Sr. Business Systems Analyst Resume
Hartford, CT
SUMMARY
- Over 8 years’ experience in Information Technology with focus on Business Analysis and Software Validation of applications for various businesses.
- Experienced cross functional professional across technology areas, and operations focusing primarily on business requirements gathering and analysis, technical writing, functional requirements gathering, and analysis
- Experience in Healthcare Industry, with good operational knowledge of Health Insurance Portability and Accountability Act (HIPAA).
- Broad knowledge of Medicare, Medicaid, PPO, HMO, POS, diagnostic codes, and claims process, EDMS (electronic data management system).
- Good knowledge of PPACA (Patient Protection and Affordable Care Act) and HIX
- Analyzedtheexisting 820 reports andmodifiedthem based on the changes resulting fromthe Health Insurance Exchange (HIX)
- Assisted with the implementation and ongoing support of the Health Insurance Exchange (HIX) environments.
- Excellent understanding of HIPAA standards (4010 and 5010 transaction sets), HIPAA code sets ICD - 9 and ICD-10, and HL7.
- Experience in Healthcare/Claims adjudication with knowledge of industry compliance standards like EDI X12 transactions (834, 837, 835, 270/271, and 276/277).
- In-depth knowledge of EDI transactions between the implementation partners in Healthcare Industry.
- Functional and non - functional Requirements Gathering.
- Good knowledge of Business Intelligence, Data Warehousing and Business Architecture.
- Well-versed with MS Visio, MS Project and Mockup screen
- Well- versed with Microsoft suite (Word, Excel, Access, Visio, Power Point and Outlook) for analysis and presentation.
- Experience in GAP Analysis, CBA (Cost-Benefit Analysis), organizing, facilitating, coordinating weekly meetings, conference calls, and other regular project meetings.
- Thorough Knowledge of various SDLC methodologies like Waterfall, Agile such as Agile XP and Agile Scrum, and Waterfall.
- Expert in facilitating Joint Application Development (JAD), Rapid Application Development (RAD), interviews, workshops, and requirement elicitation sessions with end-users, clients, stakeholders and development team.
- Experience in creating UML diagrams, Data Flow Diagrams (DFD), Use Cases, Class Diagram, Activity Diagrams, Sequence Diagram, and UML Modeling.
- Facilitated User Acceptance Testing and test strategies with developers and testers, and participated in manual front-end testing to check all functionalities of different modules.
- Involved in the development of Test Plans, Test Cases, and prepared Requirement Traceability Matrix (RTM).
- Highly motivated team player, possessing an excellent communication and presentation skills with detail oriented analytical abilities and a willingness to work in a cross platform environment.
- Expertise in Web and Client Server Applications through all stages of the Software Development Life Cycle.
- Highly proficient in working with clients and Business stakeholders including gathering requirements, analyzing them, detailing and tracking requirements.
- Excellent analytical skills in understanding the business process (AS-IS and TO-BE) understanding the functional requirements and translating them to system requirement specifications.
- Ability to create and analysis Business Requirement Documents, Functional Requirement Documents, Process flows and Use Cases.
TECHNICAL SKILLS
Microsoft Technologies: MS Project, Visio, Excel, Word, Outlook, PowerPoint
Requirements Management Tools: Rational Requisite Pro, Rational Rose, MS Visio, Share Point
Operating System: Windows 2000/7/XP, DOS, Unix
Business Skills: Business Process Analysis & Design, Process Improvement and Implementation assessment, Requirement Gathering, Use Case Modeling, JAD/JRP Sessions, Gap Analysis, Impact Analysis.
Office Tools: MS Office (Package), MS Visio, MS Project, MS FrontPage.
Languages/Standards: SQL, JAVA, XML, HTTP, HIPPA 4010/5010, ICD9/10, ANSIX12, CPT, CMS form.
Methodologies: Rational Unified Process (RUP), Agile, Waterfall, Rapid Application Development (RAD)
Other Tools: Axiom Transcend, Informatica, Cognos, Visual Basic, Mainframe.
PROFESSIONAL EXPERIENCE
Confidential, Hartford, CT
Sr. Business Systems Analyst
Responsibilities:
- Gather requirements for correspondence and report generation from functional and business owners and convert these requirements into User Stories.
