Objective

• To acquire a full - time position as a Business Analyst for an organization offering challenges and career advancement in a stimulating, innovative and fun working environment.

SUMMARY

• 7+ years of diversified experience in Healthcare domain.
• Expertise in translating user stories into System Specifications, and mapping the process design, work flows for SDLC documentation.
• Great experience documenting and managing business requirements.
• Expertise in Project Planning, Project Design, creating functional specifications and data flow diagrams.
• Experience in conducting Gap Analysis between “as is” and “to be” systems.
• Expertise in EDI and HIPAA Testing Privacy with multiple transactions exposure such as Inbound Claims
• Deep knowledge of Health Care Reform/ Affordable Care Act (ACA) law.
• Good experience in facilitating Joint Application Development (JAD) sessions to expedite and streamline the requirement gathering process.
• Proficient in UML (Unified Modeling Language); extensive experience in modeling business process using Use Case, and Activity diagrams.
• Created EDI files for test cases and verified those files, debugged the errors and corrected them according to the addenda for respective HIPAA implementations
• Thorough understanding and hands-on working experience with standards for medical transactions like 820 (premium payments), 834 (enrollment), 835 (medical claims payments), 837 (medical claims), 270 (eligibility inquiry), 271 (eligibility response), 276 (claim status), and 277 (claim status response).
• Possess strong analytical and problem solving skills with the ability to adapt to a new environment and meet stringent deadlines.
• Ability to work in ever changing environment, and meeting deadlines.
• Conducted requirement analysis techniques such as Business Process Automation, Business Process Improvement, and Business Process Re-engineering.
• Good knowledge of MS SQL Server and Oracle.
• Good Data modeling techniques.
• Conducted User Acceptance Testing (UAT)
• Strong business analysis skills and thorough understanding of full SDLC.

TECHNICAL SKILLS

Business Methodology: Agile, Waterfall.

Business Modeling Tools: Microsoft Visio, Rational tool, Smart Draw

Project Management Software: MS Project, Windows

Version Control Systems: Rational Clear Case.

Testing tools: Quality Center, Requisite Pro, SoupUI, LoadRunner and QTP.

Database: MS Access, SQL-Server, Oracle.

PROFESSIONAL EXPERIENCE

Confidential, Bowie, MD

Business Analyst

Responsibilities:

• Participate in the migration of old health records from a legacy system in Fairfax county government human services agency to a new modern EHR system.
• Facilitate a JAD sessions with project stakeholders for defining business requirements for various system redesigns.
• Work closely with project team, stakeholders to analyze and validate the user’s needs and also suggest technical feasible solutions to any change either existing or new functionalities.
• Create, manage and update System Requirements documents using Caliber RM, Business Process flow diagrams and Use Case diagram, Activity flow using MS Visio.
• Create and manage the requirements traceability life cycle using Req Pro to demonstrate the relationship between requirements.
• Support the team leadership by providing a change request monthly reports and facilitate a weekly Change Request resolution meeting with the development team.
• Create, manage and update meeting Notes and all other project artifacts.
• Experience in conducting Gap Analysis between “as is” and “to be” systems.
• Expertise in EDI and HIPAA Testing Privacy with multiple transactions exposure such as Inbound Claims
• Create the traceability matrix to demonstrate the relationship between specific requirements.
• Function as the primary liaison between the business area, operations, and the technical areas throughout a project life cycle
• Play lead/active role in the whole System Development Life Cycle (SDLC).

Confidential, Richmond, VA

Business Analyst

Responsibilities:

• Studied existing business application and processes, current source system, collected end user requirements and suggested the improvised business process model.
• Analyzed the “As is” and “To be” system documents to show the current and proposed functionalities of the system using MS VISIO.
• Perform Gap Analysis of client requirements, generated workflow process, flow charts and relevant artifacts.
• Involved in defining and documenting the vision and scope of the warehousing project.
• Worked with ACES claims data for claims subject area, Enrollment and billing data for membership subject area.
• Involved in the development of Business and Technical Requirements Document (BTRD) and Business System Design (BSD) document for the project.
• Involved in identifying and studying the ACES system data for the attribute mapping purpose.
• Conducted interviews with management team.
• Conducted and participated in the JAD session with the SME’s and project team members.
• Worked as a liaison between the business and technical side to convey the business needs to the system architects.
• Participated in weekly status meetings to present status and in corporate any digressions from the original scope.
• Designed Use Cases using UML, and managing the entire functional requirements life cycle.
• Created and managed project templates, Use Case project templates, requirement types and traceability relationships in Requisite Pro.
• Carried out a thorough target data model assessment and risk analysis.
• Involved in cross-functional teams, developing new ways to boost efficiency and delivering results in a fast changing environment to achieve company goals.
• Participated in the walkthroughs and meetings, specifically for Claims and Membership modules.
• Coordinate with Development and Business team to develop high level Business and Technical documents.
• Worked with the clients on the verification process for the requirement phase documents
• Implemented Standardized process throughout the software Development Life Cycle (SDLC).
• Involved in gathering Requirements from stakeholders.
• Involved in writing complex SQL queries to extract data from Oracle database.
• Extensively used simple and nested SQL statements for testing purposes.

Confidential, Owings Mills, MD

Business Analyst

Responsibilities:

• Facilitating joint application design (JAD) sessions to translate requirements into functional design documents.
• Created activity diagram from the use cases scenarios, business and functional requirement using MS Visio.
• Created technical requirements specifications documents for development team, GUI screen layouts and navigational flows.
• Decompose high level requirements into Work Breakdown Structure (WBS) elements.
• Performed gap analysis between ACA and Non- ACA rules.
• Worked and collaborated with stakeholders through facilitated Joint Application Design (JAD) sessions.
• Wrote test cases, test scenarios, or participating in testing activities for new functionality in an eligibility system.
• Support the scrum team developers in defining and delivering product that delivers appropriate business value to the product owners.
• Support assigned scrum team in verifying requirements to develop test cases based on acceptance criteria.
• Document requirements traceability matrix for verification of requirements.
• Support the business process analysis by becoming a Subject Matter Expert for Technical Writer’s team.
• Worked closely with Technical Writer team to create Standard Operating Procedure (SOP) documents.

Confidential, Long Island, NY

Requirement/Business Analyst

Responsibilities:

• Participates in the migration of HIPAA - EDI X12 4010 series to 5010 series for EDI Transaction code sets
• Performed GAP analysis of 4010 and 5010 EDI transaction using implementation guide to identify the changes in the segments and data elements.
• Used mapping tools to map 4010 and 5010 transactions along with ICD 9 and ICD 10 codes, and validated the HIPAA Syntax.
• Designed, analyzed and performed integration and wrote system requirements on FACETS.
• Set claims processing data for different FACETS Module.
• Collect and understood the business requirements for a project, and translating these into functional specifications and detailed test plans
• Create various flow charts using Smart Draw to provide detail outline of various processes.
• Assisted in coordinating projects from developments through implementation.
• Supporting internal and external clients, vendors, consultants and computer specialists.
• Rewrote the business, user, and system requirements to in corporate into the compliance database.
• Participated in final test sessions of various applications.
• Reviewed and analyzed current processes and systems for internal departments
• Additional duties include, data modeling, UML designs, creating and monitoring test plans.