SUMMARY

• Over 7+ years of experience as a Business Analyst in diverse industry sectors including, Banking, Finance, Insurance, Mortgage and Healthcare.
• Several years of experience and advance knowledge of the Systems Development Life Cycle (SDLC), and project life cycles such as Agile, Rapid Application Development (RAD), Extreme Programming (XP), and Rational Unified Process (RUP).
• Proficient in creating business requirement documents (BRD), functional requirements documents (FRD), Use cases diagrams, Activity diagram, Class diagrams, and Sequence diagrams.
• Actively participated and functioned in Joint Application Development (JAD).
• Well Experienced in Test Plans development, Test Conditions and Test Cases, test data creation and analysis, and interaction with the development team for error detection and correction.
• Developed Requirements Traceability Matrix (RTM) using Rational Rose to trace each software requirement to test case.
• Experienced in conducting GAP analysis, User Acceptance Testing (UAT), SWOT analysis, Risk Analysis and mitigation plan, Cost benefit analysis, and ROI analysis.
• Experienced in understanding database structures and write SQL.
• Experience in Capital markets, Financial Management
• Excellent knowledge in MS Excel - Pivot tables, graphs and MS Powerpoint
• Experienced on creating reports and dashboards
• Experience with developing RACI charts, Communication Plans, and Project Charters
• Strong knowledge of Dodd Frank, Basel and other banking regulatory requirements.
• A very good team player with excellent communication skills and presentation skills
• Experience in selecting and executing elicitation techniques such as Interviews, Facilitated Workshops, Focus Groups, Observation, User Task Analysis, Documentation Study and Surveys and overall Process Reengineering.
• Apt at writing Data Mapping Documents, Data Transformation Rules and Data Dictionary maintenance, Data Migration, and Interface Requirements Documents.
• Extensive management background within varied sectors of the healthcare industry including HMOs, PPOs, Integrated Hospital Systems, Out-Patient Surgery Centers, Dental, and Vision.
• Strong knowledge of gathering requirements for Medicaid Management Information System (MMIS) session.
• Thorough knowledge of HIX, PPACA, HIT, HIT Governance Policy and HL7
• Proficient in business requirement gathering and writing, including the EDI transaction from .
• Detail understanding of ICD 9/ANSI/HL7 to ICD 10/ANSI/HL7 coding standards in Medicare and Medicaid domains of the healthcare industry.
• Extensively worked and presented several documents and Use Cases for multiple transactions including837I, 837P, 835, 276, 277, 270, 271(both inbound and outbound) transactions for ongoing industry projects.
• Good knowledge of Health Insurance Plans (Medicare Part A, B, C and D), managed care concepts (Medicaid and Medicare), and experienced in determining the membership eligibility, billing experience within life, and disability in health plans.

TECHNICAL SKILLS

Business Analysis: MS Visio, Test Manager, Test Director, Win Runner

Project Management: MS Project (Server), Creative Pro Office, JIRA

Operating System: Windows XP, Windows 7

Languages: SQL

Application: Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Microsoft Access, Visual Studio, Share Point, Rational Suite, Micro strategy, MS Visio, Igrafx

Database: MS SQL Server, Oracle 8i, 9i, 10g, MS Access

Other Tools: SQL*Plus, Business Objects,, Rational Requisite Pro

PROFESSIONAL EXPERIENCE

Confidential, San Antonio

Business Analyst

Responsibilities:

• Participating in business requirements session with different work streams and technology teams and analyzed gathered requirements, verified requirements and created business requirement document (BRD)
• Understand and document client requirements, review, analyse the detailed requirements and related documentation and send for approval
• Designing Proof of Concept (POC) to identify baseline, adverse, and serve scenarios developed by the Board of Governors of the Federal Reserve System
• Interacting with Subject Matter Experts (SME’s) and stakeholders to get a better understanding of client business processes and gather business requirements
• Communicating status of work to appropriate parties in order to keep them informed and involved and coordinating and managing off-shore team
• Prepared Business Process Models and business rules that included modeling of all activities of business from conceptual to procedural level
• Used SQL for finding out model related information like variables and source to taget destination for the FSB models
• Create SOPs, walk-through materials for the specific service offering and the end-to-end data flow analysis.
• Facilitating the daily standup
• Data analysis of all the models and breaking down in scenarios and documenting it
• Helping the team maintain their burn down chart
• Perform data lineage exercises and create required documentation
• Coordination of documents in the project SharePoint
• Getting SharePoint access for team members as needed
• Coordinating with top management in understanding different process plans, business process, and functionality in depth

