PROFESSIONAL SUMMARY

• IT Professional with 7 years of Excellent business analyst experience in all phases and stages of Software Testing Life Cycle and Software Development Life Cycle SDLC with good working knowledge of testing methodologies, disciplines, tasks, resources and scheduling.
• Overall 7 years of experience as a Business Analyst.
• Excellent communication skills, writing skills as well as presentation skills. Experience working with business users as well as senior management.
• Solid understanding of all phases of Software Development Life Cycle SDLC methodology such as requirement, analysis, design, data modeling, business process modeling, implementation and deployment .
• Broad knowledge of Test plans, Test cases and test scripts from the Requirements Document.
• In-depth knowledge of Rational Unified Process RUP risk engineering, data modeling and mapping, and design using UML Unified Modeling Language , Rational Rose and Visio.
• Good knowledge of Oracle and SQL.
• Excellent knowledge of HIPAA Health Insurance Portability and Accountability Act transaction codes such as 270/271 inquire/response health care benefits , 276/277 claim status , 470 benefit codes , 835 payment or remittance advice , 837 health care claim and 834 benefit enrollment .
• Capable of managing multiple projects simultaneously.
• Exceptional problem solving and sound decision making capabilities.
• Experience in writing queries/scripts for data analysis ad QA report testing.
• Conducted successful projects with the help of teams to achieve deadlines timely and proficiently.
• Experience in User Acceptance Testing, Smoke Testing, Regression Testing Performance Testing and Functional Testing.
• Experience working in Medicare and Medicaid projects.
• Experience in conducting SWOT Analysis, Cost Benefit and ROI Analysis.
• Created Requirements Traceability Matrix to keep the stakeholders informed of the progress of the project.
• Strong expertise in Health Insurance Claim process, social services, Medicaid and banking.
• Belief in team work, dedication, and professional ethics within the working environment.
• Extensive experience in conducting Joint Application Development JAD sessions for project definition involving analyzing requirements, creating prototypes, user interface, database schema and system design.
• Well versed with HIPAA, Facets claim adjustments, claim processing from point of entry to finalizing, claim review, identifying claims processing problems, their source and providing corresponding solutions.
• Extensive experience in gathering Business/Functional user requirements, creating Use Cases as per user requirements, developing/designing diagrams such as Activity, Class, and or Sequence diagrams, and in addition to creating Business Requirements Document BRD .
• Organized, goal-oriented, self-starter, and ability to master new technologies, manage multiple tasks while following through from start to completion.
• Good in requirement gathering including Joint Application Development JAD and requirement analysis.
• Ability to inculcate new relevant skills with ease in a time sensitive frame.
• Analysis done to determine if the system abides by the HIPAA regulations.
• Experience in writing Use cases and Functional Requirement Document.

Areas of Expertise:

Professional Experience:

Confidential

Sr. Business Analyst

Responsibilities:

• Gathering and documenting requirements of variety of projects ranging from internal enhancements, client requests to migration of different systems
• Responsible for generating and maintaining business and functional requirements of all the reporting needs of next gen version of portal
• Conducted controlled brainstorming sessions with project focus groups for collecting high level business requirements.
• Conducted several Requirement Gathering Sessions for gaining detailed requirements and finalizing Business Requirement Document BRD .
• Conducted JAD sessions and data modeling using UML.
• Generated reports as well as wrote complex SQL queries for data validation across different tables
• Performed and defined rules for Data Extraction, Transformation and Loading ETL process from legacy system to web based system.
• Worked on multiple client requested pricing models for wholesale pharmaceutical products such as volume discount pricing and contract pricing.
• Gathered and documented requirements of Accounts Receivable Reports
• Well versed with HIPAA, claim adjustments, claim processing from point of entry to finalizing, claim review, identifying claims processing problems, their source and providing alternative solutions using best practice model and principles.
• Gathered requirements for extracting data from legacy system and transporting it to enterprise tool for data warehouse project.

Interviewed SMEs and Stakeholders to get a better understanding of client business processes and gather business requirements. Requirement gathering, Business Process flow development, and Business Analysis.

Involved in data mapping, field mapping of the data elements responsible for the migration BRD.

Performed GAP analysis of business rules, business and system process flows, user administration to be used for the new migration platform

Participated in the application scrum meetings and the sessions.

Created and maintained a project schedule using MS Project showing all target dates for deliverables.

Confidential

Lead Business Analyst

Responsibilities:

