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Business Systems Analyst Resume

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Baskin Ridge, NJ

SUMMARY

  • 7+ years of experience acting as a liaison between clients and development teams providing business/functional requirements.
  • Strong understanding of project life cycle and SDLC methodologies including Waterfall, Agile Scrum and SAFe Agile.
  • Experienced in translating business requirements and user expectations into detailed specifications using Agile methodology.
  • Efficient in conducting many workshops and JAD/JAR sessions involving company employees and end users.
  • Experience in developing Use Cases, creating Screen Mockups, conducting Gap Analysis.
  • Excellent work experience in creating Project Plans, Business Requirement Documents, Functional Requirement Documents, Use Cases, Activity Diagram, Sequence Diagram, Requirement Traceability Matrix and Test Plans.
  • Experience in conducting User Acceptance Testing, SWOT Analysis, Cost Benefit and ROI analysis
  • Skilled in Requirement Analysis, Use Case development, UML/BPMN Modeling wif Sequence Diagrams, Activity Diagrams, Data flow, Context diagram, and Process Flow diagrams using MS Visio.
  • In depth noledge of health care basics including Medicare/Medicaid, HIPAA, ICD9 and ICD10, and EDI Transactions.
  • Experience in HIPAA 4010 and 5010 EDI healthcare transactions like 837, 835, 834, 820, 270, 271, 276, 277, and 278 along wif ICD - 9/10.
  • Extensive noledge on teh various types of health insurance programs such as: Medicaid, Medicare (Part A, B, C and D), PPO, HMO, Dental claim and POS, Health Insurance Portability & Accountability Act (HIPAA) standards, Electronic Data Interchange (EDI), HL7, PBM.

TECHNICAL SKILLS

Business Planning & Work Flow Tools: UML, MS Visio, Rational Rose, MS Project, Rational Requisite Pro, MS Office, Word Perfect, BPMN 2.0

Processes: RUP, RAD, Agile, Spiral JAD, Waterfall SDLC models

Databases: MS Access, MS SQL Server, ORACLE, DB2

Testing/Defect Tools: Rational Test Manager, JIRA, Quality Center, Clear Quest, QTP

Operating Systems: Windows, Unix, Linux

Management Tools: Microsoft Project, MS Office, MS Outlook, VersionOne, Confluence, Rally

PROFESSIONAL EXPERIENCE

Confidential, Baskin Ridge, NJ

Business Systems Analyst

RESPONSIBILITIES:

  • Evaluated requirements and prepare detailed user stories in CA Rally Tool for Developers.
  • Created new and maintain existing documentation related to web processes and functionality and servers.
  • Reviewed recommendations on existing implementations wif developers and application architects.
  • Collaborated wif QA team to ensure testing efforts align wif system deliveries and business processes.
  • Performed As-Is and To-be analysis and GAP Analysis to verify teh required information on teh existing system and created teh business process workflows based on Business Process Modeling and Notation (BPMN).
  • Designed and implement product features in collaboration wif business and IT stakeholders
  • Participated in strategic decisions regarding enterprise architecture for technology domains.
  • Conducted technical analysis wifin requirements context, diagrams and documents formats.
  • Worked closely wif executives and subject matter experts to establish portfolio architecture strategy.
  • Developed detailed source to target data mapping anddata transformation rules fordata modeling.
  • Used SQL noledge to retrieve and understand data from relational database warehouse to make recommendations to product team.
  • Host JAD sessions wif co-workers from other functional areas to create solutions.
  • Write documents for solutions, such as, Solution Summary Document, High Level Documents, Requirement Traceability Matrix, etc.
  • Understand user stories and define which user stories were technical and acceptable, create a solution for teh user story, and review code and test results wif teh developers and CQA.
  • Use of CA Rally to report daily progress on solutions and user acceptance testing.

Confidential, Richardson, TX

Business Systems Analyst

RESPONSIBILITIES:

  • Working on master documents of Business and Technical Architecture for end to end enrollment.
  • Developing capabilities for current state of End to End Enrollment per stakeholder’s requirements.
  • Conducting requirement gathering sessions to define teh project and to reduce teh time frame required to complete deliverables.
  • Monitored and supervised submission of monthly Medicaid encounters to MDCH for timely processing per State compliance.
  • Responsible for business analysis, requirement specifications, risk analysis, project planning and identifying teh resources and implementation of teh project.
  • Coordinated quality management factors,clinical documentation, risk management analysis, clinical workflow review, and provide analytical support and document performance improvement processes.
  • Coordinated project tasks relating to teh use of Health Information Technology to improveclinical care.
  • Involved in EDI transactions Analysis, Design, Implementation and Documentation.
  • Conducted Functional meetings wif teh Project Manager to align and analyze resource capacity for planning teh demands of teh project.
  • Provided Technical inputs from Facets perspective in teh BTRD completion process for satisfying teh downstream system needs especially to PBM.

Confidential, Fargo, ND

Business Analyst/ Data Analyst

RESPONSIBILITIES:

  • Analyzed teh current software used to manage health claims..
  • Responsible for business analysis, requirement specifications, risk analysis, project planning and identifying teh resources and implementation of teh project.
  • Performed Gap analysis pertaining to HIPAA conversion to accommodate teh ICD-10-CM and ICD-10-PCS code sets.
  • Assisted wif building teh EDI 837, 835, 270/271, 276/277, 278, 820 and 834 transactions processing flow from teh Trading Partners to teh translator.
  • Facilitated review of Enrollment, Claims, Commissions, and membership port designs wif architects and developers to ensure that teh goals of teh portal requirements were satisfied.
  • Communicated wif business, technology leadership for overall project/program office milestones.

Confidential, Chicago, IL

Business Analyst

RESPONSIBILITIES:

  • Responsible for developing and reviewing business requirements, functional specifications, project schedules, documentation and test plans.
  • Coordinated wif Project Managers to resolve risk issues and ensure compliance of Security System-Related to teh HIPAA.
  • Coordinated wif Project Managers to resolve risk issues and ensure compliance wif HIPAA standards.
  • Managed and developed EDI specification, gap analysis and applications structures for data feeds and mappings for integration between various systems to follow ANSI X12 4010 formats including:
  • 270/271: Eligibility/Benefit Inquiry and Information.
  • 276/277: Claim Status Request and Response.
  • 834: Benefit Enrollments.
  • 835: Remittance Advice.
  • 837: Claims and Encounter.
  • 997: File Transmission Acnoledgement to meet and exceed HIPAA requirements set forth by teh federal government.
  • Developed use cases, and traceability matrices to better assist software development.

Confidential, Mountain View, CA

Business Analyst/ Content Engineer

RESPONSIBILITIES:

  • Maintaindataaccuracy and identify patterns indatafor Confidential Maps.
  • Making outbound calls in needed language to verify and correct information on Confidential database.
  • Compare between multiple sources of information wif strong attention to detail in order to ensure alldatareflected on Confidential Maps is accurate, user friendly and in accordance wif Confidential ’s policy.
  • Experience in Software Development Life Cycle (SDLC) methodologies
  • Led requirement gathering sessions (RGS) and joint application development (JAD) sessions.
  • Assisted in deriving functional requirement specifications (FRS) based on user requirement specifications (URS).
  • Knowledge in documenting Unified Modeling Language (UML) diagrams like Use Case Diagrams, Activity Diagrams, Sequence Diagrams, Data Flow diagram, Businessprocess modeling andBusiness Flow Diagrams using MS Visio.

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