SUMMARY

• Around 8+ years of IT and Management experience in Software Development Life Cycle (SDLC) and Project Life Cycle working as Business Analyst mainly in Healthcare.
• Extensive exposure to Rational Unified Process (RUP), Agile and Waterfall Methodology. Experience in conducting/participating in JAD sessions for project definition involving analyzing requirements, creating prototypes, user interface.
• Extensive experience with analyzing business processes and documenting them using MS Visio, MS PowerPoint, MS Excel, and MS Project.
• Experience in understanding database structures and in writing SQL queries
• Strong experience in developing Use Case Diagram, Use Case Specification document (UC), FRD (Functional requirement document), BRD (business requirement document), Functional design and Traceability Matrix.
• Worked as a Business Analyst, understanding client requirements, summarizing client needs, and translating into technical options and solutions that meet end user business needs.
• Broad experience with SDLC requirement gathering and deployment using agile methodology - Scrum framework, Waterfall.
• Proficient in creating UML diagrams like Use Case, Activity, Sequence, Collaboration, Class, State, Workflow, Process flow, Data flow and Deployment Diagrams using tools like Draw.io, MS Visio.
• Coordinated meetings with customers, analyst and developers to identify customer needs, gather requirements and authorize BRD, FRD across multiple projects.
• Experience reviewing Test plans, Test cases and Test case execution. Writing test cases using Quality Center.
• Strong expertise in building, Templates, Graphical analysis charts and Statistical reports using MS Excel and also expertise in MS Word, MS PowerPoint, MS Project.
• Strong experience in documenting existing process, analyzing business requirements, re-engineering business processes and designing.
• Expertise in managing multiple projects and teams with an excellent track record.
• Experience with claims process and adjudication in the Medicare, Medicaid and Private Insurance Sectors.
• Experience in business requirements gathering and writing EDI. Versed on HIPAA regulations and requirements. Experienced in HIPAA Transactions 270/271, 837, 835 within ICD9/10; 4010/5010 projects.
• Proficient in creating mapping spreadsheets, Source to Target mapping documents including transformation rules.
• Ability to plan and coordinate all testing phases including making test plans, conducting User Acceptance Testing (UAT) and creating & executing Test Scripts/Test Cases and highly involved with Regression, system testing and integration testing.
• Generated Traceability Matrix to ensure that all the requirements are covered by the test cases.
• Developed and documented business requirements which include wire frames, Mockup Screens, Prototyping and Business workflows.
• Ability to develop high quality documents and presentations for multiple audiences including business and detailed requirements specifications.
• Proficient in creating BRD (Business requirement Document), TRD (Technical Requirement Document), FRD (Functional Requirement Document) and UAT Documents, and Use Case Narrative.
• Excellent management skills-participating in daily scrum meetings.
• Excellent minute taking and document preparation.
• Strong communication and analytical skills.
• Strong team player and problem solver with solid presentation skills
• Self-starter and quick learner.
• Excellent organizational, multi-tasking, problem solving, risk and time management skills.

PROFESSIONAL EXPERIENCE

Confidential, Alpharetta, GA

Business Analyst

Responsibilities:

• Gathering requirements from stakeholders for provider management and member management.
• Managed Modification and Maintenance Service Requests through the stages of Initial Review, Analysis, Design, Build, Product Test, User Acceptance Testing and Deployment.
• Established project plan and timelines in MS Project.
• Modeling the ‘as-is’ and the ‘to-be’ process flow and analyzed the gap and developed the action steps to fill the gaps.
• Working with legacy team in developing BRD and FRD for system change requests and participated in system testing.
• Working within project team to identify and interpret state Medicaid policies as applicable to customer defined algorithm research as well as assist with internal development of new healthcare analytics.
• Collaborate with business stakeholders and find their requirements and deadlines for a particular sprint in a project.
• Connect with team members for problem solving and find the problems they are facing and create Google calendar events and meetings to address the situation and find solutions.
• Ensure that all teams have required accessibilities for each project and find alternatives and address their problems meet deadlines.
• Extensively interacted with the stakeholders and the IT Department in finalizing the requirements according to the CMS Compliances/Regulations and HIPAA Regulations.
• Assisted JAD sessions to identify the business flows and determine whether any current or proposed systems are impacted by the EDI X12 Transaction, Code set and Identifier aspects of HIPAA.
• Worked on Claims processing system.
• Worked on requirements, analysis and design, project management, testing (functional and user acceptance tests)
• Worked on EDI transactions: 270, 271, 834, 835, and 837 (P.I.D) to identify key data set elements for designated record set. Interacted with Claims, Payments and Enrollment hence analyzing and documenting related business processes.
• Preparing UML artifacts viz. Use Cases, Activity Diagrams, recommended by RUP (Rational Unified Process) for Requirements.
• Involved with all the phases of Software Development Life Cycle (SDLC) methodologies throughout the project life cycle.
• Involved in the meeting with Business Process Owners, SME (Subject Matter Experts) and store users for Requirement gathering in Definition Stage.
• Conducted the FRS and SRS reviews and walkthroughs with designers, developers and stakeholders.
• Created Activity diagrams and Use case Diagrams (UML Diagrams) using Rational Rose.
• Involved in preparing Test Plans based on User Requirements Document (URD) and prepared the Test Cases using Test Director/Quality Center.
• Maintained Traceability Matrices
• Resolved issues related to requirements during system testing and UAT plan preparation.
• Participated in the planning of the User Acceptance testing effort.
• Creation of Test Cases for functional testing of the system.
• Performed GAP Analysis to analyze the current system and worked with internal users to help define system requirements.
• Helped with data modeling and defining the conceptual and logical model of the data warehouse.
• Involved with the Test planning, test development and test execution.
• Responsible for scheduling meetings with users, SME’s and stakeholders to identify problems resolve issues and improve the process to ensure a stable and accurate solution.
• Performed extensive Manual Testing to verify the application is complete and stable.
• Identify timelines for the different kinds of testing to be performed and estimate the risks involved.
• Performed test data analysis and ensure data requirements are met prior to start of various testing phases.
• Cardinal Health, OH Business System Analyst
• Involved in gathering, documenting and verifying business requirements.
• Developed, coordinate and support Information Technology Division on all operational requirements of FACETS claims processing system and production management.
• Participated in user meetings, gathered Business requirements & specifications for the Data-warehouse design.
• Established a business Analysis methodology around the SDLC, helped to develop use cases, project plans and manage scope.
• Involved in the meeting with Business Process Owners, SME (Subject Matter Experts) and store users for Requirement gathering in Definition Stage.
• Assisted in developing Project Proposal, Business Case and Business rules.
• Gathered business requirements from stakeholders and translate them into detailed requirement specifications.
• Assisted JAD sessions to identify the business flows and determine whether any current or proposed systems are impacted .
• Used SDLC (System Development Life Cycle) methodologies like the Agile and the waterfall.
• Performed requirements gathering process in iterative approach using Agile methodology.
• Prepared Business Requirement Document (BRD) and Software Requirement Specification (SRS)
• Analyzed Business Requirements and segregated them into high level and low level Use Cases, Activity Diagrams/State Chart Diagrams (UML).
• Worked in designed and development of Project document templates based on SDLC methodology.
• Helped with data modeling and defining the conceptual and logical model of the data warehouse.
• Work with architects and Business Analyst to design SRS.
• Performed Gap analysis and implemented updates for the Data Warehousing Application.
• Managed and documented the change requests.
• Maintained Requirement Traceability Matrix.
• Understanding the key concepts of SWIFT messaging and the routing rules set up for delivering the trade messages to the providers.
• Involved in User Acceptance testing (UAT) and validation of the application
• Analyzed Business Requirements and segregated them into high level and low level Use Cases, Activity Diagrams/State Chart Diagrams (UML).
• Created Data Stage jobs to extract, transform and load data into data warehouses from various sources like relational databases, application systems, temp tables, flat files etc.
• Created Process Flow diagrams, Use case diagrams (UML) using MS-Visio
• Prepared wireframe and web layouts for the application
• Prepared Test Strategy, Test Plan, test report and Gap Report
• Performed UAT based on Requirements Document and prepared the Test Cases using Quality Center.
• Maintained Traceability Matrix in Excel.
• Used MS-Visio analyzed business requirements and process through Use Cases, Class, Sequence, and Activity diagrams, and adapted UML standards to define modularized Data Process Models.
• Developed a Business Acceptance testing strategy and plan.
• Created test files and analyzed test results using MS-Excel.
• Coordinated and facilitated the execution of User Acceptance testing.

