SUMMARY

• Business Analyst with 7 years of extensive experience in Business and System Analysis with great amount of noledge in Property & Casualty insurance and Healthcare industry.
• Creative and aggressive professional capable of forming and maintaining a positive and productive team environment along with integrative thinking skills.
• Excellent skills in Performance Management to support strategic planning, goal setting, strengtan accountability, enhance decision making, and improve customer service.
• Comprehensive experience in working on Requirements Planning and Management, Requirements elicitation, Requirements Analysis and Communication, Change Management, Solution evaluation and Project Validation.
• Experience in creating standard Project deliverables, documenting requirements in Enterprise Models and focusing on conceptual Business Requirements.
• Excellent analytical skills in understanding the Business processes and Functionalities to translate them into Functional Requirement Specifications, developing Functional Specifications for Business Process refinement and Automation, experience in working with Data Modelers to create Data models, conducting feasibility studies and Scope management.
• Extensive experience in working throughout the Software Development Life Cycle (SDLC) which includes hands on experience in Feasibility Analysis, Requirements Gathering, System Analysis and Design, Development, Testing, User acceptance Testing (UAT), Deployment and Post - deployment support and validation.
• In depth noledge and thorough understanding of widely acnoledged Software Development Life Cycle (SDLC) methodologies in the software industry like, Traditional Waterfall, Spiral, Iterative Software Development Life Cycle and experience in Agile Software Development, Scrum, Rational Unified Process (RUP), Joint Application Development (JAD), Rapid Application Development (RAD), Rapid Prototyping and familiar with Capability Maturity Models (CMM), Six Sigma (DMAIC).
• Experience in conducting and facilitating Joint Application Development (JAD) and Rapid Application Development (RAD) sessions.
• Strong Knowledge of the Unified Modeling Language (UML) and proficient in creating Use Cases, Use Case diagrams, Sequence diagrams, Activity diagrams, Process Flow diagrams and Data Modeling.
• Experience in conducting GAP analysis, SWOT analysis and User Acceptance Testing (UAT).
• Extensive documentation skills including experience in creating and maintaining Business Requirements Document (BRD), Functional Requirements Document (FRD), Use Cases, Project Plan, Requirements Traceability Matrix (RTM), UI Specification Document, Change Request Document, Test Plans, Test Cases, Training manuals, User Manuals and Standard Operating Procedures (SOPs).
• Comprehensive experience in working with Business partners, SMEs, Data Modelers, Development and Testing teams as well as the Project Managers, Sponsors and Service Managers to analyze the Project Scope, Requirements and Project Planning.
• Strong Functional noledge of different modules of Property and Casualty Insurance and Healthcare standards like Health Insurance Portability & Accountability Act (HIPAA) standards, Electronic Data Interchange (EDI), HIPAA code sets, ICD-9, ICD-10 coding, Medicare (Part A, B, C and D), Medicaid Health Insurance Policies, HL7, HMO, PPO, HIPAA 4010 to 5010 changes and well versed with Medicaid Management Information Systems (MMIS), National Provider Identification (NPI) and familiar with Patient Protection and Affordable Care Act (PPACA).
• A great team player with strong interpersonal and communication skills as well as efficient in conflicted solution and escalation awareness.

TECHNICAL SKILLS

Methodologies: RUP, UML, CMM, Data Modeling, Agile, Scrum, Waterfall, Spiral, Iterative, JAD, RAD, OOAD.

Testing Tools: Quality Center, Test Director, WinRunner, Test Manager, and QTP, Testlink, TRAC (Defect Management).

Change Management Tools: Rational Clear Quest, Mercury Quality Center, Rational Requisite Pro, LoadRunner, HP Service Manager.

Modeling Tools: Rational Rose, MS Visio, DOORS and MEGA.

Version Control: Rational Clear Case.

Project Management: Microsoft Project, Microsoft Office, Microsoft Exchange, MS SharePoint, and Lotus Notes.

