SUMMARY

• Senior Business Analyst Professional with 8 years of experience in Business Requirement Gathering, Business Process Flow, Business Process Modeling and Business Analysis.
• 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.
• Extensive experience of Software Development Life Cycle (SDLC) using Rational Unified Process (RUP), Extreme Programming (XP), Agile Methodologies (SCRUM), and Waterfall methodologies in multi - tier-web-based architecture.
• Experience in Gathering user requirements, Analyzing, and preparing Project Deliverables, such as Project Charter, Business Requirement Document (BRD) and Functional Requirement Document (FRD), Use-Case Specifications, and Systems Requirement Documents (SRS).
• Adept at coordinating with Stakeholders, Subject Matter Experts (SMEs) and end users to understand, Analyze, Communicate and Validate requirements through User interviews, Joint Application Design (JAD), Joint Application Review (JAR) sessions.
• Expertise in performing GAP Analysis (AS-IS & TO-BE process flow diagrams), maintaining Requirement Traceability Matrix (RTM), creating Work Breakdown Structure (WBS), and Data Analysis.
• Experience with claims process and adjudication in the Medicare Part A, B, C and D, Medicaid and Private Insurance Sectors.
• Expertise in EPIC, practice fusion, Medical software application (EMR).
• Created Use Cases, Activity Diagrams and Unified Modeling Language (UML) to provide better view of the project to the stakeholders.
• Strong Healthcare Domain knowledge with implementation experience in EDI, X12 transactions complying with HIPAA and HL7 standards and CMS Compliances/Regulations.
• Experience in Change Management Process (Identify, Analyze, Evaluate, Plan, Implement, Review and Close) as well as quality management using PDCA cycle.
• Defects tracking prioritized outstanding defects in reporting system. Co-ordinated between development team and the management team to resolve any conflicts/defects in terms of requirements.
• Involved in various Testing Methods such as Black box testing, Functional Testing, Regression testing, Performance Testing and User Acceptance Testing (UAT).
• Participated in writing Test plans and Test cases.
• Experience with Data Analysis using Excel and SQL as the querying interface.
• 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, ICD 10, CPT, SNOMED codes and various modifiers where applicable in compliance with HIPAA 4010 and HIPAA 5010.
• Proficient in conducting Business process modeling (BPM), feasibility studies, Impact Analysis, Cost/Benefit analysis, Gap Analysis and Risk analysis.
• Excellent meeting facilitator with excellent interpersonal and conflict resolution skills.
• Possess strong verbal and written communication skills with strong interpersonal skills and extremely reliable, quick learner and able to work independently as well as a team member.

TECHNICAL SKILLS

Methodologies: Scrum, Waterfall, Agile, RUP.

Business Modeling Tools: Rational Rose, MS Visio, Enterprise Architect, Mockup Screens, Wireframes.

Project Management: MS Project, Microsoft Office Suite and MS SharePoint.

Requirement Management Tools: MS Office, JIRA, RALLY, Confluence, HP ALM 11.5, Rational ClearQuest.

Programming Languages: SQL, UML 2.0, HTML, CSS, jQuery, C++, .Net, Java.

Testing Tools: HP AC v10.0, HP ALM v11.5, Load Runner, Fiddler, HedgeHog, Quick Test Pro, Jira, Rally, Rational Clear Quest

Operating System: Windows 98/2000, Windows 7, Windows 8, Windows XP, UNIX

Databases: SQL server and ORACLE.

Web Technologies: HTML, CSS, JSP, XML, AJAX

PROFESSIONAL EXPERIENCE

Confidential, Lake Oswego, OR

Business Analyst

Responsibilities:

• Worked as a liaison between the business and the technical team (developers).
• Involved in gathering business requirements and drafting Build Requirements Document (BRDs) and getting sign-offs from the managers.
• Created new and update existing BRDs based on new template given by the business.
• Worked with the IT Business Analysts in creating Support and Admin Guide (SAG) for Confidential ’s California Region (NCAL & SCAL).
• Involved in updating the chapters in the Support and Admin Guide according to the format given by the business to be used by all the regions.
• Assisted in Claims Dashboard for the business users by using requirements elicitation techniques such as face to face interviews, group sessions, Questionnaires and surveys.
• Conducted requirements gathering session with the team of business analysts working on the business side and providing required information to the developers on reporting team.
• Conducted and facilitated meetings such as Joint Application Design (JAD) Sessions & Joint Application Requirements (JAR) sessions while coordinating with the different regions.
• Worked on the Business Objects tool to create new reports and update existing BRDs and provide them to the developers.
• Worked on updating the Technical Specifications in Physical Solutions Design Document (PSDD) by replacing the existing data from Reporting Work bench by capturing the data from Business Objects tool.
• Handled the change requests coming from the business users and getting new requirements and ensure that the developers have sufficient information to work on the change requests.
• Backfilled BRDs on few reports and updated them by following the new template and getting the sign-off from the managers.
• Working on Microsoft tools such as Outlook, SharePoint, Word and Excel.