Confidential, Littleton, CO

Business Analyst

Responsibilities:

• Involved in requirements gathering sessions with Business Analysts and Architects to understand requirements in terms of business change.
• Actively worked on Business requirement analysis and Data analysis.
• Assisted in developing Project Proposal, Business Case and Business rules.
• Gathered business requirements from stakeholders and translate them into detailed requirement specifications.
• Assisted JAD sessions to identify the business flows and determine whether any current or proposed systems are impacted by the EDI X12 Transaction, Code set and Identifier aspects of HIPAA.
• Used SDLC (System Development Life Cycle) methodologies like the and the waterfall.
• Performed requirements gathering process in iterative approach using Waterfall methodology.
• Prepared Business Requirement Document (BRD) and Software Requirement Specification (SRS)
• Analyzed Business Requirements and segregated them into high level and low-level Use Cases, Activity Diagrams/State Chart Diagrams (UML).
• Worked in designed and development of Project document templates based on SDLC methodology.
• Helped with data modeling and defining the conceptual and logical model of the data warehouse.
• Work with architects and Business Analyst to design SRS.
• Performed Gap analysis.
• Managed and documented the change requests.
• Maintained Requirement Traceability Matrix.
• Understanding the key concepts of SWIFT messaging and the routing rules set up for delivering the trade messages to the providers.
• Involved in User Acceptance testing (UAT) and validation of the application
• Analyzed HIPAA 5010 standards for 837P EDI X12 transactions, related to providers, payers, subscribers and other related entities.
• Dealt with the EDI transaction-835 claims payments and remittance advice, which deals the payment from payer to provider.
• Ensure the UAT test scripts review sessions with business owners to test the application functionality and providing necessary training material.
• Got exposure of EDI, Web Portal, DSS and System documentation.
• Analyzed MMIS system impact for Windows and Interfaces.
• Excellent writing skills in preparing business requirements documents (BRDs), system requirements specifications (SRS), system design specification (SDS), functional specifications, and defining project plans.
• Responsible for gap analysis in changing legacy system and Involved in testing new System.
• Gathered all the needed data (table names, column names, field names, notes) from the Windows and Interfaces documents.
• Elicited business requirements and business needs as part of an Agile Scrum team
• Responsible to meet the information demands of business users by delivering timely, accurate, meaningful and standardized data and reporting.
• Documented analysis, observations and recommendations.

Confidential, Bellefonte, PA

Business Analyst

Responsibilities:

• Responsible for creating Functional Requirement Document (FRD) based on the requirements captured.
• Created Business Requirement Document (BRD) where the client requested for a Statement of Work (SOW) to be produced before a project is approved
• Conducted interview sessions and follow-up sessions to ensure requirements are current and accurate.
• Worked on EDI 856 ASN (Advanced Ship Notice) set up in regulation with the Drug Quality and Security Act (DQSA) and made sure it was in compliance.
• Worked on EDI 850 set up to order inventory for clients by replacing the traditional process of ordering inventory via email.
• Used Microsoft Team Foundation Server (TFS) as a ticketing tool
• Responsible for Medicaid Claims Resolution/Reimbursement for state health plan using MMIS.
• Involved in integration of FACETS with legacy and third-party vendor applications.
• Analyzed and document Medicaid EDI transactions issues related to implementation of HIPAA 5010 and ensure these issues are documented and addressed in the approach to the HIPAA 5010 version.
• Worked on SSRS reports and Workflow set up for the purpose of client reporting.
• Involved in multiple launches of physician portals by understanding the end-to-end business needs and structure of the portal to deliver the precise product.
• Involved in conducting GAP analysis to understand the AS-IS and TO-BE requirement documents