Databases: Microsoft Access, Oracle, SQL, RDBMS.

Languages: C++, Java, HTML, SQL, XML.

Operating Systems: UNIX, Windows 2000/XP/Vista/7.

PROFESSIONAL EXPERIENCE

Confidential, Bloomington, IL

Lead Business Systems Analyst

Responsibilities:

• Prepared standard project documentation like, Functional Requirements Document, Business Requirements Document, Business Data Elements Matrix, and Process Maps.
• Documented Business Data Elements in facilitated sessions, which involved the business and systems partners.
• Documented and stored Business and Functional requirements in MEGA tool.
• Worked closely with the Business Architects to develop the Business Process Maps.
• Liaised between Business and Systems to communicate Business needs and resolve issues.
• Worked extensively with the Digital Experience team to develop Wireframes.
• Documented Business Rules to ensure tight enforcement of requirements and rules to the application.
• Coordinated dependencies, ensured their were no gaps in the requirements and thorough communications between teams.
• Designed and implemented basic SQL queries for QA testing and report / data validation.
• Worked as a Lead Business Systems Analyst across several projects geared towards enhancing existing functionalities and developing new solutions and automation of overall Claim Handling.
• Also worked as a Requirements/Process analyst for the Enterprise Requirements Management along with being a part of DOORS Team (Enterprise Requirements support).
• Assisted the Project Managers by coordinating with various teams to get the assigned tasks done, deliverables completed, and gatheird development and testing hour estimates for Portfolio Management.
• Worked with the Project Managers and the Project Planners to build an overall Project Schedule and allocate appropriate hours and tasks to the team members along with Scope Management.
• Documented Business and Functional Requirements in facilitated sessions involving the Business and System Partners.
• Mapped new enhancement requirements to the enterprise model of requirements using Use Cases.
• Worked on Gap Analysis for the HIPAA 4010 to 5010conversion and documented detailed requirements for the conversion including the ICD-9 to ICD-10 diagnosis code changes.
• As a part of the ICD 10 upgrade project, documented requirements for Diagnosis Code search screens to handle different ICD code versions.
• Worked with the SMCs, Business Partners and Test Leads to validate the requirements.
• Coordinated with SMCs from multiple functional areas to make sure integration points are correctly documented and validated.
• Prepared standard project documentation like Business and Functional Requirements Document, Requirements Approval Package, Knowledge Transfer document, Transition Acceptance Agreement and maintained requirements in DOORS.
• Facilitated the Requirements change process by documenting impacts and scope change on overall project followed by Management approval.
• Supported the UAT Process by assisting the Business Partners in validating requirements and resolving defects.
• Performed post implementation transition activities and facilitated the transition agreement process at the Leadership level.

Environment: MEGA, DOORS 9.2, MS Office, Lotus Notes, Visio, TRAC, MS OneNote, HP Service Manager.

Confidential, Trumbull, CT

Business Analyst

Responsibilities:

• Translated User and Business Requirements to create Business Requirement Document(BRD) and Functional Requirements Document (FRD).
• Worked around RUP methodology along with comprehensive documentation and traceability of all the functionalities of the web-based projects.
• Conducted and facilitated joint requirements gathering sessions and JAD sessions with all the involved stakeholders and IT teams.
• Designed future state processes for HIPAA 5010transactions, which processed EDI837, and 835.
• Validated EDI 837, 835, and 834 transactions to be in compliance with HIPAA 5010 standards, analyzed ICD-10-CM and ICD -10-PCS coding and claims processing of 5010 standard.
• Performed GAP analysis, determined field additions/deletions, and error conditions changes between as-is process (4010)& to-be process (5010).
• Held meetings with SMEs from the Medicare/Medicaid division to gain an insight on existing claims processes.
• Participated in development and maintenance of Workflow models and artifacts.
• Ensured we had a better understanding of the markets and a perfect project execution with SWOT analysis.
• Developed Business Process Models, which included modeling of all activities from conceptual to procedural level.
• Maintained a Requirement Traceability Matrix (RTM) for requirement elicitation and correspondence to product deliverables.
• Collaborated with the team leads to give project walkthroughs and discussions on updates and issues.
• Created Test Plans for 837I, P, D highlighting field increases, new elements, new segments, deleted segments, new values & codes, valid values & usage changes etc.
• Analyzed and developed Test Plans, Use Cases and Test procedures in accordance with RUP methodology.
• Conducted feasibility study and performed impact analysis for proposed enhancements in the existing system.
• Critically analyzed the information gatheird from various sources during requirements gathering and analysis.
• Kept track and maintained requirements using Rational Requisite Pro.
• Logged defects using Rational Clear Quest& produced Defect Status Reports to ensure quality standards.
• Worked jointly with the Testing team to make sure a high quality product is delivered. Helped them understand the complex requirements whenever needed.

