Summary

• Committed, Goal Oriented Professional with Eight years of Business Analysis experience, actualized through persistent drive for Excellence and Continuous Improvement.
• Acted as a liaison between the business and the technical team in the areas of Software Design and Development Life Cycle and Web based technologies.
• Extensive Experience in Pharmaceutical, Insurance and Health Care Industries.
• Hands on experience with Web Content Management tools like Alfresco and Ektron.
• Experience with claims process and adjudication in the Medicare, Medicaid and Private Insurance Sectors.
• Strong experience in Complete Software development Life cycle SDLC of Data warehouse and Business Intelligence Applications.
• Validated 837 Healthcare Claims , 835 Healthcare Claims payment/ Remittance , 270/271 Eligibility request/Response , 834 Enrollment/Dis-enrollment to health plan for Part B and Part A of Medicare health claims.
• Validated codes for billing process which included ICD-9, CPT codes and various modifiers where applicable in compliance with HIPAA 4010.
• Hands on experience in Waterfall, RUP and Agile scrum methodologies and thorough understanding of Object Oriented Analysis and Design OOA D concepts.
• Experience in conducting Joint Application Development JAD sessions and requirement gathering sessions to converge early toward a design acceptable to the customer
• Experience in using Requirements Management tools like Rational Requisite Pro Optimal Trace. Knowledge of Project Management Tools like MS Project and RallyDev Agile .
• Proficient in conducting Business process modeling BPM , feasibility studies, Impact Analysis, Cost/Benefit analysis, Gap Analysis and Risk analysis.
• Good conceptual understanding of Data Warehousing. Proven experience in complete project life cycle - Design, Development, Maintenance and Documentation of Enterprise Data Warehouse, Data Marts, and Operational Data Stores ODS
• Worked with various teams and data-architects to come up with processes in development/Quality Assurance QA /production for extraction, transformation and loading ETL the data into the data marts.
• Facilitated User Acceptance Testing UAT with the stakeholders and the business users.
• Worked in close co-ordination with the testing team in developing Test plan and Test cases from functional and business requirements.
• Working experience in a cross-functional team environment/different geographical locations teams.
• Commendable working knowledge of the industry standards such as HIPAA, Six Sigma CMMi.
• Excellent Interpersonal communication skills, which facilitated a high level of collaboration among co-workers in a team-oriented environment.

Technical Skills

• Methodologies: RUP, Agile Scrum .
• Tools: MS Visio, MS Project, SSRS
• Languages: UML, SQL.
• Databases: MySQL, SQL Server, DB2 and ORACLE.
• Web Technologies: HTML, XML, JavaScript, MS SharePoint, Alfresco Ektron.
• Health Care
• Compliance: HIPPA, HL7.
• Other Skills: Minitab, SAS, SPSS and Statistical package.
• Packages: MS Office Suite

Professional Experience

Confidential

Sr. Business Analyst

Responsibilities:

• Gathered requirements through a series of interview sessions and group meetings with the identified users and developers to design, build and release the Public facing Website.
• Conducted Joint Application Development JAD sessions with stakeholders throughout SDLC to resolve open issues.
• Performed HL7 standards analysis and documented the enhancements to meet the end state requirements.
• Worked closely with the architects and Content Engineers for Design and Development of Infobutton WebServices.
• Produced Visuals for the application using Azure tool and created Use Cases, State diagrams, Sequence Diagrams and Activity Diagrams.
• Developed FRD, HL7 mapping and UI document for the Website.
• Created UI mock ups and PoC's for the Public facing user interface and the adverse event Reporting form.
• Extensively analyzed XML's and documented business rules and Validations for XML documents..
• Entered data into database using SPSS and summarized results to be presented to research team.
• Worked with QA team to go over the various test scenarios for different types XML Elements and Data Fields in the Web Services.
• Created the UAT document and conducted the UAT testing and Smoke Testing for the Release.

Confidential

Sr. Business Analyst

Responsibilities:

• Reviewed BRD for different Part D functional areas such as for Adjudication-wrap plan formulary determination, Pharmacy handling. For Marketing-Member communications, Claim determination-Grievances, PA Authorization, Appeals and Exception, COB adjudication, PDE Prescription drug events .
• Performed GAP analysis assessed As-Is processes through user interviews, data collection and analysis, design and evaluation of To-Be process solutions.
• Claim Transactions and Billing Transactions created flows for adequate matching of claims. Performed data mapping by matching the billing file and EDI claim file record claims received from Medicare and Medicaid agencies.
• Validated 837 Healthcare Claims , 835 Healthcare Claims payment/ Remittance , 270/271 Eligibility request/Response , 834 Enrollment/Dis-enrollment to health plan for Part B and Part A of Medicare health claims.
• Validated codes for billing process which included ICD-9, CPT codes and various modifiers where applicable in compliance with HIPAA 4010.
• Developed Business Flow diagrams, Activity/State diagrams and Sequence diagrams so development team and other stakeholders can understand business process.
• Developed and maintained central repository populated with Metadata.
• Designed and developed reports for data in the data warehouse using BO.
• Analyzed data using Slice/Dice and Drill up/Drill down to analyze data to meet end user's requirements.
• Assisted QA Leads to develop Test plan and Test Case.
• UAT Developed UAT Test Plan and performed UAT tests along with the Business Users.
• Testing - developed Test Scripts using Test Director/QualityCenter and coordinated with developers to quickly resolve the defects associated with them.
• Helped create 'Business Glossary' to facilitate efficient understanding of business process amongst other teams.