• Analyze and document business requirements for secure Physician web portal and secure Member / Customer web portal.
• Write Project Requirement Documents PRDs which are standardized documents describing business needs, summary descriptions, dependencies, etc. Distribute for review and approval according to Requirements and Solution Analysis RSA process.
• Translate business requirements into technical requirements for IT development teams.
• Participate in high-level technical solutioning sessions
• Report project status, risks, roadblocks, etc, to immediate manager.
• Conduct User Acceptance Testing UAT on behalf of project stakeholder and review testing results for approval.
• Perform Operations Maintenance tasks O M including reviewing help desk requests, determining nature of problem / root cause analysis, assign to appropriate systems area for resolution, and monitor progress and communicate status to stake holder.
• Involved in Prod Verification and Production support.
• Worked on Member team for requirements Gathering, analysis and Documentation.
• Gather and organize information on problems or procedures.
• Analyze data gathered and used ETL for establishing staging area of data warehouse
• Confer with personnel concerned to ensure successful functioning of newly implemented systems or procedures.
• Executed SQL queries to test the database for records that detect and submit functional acknowledgement and remittance advice in the claims application.
• Knowledge and implementation experience of Quality Assurance, Testing Principles, and Configuration and Change Management Disciplines.
• Also developed a UAT User Acceptance Testing plan to guide a select group of key end-users in testing the user interface and functionality of the application.
• Develop and implement records management program for filing, protection, and retrieval of records, and assure compliance with program.
• Review and confer with management and users about format, distribution, and purpose, and to identify problems and improvements.
• Document findings and prepare recommendations for implementation of new systems, procedures, or organizational changes.
• Design, evaluate, recommend, and approve changes

Confidential

Business Analyst

Responsibilities:

• Implemented the SDLC for the developing life cycle and followed the standards process in the application.
• Translated business requirements into functional requirements and approaches for developers.
• Provided management support to the off-shore End to End integration/ Regression Test Team.
• Workflow documentation and comprehensive training to the healthcare clients.
• Analyzed corporate healthcare business processes to develop customized solutions.
• Working with Medicare operational management to monitor, trend and report on operational metrics such as timeliness, workload, and staff trending, customer satisfaction, and other key measures to facilitate performance excellence.
• Interacted with healthcare clients to gather requirements, objectives, and input and output requirements.
• Developed test cases and scripts for front end testing.
• Performed execution of test cases manually to verify expected results.
• Ensured the accuracy and consistency of the data during the data loading process.
• Developed Use case, Functional, Object diagrams using Rational Rose.
• Responsible for architecting integrated HIPAA and Medicare solutions
• Involved in managing the Daily Standup meetings and also ensured that quality standards were enforced as per the build-release schedule.
• Developed a detailed test plan and test cases to cover all the requirements.
• Used Rational Rose to create UML diagrams such as use case, activity, sequence, class and component diagrams.
• Developed Flowchart and process diagram using Microsoft Visio.
• Analyzed data architecture, documented and delivered data mapping, performed risk analysis.
• Frequently communicated with developers to resolve technical issues.

Confidential

Business Systems Analyst

Responsibilities:

• Collected the information related to ongoing application upgrade and their impact on ICD-10 implementation and impact, benefits and risks of ICD-10 code application.
• Re-Organize the collected data and prepared documentation for implementation.
• Constant touch with all the submitters of part A and B helping them with transition from 837 4010 to 837 5010 transaction.
• Vendor Management Work as a facilitator for Testing Efforts and New Requirements between the Healthcare Company and its various Vendors.
• Helped in gathering requirements for making TPA for third party vendor.
• Check test files and production files in M2 and update PIMS with any additional or changed information of providers.
• Coordinated the upgrade of Transaction Sets 837P, 837I and 835 to HIPAA compliance.
• Analysis and Design of existing transaction sets, and modification of these transaction sets to ensure HIPAA compliance.
• Did gap analysis for HIPAA 4010 837P, 837I and 835 transactions and HIPAA 5010 837P, 837I and 835 transactions.
• Conducted JAD sessions with business units and stakeholders to define project scope, to identify the business flows and determine whether any current or proposed systems are impacted by the new development efforts.
• Gathered Business Requirements from the Subject Matter Experts SMEs and documented the requirements in the BRD. Utilized data flow diagrams, use case diagrams and process flow diagrams to represent information provided by the Business Owners.
• Attended daily SCRUM and guided QA and Developer regarding the defects, Technical Specification Documents.

Confidential

Business Analyst

Responsibilities:

• Acted as an interface with different stakeholders of the project.
• Defined Business Rules by interacting with stakeholders and users through Surveys Brainstorming.
• Developed a vision plan that defined the primary goals and objectives of the project.
• Conducted Joint Application Development JAD sessions.
• Performed Gap Analysis, conducted walkthroughs and acted as a liaison between the business users, stakeholders and the team to perform requirements, quality and risk analysis.
• Involved extensively in the inception phase for understanding the Scope of the Project, feasibility of the implementation and define the risk factors involved in the project.
• Gathered business requirements through sessions and analysis by interviewing users and Subject Matter Experts SME .
• Analyzed business/system requirements using requirement arbitrage and assigned appropriate priorities.
• Documented AS-IS and TO-BE analysis, and conducted process evaluations and write recommendations based on the analysis.
• Applied Unified Modeling Language UML notations and methodology in developing models that accurately represent the business process and workflows to effectively communicate them to the stakeholders.
• Got system approvals by conducting UAT sessions.

Confidential

Engineering Analyst

Responsibilities:

• Gathering requirements and preparing documents to meet project needs
• Worked with the project manager for planning and organizing the project activities
• Analyzing the work flow process and coordinating various improvement initiatives
• Conducting time study analysis of boiler processes
• Working on gathering requirements of cost reduction projects
• Responsible for creating various daily reports