- Define scope for the Claims Business area and updating EDI Transactions with the HIPAA 4010 to HIPAA 5010 Changes and participate in full life cycle implementations (SDLC) from project initiation to final deployment.
- Create Business Requirement Documents (BRDs), Use-Case Narratives including business process workflow diagrams and Requirements Traceability matrix.
- Perform GAP analysis in order to identify the changes in 837, 270/271, 275, 276/277, 834 and 835 transactions being proposed in the upgrade from HIPAA 4010 to HIPAA 5010.
- Create business use-cases, flow diagrams and validate business rules and data elements for EOB and adjustment application
- Map 4010 and 5010 differences
- Participate in all Iteration, Scrum, Daily stand-ups and Iteration review meetings working in an agile development methodology.
- Leading Sprint Planning meetings, getting estimates from individuals (BA’s) and assigning tasks based on velocity/capacity.
- Introduce the Agile SCRUM process for the Risk Data team and utilized Microsoft Team Foundation Server (TFS) to manage the team's software development lifecycle including deriving product backlog items, assigning sprint work items to developers and conducting sprint review meetings.
- Closely work with all BA’sand stake holders for reviewing User Stories and scoping documents.
- Working with Carriers to gather their requirementsand creating mapping documentsand interpreting XML documents.
- Coordinate withConnecticutHealth Exchange HIX program staff and other stakeholders to define and develop requirements for correspondence generation across various business lines.
- Practice agile methodology, lead sprints and prioritize line items based on key business initiatives with respect to the ACA mandate and Health Care Reform Act
- Lead JAD sessions withsubject matter experts (SMEs) from each work stream/business unit for particular correspondence lifecycles, process flows, and triggering conditions etc. for development within the HPExstreamenvironment; translate business requirements into a functional document and solution design.
- Create data mapping documentation including standardizing and validating data tags, creating data dictionaries for new and existing correspondences and reports for the purposes of data analysis. Work closely with HPExstreamand Health Rules developers to understand system specifications and formulate requirements to align with these specifications.
- Served as the project teamlead for the Cram functional areas of Organization Structure, Security Structure and Location Structure for the CT HIXproject
- Help develop integration solutions that create interoperability between Health Rules and HPExstream.
- Track user stories, tasks, burn down hours and project progress in Version 1 for correspondence and reports efforts across various work streams, participate in daily scrum meetings, provide status reports, impediments and milestones to scrum masters to meet tight project deadlines. Raise issues and escalations in IRAAD as possible threats to project deadlines.
- Lead Member Experience Review Boards to gather a user experience perspective on content, usability and readability of correspondences. Liaison closely with content writers to align the content to specific and unique business needs.
- Devise workarounds, make recommendations and modify procedures to solve intricate problems considering system capacity and limitations, operating time, and desired business results.
- Work with Quality Assurance team to validate system acceptance and user acceptance test plan and test scripts.
Environment: HP Exstream, Health Rules, XML, Agile- Scrum, Version One, MS Visio, MS-Word, Excel, Power Point, TFS, Sprint .NET, IBM On Demand (COTS).
Confidential, Columbus, OH
Sr. Business Analyst
Responsibilities:
- Conducted Interviews and JAD sessions with SME’s and stakeholders to understand the business requirements.
- Gathered and created Business Requirement Documents (BRD), performed cost-benefit analysis with Project Manager.
- Performed transactional/encounter processing, and reviewed claims creation using Axiom Transcend.
- Performed detailed analysis for the functional areas that will be impacted by implementation of ICD-10 codes
- Conducted GAP analysis and Impact Analysis and prepared an Implementation and Recommendations Report communicated to the stakeholders.
- Created Functional Requirement Documents (FRD) based on the signed-off business requirements.
- Developed Use Case diagrams, business flow diagrams- Activity/State diagrams and Sequence diagramsso that developers and other stakeholders can understand the business process.
- Created and maintained a Requirement Traceability Matrix (RTM) to see if all the requirements are being captured and are being worked on.
- Managed all the Change Requests Document that came in through after signoff and maintained all the artifacts on SharePoint.
- Arranged meetings with the IT team to create Data Mapping Document facilitate the conversion from ICD-9-CM codes to ICD-10-CM/PCS codes to ensure that both the application and Health Record comply with new regulations.
- Analyzed the impact of ICD-10-CM/PCS coding system and Identified General Equivalence Mappings to facilitate the conversion from ICD-9-CM codes to ICD-10-CM/PCS codes to ensure that both the application and Health Record comply with new regulations.
