SUMMARY

• An accomplished Business Analyst with strong acumen towards business and 8+yrs. of progressive experience in the areas of Application Development, System Redesign, Implementation of end - to-end SDLC Projects.
• SDLC: In depth strong working knowledge of theSoftware Development Life Cycle (SDLC) phases such as Planning, Analysis/Design, Development, and Testing for the software/system development process
• Experience with Medicare, Medicaid, and commercial insurances in HIPAA ANSI X12 formats to third part vendor applications including NEIC, SSI, ESI, Bluecross, Medicare, and several others.
• Experience in Software Development Life Cycle (SDLC)-Waterfall, V-Model, Prototype 89and Spiral model. Knowledge of reporting tools (Cognos, Crystal Reports & Microsoft Reporting Services).
• Experience with developing HIPAA Companion Guides for 834 Enrollments, 270/271 Eligibility Inquiry/Response & 820 - Health Plan premium payments for MMIS (Texas, Maryland, Illinois and Virginia).
• Methodically implemented Rational Unified Process procedures for all phases of a project
• Proficient in Rational Enterprise Suite including Rational Unified Process, Rational Rose and Requisite Pro. Excellent skills in Data Analysis, Requirement Analysis, Business Modeling and Use Case development using UML methodology.
• Experience with health care Systems: FACETS
• Initiated requirements gathering, prepared the Software Requirement Specifications (SRS) document and used Rational Requisite Pro to maintain the requirements.
• Prepared graphical depictions of Use Cases and Analytical Diagrams including State Diagrams, Activity Diagrams, Sequence Diagrams, Class Diagrams and Collateral Diagrams including Business Workflow using Rational Rose.
• Conducted Joint Application Development (JAD) sessions with end-users, expert and quality assurance teams for project meetings.
• Worked individually, as well as in a team environment to achieve project quality goals.
• Outstanding organizational skills including ability to multi-task, prioritize, and manage increasingly complex issues.
• Experienced with Health Care domain clients.
• Efficient in MS Project for planning and status reporting.
• Experienced in developing functional specs through JAD sessions and user interviews.
• Expertise in developing Use Case Diagrams and creating Use Case Specification document (USD).
• Actively involved in developing, executing and managing User Acceptance Testing (UAT).
• Highly proficient in working in agile methodology with users, SMEs, data stewards and stakeholders to elicit, analyze, communicate and validate requirements using JAD and Brainstorming sessions, identify Functional, Non-Functional, and Business Rules, and then subsequently model them to meet SLAs.
• Proficient in creating process maps and writing User Stories, Pre-conditions and Acceptance criteria.
• Strong business domain knowledge of Healthcare across different lines of business.
• Extensive experience documenting Business Requirement Documents (BRD) and Functional Requirement Specifications (FRS).
• Proficient in analyzing and creating Use Cases and Use Case Diagrams using MS Visio and Draw IO.
• Gathered User and business requirements through interviews, surveys, prototyping and observing Stored and modified requirements in JIRA.
• Experience in functional testing, unit testing, integration testing, regression testing and GUI testing.
• Multi-Tasking and Organizational Aptitudes, with proven experience in Development and Implementation of Strategies.
• Advanced knowledge of MS Office (Word, Excel, Pivot table, Visio, Power Point, Outlook, Project) for analysis, presentation and documentation throughout the projects.
• Excellent communicationandinterpersonal skills. Exceptional mediator between external and internal customers, capable of interpreting their needs and positions to ensure the success of the projects.
• Very well versed in technical writing,documentation, presentationand delivery.
• Proficient in creating Process maps and writing User Stories, Pre-conditions and Acceptance criteria.
• Strong interpersonal, written, and verbal communicator who can deliver effective presentations, consult on technology projects, and maintain collaborative relationships.
• Comprehensive knowledge about SCRUM through organizing/attending Scrum Meetings, Release Planning, Testing planning, Sprint Planning, Backlog Grooming, and Retrospective meetings during Waterfall and Agile projects.
• Excellent conceptual and technical skills to create Business Requirements Document, Functional Specifications Document, Process Flow Diagram, and Detailed Design Document.
• Work as an liaison between client (Business), solution providers (vendors) and internal development teams to understand the system integrations and to ensure the successful implementation of system.
• Experience in coordinating with solution architects and developers to find out the multiple possible solutions that can feed project & business needs.
• Document user stories by working closely with stakeholders and SME’s and maintain it throughout the whole cycle.
• Create and maintain product backlog after each sprint delivery.
• Participate in UAT and system integration testing in collaboration with QA and Business system teams to accurately test the solution after each sprint delivery.
• Working in Agile / Scrum environment as well as using waterfall methodology based on the client & project needs.