Environment: Java, Spiral, Windows 8, MS Office Suite, MS Project, Visio, HPALM, Business Objects, Reporting Workbench.

Confidential, Owings Mills, MD

Business Analyst

Responsibilities:

• After being on boarded I conducted GAP Analyses by understanding the AS-IS business process and TO-BE business process.
• I was responsible for creating the BRD which was translated into FRD & SRS.
• Developed business process diagram, activity diagram, sequence diagram to understand the data flow between the provider and the Payer.
• Worked on QNXT Provider and Payer modules.
• Have experience in project management tools such as JIRA.
• Prioritized the user stories with the help of the product owner using MOSCOW and Planning Poker Techniques.
• As a Scrum Master, I was responsible for facilitating the Sprint ceremonies and helped the scrum development team in resolving impediments.
• Maintained Sprint Burn down Charts throughout the sprints to track the velocity of the team.
• Validated 837 (Healthcare Claims), 835 (Healthcare Claims payment/ Remittance), 270/271 (Eligibility request/Response), 834 (Enrollment/Dis-enrollment to health plan) for health claims.
• Created high-level Use Cases from Business Requirements and created UML diagrams like use case diagram and activity diagram by using MS Visio and UML 2.0 for various stakeholders.
• Validated codes for billing process which included ICD-9 and ICD 10, SNOMED codes and various modifiers where applicable in compliance with HIPAA 4010 and HIPAA 5010.
• Performed Claims Unit Testing during the project.
• Well versed with HIPAA, Facets, STAR CHIP claim adjustments, claim processing from point of entry to finalizing, claim review, identifying claims processing problems, their source and providing corresponding solutions.
• 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/Quality Center and coordinated with developers to quickly resolve the defects associated with them.
• Conducted JAD sessions during the various stages of upgrading the matching system and discuss the current system preference.
• Developed Requirements Traceability Matrix (RTM) using MS excel to trace each software design requirement to test case.

Environment: Agile (Scrum), SharePoint 2010, rational requisite pro, MS VISIO, Tableau, Service Now, UML, HPQC.

Confidential, Alpharetta, GA

Business Analyst

Responsibilities:

• Designed and developed project document templates based on the scope and plan for the project.
• Interacted with client and the technical team for requirements gathering and translation of Business requirement to technical specifications.
• Gathered Business Requirements, Functional & Nonfunctional requirements.
• Followed the Agile Scrum SDLC methodology throughout the project.
• Mapped out timelines, milestones, communication processes, Q&A sessions, MS Excel based query tracking.
• Maintained Sprint Burndown Charts throughout the sprints to track the velocity of the team.
• Involved in Sprint planning meeting and Backlog Grooming meeting with the Product owner and the Scrum Development team.
• Communicated with business and other functional stakeholders for all JAD sessions to derive and execute action plans, meeting deadlines and standards.
• Managedchange requests as a part of CCB.
• Conducted GAP analysis of transition from ICD9 to ICD10 codes.
• Created a well-defined As Is and To Be process for both project roadmaps as well as for final deployment.
• Maintained Requirements Traceability Matrix.
• Assisted in creating and reviewing test plan & test cases and conducted User Acceptance Testing (UAT).
• Was involved in testing methods such as Unit testing, integration testing, system testing and regression testing.
• Assisted all other Medicaid groups involved in integration efforts across the practice that involve EDI & QNXT Data of Provider modules.

Environment: Web Logic 8.1, MS SQL Server 2008, SQL, Rational Requisite Pro, Dreamweaver, MS project, Enterprise Architect, JIRA, MS Visio, Symantec DLP, HP Quality Center.

