SUMMARY

• Over 6+ years of IT experience in Business Data Analysis, UAT Testing, System Development Life Cycle (SDLC), RDBMS, Project Cycle Management (PCM), Software Validation, Data Modeling, and Decision Support Systems.
• Full life cycle System Development experience including Requirements, Analysis/Design, Development/testing, and Implementation.
• Experience in writing User stories and Epics.
• Participated in the designing test plans, test scripts for software development.
• Familiarity with White - Box and Black-Box testing techniques such as Load Testing, Regression Testing, Unit Testing, System Testing, Quality Center, and Performance Testing.
• Knowledge of Medicare, Medicaid, PPO, POS, diagnostic codes, and claims process.
• Created and analyzed Business Requirement Documents (BRD) and Functional Requirement Documents (FRD).
• Experience in development of Process Flow Diagram, Use Case Diagram, Activity Diagram, and Sequence Diagram by using UML methodology using MS Visio.
• Experience Working on MS Excel VLOOLUPS and PIVOT TABLES.
• Worked on Claims, Customer services, Members, Billing-Enrolment interfaces, and extensions for FACETS as a part of FACETS implementation team
• Expertise in Manual Testing for Web and Client/Server applications on UNIX and Windows Platforms.
• Extensive experience with Business Process Management (BPM).
• Specializing in working with technical staff to create, interpret, and implement business requirements into technical specifications. Excellent understanding of HIPPA standards (4010 and 5010) and HIPPA code sets (ICD-9, ICD -10 and HL7).
• Medical claims experience in process documentation, Analysis, and implementation in 835, 837IPD, 834, 270/271, 276/277, 999/TA1 (X12 Standards) processes of medical claims industry from the provider/payer side.
• Excellent knowledge of Health Insurance Plans (Medicare Part A, B, C, and D) products and procedures managed care concepts (Medicaid and Medicare) and experienced in determining the membership eligibility, billing experience within life and disability in health plans.
• Test Cases of FACETS system upgrade
• Familiar with RDBMS tools like oracle, DB2, IBM Mainframe and MS SQL Server.
• Documentation skills and technical understanding of the BI environment.
• Strong knowledge of and experience with reporting packages (Tableau & Power Bi).
• Very Strong SQL skills (writing queries and verifying data). Solid understanding of databases, data warehouse, Modeling, Business Intelligent tools.
• Goal Oriented Project Management, Business Process Analysis and Modeling, Testing: Planning, Coordination, Execution, Process Re-engineering & Analysis
• Documentation and delivering ODS to EDW (Enterprise Data warehouse) information mapping for ETL Guide.
• Developed test scenarios and implemented test plans for system testing and user acceptance testing (UAT).
• Involved closely with the Developer and Testing team during defect resolution phase

TECHNICAL SKILLS

Project Methodologies: SDLC, Agile, WaterfallBusiness Modelling Tools Microsoft Visio, Rational Rose

Platforms: Windows

Testing tools: HP Quality Center

Change Management Tools: Rational Clear Quest

Office Tools: MS Project, MS Office, MS Visio, MS Power BI.

Database: MS SQL Server, MS Access, and Oracle

Data warehouse: TERADATA

PROFESSIONAL EXPERIENCE

Confidential, Greensboro

Business Analyst

Responsibilities:

• Work on SMS Application and JIRA for Business process management and requirements gathering.
• Work with Project manager and Business stakeholders to document User Stories, Assumption and Acceptance Criteria.
• Attend Project Planning, Daily stand ups, technical requirement meetings, Data meetings and Grooming Sessions.
• Closely working with SOW (Service Order Workflow) team and Microsoft AX team for any dependencies on SMS-application.
• Working on the Production defects as a first line of defense to analyze the defect on the SMS-application and related Scheduler Jobs.
• Creating a new JIRA project for the defects which need a code change or Database updates.
• Resolved around 45 tickets on service now high priority defects which are affecting revenue for Gilbarco.
• Resolved 16 high priority incidents which are impacting $22 million revenue for Gilbarco since the service is being delivered but the payment and invoice was not processed for few customers.
• Working within Team to ensure developers are unambiguous about the Technical requirements.
• Create Impact Analysis report to understand which tables are affected with proposed logic change.
• Created Data Dictionaries and Mapping Documents for the Data Elements.
• Created Mock UI for Data elements following UI/UX standards.
• Created Wireframes, User Interface Design documents, Interface Control document (ICD) on the SMS application workflows.
• Performing analysis on the requirements and clearly defining them in the user stories.
• Defining Acceptance Criteria in Gherkin Format in JIRA user stories.
• Ensuring solutions meet business requirements and Performing user acceptance testing.
• Analyze whether the Data Gap really exists in Database tables, and if no Data Gaps exists, then create user education manual with program/code modification to pull missing data.
• Created Test Plan and Test Case Based on the Business Requirements.
• Executed test cases manually to verify the expected results in SMSTST and SMSUAT environments.
• Involved in creating test cases for regression testing and assist test lead during the testing activities.
• Analyzed the requirement coverage and traceability to ensure the testing coverage.
• Analyzed test cases and defects to ensure the link entities and accuracy of data.
• Works closely with the technical development team to clearly document source elements and ensures standardized values, formats, business rules/algorithms, and data element relationships are understandable to the Gilbarco business.
• Suggest possible logic change and work towards resolution of the data gap one of the other.
• Create System Specification Documents and data dictionaries to locate and specify the actual tables and columns for Developers to make necessary design changes.
• Responsible for the data management and data cleansing activities.
• Responsible to preform analysis and present results using MS SQL, Excel & Power BI.
• Identifying risks, problems, requirements, and concerns in order to comply with source changes byconducting interviews.
• Update mapping spread sheets with suggested Transformation logic changes as a part of Enterprise Documentation process.
• Creating Project related documents and Data dictionaries in SharePoint for the features available in production.

Confidential, Norfolk

Business Analyst

Responsibilities:

• Work on PEGA Application and JIRA for Business process management and requirements gathering in SAFe Agile methodology.
• Work with Product Owner and stakeholders to document User Stories, Assumption and Acceptance Criteria.
• Attend PI Planning, Daily stand ups, technical requirement meetings, Data meetings, API meetings and Sprint Grooming Sessions.
• Closely working with Subject Matter Experts and PEGA developers from Broker, Member and Provider areas.
• Working within Agile Scrum Team to ensure developers are unambiguous about the Technical requirements.
• Create Impact Analysis report to understand which tables are affected with proposed logic change.
• Created Data Dictionaries and Mapping Documents for the Data Elements.
• Created Mock UI for Data elements following UI/UX standards.
• Created Wireframes, User Interface Design documents, Interface Control document (ICD) on the solution central project- Pega application workflows.
• Performing analysis on the requirements and clearly defining them in the user stories.
• Ensuring solutions meet business requirements and Performing user acceptance testing.
• Analyze whether the Data Gap really exists in Database tables, and if no Data Gaps exists, then create user education manual with program/code modification to pull missing data.
• Working on Postman and Swagger API tools to access the APIs required for the new fields on Solution Central PEGA Application.
• Worked on Enterprise Data warehouse (EDW) using TERADATA for data analysis.
• Explore mapping spreadsheets to understand ETL logic to investigate of the rationale of the logic used to data transformation and subsequent load.
• Working with SMEs for State health benefit plans for all the states to create work management structure for the dedicated teams on claims, enrollment and billing, Coordination of benefits, Grievance and appeals and Refund Requests Service requests.
• Suggest possible logic change and work towards resolution of the data gap one of the other.
• Work closely with the BI team to develop member and provider data infrastructure to provide access to information and expand reporting capabilities.
• Worked on Power BI for member enrollment data visualization and different elements involved in both member, provider and broker.
• Create System Specification Documents and data dictionaries to locate and specify the actual tables and columns for Developers to make necessary design changes.
• Responsible for the data management and data cleansing activities.
• Identifying risks, problems, requirements and concerns in order to comply with source changes byconducting interviews.
• Update mapping spread sheets with suggested Transformation logic changes as a part of Enterprise Documentation process.
• Migrating Data dictionaries from SharePoint to Confluence and updating data dictionaries on confluence for the features available in production.

