SUMMARY

• Business Systems Analyst with over 7+ years of experience.
• Provided SDLC Methodology for developing HIPAA EDI applications used by State Government to completely automate payments posting for Medicare, Medicaid and commercial payers.
• Business Analyst with hands on experience in business consulting in health care and application development with excellent skills in client interfacing, requirement gathering, user support, quality assurance, problem solving, and documentation.
• Lead and provided mentoring to various team members and various developers.
• Skilled in determining system requirements and specifications for complex application development projects. Past experiences of leading and interacting with business teams, programmers and technical staff at all levels.
• Independently implemented enterprise solutions complexity and services
• Formulate and define systems scope and objectives based on both user needs and a good understanding of applicable business systems and industry requirements.
• Expertise in various software testing tools and utilities such as Quality Center (QC), Quick Test Professional (QTP), and HP ALM.
• Adding multiple checkpoints, parameterized points, recovery scenario points within the application with QTP.
• Performed Functional and Regression testing using automation tool QTP.
• Proficient in gathering business and technical requirements from both formal and informal sessions through interviews, NetMeeting, questionnaire, video conferencing, JAD sessions and conference calls.
• Strong knowledge of Use Cases, Sequence Diagrams, Collaboration Diagrams, Activity Diagrams, and Class Diagrams.
• Experienced in creating Use cases, Cross - functional flowcharts, activity diagrams and sequence diagrams.
• Extensive experience in Functional, Integration, Regression, User Acceptance (UAT), System, Load and Black Box Testing.
• Knowledge of complex SQL queries to create the data-warehouse for analysis of DATA.
• Used extensive SQL for Data validation and data analysis.
• Well versed in using Defect Tracking Tools including Mercury Quality Center, QTP and Test Director.
• Good Management, Execution and Documentation skills.
• Expert in application/system development life-cycles; concurrent development strategies, process streamlining, iteration modeling, rapid application development (RAD/RUP/UML), and Agile/Waterfall methodologies.
• Participated in Data Analysis and Design and data mining with the Data analyst in defining data sources and required data content for the data warehouse component.
• Excellent knowledge of MS Office especially MS Excel, Power Point, Visio, Word etc

TECHNICAL SKILLS

Modeling Methodologies: Agile, Rational Unified Process (RUP), and Waterfall

Process / Modeling Tools: Rational Rose, MS Visio

Testing & Management Tools: HP ALM, QTP, QC, Cucumber

Databases: MS Access, SQL Server

Languages: SQL

Operating System: WINDOWS Vista/7/8/10

Office Tools: Microsoft MS Word, MS Excel, MS PowerPoint, MS Access, MS Project, MS Outlook, SharePoint

Project Management: MS Project, SharePoint, Atlassian JIRA

PROFESSIONAL EXPERIENCE

Confidential, Silver Spring, MD

Sr. Business Systems Analyst / Scrum Master

Responsibilities:

• Formulating and defining systems scope and objectives based on both user needs and a good understanding of applicable business systems and industry requirements.
• Devises or modifies procedures to solve complex problems considering computer equipment capacity and limitations, operating time, and form of desired results.
• Includes analysis of business and user needs, documentation of requirements, and translation into proper system requirement specifications. Guides and advises less-experienced Business Systems Analysts.
• Develops and maintains requirements, performs business process analysis. User interface design.
• Creating test plans, UML diagrams, flowcharts, and system requirement specifications
• Conduct UAT sessions, reviewed test results and reported bugs/issues using JIRA and HP ALM.
• Designated work at the highest technical level of most phases of systems analysis while considering the business implications of the application of technology to the current and future business environment.
• Facilitate communication between key stakeholders to ensure concise communication of project requirements to achieve consistent quality deliverables within client expectations.
• Communicate and consult with Project Management, O&M and DME teams to ensure effective project transition, to clearly define project status and to identify areas of improvement within the Operations workflow.
• Collaborate with key process owners across the organization to plan, lead and implement strategic business improvement processes, policies and procedures.
• Create/manage requirements in Application Lifecycle Management (ALM) and generate requirement documents.
• Design and develop documentation including procedures, process flow diagrams, work instructions, and protocols for processes.
• Collaborate with product IPT team across the various development phases to ensure enhancements/changes are implemented and tested according to requirements.

Environment: MS Visio, UML, JIRA, HP ALM, SharePoint, SQL, TOAD, MS Office

Confidential, Warwick, RI

Sr. Business Analyst/ Quality Analyst

Responsibilities:

• Wrote business design documents to document processes involved in implementing new CMS additions to Rhode Island’ monthly and daily files for entire state population.
• Worked with PM and SE to write well defined and comprehensive Technical Design Documents (TDD) for effective implementation of required changes.
• Created and Executed SQL statements to check if the data integrity has been maintained and also queries or data validation.
• Created Business vision, scope, and Use Case documents; Business Process Models, Use Case diagrams, Activity Diagrams, and Sequence Diagrams using MS Visio to clearly define the data process model, and the business process model
• Created walkthrough documents and facilitated walkthrough sessions for both internal and statewide clients to validate documents and initiated processes.
• Facilitate ad-hoc reporting and data analysis.
• Effectively maintaining Monthly state MMA files via correspondence with CMS to implement change requirements to file structure and data real-time and as often as needed.
• Worked as a Peer review member to verify, validate and modify necessary changes made considering technical and business aspects, in the deliverable documents and thereby uploading it on SharePoint. Consolidated individual Statistical Summary from the team deliverables, various reports, jobs, files and Inventory documents to present it in weekly status meetings
• Facilitated sessions with off site developers and project team members to develop best strategies for evolving Rhode Island Executive Office of Health and Human Services (EOHHS) needs.