Confidential, Eden Prairie, MN

EDI Analyst-Business Analyst

Responsibilities:

• Drove up to 8% increase in customer EDI usage through go-live with additional transaction sets, invoices, advanced ship notifications, and price catalogues.
• Monitored inbound and outbound transactions, working primarily with X12 documents, Purchase Orders (850), Acknowledgements (855), Advanced Ship Notifications (856), and Invoices (810), version 4010.
• Inbound and outbound ANSI X12 Financial transactions 810, 850, 855, 856, 852, 846, 867, 870 and 824 mapping from Oracle flat file. Worked on various X12 and EDIFACT transaction sets like 850,810, ORDERS, INVOIC.
• Created PO (850) and Invoice (810) maps with Tax guidelines. Maintain documentation such as procedures, flowcharts and guidelines with Documentum according to new compliance requirements.
• Analyse B2C and B2B web properties and create new business plan, business requirements, and staffing requirements.
• Gathered Business Requirements, Functional & Nonfunctional requirements.
• Maintained Sprint Burndown Charts throughout the sprints to track the velocity of the team.
• Created business processes for EDI, XML, Flat file, Punch-out and punch back process flows.
• Followed all the phases of the Software Development Life Cycle (SDLC).
• Designed Activity, Sequence and Process Flow Diagrams using MS Visio to simplify and elaborate certain selection criteria and filter conditions.
• Created test plan, test data and conducted manual testing to validate functionality and performing regression testing.
• Gathered requirements using Joint Application Requirements (JAR) and Joint Application Document (JAD) sessions in order to collect and define data.

Environment: Waterfall, Scrum, MS VISIO, UML, HPALM, HPQC, RALLY, Rational RequisitePro.

Confidential

Business Analyst

Responsibilities:

• Worked closely with the Pharmaceutical sales team to gather requirements and understanding the process of allocation planning and management.
• Documented BRD supporting documents containing the essential business elements, detailed definitions, and descriptions of the relationships between the actors to analyze and document business data requirements.
• Acted as a scrum master and helped product owner prioritize the product backlog and helped team to deliver the product on time.
• Organized daily defect SCRUM meeting in order to identify the defects encountered in the current release and worked with the development team for resolution.
• Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams, and OOD
• Worked with Quality Control Teams to develop Test Plan and Test Cases.
• Interaction with the developers to report and correct bugs.
• Worked with SQL queries for data manipulations.

Environment: Oracle, PL-SQL, IBM Cognos, Framework Manager, IBM Cognos, Business Intelligence Suite 10.2,Jira, Rally, IBM BPM, SQL Developer, MS Project, IBM Infosphere, Optim, Excel, Word.

Confidential

Business Analyst

Responsibilities:

• Worked on Hospital data processing for improving database for storing user files.
• Analyzed business needs, created and developed new functionality to meet real time data integration that facilitated decision.
• Worked on functions such as Change Control and Request, and managed complaints to ensure customer satisfaction.
• Active involvement in ETL design for data integration and master data management.
• Worked with SQL queries for data manipulations.
• Created Entity relationship diagrams for the proposed database.
• Participated in the development and creation of the data warehouse.
• Participated in creation of database objects.
• Assisted in building a business analysis process model using Rational Rose, Requisite Pro and Visio.
• Designed and developed Use Cases, Activity Diagrams and Sequence Diagrams.

Environment: Oracle, PL-SQL, IBM Cognos, Framework Manager, Business Intelligence Suite 10.2, Jira, IBM BPM, SQL Developer, MS Project, Excel, Word, Outlook, Visio, XML, AS400, Windows 8/XP.

Confidential

Business Analyst

Responsibilities:

• Interacted with Stakeholders to finalize the Business Requirements, business processes and support critical business strategies for the application.
• Elicited business needs, conducted business process modeling work and facilitated work sessions (JAD), to analyze, validate and prioritize requirements.
• Active involvement in ETL design for data integration and master data management.
• Discussed quality pathways and requirements for pharmaceutical industries.
• Conducted JAD sessions to allow stakeholders with different backgrounds to communicate their perspectives with each other and resolve issues.
• Designed and created Excel sheets to provide market analysis charts.
• Created Business Insight Dashboards and Business Insight Advanced prototypes for the user to understand the new Cognos 10.1 features and functionalities.
• Developed use cases, activity diagrams and sequence diagrams for a clear understanding of the vision document.
• Created Clinical, Regulatory, laboratory, EHR, etc. data segregation and data migration diagrams using MS Visio.
• Actively gathered requirements from teams involved in pre-formulation and research of potent drugs.

Environment: Windows XP/2000, Oracle 8, XML Spy, Test Director, Manual and Automated testing, SQL, Toad 8.5, UML and Cognos BI, MS Word, MS Visio, MS Excel and MS PowerPoint.