutions for defects that were uncovered during testing.
• Worked on the continuous improvement of QA process by reviewing and evaluating existing practices with standard testing guidelines.

Environment: SQL, Java, SharePoint, MS Office, HPALM Quality Center 11.0, DB2, MS Excel, HTML, XML, UNIX. Windows XP.

Confidential

Business Analyst

Responsibilities:

• Collected and documented business processes as well as business rules.
• Gathered Requirements through requirement analyze sessions. Developed and implemented processes for Requirements gathering, Analysis, planning, tracking and delivery.
• Integrate data from internal and external sources in order to provide data for analysis and/or reporting; design new reports and identify opportunities
• Used MS Project to maintain the project schedule and track its status.
• Worked on Gap analysis. Also worked on current flow and future state diagram.
• Assisted in developing test scenarios, test scripts & test data to support unit & system integration testing.
• Assisted the Project Manager in setting realistic project expectations and in evaluating the impact of changes on the organization and plans accordingly.
• Developed timelines for project delivery, and managed projects and resources for successful completion
• Environment: SQL, MS Office, DB2, MS Excel, HTML, XML, UNIX. Windows XP.