Environment: MS SharePoint, MS Word, MS PowerPoint, MS Excel, Agile-Scrum, MS Outlook, Igrafx SQL

Confidential, NY

Business System Analyst

Responsibilities:

• Participated in business requirements session with different work streams and technology teams.
• Communicate status of work to appropriate parties in order to keep them informed and involved
• Analyzed gathered requirements, verified requirements and created business requirement document(BRD)
• Translated business requirement into Functional requirement document
• Translate functional requirements into use cases forecommerceapplications
• Created Process flow diagrams, use case diagram using Visio.
• Worked in agile/scum methodology for better and rapid delivery of the business enhancements.
• Experience on XML and Data Mapping skills.
• Responsible for creating test cases in Mercury Quality center.
• Tested Business Objects data and reports to ensure that the Global view for Treasury Line of Business matches the books and records balances
• Engage with business units to develop long-term relationships in order to deliver quality insights.
• Tested the Business Objects to ensure that the business can view the cost centers and historical balances after the local org changes were made in the system.
• Tested the reports to ensure that the account names and reference data match as reported in SAP General Ledger.
• Performed data analysis for breaks and worked with reference data and accounting/ corporate team to resolve the same.
• Experience with creating Risk Plans and assist with Risk Mitigation.
• Experience in GL/SL and Reserving work stream using ReservePro
• Experience with developing RACI charts, Communication Plans, and Project Charters
• Raised defects in Mercury Quality Center and tracked all the defects until closure.
• Attended weekly calls for reporting project status to senior management.
• Provided approval as Business Lead for the enhancements to be moved to production.
• Trained business users with the BO reports for their daily operations.
• Interacted with Subject Matter Experts (SME’s) and stakeholders to get a better understanding of client business processes and gather business requirements.
• Analyzed business requirements and segregated them into high level and low level use cases, activity diagrams, and sequence diagrams using Rational Rose according to UML methodology.
• Analyzed and diagnosed issues which may impact performance or availability in theecommerceenvironment.
• FollowedAgile Iterative development approachand was involved with all iterations of the development life cycle and risk management.
• Prepared Business Process Models and business rules that included modeling of all activities of business from conceptual to procedural level.
• Used Test Director to coordinate and manage the master test plan, test scripts, testing resources, pass vs. fail cases and the entire testing process.
• Wrote clear, concise detailed system requirements specification (SRS) documents and user documentation in accordance to guidelines and standards of a level where developers can interpret, design and develop the application with minimum guidance.
• Designed the business requirement collection approach based on the project scope and SDLC methodology.

Environment: Environment: MS SharePoint, MS Word, MS PowerPoint, MS Visio, MS Project, HP Quality Center, MS Excel, Agile-Scrum, MS Outlook, Rational Requisite Pro,Java, Oracle, SAP, SQL, Business Objects

Confidential, Chicago, IL

Business System Analyst

Responsibilities:

• Coordinated with Business Owner, Application Vendor, Business Project Teams, Payers, and Clearinghouses to bring all processes to a level of execution to mitigate any impact to current revenue flow under the 5010-compliancy requirements
• Helped with building ICD 9 to ICD 10 crosswalk map by grouping thousands of codes and ranges in Clinical, Benefits, Financial, and Medical policy waves
• Facilitated Workshops for requirements analysis
• Conducted Impact analysis when there is any change in the requirements and updated theBusinessRequirements Document (BRD), and Systems Requirements Specification (SRS).
• Conducted requirement gathering sessions for MMIS Mainframe Claim processing screens.
• Strong Understanding of State/Commercial Medicaid Claims, Benefit Plans, Claims Payment Cycle, Waiver Programs and Reference
• Knowledge of Laboratory Information Management Systems(LIMS)
• Strong knowledge of Data Warehousing, and Business Architecture
• Conducted working sessions to gather and document high level business requirements and detailed level business requirements for different business units impacted by ICD 10 such as EDI ClaimsIntake, Medical Management- Utilization Management, Case management, and Provider Reimbursement- Provider Payment.
• Worked on Financial Analysis of DRG shifts from ICD 9 to ICD 10 to avoid any over or under payments to the providers.
• Used General equivalence Mappings (GEM) to convert ICD 9 to ICD 10
• Facilitated JAD and JRP sessions with management, development team, users, and other stakeholders to refine functional requirements.
• Prepared use cases and data flow diagrams to analyze the impact of ICD 10 diagnosis codes embedded in different systems and applications.
• Gathered and validated inventory of applications, interfaces, and reports that will need to be modified to comply with ICD-10 requirements.
• Used UML for Specifications, Documentation, and Construction of systems.
• Designed and developed Business Rules Document about the Claim Component and HIPPA.
• Created business workflows on the claims module for the client to get a better understanding of the software and prepared a detailed BRD including all functional and non-functional requirements.
• Validated that the system claim scrubber included editing based on the CEM published edits to ensure a positive 999 and 277CA transaction.
• Worked closely on 834 transaction code for Benefit Enrollment and was involved in Validation of HIPAA for 837, 270/271, 276/277,835, 834 EDI transactions.
• Knowledge on Affordable Care Act project.
• Designed robust 5010 testing and 4010 regression SIT and UAT Testing Scripts for the 5010 Project.
• Analyzed the testing results to ensure that the results were in accordance with the Gap Analysis and expected results for 5010 compliance.
• Documented workflows and executed comprehensive testing and training plans to ensure that the new acknowledgement results demonstrated in the 999 and 277CA were properly interpreted and managed to ensure Payer acceptance of the 837 files.
• Took action in the process flow to prevent rejected claims from falling into “limbo”.
• Mitigated claim denial increase through a complete analysis of the application “Claims Scrubber” to ensure 277CA accepted claims would not result in an increase in Denials at the payer adjudication level.
• Identified all risks associated with the project and proposed suggestions for mitigating the identified risk related to the business.

Environment: MS Project, MS Visio, MS Access, MS Excel, MS Word, MS Power Point, Rational Requisite Pro, LIMS, Clear Case, Clear Quest, RUP, Share Point

Confidential, Baltimore, MD

Business 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.
• Formulated Data Mapping Guide for the technical team.
• Coordinated with system architects and developers to convert business requirements into system requirements.
• Experience with Web Development E commerce projects.
• Facilitated JAD and JRP sessions with management, development team, users, and other stakeholders to filter functional requirements
• Prepared the Business requirement Document (BRD) and functional requirement document (FRD) for the enhancement of the existing services.
• 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.
• 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 to migrate 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 SMEs.

Environment: RUP, MS Visio, MS Project, MS Office Suite Word, Excel, Access, Power Point, Outlook, Rational Requisite Pro, Clear Case, Oracle, Clear Quest

Confidential

Business Analyst

Responsibilities:

• Involved in gathering, analyzing, and documenting business requirements and data specifications.
• Involved throughout the business Solution Development Life Cycle (SDLC).
• Followed Agile with Scrum SDLC.
• Created and reviewed business requirements, functional specifications, project schedules, and documentation.
• Involved extensively in the inception phase for understanding the Scope of the Project, feasibility of the implementation, and definition of the risk factors involved in the project.
• Conducted JAD sessions for communicating with all project managers, senior management, and other stakeholders.
• Created Process Flow diagrams, Use Case Diagrams, Class Diagrams, and Interaction Diagrams using Microsoft Visio and Rational Rose.
• Conducted meetings with business users and SMEs to identify and gather various functional and non-functional requirements.
• Helped identify reports for decision support system and interacted with database designers and architect to gather the requirements for reporting.
• Functioned as the primary liaison between the business line, operations, and the technical areas throughout the project cycle.

Environment: MS Access, MS office 2003, MS Excel, Rational Rose, MS Visio, MS Office