Environment: Microsoft Office, Rational Requisite Pro, RUP, XML, VB.NET, Oracle, UML, SQL, Test Director.

Confidential, Buffalo, NY

Business Analyst

Responsibilities:

• Incorporated Agile/Scrum methodology for product development.
• Conducted and facilitated Sprint sessions with various SMEs and Business departments, for planning and Requirements Gathering, and project status updates.
• Made use of Sprint sessions and individual meetings to determine business and system requirements, and come up with ProcessFlow diagrams and documentation.
• Created reports on how the existing system processes Claims, benefits and other information on the web portal and proposed strategies to improve it.
• Supervised a number of team members on HIPAA guidelines and best practices.
• Performed an assessment on the current status of the organization using SWOT analysis and to determine the future scope of the application.
• Collaborated with the business users and internal stakeholders to gather comprehensive requirements.
• Developed and maintained Business Requirements Document (BRD), Project Plan and the Functional Specifications Document (FSD).
• Ensured dat the user stories comply with the requirements and has business values and story points.
• Assisted product owners, scrum masters and teams to improve and ensure product backlogs are created.
• Worked with the testing teams to develop test plans, test cases and test scenarios which were used to ensure compliance with the specified Business and Functional requirements.
• Created Acceptance test cases for the User Acceptance Testing (UAT).
• Followed UML based methods and created State Diagrams and Sequence Diagrams using MS Visio.
• Maintained and documented User stories and updated project status reports at the end of every iteration.
• Prepared the End User Manual and Training guide.
• Assisted the technical team in understanding and developing the appropriate functionality of system.
• Evaluated all the test cases with detailed description of each test scenario of the system according to HIPAA standards.

Environment: HTML, Java, J2EE, MS Visio, Rational Requisite Pro, Rational Clear Case, Rational Clear Quest, MS Office Suite, MS Project, Agile/ Scrum.

Confidential, WI

Business/ Quality Analyst

Responsibilities:

• Worked within the requirements team to gather requirements for the proposed system around Agile methodology.
• Participated in meetings with different SMEs for capturing business needs, product features and requirements.
• Developed a Business Requirement Specification (BRS)documents as well as high-level Project Plan.
• Created and maintained a Functional Specifications Document (FSD) based on business requirements.
• Developed Use Cases and used UML diagrams like Use Case Diagram and Activity Diagrams to model the system.
• Assisted the other Business Analysts in formal requirements review sessions to review the system requirements.
• Collaborated with the testing team in functional, regression and User Acceptance Testing(UAT).
• Worked with development and testing teams to ensure successful implantation of requirements on time.
• Performed in multiple roles throughout the project lifecycle along with User Acceptance Testing and deployment.
• Provided feedback whenever requested by senior management on current project status and on other business areas.
• Assisted the Lead Business Analyst in JAD sessions for communicating efficiently with the involved stakeholders and senior management.

Environment: Agile, HTML, Java, J2EE, Rational ClearCase, Clear Quest, Rose, RequisitePro, MS Office Suite, WinRunner, QTP.