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Business Analyst Resume

NJ

SUMMARY

  • 11+ years of experience as aBusinessAnalystwith a strong understanding of Business Analysis, System Analysis,BusinessProcess Management andBusinessProcess Modeling.
  • Expertise in Software Development Life Cycle (SDLC) and Validation Life Cycle (VLC) methodologies such as Agile / Waterfall methodologies with hands - on experience in all of them.
  • Expert in creatingBusinessRequirement Document (BRD), Functional Specification Documents (FSD), gap analysis, cost benefit analysis, Use Case Diagrams, Sequence Diagrams and Activity Diagrams.
  • Extensive experience in the development, implementation, and integration strategies within a team-oriented environment, utilizing quantitative and qualitative analytical skills.
  • Good understanding of healthcare industry - claims management process, Medicaid and Medicare Services and insurance sector. Expertise in Healthcare Payer systems Claims, Billing with backend data mapping, data integration.
  • Strong functional expertise in the Healthcare Payer Area - Membership claims, benefits, eligibility check, ICD10, HIPAA. Exposure to Health Care Industry standards like HIPAA
  • Experience in conducting JAD sessions with SME (subject matter experts), stakeholders, developers and end-user representatives to make sure all the stakeholders and developers are on the same page.
  • Expertise and hands-on experience in SQL for Analysis, Reporting and testing purpose.
  • Expertise in managing multiple projects while maintaining constant communication with the relevant stakeholders. Tracing requirements throughout the development process and verifying adherence using the Requirements Traceability Matrix(RTM)
  • Good experience in developing Test Plans, Test Strategies, Test Scenarios, Test cases by reviewingBusinessand Software Requirement specifications and creating Gap Analysis for test purpose
  • Experience with JIRA software platforms
  • Some experience with Project Management, such as scheduling meetings with clients, creating and maintaining project agendas, organizing internal QA documentation completion, and handling delivery/ pickup of onsite equipment pre and post event.
  • Proficient in facilitating and performing User Acceptance Test (UAT) by working with internal and external Users / Customers and obtaining delivery approval for the project.
  • Proven strength in problem-solving, system analysis and strong analytical and product management.
  • Excellent communication and interpersonal skills, capable of communicating with highly technical engineering teams. Exceptional mediator between external and internal customers, capable of interpreting their needs and positions to ensure the success of the projects.

TECHNICAL SKILLS

Methodologies: Agile, Waterfall model

Project Management Skills: Custom software development, packaged software development, Agile development, strategic planning, cross-functional supervision requirements management, vendor managementImprovement, presentations, and status reporting.

Database: SQL, My SQL

Business Modeling Tools: Microsoft Office, UML, Rational Requisite Pro, Rational Rose

Tools: MS Project, Project Server, Visio, Excel, Word, PowerPoint

Bug Tracking Tools: JIRA, HP ALM, Quality Center

PROFESSIONAL EXPERIENCE

Confidential, NJ

Business Analyst

Responsibilities:

  • Engage client to gather software requirements/business rules, and ensure alignment with development teams. Used MS power point presentations for conducting JAD sessions with the stakeholders.
  • Translated stakeholder requirements into different tangible deliverables such as functional specifications, user cases, user stories, workflow/process diagrams, data flow/data model diagrams.
  • Organized and facilitated Agile and Scrum meetings, which included Sprint Planning, Daily Scrums.
  • Worked throughout the SDLC, which included requirements, specifications, design, analysis and testing utilizing AGILE methodology. Performed Agile methodology from requirement analysis to maintenance phase.
  • Conducted project kick-off meetings, defined project objectives, scope tracked risks, assumptions and status of the project using JIRA
  • Determined user/business/functional requirements. Created UML diagrams including Use Case diagrams, Activity Diagrams using MS Visio
  • Supported the organization's accounts receivable goals through timelyresolution of patient demographic anddataintegrityissues. Pulled credit report and shot records for required companies to ensuredataintegrity.
  • Coordinated with the systemAnalyst, Project manager andBusinessAnalystto set up the Pre- Validation and Validation Environment to execute the scripts.
  • Responsible for the fullHIPAAcompliance lifecycle from gap analysis, mapping, implementation, and testing for Medicaid Claims.
  • Worked on creating specifications for transitioning business fromHIPAA4010A to 5010 and from ICD-9 to ICD-10.
  • Used Healthcare Portal for various health insurance areas such as enrolment, eligibility, member opt out, Claims and other related modules. Worked with HIPPA rules and regulations to draft business rules and claim processes.
  • Used HIPAA guidelines and regulations to keep track ofHealthcaretransactions like Eligibility Request/ Response, Request and Response for Claims Status, Prior Authorization, Claims Vision and Claims Payment
  • Developed and wrote guidelines and standards for the process ofdataintegritymonitoring and maintenance for educational purposes.
  • Responded to external department queries on identity, working with the compliance departments to ensure accuracy indata integrity.
  • Created Product Backlog, sprint backlog and managed and updated Issues (Epics, Stories and Tasks) onto JIRA. Participated in Sprint Planning, daily Scrum Stand up and Sprint Retrospective meetings.
  • Redesigned and implemented system and backlog workflow using Project tracking tools like JIRA in order to coordinate different stages of a product life-cycle within the team
  • Designed process flows and uses cases which helpedbusinesson enterprise prospecting capability, enhanced marketing and sales processes
  • Worked with theBusinessand Platform team to identify current capabilities and identify opportunities for improvement
  • Collaborates with the Development Lead, Product Manager/owner and Program manager to develop and implement software implementation plans
  • Designed the Test Cases, Test Plans for all the processes using HP ALM and tracked defects on JIRA, hence was part of Black Box Testing, and was part of Interface Testing,SystemTesting.
  • Execute, analyze and write SQL queries in Oracle to verify data and reconcileBusiness Intelligence reports.
  • Created SQL reports, data extraction and data loading scripts for different databases and Schemas with also prepared a handbook of standards and Documented standards for code development
  • Worked closely with the development team to analyze and troubleshoot bugs using defect tracking toolJIRA
  • Responsible for conducting QC (Quality Center) training sessions for the Business Users. To give them a walkthrough over the tool. And to show them how to write test case, logging defects etc
  • Created various validation deliverables including but not limited to Validation Plan, Design Specification, User Requirements Specifications, Test Plan, System & UAT Test Scripts, Requirements Traceability Matrix, Test Summary Report, and Validation Summary
  • Responsible for planning, conducting and coordinating the User Acceptance Testing (UAT).

