SUMMARY

• 8 years of extensive experience as a business analyst in industry domains including Health care, Finance, Corporate banking.
• Expertise in Software Development Life Cycle (SDLC) process, use cases and Rational Unified Process (RUP), Agile Techniques,waterfall.
• Excellent understanding of Business Requirements Elicitation, Business Process Modeling, Data Mapping and Data Warehousing concepts, data analysis, data mining, data mapping, SQL queries, and DataModelling (Conceptual, Logical, & Physical), ETL.
• Hands on experience wif working in all phases wifin the Software Development Life Cycle (SDLC) and following UML methodologies using MS Visio, Smart Draw 2008 and Adobe LiveCycle to create Use Case models, Activity Diagrams, Sequence Diagrams and Business Workflow Models.
• Articulate, confident and able to communicate comfortably wif all levels of the company.
• Expertise in grooming the product backlog entails decomposing larger product backlog items using User stories.
• Experience in Electronic data interchange (EDI) transactions, Facets, Electronic Medical Record(EMR/EHR) and Health Information Technology (HIT)
• Creating project and process specifications, working wif development team to continually articulate requirements, and troubleshooting production issues including new investment products, applications, data analysis and QA report testing.
• Highly experienced in performingFeasibility Studies,Impact analysis,GAP analysis, SWOT analysis and Risk Analysis.
• Leading JAD/JAR sessions to reduce time spent in moving information between stakeholders and team members.
• Documenting requirements using TABLEAU.
• User training on the changes being released and conducting post production activities like getting feedbackfrom users. In case of any issues - doing root cause analysis, prioritizing tasks wif business users.
• A great deal of experience wif Health insurance administration systems included NCPDP D.0 and ANSI X12 (270, 271, 275, 276, 277, 834, 835 & 837) standards.
• Good understanding in analysis of healthcare claims, Benefit Management, use of ICD - 9 & 10diagnosis coding wif HIPAA 5010 initiatives
• Strong understanding of Retail Banking, including Credit Card, Mortgage, Account Transactions, Wire Transfers, BillPayment.
• Familiar wif current industry standards such as HIPAA compliance and Healthcare systems
• Well versed in translating business requirements and user expectations into detailed specifications employing Unified Modeling Language (UML) diagrams using MS Visio and Rational Rose.
• Assisted testing team for successful completion of Integration Testing, Unit testing and User Acceptance Testing (UAT).
• Involved in maintaining Requirements Traceability Matrix (RTM) to track all requirements during the life cycle.
• Expert level skills in MS Office products like MS Project, MS Project Server, MS Word, MS Excel, MS PowerPoint, and MS Excel.
• Good knowledge of Health Insurance Plans (Medicare Part A, B, C and D), managed care concepts (Medicaidand Medicare), and experienced in determining the membership eligibility, billing experience wifin life, anddisability in health plans.
• TEMPEffective Communication and Presentation skills, which enable the ability to act as a liaison between business and IT teams.
• Excellent Management Skills, proficient in leading and mentoring individuals to maximize levels of productivity, while forming unified team environments.
• In-depth knowledge on different modules wifin healthcare domain such as medical management system, Case Management, Utilization Management, Membership, Eligibility, Billing, Enrollment, Claims, Capitation, and Providers etc.,
• Excellent understanding of different modules in Banking domain such as Identity and Access Management, Entitlements & Privileges, Force removal Access, Payments, Mortgage, Interactive Voice Response (IVR), Billing etc.,

TECHNICAL SKILLS

Operating systems: windows 7/2008/2003/XP, UNIX, Mac, LINUX

Languages: C, Java, Visual basic, HTML, SQL

Methodologies: SDLC, Waterfall, Agile, Scrum,RUP

Project Management: Microsoft project, Microsoft office, Microsoft Excel, MS Visio, Visual studio

Programming: HTML, C,JAVA, UML, SQL

Reporting Tools: Tableau, OpenRefine, Rational Rose, Requisite Pro, Clear Case, Clear quest

Business Analysis software: MS Visio, MS SharePoint, smart draw, Adobe Acrobat, Adobe Lifecycle Designer

Change Management: Stakeholder Analysis, Change classification, Prioritization and Implementation

PROFESSIONAL EXPERIENCE

Confidential, Los Angeles

Business Analyst

Responsibilities:

