Business Systems Analyst Resume
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.