SUMMARY

• Business Analyst with 7+ years of excellence experiences in business process analysis/modelling, business requirements in HealthCare based Industries.
• Pro - efficient in Requirement gathering, Requirement analysis in terms of AS-IS, To-Be documentation, Solution design, requirements management (Backlog creation, Refinement, Prioritization), Test case review and testing the solution.
• Proficiency in Business Process Analysis, Improvement and Transformation, worked towards enhancing system design / implementation, etc.
• Proficiency in requirements elicitation practices including interviews, questionnaires, user empathy, workshops, JAD sessions, user stories, role playing and prototyping.
• Analyse and describe the functional behaviour of systems and their interactions in UML or other standard modelling tools, Translate business requirements into functional specifications.
• Skilled in writing user stories, cases, use case diagrams, workflow diagrams, sequence diagrams by using MS Visio and Pencil tool for writing UML diagrams.
• Experienced in FACETS, ICD 9-ICD 10 conversion.
• Excellent knowledge of HIPAA transaction codes such as 270/271(Inquire/Response Health Care Benefits), 276/277 (Claim Status), 835, 837 (HealthCare Claim), 834 (Benefit Enrolment)
• Creating Screen Mock-ups and conducting GAP, Impact, SWOT, Cost Benefit & Risk Analysis.
• Involved in Test Planning, Test Preparation, Test Execution and Issue Resolution and Report.
• Proficient in using Agile Scrum and KANBAN methodologies.
• JIRA tool extensively to write user stories analysed the Iteration Burn Down charts and reviewed defects.
• Expertise in using Agile Scrum methodologies, Expert in Cost-benefit Analysis/Efforts calculation and ROI calculation in project/product feature development.
• Developed Requirement Traceability Matrix (RTM) using MS-Excel.
• Proficient in writing SQL queries and in creating complex SQL Queries using Joins and Sub-Queries.
• Extensively worked with the On-site and Off-shore Quality Assurance Groups by assisting the QA team for developing Test Plans, Test Cases, and Test Scripts etc. conducted User Acceptance Testing (UAT).
• Trained in Artificial intelligence, developed Chat bots using IBM Watson assistant.
• Good experience in Java development, UI and Chatbot.

PROFESSIONAL EXPERIENCE

Business Analyst

Confidential, Basking Ridge, NJ

Responsibilities:

• Participated in Business Modelling by understanding the needs of the business, and documenting Business Use Cases as well as System Use Cases.
• Develop the supporting plans such as scope, cost, risk, schedule, quality, resource, security deliverables, procurement and change management plans.
• Developed Oracle based (SQL and PL/SQL) programs for the creation of DW/ETL Process, ad hoc queries/reports, including requirements gathering, design, coding and unit testing.
• Facilitated Joint Application Development (JAD) sessions with the Management, Mainframe and HIPAA team to make sure everyone is in synchronous with the business requirement processes.
• Reviewed Use cases, used MS-Visio, created flow diagrams, activity, sequence diagrams, worked on UML 2.0
• Conducted GAP Analysis &Data mapping for ICD-9 to ICD-10 implementation as well as also developed RFP for vendor analysis.
• Captured detailed BRD/FRD for ICD-10 & conducted testing: SIT/UAT: Test-Plan development/Test-Cases development/Test-Data creation etc.
• Developed BRD for new MMIS system and conducted data mapping as well as developed Use Cases/Activity Diagrams.
• Worked on HIPAA Transactions 270, 271, 276, 277 for CORE certification 834, 835 and 837 for HIPAA 5010 project.
• Involved in HIPAA 5010 gap analysis of ANSI X12 4010.Created Macro and Micro Design technical specification documents based on the user stories and requirement by the client.
• Wrote PL/SQL statements and stored procedures in Oracle for extracting as well as writing data from Operational Data Stores.
• Developed plan for data feed and data mapping for integration between various systems, Including XML, to follow ICD 10 code set and ANSI X12 5010 formats.
• Develop Project charter and obtained approvals. Define project goals, objectives and success criteria.
• Performed testing for Medicare, Medicaid and X-Over claims for Medicaid Management Information System
• Identified and document Project constraints and assumption. Used MS Visio to create Use Cases and Sequence Diagrams.
• Accomplished experience through whole SDLC from requirement analysis till deployment.
• Assisted development team to translate requirements into technical specifications.
• Created and Maintained the Requirement Traceability Matrix (RTM) throughout the project.
• Initiated Test Plans, developed and executed test cases and scenarios, worked with users to develop specific acceptance criteria and prepare test exhibits.
• Trained End Users through navigating through Market prominence.
• Conducted User Acceptance Testing (UAT) sessions with business users and prepared document for enhancements and bug fixes.

Business Analyst

Confidential - Durham, NC

Responsibilities:

• Worked on the Member portal for the Individual/Group Members maintenance in web/mobile and Coordinated SIT (System testing) activities for Major releases on the testing project for the Shopping, Enrollment and Member maintenance areas.
• Tested Facets and the Member Portal application related to Enrollment, Benefits, Claims processing and Billing.
• Reviewed Business Requirements, test scenarios and Process flow Diagrams.
• Defect Tracking, Reporting and Verification through ALM and actively participated in the triaging of the defects. Also participated in Project Stakeholder meeting, Sprint Planning, Sprint Review, and Daily Standup meetings with Clients.
• Prepare Test Estimation, Test design, Test Plan, Test execution, Test Reporting, Project Release reporting and actively involved in Onsite/ offshore project coordination and test execution and actively involved in client presentations and walkthroughs.
• Apprise on Daily and Weekly status reporting, Signoff document and Project closure artifacts

Business Analyst

Confidential - Norfolk, VA

Responsibilities:

• Involved with the project from its inception phase.
• The project was implemented using the Agile (SCRUM) Methodology to produce artifacts in the different phases of the Software Development Life Cycle (SDLC).
• Involved in weekly scrum meeting for weekly status updates of the project and the issues.
• Analyzed and identified gaps in the existing system with the help of comparing and contrasting documented business requirements and worked on creating a design for a new revised improved system.
• Worked on the Availity portal to create documentation for Authorizations,
• Claims, Patient 360, and PLUTO tools.
• Created UML diagrams to support the above-mentioned tools, using Microsoft
• Visio.
• Ran SQL queries to pull relevant data from Facets, using Oracle SQL Developer
• 2.0.
• Created SEWF (Small Effort Work Form) and presented the same during the CAB
• (Change Advisory Board) Meetings.
• Was responsible for updating the progress of SEWF on JIRA.
• Created templates for common SQL queries on SharePoint for future references.
• Actively involved during the testing phase with involvements in Unit Testing,
• UAT and Integrated Testing.

Business Analyst

Confidential

Responsibilities:

• Worked as a liaison between technology and business users to improve business processes and support critical business strategies.
• Performed feasibility studies of different technical implementation and came up with recommendations.
• Reviewed the Business Requirements Document (BRD) with the business users,
• Subject Matter Experts and with technical teams.
• Worked closely with QA and Development teams to clarify/understand functionality, resolve issues and provide feedback to resolve bugs.
• Provided training to business users.
• Interviewed Stakeholders to gather the Business requirements and review the same with the Product Owner and Technical users
• Defined roles and responsibilities of participants in Business Process.
• Managed day-to-day project activities and coordinated tasks with other teams.
• Provided enhancements to Applications portal.
• Ensured change process & compliance are properly adhered to by approvers, assessors, change owners and client.
• Documented User stories and Product Backlog Lists for Agile Sprint development.
• Provided support for User Acceptance testing and worked with Business Users and
• Technical Teams issues to resolve the issues.