• Involved in defining the scope of the project along wif the vision statement using Agile and waterfall methodologies.
• Worked as a primary liaison between the business line, operations and technical areas throughout the project cycle.
• Created user stories, BRD and FRD for defining business requirements documents.
• Worked on HIPAA rules and regulations to draft business rules and claim processes.
• Interacted wif the client and technical team for Requirements Gathering and translation of Business requirements to Technical specifications.
• Created business workflows on the claims module for the client to get a better understanding of software and prepared a detailed BRD including all functional and non-functional requirements.
• Lead JAD sessions wif stakeholders to analyze system needs and integrate requirement to develop a consistent navigation structure.
• Gathered and documented BCBS’s business requirements and developing, entering and verifying testcases for ANSI 5010 / ICD 10 Code Set Implementation and Configuration.
• Involved in processing Medicare stand-alone plan part D and part C managed care plans.
• Did gap analysis for HIPAA P and 835 transactions and HIPAA P and 835 transactions.
• Worked on healthcare EDI systems and electronic claim transaction technology.
• Defined Business Process that aligned wif Company goals and existing HIPAA regulation to communicatewif CMS Programmatically from Amisys system.
• Identified and documented the dependencies between the business process.
• Created and documented the use cases, activity, sequence diagrams and Logical views using MS Visio, MS office and Rational rose for providing a clear understanding of the requirements for the development team.
• Worked wif Medicare operational management to monitor, trend and report on operational metrics such as timelines, workload staff trending, customer satisfaction and other key measures to facilitate performance excellence.
• Involved in Gap analysis in changing old MMIS and testing new MMIS.
• Responsible for business analysis, requirement specifications, project planning, identifying the resources and implementation of the project.
• Worked wif QA (Quality Assurance) team for designing Test plan and Test cases for the User acceptance testing - Defined test cases, creating test Scripts, analyzing bugs, interacting wif the QA/ development teams in fixing errors and User Acceptance Testing(UAT).
• Implemented Traceability Matrix and Business Requirement Specification Document verified the Functionality coverage.
• Used MS project to maintain the project schedule and track its status.
• Responsibilities involved interfaces wif end-users, obtaining approval, identifying information, Procedures and decision flows, evaluating existing procedures, methods and technical documentation.

Confidential, Warren, NJ

Business Analyst

Responsibilities:

• Interviewed Subject Matter Experts(SME’s)from various business areas including mortgage servicing, Loan monitoring and asset monitoring by asking detailed questions and carefully recording the requirements in a format that could be reviewed and understood by both parties’ business and technical.
• End to End project management and business analysis for several modules from inception to delivery.
• Tracking and maintaining release schedule to estimate efforts and aligning stakeholder’s expectations wif the availability of time and resources for development of features and functionalities promised to business-users.
• Documented minutes of meeting and FAQs.
• Facilitating the development and unit-testing phase wif the build team to clarify questions wif business users.
• Participated in daily SCRUM meeting to discuss the progress of project and steps needed to meet the deadlines.
• Managing pre-production and post-production user verification sessions and providing artifacts for post-implementation verification and sign-off.
• Assisted the project manager wif timelines, risk and another project documentation.
• Run SQL Queries in production and Development databases using SQL developer to understand data flow for TEMPeffective data mapping and for creating Data flow diagrams for better understanding the impact of the application.
• Facilitate User Acceptance Testing (UAT) and production rollouts and the defects detected were tracked and managed using Jira.
• GAP analysis and feasibility study of new feed formats and report standards.
• Designing UML diagrams for prototypes and use cases for various feed flows.
• Used MS office extensively (word, Excel, Power point, Outlook) for analysis, presentation and documentation throughout the project.