TECHNICAL SKILLS

Methodologies: Agile Scrum, Iterative, Waterfall, Waterfall-Agile Scrum Hybrid

Operating Systems: Windows XP, Vista, 7, 8, Mac OS X, UNIX, Linux

GUI Tools: MS Office, Google suite, Lotus Notes, HP PPM, HP SM9

Programming: HTML, SQL

DLP Tools: CA Data Protection, CA iconsole

Visualization Tools: MS Visio, Rational ROSE, Mock-up screens

Content Management Tools: Sharepoint, Confluence, MS Visio

Domains: Healthcare, Human Capital, Finance, GRC

Methodology Tools: VersionOne, JIRA, Rally, TFS, Bugzilla, Rational Clear Quest

Testing/Defect Management Tools: HP ALM/QC

PROFESSIONAL EXPERIENCE

Confidential

Business Analyst

Responsibilities:

• Study the previous state BRD to get the maximum inputs in order to create User story points.
• Create play book points to discuss scope of the project with stack holders.
• Schedule and conduct meeting to discuss scope confirmation along with IT team, QA team and all the stack holders.
• Write user stories on the basis of feedback received in scope confirmation meeting and post it Jira board.
• Coordinate with Product owner for validating user stories and make necessary changes.
• Communicate with Scrum master and leads to report him overall progress of the project.
• Communicate with Business Architecture team to get the missing information required to write effective user stories.
• Schedule meeting with IT team to validate the user stories to verify within project scope.
• Schedule and conduct back log grooming sessions with IT team, QA team, Product Owners and Business.
• Facilitate the team to get the required information from the Business and help them to assign story points for each user stories.
• Coordinate with development team to help them for smoothen their process flow.
• Interact with Business team and provide them report on overall performance of the project and any questions and concerns, pain points if any.
• Assist QA team to get the required clarifications from the business.
• Assist in deployment of the system.

Confidential, Durham, NC

Enterprise Sr Business Analyst

Responsibilities:

• Gather the requirements from the Business Owner SME.
• Document the requirements categorized into Regulatory Operational in the Business Requirement Document BRD.
• Facilitate numerous meetings for the creation of design documents, gathering requirements from the users, Business Owners Project Managers.
• Use key Scrum metrics (burndown, velocity) to help deliver committed work.
• Track and communicate team velocity and other development metrics with, and to all affected teams and management.
• Experienced working in an Agile Scrum environment
• Gather requirements, perform UAT testing and implemented.
• Develop reports and analyze data to measure clinical outcomes, network performance, and methodology levers.
• Coordinate SAS algorithm development projects of varying complexity.
• Analyzed on Facets 5.0 Versions.
• Create and communicate the prototype requirements to the development team in Excel formats as templates for the reports.
• Assign tasks to the project development team, monitoring, and tracking process of the project.
• Responsible for configuration/ compatibility and BA testing with the help of Facets, SharePoint, and Tidal scheduler.
• Perform research on Member, Provider, Claims, Authorization, Appeals, and Grievances data from Facets back end and front-end application system for reporting purposes.
• Acquire signoffs at the beginning and end of each process from the Project sponsors and Stakeholders.
• Perform UAT with the Business Owners, respectively.
• Conducted JAD sessions with various SMEs and users to analyze and discuss project scope, to identify the business flows and determine whether the new development efforts impact any current or proposed systems.
• Responsible for maintaining the change notification request document and communicating with the developers and stakeholders in each iteration review meetings.
• Create and managed requirement types and traceability relationships.
• Interacted with the Stakeholders, End Users to understand and gather stakeholder requirements and create the Business Requirements Document BRD and Functional Requirement Document FRD and communicating it to the entire team involved.
• Conducted Gap Analysis to check the compatibility of the existing system infrastructure with the new Business Requirements.
• Communicate with the business owners to identify clinical and operational reporting metric requirements.
• Documented the Traceability Matrix for tracing the Test Cases and requirements related to them.
• Provided input (scope, goals, risks, constraints, timeline, and interfaces) to PM for project planning and control.
• Followed a systematic approach to eliciting, organizing, and documenting requirements of the system.
• Worked closely with QA and Developers to clarify/understand functionality, resolve the issue, and provided feedback to nail down bugs.
• Developed Test Cases for unit testing, prepared spreadsheet for testing criteria, including regression, positive and negative testing, process flow testing, and screenshot for test results to complete expected and actual results.