Confidential

Business Analyst

Responsibilities:-

• Gathered requirements through a series of interview sessions and group meetings with the identified users and developers to design, build and release the Public facing Website.
• Conducted Joint Application Development JAD sessions with stakeholders throughout SDLC to resolve open issues.
• Performed Gap analysis by identifying existing technologies, documenting the enhancements to meet the end state requirements.
• Worked closely with the architects and Content Engineers for Design and Development of associated Content in Alfresco CMS.
• Produced Visuals for the application using Azure tool and created Use Cases, State diagrams, Sequence Diagrams and Activity Diagrams.
• Developed FRD, Detail Design Document and UI document for the Website.
• Created UI mock ups and PoC's for the Public facing user interface and the adverse event Reporting form.
• Extensively analyzed XML's and documented business rules and Validations for XML documents.
• Developed design for Retrieve form for Data Capture via XML, XForm and XHTML.
• Extensively used SQL scripts/queries for data verification and Validation at the backend.
• Worked with QA team to go over the various test scenarios for different types Data Elements and Fields in the Adverse event Reporting Form.
• Created the UAT document and conducted the UAT testing and Smoke Testing for the Release.

Confidential

Business/Data Analyst

Responsibilities:

• Worked with the core team to gather business requirements from multiple stakeholders, Business Teams and management groups - and reconciled conflicts by conducting Joint Application Development JAD sessions based on the project scope.
• Created Functional Specifications Document and designed high and low level Use Cases and Activity Diagrams using MS Visio.
• Performed GAP analysis and Impact Analysis involving the current state and proposed state.
• Worked Closely with Application Architects and Business teams to converge on requirements for the Enterprise Consumer Matching WebService.
• Worked closely with Data Architects and ETL Leads/Managers and was responsible to perform detailed data requirements analysis and create design specifications and operational documentation.
• Provided the ETL team with the Data mapping document and assisted them to create the mappings.
• Worked closely with the architects, database administrators and technical team during Data Mapping and Data Integration
• Involved in data modeling and building fact and dimension tables.
• Analyzed and presented the Business with information on data anomalies, issues, input errors, field value ranges, data patterns, referential integrity gaps and the level of record incompleteness that is in the source systems.
• Organized meetings with the SMEs and Data Owners to walk through the findings and determine the cleansing process.
• Participated in various sessions with Business to understand the business rules and to come up with naming conventions to standardize the data..
• Played a key role in the user acceptance testing UAT , and implementation of system.

Confidential

Business Analyst

Responsibilities:

• Worked with the core team to gather business requirements from multiple stakeholders, accounting, operations and management groups - and reconciled conflicts by conducting Joint Application Development JAD sessions based on the project scope.
• Analyzed Business Requirements and segregated them into high and low level Use Cases and Activity Diagrams using MS Visio.
• Performed GAP analysis involving the current state and proposed state.
• Worked closely with other BAs and ETL Leads/Managers and was responsible to perform detailed data requirements analysis and create design specifications and operational documentation.
• Provided the ETL team with the Data mapping document and assisted them to create the mappings.
• Worked closely with the architects, database administrators and technical team during Data Mapping and Data Integration
• Involved with Analysis of reference data from Accounting Systems and Investment Accounting Groups.
• Analyzed and presented the Business with information on data anomalies, issues, input errors, field value ranges, data patterns, referential integrity gaps and the level of record incompleteness that is in the source systems.
• Organized meetings with the SMEs and Data Owners to walk through the findings and determine the cleansing process.
• Participated in various sessions with Business to understand the business rules and to come up with naming conventions to standardize the data.
• Conducted JAD sessions with Management teams and Decision support teams to elicit, Collect and agree upon requirements for BO Reports.
• Created Ad-hoc Reports as per business requirement.
• Played a key role in the user acceptance testing UAT , and implementation of system.
• Extensively used SQL scripts/queries for data verification and Validation at the backend.
• Created User Training Documentation and conducted demos.

Confidential

Business Analyst

Responsibilities:-

• Gathered requirements through a series of interview sessions and group meetings with the identified users and developers. Involved in documenting Business process Model and process Overview.
• Conducted Joint Application Development JAD sessions with stakeholders throughout SDLC to resolve various issues raised by the Network Physicians in adapting eScribe.
• Performed Gap analysis by identifying existing technologies, documenting the enhancements to meet the end state requirements.
• Prepared a comprehensive set of wireframes to ensure the consensus on UI with the help of SME and by continually interacting with the network Physicians for feedback.
• Gathered requirements to customize the Electronic Health Records for Smartphone UI, provided wireframes and mockups for user Satisfaction.
• Ensured that the drug Categories are updated and maintained according to the client requirement.
• Interfaced with business users to prepare and update Business Process Requirements BPR and Software Specifications Requirements.
• Followed Rational Unified Process RUP methodology and Managed Requirements using Rational Requisite Pro.
• Developed workflow, screen mock-ups, and conversion requirements.
• Produced Visuals for the application using Rational Rose and created Use Cases, State diagrams, Sequence Diagrams and Activity Diagrams.
• Extensively used SQL scripts/queries for data verification at the backend. Worked to regulate flexibility of the application's features during development to help in customization of the product onsite at the client organization.
• Prepared User Manual detailing the functioning of the Software Application.