- Worked extensively with IT team on building the architecture and underlying logics of the system.
- Involved in designing and developing Data Models and Data Marts that support the Business Intelligence Data Warehouse.
- Extreme involvement in production and development phase to report out to the stakeholders about the current status of the project.
- Created test plans and scripts, facilitated user acceptance testing and tested strategies with developers and testing team
Environment: Rational Rose, Rational Requisite Pro, MS Project, Quality Center 9.0,9.2,MS Visio, Siebel, Clear Case, Rational Clear Quest, XML, JAVA, HTML, Microsoft SQL Server, Agile .NET, Oracle, MS SharePoint, AXIOM Transcend. .
Confidential, CT
Business Analyst
Responsibilities:
- Interfaced with, and interviewed, cross-functional stakeholders to generate requirements.
- Leveraged Agile - Scrum methodology for portal development.
- Prepared Data mapping document for EDI 834 toCigna Healthinternal format.
- Gathered high level requirements from the business, created user stories, and prioritizedthe backlog with project manager.
- Collaborated with the development team through iteration and attended every Scrummeetingto represent the product team.
- Enabled product-centric testing and facilitated QA team's understanding of acceptance criteria and test scenarios.
- Developed Activity Diagrams, Use Case Diagrams, and Workflow Diagrams using Microsoft Visio.
- Accountable for extensive User Acceptance Testing.
- Interfaced between users and diverse teams and was involved in application development to enhanceunderstanding of both business and IT processes.
- Worked with team to stay abreast with new process and render it more effective.
- Utilized technical writing skills to create effective documentation and training materials.
- Performed a baseline assessment and related interfaces, existing service level agreements, policies,andoperational business proceduresfor readiness to comply with ICD-10requirements.
- Identified risks, problems, requirements and concerns in order to comply with ICD-10 changes byconducting interviews.
- Activelyworked on Data analysis and Report analysis with respect to ICD-10 impact.
- Collected the information related to ongoing application upgrade. Studied their impact on ICD-10implementation.
- Responsible for defining the scope and implementing business rules of the project, gathering businessrequirements and documentation.
- Responsible for writing Functional Requirement Specifications (FRS) and User RequirementSpecification (URS).
- Created Test Plan, Test Cases and Test Scripts with respect to Test plan.
- Analyzed Business Requirements and segregated them into high level and low level Use Cases,Activity Diagrams, State Chart Diagrams using UML methodology. Clearly defined the Data Process Models.
- Capturedanddocumentedgovernance requirements.
Environment: Rational Requisite Pro, Microsoft Office, MS Visio, Quality Center, XML, Rational Rose, Microsoft Outlook, MS SharePoint.
Confidential, Atlanta, GA
Business Analyst
Responsibilities:
- Created Business Requirement Document (BRD), Functional Requirement Documents(FRD) and supporting documents that contain the essential business elements and detailed definitions.
- Worked on Medicare Part C and Part D transactions.
- Conducted meeting with the EDI team and other stakeholders, team members to discuss the requirements.
- Performed Requirement Analysis to Develop Use Cases, Activity Diagrams and Sequence Diagrams.
- Extensively used Waterfall software development lifecycle methodology during the project
- Collected requirements using Brain storming, Document Analysis, Interviews and JAD session.
- Identify, analyze, define and created business processes and use case scenarios using MS-Visio.
- Helped the Project Manager with project estimation and cost-benefit analysis, resource and financial Planning of the system.
- Implemented data access, storage and validation routines on the database server using SQL.
- Coordinated QA reviews, sign-off, and validation migration from UAT to production environment. Also coordinated business review, sign-off and production validation.
- Evaluated alternative solutions and recommend solution that best meets the need of the business.
- GAP Analysis of client requirements, generated workflow process, flow charts and relevant artifacts.
- Used Rational Requisite Pro for overall Requirements Management and to build the Requirements Traceability Matrix (RTM’s)
- Experienced as a Business Analyst in a role of responsibility encompassing requirement gathering, and Analysis besides Quality Assurance.
- Evaluated and analyzed various solutions and provided recommendations that best suits the business.
Environment: GAD (Gap Analysis Document), Rational Rose, Rational Requisite Pro, Microsoft Office, MS Visio, MS SharePoint.