Confidential, Woonsocket, RI

Business Analyst

Responsibilities:

  • Used agile methodology to execute complete software development lifecycle (SDLC) solutions, including requirements gathering, test planning and execution, design, development, and deployment for clients.
  • Worked in Agile environment from the design phase till the Deployment phase.
  • Led Joint Application Development (JAD) session and user interviews to get a better understanding of client business process.
  • Worked with other teams on integrating the Appointments solution and other solutions withinCvent.
  • Performed GAP and Risk analysis of existing system and evaluating benefits of new system.
  • Conducted functional requirement reviews and walkthrough with the Integration experts and stakeholders.
  • Created UML diagrams like Use Case Diagrams, Activity Diagram using MS-Visio for various stakeholders.
  • Conducted user interviews, gathered requirements in JAD sessions withbusinessteam to prepare User Stories using JIRA.
  • Researches and verifiesdatato substantiate request validity. Maintainsdatafile in terms of dataintegrity. Responsible for manualdataentry. Recommended corrective actions and may recommend enhancements to improvedataintegrity.
  • Database maintenance, reporting and extractingdatafor various reports, analyzedata integrity, and then initiate improvements based on results of analysis to reduce errors and improve processes.
  • Validated the following 837 Health Care Claims or Encounters, 835 Health Care Claims payment/ Remittance, 270/271 Eligibility request/Response, 834 Enrollment/Dis-enrollment to a health plan.
  • Responsible for attaining HIPAA EDI validation from Medicare, Medicaid and other payers of government carriers.
  • Involved in testing HIPAA EDI X12 transactions & Code Sets Standards like (820-Premium Payment for enrolled health plan members, 834-Enrollment to a health plan, 837- Health Care Claims and 278 Authorizations.)
  • Developed and maintains standards for databaseintegrityand quality assurance, coordinates corrective activities to clean database and retain users, and manages communication processes with other departments regarding database improvements.
  • Maintains current providerdata integrityto ensure the quality of the network. May be responsible for representing the provider network area on company IT projects, reporting and tracking provider calls and complaints, or for the support, coordination, and production of the directory cycles.
  • Generated Validation Summary Report to summarize and document all validation activities.
  • Maintained all the stories and tasks in JIRA which was used to know the status of requirements. Implemented JIRA Safe methodologies in the project.
  • Wrote Complex SQL queries, optimizing SQL Queries and performed Data Analysis of existing data through SQL.
  • Reviewed defect/reports and assign valid defects to the relevant developer/ development manager using HP Quality Centre, JIRA and follow the defect life cycle.
  • Performed Quality Assurance responsibilities by reviewing validation deliverables for various projects for compliance with SDLC
  • Tested the final application for usability testing (UAT) to verify whether all the user requirements were catered to, by the application.