Environment: FACETS 5.01, HIPAA 4010/5010, EDI 837, 270, 271, Quality Center, JIRA, MS Visio, Word, Excel, PowerPoint, SQL, and .NET.

Confidential, Dallas, TX

Quality Analyst

Responsibilities:

• Validating the requirements and creating mapping specifications based on functional requirement specifications.
• Performing thorough smoke, functional, Integration and regression testing when bugs are resolved.
• Proficient in identifying, recording, documenting, tracking bugs thoroughly.
• Review requirements, specifications and technical design documents to provide timely and meaningful feedback.
• Estimating, prioritizing, planning and coordinating testing activities.
• Participated in requirements gathering meetings, provided assessments based on the requirements, which include testing estimates.
• Creating detailed, comprehensive and well-structured test plans and test cases at program level and presenting to team and QA program lead.
• Create and execute SQL queries for validation purpose.
• In Agile environment, attended daily standup meetings, reviewed user stories.
• Taken Initiative to organize the regression status and issues for the builds released every fortnight.
• Tracked the Defects, Maintaining Test Cases and Requirements using ALM.
• Also involved to create test case scenarios and validate end to end testing in validation environments.
• Attending Scrum meetings for tracking development process and perform thorough regression testing when bugs are resolved.
• Responsibilities include designing and implementing tests, debugging and defining corrective actions
• Involved end to end testing of Billing, Claim Processing and Subscriber/Member module.
• Involved in the testing of claims module and claims adjudication process.
• Wrote test cases, implemented ran and added versions and iterations using test manager for positive, negative and end-end test cases.
• Performed compliance testing on 837 and 835 EDI transactions.
• Wrote test cases and validate them against functional specifications.

Environment: Windows 2010, Jira, UAT, MSSQL, SQL,MS word, Ms Visio, MSExcel

Confidential, Charlotte, NC

Business Analyst

Responsibilities:

• Involved in the Collection of loan proposals and ensuring they are processed accordingly and verifying the accuracy, thoroughness of the loan application along with other related documents
• Involved in testing all the data elements in Mortgage Account Inquiry Service, which is called to obtain Mortgage loan data from MSP
• Review and validate MSP system reports and calculation of remittances
• Worked with MSP to distribute the tasks and keep track of status.
• Performed the as-is and to-be analysis. Interacted with front office to gather requirements and acted as the liaison between IT and business departments.
• Went through product specifications and project charter to understand the product better, surf through the product proof of concept and created user’s manual and training manual using RoboHelp and Frame Maker
• Interacting with the stakeholders to get a better understanding of client business processes and gathered and documented the business requirements specific to the Loan origination system project.
• Conducted a comprehensive use case analysis to determine key abstractions such as loan underwriting, loan-closed, borrowers-info, mortgage-payments and their mapping to the standard analysis mechanism to enable maximum reuse.
• Using Agile SDLC, I organized and facilitated daily scrum meetings, Sprints planning meeting and sprint review meeting.
• Identified, analyzed, defined and documented business processes and Use Case Scenarios.
• Conducted joint interactive sessions with the team to decide the new enhancements and project change requests to be included in new releases.
• Created high level functional requirements and broke them down into User Stories. Also created Functional Requirement Documents, conducted analysis and prioritized requirements.
• Responsible to track, document, manage and communicate the requirements using Rational Requisite Pro which helped in controlling artifacts produced by teams who are working on the same projects by keeping track of simultaneous updates and change notifications.
• Performed Root Cause Analysis of the requirements to identify the key business risk areas for the project and prioritized the application development and testing.
• Maintained a requirement repository for tracing requirements to test cases and solutions.
• Played a key role in planning the UAT, and implementation of system enhancements and data migration and conversions.
• Participated in the bug review meetings. Updated requirement document as per business user feedback and changes in functionality of the application.
• Translated business requirements and user expectations into detailed specifications employing Unified Modeling Language (UML) using MS Visio.
• Designed and implemented basic SQL queries for QA testing and report/data validation.
• Reviewed Test Cases with QA to make sure all application defects were resolved.

Environment: SCRUM - Agile methodologies, Waterfall, User Experience Design (UXD), Personas, MS Office (Excel, Visio, Project), TeamCenter PLM, HP Quality Center,Ms Projects & Visio

Confidential, Eden Prairie, MN

Business Analyst

Responsibilities:

• Involved in claims submission and payment (remittance) retrievals by using ASC x12N 834 for the Inbound Enrollment and Maintenance; ASCX12 276/277 for the claim’s status inquiry and response; and ASC X12 835 (Explanation of Benefits) for the healthcare claim payments.
• Prepared the Business Requirement Document (BRD) and Functional Requirement Document (FRD) for the enhancement of the existing services.
• Created Reports on clinical data exchange for payment between providers and payers.
• Conducted daily SCRUM meetings during the Sprint Development as a part of Agile Methodology. Also captured and addressed concerns from IT to Product Management or Business Team as needed.
• Excellent knowledge of HIPAA standards, EDI (Electronic data interchange) Transaction syntax like ANSI X12, Implementation and Knowledge of HIPAA 5010 code sets, ICD-9, ICD 10 coding, and HL7.
• Manage and facilitate simultaneous end-to-end Electronic Health Record (EHR) integrations by on-boarding new clinical requests through implementation, which ultimately go-live receiving electronic toxicology reporting services.
• Successfully used Agile/Scrum Method for gathering requirements and facilitated user stores workshop.
• Analyzed Clinical Quality Measures under the Meaningful Use EHR Incentive Program of the Centers for Medicare and Medicaid Services (CMS).
• Medical Claims experience in Process Documentation, Analysis, and Implementation in 835/837/834/270/271/277 (X12 Standards) processes of Medical Claims Industry from the Provider/Payer side.
• Was involved in entering the bugs inJIRA
• Performed Data Mapping to map the EDI 834 data to XML.
• Resolve Affordable care act customer’s premium and coverage disputes through analysis of CMS and payer data.
• Analysis and Design of existing transaction sets and modification of these transaction set to ensure HIPAA compliance.
• Requirements Gathering & Analysis to ensure HIPAA Compliance Auditing.
• Creating user stories and maintaining and tracking them using JIRA.
• Responsible for attaining HIPAA EDI validation from Medicare, Medicaid, and other payers of government carriers.
• Ensured system configuration and functionality adheres to HIPAA 5010, Medicare, Medicaid other market-specific regulations, and business rules.
• Tracking the bugs and Stories status using JIRA.
• Performing business analysis, software validation and testing for client/server, multi-tier and web-based applications for EMR and commercial business for managed healthcare plans and Industries

Environment: Windows XP Professional, MS Access, MS Excel, DB2, JIRA, UML, Agile, Rational Clear Quest, MS Office suite, MS Visio.