Environment: SQL, MS Word, Excel, MMIS, ACCESS, QTP, QC, File Viewer, Bugzilla, TFS, Clear Quest, MS Visio, SharePoint

Confidential, Quincy, MA

Sr. Business System Analyst /Quality Analyst

Responsibilities:

• Wrote business requirements identified to process the census data extract file Received by MassHealth IT department from Optum.
• Worked with PM to prepare Project charter, Project plans, daily, weekly and monthly team deliverables for each phase, drafting WBS and RBS systematically using MS Project.
• Served as a Peer review member to verify, validate and modify necessary changes made considering technical and business aspects, in the deliverable documents and thereby uploading it on SharePoint. Consolidated individual Statistical Summary from the team deliverables, various reports, jobs, files and Inventory documents to present it in weekly status meetings
• Loading this census data file to the Mass Health data warehouse.
• Facilitate ad-hoc reporting and data analysis Created Text area Checkpoints to test the properties of the text in the application using QTP.
• Responsible for creating and execution of automated test scripts using QTP.
• Created page checkpoints to test the properties and contents of the web page Quick Test Pro.
• Ran the scripts on multiple environments (QA, UAT and Production) to ensure that requirements were still met.
• Carried out GUI, Functionality, Integration and Regression testing using QTP.
• Performed Data Driven Testing using QTP.
• Maintained the effective Data intake which aims to bring HCentive data into existing EHS DW Infrastructure and environment to meet EHS short term business need
• Managing query capabilities for HCentive data to EHS IT Analytic Power Users
• Facilitate ad-hoc reporting and data analysis.
• Create evolving data intake processes which involved Data Dump, Independent new subject area in DW like Encounter and batch.
• Meet current reporting expectation and View, understand Data and Bring it at STG/ODS levels, also Understand Business data usages, report needs, data behavior, business edits and also update the data layout
• Created and Executed SQL statements to check if the data integrity has been maintained and also queries or data validation.
• Used Data Mining extensively to analyze data from different perspectives and summarizing it into useful information
• Determined user/business/functional requirements. Created Business vision, scope, and Use Case documents; Business Process Models, Use Case diagrams, Activity Diagrams, and Sequence Diagrams using MS Visio to clearly define the data process model, and the business process model

Environment: SQL, MS Word, Excel, MMIS, ACCESS, QTP, QC, File Viewer, TFS, Clear Quest, Requisite Pro, MS Visio, SharePoint.

Confidential, Lincoln, NE

Business Systems Analyst / Scrum Master

Responsibilities:

• Worked as a liaison among business client and development team for the implementation of 4010 to 5010 transition in compliance with HIPAA standards.
• Identified the business functions and processes, and prepare system scope and objectives based on user needs and industry regulations.
• Defined terms, conducted stakeholder analysis, elicited business needs, conducted business process modeling work, facilitated work sessions (JAD), elicited requirements, wrote requirements and use cases, analyzed requirements, validate & prioritize requirements, trace requirements to related project documentation (process models, designs, test scenarios & scripts).
• Gathered requirements by using interviews, observation, JAD, brainstorming sessions, and documents analysis.
• Determined user/business/functional requirements. Created Business vision, scope, and Use Case documents; Business Process Models, Use Case diagrams, Activity Diagrams, and Sequence Diagrams using MS Visio to clearly define the data process model, and the business process model.
• Documented the Requirements and Approach and circulate to the Business & Tech teams for Signoffs using Clear Quest.
• Worked on different testing on NCPDP D.0 claims.
• Identified testing scenarios and defined Test Cases for detailed functional testing.
• Facilitated claims processing while passing 837 claims for compliance check and running through load processing.
• Tested GUI, Functionality, Integration and Regression testing using QTP.
• Involved in Data Driven Testing using QTP.
• Responsible for the analysis, design, development, testing, and support of data extract, transform, and load processes within the enterprise data warehouse
• Developed complex SQL queries to create OLAP cubes inside the data-warehouse.
• Setting of timelines to meet the required time and designing project plans using Microsoft project.
• Documented standard procedures for developing and designing all BI solutions.
• Work closely with the team members to identify any bugs, fixes, any issues regarding the development and designing.
• Used Data Mining extensively to analyze data from different perspectives and summarizing.
• Used MDM tool to support Master Data Management by removing duplicates, standardizing data (Mass Maintaining), and incorporating rules to eliminate incorrect data and filter data as per requirements.
• Involved in Data mapping, logical data modeling used SQL queries to filter data within the database tables.
• Participated in Data Analysis and Design and data mining with the Data analyst in defining data sources and required data content for the data warehouse component.
• Maintained the research database, renew and improve it from time to time and make sure safe storage of data.
• Developed a Schedule and identified project milestones.
• Analyzed business scenarios to track possible business outcomes for the functions which could be incorporated into more detailed test scripts.
• Reported project progress to the team, senior management and all stakeholders periodically.
• Identified risk and project impact and performed risk assessment and mitigation.
• Reviewed various Re-engineering techniques with Technical Experts to finalize the Approach. Reviewed functional test cases to confirm the expected outcome and behavior.