Confidential, Atlanta GA
Business Systems Analyst
Responsibilities:
- Coordinated participation and sign-off of various business partners and customers.
- Involved in the analysis of the existing credit card processing system, mapping phase according to functionality and data conversion procedure.
- Thoroughly studied the requirements for the process re-engineering
- Performed Gap Analysis to check the compatibility of the existing system infrastructure with the new business requirements.
- Followed solely RUP methodologies during the course of the project.
- Created Data Stage jobsto extract, transform and load data into data warehouses from various sources like relational databases, application systems, temp tables, flat files etc.
- Designed and developed use cases, activity diagrams, and sequence diagrams using UML.
- Used the DataStage Designer to develop processes for extracting, cleansing, transforms, integrating and loading data into data warehouse database.
- Develop, maintain and publish project plan & scheduled project deliverables using Niku/Clarity resource database as well asMS Project.
- Extensively involved in the modeling and development of Reporting Data Warehousing System
- Was involved n the creation of new E-Commerce Products (Arrival Notices and Customized Reporting)
- Accumulated system requirements from various departments through surveys and interviews.
- Involved in Prioritizing the defects and writing business requirements to resolve them.
- Conducted JAD sessions with management, SME, vendors, users and other stakeholders for open and pending issues.
- Involved in mentoring specific projects in application of the new SDLC based on the Agile Unified Process, especially from the project management, requirements and architecture perspectives.
- Create technical design documentation for thedatamodels,dataflow control process,metadatamanagement.
- Worked on exporting data using Teradata.
- Wrote detailed specifications for various reports generated using Cognos.
- Analyzed the data collected and process maps to determine the root causes and identify opportunities.
- 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
- Created business requirement documents and integrated the requirements and underlying platform functionality.
- Interfaced between Business new product builders and System platform builders.
- Worked with systems area to translate business needs into system requirements.
- Involved with all the phases of Software Development Life Cycle (SDLC) methodologies throughout the project life cycle.
- Used SDLC (System Development Life Cycle) methodologies like the RUP and the waterfall.
- Use Cases and other Process Flow Models were designed using Visio and Rational Rose.
Environment: RUP, UAT, GAD (Gap Analysis Document), Niku/Clarity, MS Visio, Java, J2EE technology,Agile, .NET, ASP.NET, SQL Server, Windows 2000 Advanced Server, UNIX / Oracle Platform, Web Form, Cognos.
Confidential, Chicago, IL
Business System Analyst
Responsibilities:
- Interacted closely with the Business users along with the administration and management to gather business requirements and analyze the functionalities to be incorporated into the system.
- Attended demo sessions to understand existing system functionalities.
- Followed the Agile methodology during the entire SDLC
- Arranged interviews with all the stakeholders to review and understand the gathered business requirements.
- Formulated Data Mapping Guide for the technical team.
- Coordinated with system architects and developers to convert business requirements into system requirements.
- Conducted meetings to document Change Requests for new requirements.
- Analyzed business requirements and segregated them into Use Cases. Created Use case diagrams and documented Use case specifications
- 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.
- Coordinated with the Project Manager to prioritize outstanding defects inQuality Centeror enhancement/system requests based on business requirements and available human resources, allowing sufficient time to ensure accuracy and consider deadlines.
- Documented project plans,process flow, timelinesand other requirements.
- Ensured that all the artifacts are in compliance with corporateSDLCPolicies and guidelines.
- Facilitated meetings and Joint Application Development (JAD) sessions with business stakeholders and technical units.
- Implemented best practices, facilitated meetings between business users and third party application vendors.
- UsedMS Excel/Word/MS Officefor status reporting and planning.
- Performedrequirements traceabilityand managed changes to requirements for theMARSapplication.
- UsedQuality Centerfor bug tracking.
- Maintained various versions of the documents generated during the project using Rational Clear Case.
- Was responsible for creating and updating project schedule and managing resources and timeline using MS Project.
- Worked with the ETL development team for migrating the data from the old data mart to the new IDW (Insurance Data Warehouse) and to validate the data integrity.
- Prepared the project status reports and represented the BA team in the PMO meetings.
- Participated in UAT along with Business SME’s.
Environment: RUP, MS Visio, MS Project, MS Office Suite Word, Excel, Access, Power Point, Outlook, Rational Rose, Rational Requisite Pro.