Confidential, Minnetonka, MN

Business Analyst

Responsibilities:

  • Gathered detailed business and technical requirements and participated in the definitions of business rules and data standards
  • Responsibility fordataintegrity to catch any errors in accounting and handle any problems that may arise while organizing the company’s data, which also includes keeping financial paperwork organized and ensuring its distribution.
  • Prepared business requirements specifications and functional system specifications for usability enhancements, alert workflow.
  • Conducted meetings and JAD sessions for project definition, resource identifications and deliverable prototype identification.
  • AnalyzedBusinessrequirements and developed functional and nonfunctional requirements in product backlog usingJIRA.
  • Translated business requirements into functional use cases (JIRA) for the IT organization, managed changes to such specifications, and educated the IT organization on the direction of the business.
  • Successfully used Agile Method for gathering requirements and facilitated user stories workshop.
  • Worked in development of a thorough and repeatable software requirements methodology utilizing the agile model.
  • Involved in ensuring the dataintegrityof the legal record and must strictly uphold business confidentiality
  • Analyzed and reviewed validation deliverables like Validation Plan, Risk Assessment, Quality Assurance review, Validation Summary Report
  • Developing User Stories throughout the Agile Lifecycle as well as created UML diagrams such as Use Case, Activity and Chart diagrams with MS Visio.
  • Authored data flow diagrams, sequence diagrams and business process models that describe how the EDI Health Care Encounter Claim Transaction set (837) is used to submit health care billing information and encounter.
  • Incorporated HIPAA standards, EDI (Electronic data interchange), Implementation and Knowledge of HIPAA code sets, ICD9, ICD10 coding. Determined eligibility benefits for customers with EDI Health Care Eligibility/Benefit Inquiry (270).
  • Designed and development of test cases based on functional requirements for Institutional and Professional claims for EDI and HIPAA Transactions 837/835, 834, 276/277, 270/271 testing.
  • Audited and reconciled employee information in ADP systems and employee files to ensure dataintegrity.
  • Used JIRA for writing epic, user stories with acceptance criteria or user stories with use cases
  • Retrieved Data using SQL queries and did Data Mapping and Data analysis. Involved in authoring a Test Plan for outlining the validation effort of testing.
  • Interfaced with developers, analysts, customers and project managers to discuss requirements and recommended solutions, to help resolve issues.
  • Assists withdataintegrityinitiatives to ensure the ongoing accuracy of trail data. Coordinates research tasks. Assists with QA testing
  • Led the User Acceptance Testing efforts to verifying that the developed reports meets the requirements
  • Involved in developing the test strategy and helped in developing QA Test plans for Functional, Integration and System Testing.
  • Responsible for coordinating and supporting User Acceptance Testing (UAT) by providing UAT Test Plan Documentation and developing test scripts accordingly

Confidential, Dublin, OH

Business Analyst

Responsibilities:

  • Gathered requirements to identify and create database objects such as tables, views, triggers and indexes, User defined functions, Cursors, Stored Procedure, Constraints and Roles.
  • Facilitated Joint Requirement Planning (JRP) sessions withBusinessUser Groups, along with conducting Joint Application Development (JAD) sessions with IT Groups and Conflict Management with Project team members.
  • Identified efficiencies in "current state" of casualty underwriting divisions and helped with development and implementation of "future state" plan (As-Is/To-Be) by removing non-value added process and workflow automation.
  • Created and maintained the Requirements Traceability Matrix (RTM)
  • Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams, using UML and Visio/lucid charts
  • Incorporated Rational Unified Process (RUP) to create Requirement Document Specifications using VisibleAnalyst.
  • Used Rational Clear case for version control
  • Responsible for conducting QC (Quality Center) training sessions for the Business Users. To give them a walkthrough over the tool. And to show them how to write test case, logging defects etc.
  • Worked with Source system Subject Matter Expert (SME) to ensure that the extracts are properly mapped.
  • Used SQL for data mapping and querying.
  • Involved in formal requirements gathering methodologies, and developed reports based on specifications.
  • Involved in writing and implementation of the test plan, and various test cases for UAT

Confidential, Louisville, KY

Business Analyst

Responsibilities:

  • Interacted with client groups to determine user requirements,Businessrules and goals and create aBusinessRequirement Document (BRD).
  • Utilized the Agile Scrum methodology to analyze the requirements to create stories.
  • Worked with the clients and the technical team in communicating the requirements, designing of the system, and implementing the system by conducting several JAD sessions.
  • Used Rational Rose to createUMLdiagrams such asusecase, activity, sequence, class and component diagrams. Intricately involved inBusinessProcess Flow development,BusinessProcess Modeling, and ad hoc Analysis
  • Maintained meeting minutes, meeting agenda and communicated them with the SMEs and the stakeholders on timely manner using MS Word, MS PowerPoint and created reports using MS Excel.
  • Maintained requirements traceability matrix (RTM) to ensure that all requirements are traceable from top to bottom and to provide a basis for test plan using JIRA.
  • Reviewed defect/reports and assign valid defects to the relevant developer/ development manager using HP Quality Centre, JIRA and follow the defect life cycle.
  • Designed and implemented SQL queries for QA testing and report / data validation including joins, aggregate functions to bring together data from various tables, for reporting purposes
  • Utilized defect tracking tool JIRA for reporting bugs/defects in functionality. Conducted weekly status meeting with development teams for defect resolution. Utilized SQL for querying database tables during testing.
  • Involved in writing Test Cases and developing test strategies with Quality Assurance group to implement them.
  • Tested the final application for usability testing (UAT) to verify whether all the user requirements were catered to, by the application.

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