Confidential, NJ

Senior Business Analyst

Responsibilities:

• Using Agile and waterfall methodologies defined the scope of the project along wif vision statement.
• Worked as a primary liaison between the business line, operations, and technical areas throughout the project.
• Involved in GAP analysis in the identification of business rules, business and system process flows, requirements and assumptions.
• Organized and conducted meetings, briefings, demonstrations and JAD sessions.
• Worked along wif different team’s developer, mainframe and backend system support team to understand existing and future implementations.
• Business requirements are defined and documented using User stories, BRD & FRD.
• Worked on HIPAA rules and regulations to draft business rules and claim process.
• Involved in identifying functional and Non-functional requirements and created Functional system design document(FSD).
• Worked on SharePoint web parts for updating web contents and created project SharePoint pages to maintain project documents during the life cycle.
• Conducted User Acceptance Testing(UAT) and verified performance, reliability, and fault tolerance issues.
• Performing A/B tests and reporting/analysis standards.
• Verified claim, encounter and pharmacy original, voids and replacements logic.
• Documented SQL queries in Teradata SQL assistance to perform data analysis.
• Created use-cases, sequence and collaboration diagrams to demonstrate software architecture and interaction of system components before prototyping.
• Used Rational Rose, Requisite-pro for requirement traceability.
• Worked closely wif QA and Developers to clarify and understand functionality, resolve issues and feedback provided feedback to nail down the bugs.
• Responsible for weekly status meetings showing progress and future testing progress.

Confidential, Worcester, MA

Senior Business Analyst

Responsibilities:

• Analyzed User Requirement Document, Business requirement Document and the relationship between business needs.
• Elicited requirements for Dashboard implementation and acceptance criteria and documented business needs through product backlogs and user stories.
• Simplified client functional requirements through Q&A and feedback sessions.
• Prepared AS IS and TO BE of existing architecture and created requirement traceability matrix to map the requirements TEMPeffectively in to MUST HAVE and NICE TO HAVE buckets.
• Employed SDLC and implemented change management techniques for successfully monitoring and fine tuning the project changes.
• Extensively used Requisite Pro for purpose of writing Use cases and customizing and filtering requirements to maximize the informative value of each requirement and to meet client deadlines.
• Created a file of ACORD Forms for both commercial and personnel lines of business used as the standards in all property and Casualty markets.
• Worked wif the ETL team to use Informatica power center/Power exchange to extract/transform and Load data from different operational sources from Oracle, Flat files, XML files into staging area and load data into data warehouse.
• Wrote and executed SQL queries to verify data in the reporting system and used Tableau to generate reports from upper management.
• Built Use case scenarios, workflow scenarios, designed new process flows from the requirements gathered to create use case diagrams and Use case documents.
• Created and executed test plans and test scripts.
• Performed quality assurance testing of systems and solutions.
• Facilitated the user acceptance testing phase of each assigned project.
• TEMPEffectively deliver projects using the Agile (Scrum) methodologies.
• Managed daily data exception reports plus created filters, sorting and prompts wif the layout on different set of reports. Also tracked progress on updates in project plans and took signoff from the personal and commercial lines of business owners.
• Developed test plans, test case objectives and test cases.

Confidential

Business Analyst

Responsibilities:

• Participated in gathering user requirements, developing functional and non-functional requirements and technical specifications.
• Developed use cases/diagrams, conceptual model, behavior diagrams (sequence, collaboration, state chart, Activity) using MS Visio.
• Worked wif the manager and other users and creating work flow diagrams as per the data analysis.
• Develop the test plan, test conditions and test cases to be used in testing based on business requirements, technical specifications and/or product knowledge.
• Created a vision document to explain user demographics, profiles, environments and requirements.
• Worked wif the Technical Analyst and development team to ensure that they understand the specifications

Confidential

Business Analyst

Responsibilities:

• Documented use case specifications based on requirements gathered from stakeholder.
• Prepared vision document for defining the scope of the project and the various functional and non-functional requirements involved in it.
• Designed sequence diagrams and use case diagrams in MS Visio.
• Responsible for design, information architecture and user experience of newly proposed websites portals and web-based applications.
• Created new user-interface designs, mock-ups, wire frames and prototypes.
• Analyzed and collected business requirements, identified system interfaces and created the requirements specification document.
• Developed Requirement specifications and process diagrams including context diagram and dataflow diagram.
• Used questionnaire, surveys, JAD sessions and Brainstorming sessions as requirement elicitation techniques.
• Framed a detailed agenda and facilitated JAD sessions. Took aggressive efforts towards completion and finalization of documentation towards the end of JAD sessions.
• Analyzed requirement document by identifying ambiguous, incomplete and incorrect requirements.
• Helped in developing attribute matrix and functionality traceability matrix.
• Studied carefully all the organization’s policies and procedures relating to insurance.
• Conducted walkthroughs wif development team and stakeholders.