Environment: SQL, MS Word, Excel, MMIS, NCPDP, ACCESS, File Viewer, Web Client, Clear Quest, Requisite Pro, MS Visio, SharePoint.

Confidential, Chicago, IL

Business Analyst

Responsibilities:

• Gathered analyzed, documented business and technical requirements from both formal and informal sessions and validate the needs of the business stakeholders.
• Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Health Insurance Claims. Worked on HIPAA Standard/EDI standard transactions: 270, 271, 276, 277, 278, 834, 835, and 837 (P.I.D), 997 and 999 to identify key data set elements for designated record set. Interacted with Claims, Payments and Enrollment hence analyzing and documenting related business processes.
• Designed and developed Use Cases and Use Case scenarios, Activity Diagrams, Sequence Diagrams, High Level and Low Level Process Flow Diagrams, OOAD using UML and Business Process Modeling.
• Responsible for creating test case scenarios, creating test data plan and writing test scripts for the UAT using testing tool and defect management for Policy Management Systems, Payables/Receivables and Claims processing.
• Used QTP for testing and regression testing and data driven testing.
• Conducted surveys, interviews, and JRP, JAR and JAD sessions and translated them into system Requirements. Suggested measures and recommendations to improve the current application performance of the system.
• Expert in ICD 9 - 10 Conversion Analysis. Full knowledge of the Diagnosis and Procedural Code changes for Healthcare Entities like Payers, Employer Groups, and Providers. Worked on ICD 9 codes and gathered future requirements based on ICD 10 codes. Managed creation of sample mappings for the conversion of EDI X12 transactions code sets version 4010 to 5010 and translation of ICD 9 codes into ICD 10 codes.
• Supported new business requirements by extending the functionality of the core Facets system using the Facets extensibility architecture feature.
• Gathered requirements from the users and analyzed the requirements for RQ System, Facets etc.
• Worked withFacetsApplication Groups: Claims Processing, Customer Service, Guided Benefit Configuration, Medical Plan, and Enrollment, Pricing Profile, Provider, Subscriber/Member, and Workflow Configuration.
• Worked withHIPPAcompliance5010and EDI transaction set 270/271/276/277/997.
• Gathered and documented functional requirements for testing and verification of HIPAA.
• Data mapping on Enrollment Module (EDI 834) ofFACETS.
• Responsible for working with the State to review and modify process flows to increase productivity and effectively utilizeFACETSfeatures not provided by the legacy systems.
• Lead requirements analysis and inspection, ensuring that requirement statements and business rules are complete, consistent, concise, comprehensible, traceable, feasible, unambiguous, and verifiable, and that they conform to standards.
• Facilitated various brainstorming, requirement gathering sessions, and provided training on HIPAA Compliance, HIPAA Standard transactions and current version of X12 HIPAA 4010A1.
• Managed requirements traceability information and tracked requirements status throughout the project. Also managed changes to baseline requirements through effective application of change control processes and change management tools.

Environment: RUP, QTP, COBOL, IBM AS/400, CICS, Citrix, DB2, MS Excel, MS Word, MS Access, MS Project, MS Visio.

Confidential, Wilmington, DE

Business Analyst

Responsibilities:

• Followed all the phases in the project management life cycle.
• Acted as a liaison between the business users and technical teams to build applications based on the business requirements - provided a single point of contact for user communication (managed issue tracking, prioritization and resolution).
• Developed the scope and vision document that defines the primary goals and objectives.
• Worked closely with the business users to gather the functional requirements for the investment banking application.
• Coordinated with developer and testers for transition of EDI X12 4010 series to 5010 series. Maintained traceability BUR and FRD through updates to RTM using Requisite Pro.
• Provided SDLC Methodology for developing HIPAA EDI applications used by State Government to completely automate payments posting for Medicare, Medicaid and commercial payers electronic payments files.
• Worked with OWM Team to write up Requirement Documents (define user and system interfaces - actors with the help of use case diagrams).
• Refined the requirements (use-cases) and Business Process Models to detailed level appropriate for technical analysis and system design.
• Participated in sessions to define the solution approaches, and identifying assumptions, constraints, risk and issues. Analysis and specification of system changes.
• Revealed unidentified requirements, evaluated changes to requirements, and assessed impact of changes.
• Worked independently with minimum supervision as part of a dynamic IT team.

Environment: MS Word, MS Excel, MS Visio, QTP, SQL Server, MS Project 2002, MS Visio, MS Word, MS Excel, Windows NT/2000, EDI, Quality Center