Confidential, OH

Business Analyst

Responsibilities:

• Responsible for requirements analysis, design and developing technical requirements for new revenue recognition accounting systems.
• Converted Business Requirements to the Functional Specification
• Created Use Cases / Activity Diagrams / State Chart Diagrams, Sequence Diagrams thus defining the Data Process Model and Business Process Mode
• Conducted JAD Sessions to develop an architectural solution that the application meets the business requirements, resolve open issues, and change requests. Implemented and monitored Individual Development Plans focusing on total performance, including both quality and productivity
• Created databases, tables, views & schemas. Performed users access authorization, defined locations, populated tables with data and performed unload/copy/replicate data from one database into another after detail analysis and design.
• Worked on Postman and Swagger API tools to access the APIs required for the new fields on ACSS Confidential Billing System.
• Involved in the Database design and application development to support the creation and management of online business units for business users and customers usage.
• Worked on Enterprise Data warehouse (EDW) using TERADATA for data analysis.
• Designed and developed Power BI graphical and visualization solutions with business requirement documents and plans for creating interactive dashboards.
• Generated ad-hoc reports in Excel Power Pivot and sheared them using Power BI to the decision makers for strategic planning.
• Utilized Power Query in Power BI to Pivot and Un-pivot the data model for data cleansing and data massaging.
• Mapped the source and target databases by studying the specifications and analyzing the required transforms and documented the purpose of mapping so as to facilitate the personnel to understand the process and in corporate the changes as and when necessary.
• Involved in discussion with the Subject Matter Experts (SME) during creation of test plans for opening balance historical conversion data, go-forward data processing including future application change requests, revenue accounting automation modeling, reconciliation reporting and error handling controls.
• Performed Data Validation using VLOOKPUP and PIVOT TABLES in EXCEL with Open Balance Sheet Dec 2017 of Confidential wireless contracts.
• Developed and executed SQL to extract and validate Backend data as well as perform data validationsthrough the key stages of data processing.
• Involved in Confidential wireless customer Contract Life cycle Management and Billing cycle management.
• Gathered and analyzed CRM requirements across departments and management stakeholders.
• Presented and discussed needs and solution options to management including visual layouts of the CRM reports that meets manager’s requirements.
• Created Test Plan and Test Case Based on the Business Requirements.
• Validating the complex test cases to ensure correct ASC606 financial contract construction and accurate journal entry creation.
• Performing high level test scenarios to validate contracts and contract assembly tables are populated correctly.
• Performing Sample based validation on each test case to ensure business requirements are met.
• Creating and performing SQL queries on contracts billing data and to perform validations.
• To implement, support, and manage business process that span the company and various systems such as CRM (NetSuite), reporting tools and ACSS application.
• Responsible for tracking testing progress and defects using Jira, ALM and Quality Center.
• Performed Strong System Integration Testing using Oracle.
• System testing to validate complex test cases to ensure correct ASC606 financial contract construction and accurate journal entry creation
• Had an extensive knowledge on customer equipment and billing transactional data in Automated Customer Support System (ACSS).
• Involved in fixing the bugs and keeping a track of all the defects in Jira and ALM/QC.
• Involved in the testing of web portal of Confidential New Billing system (ACSS).
• Performed Back-end Testing using PL/SQL for Database Validation.
• Performed Manual Testing using ALM (Application Lifecycle Management) and User Acceptance Testing (UAT).

Confidential, CO

Business Analyst

Responsibilities:

• Responsible for developing in-house application comparing data from different sources i.e., EDI, XML and FACETS.
• Perform system requirements gathering and analysis; interview the subject matter experts, stakeholders, and executive sponsors.
• Interact with the business analysts & business users for design & requirement clarification for external projects & change requests.
• Gather requirements for different products and do the gap analysis for the products.
• Gather requirements and prepare business requirement documents (BRD), System Requirement Documents. Responsible for translating BRD into functional specifications and test plans. Closely coordinate with both business users and developers for arriving at a mutually acceptable solution.
• Conduct JAD sessions to define the project and to reduce the time frame required to complete deliverables.
• Constantly interact with the Product Director for enhancements and discussion on the changes.
• Work on EDI X12 transactions, HIPAA standard transaction codes including 837, 834, 835, 270, 271, 276, 277 and perform analysis of such transactions.
• Designed and wrote anomaly testing procedures for new web-based developments and services; resulted in more accurate, streamlined, and accurate testing of products
• Involved in fixing the bugs and keeping a track of all the defects.
• Extensively worked on PEGA tool to update the status of the project in order to be able to meet the internal audit.
• Performed data analysis and data profiling using complex SQL on various sources systems
• Documented the User Acceptance Testing (UAT) Plan for the project and worked with the UAT Team to ensure every acceptance-criteria for the requirements had been included in the UAT task plan for Pega Applications.
• Responsible for Database testing using SQL queries
• Written complex SQL queries for validating the data against different kinds of reports generated by Business Objects
• Wrote use cases for the Escalation & Reconciliation Management System (ERMS) Pega Application to include adding Billing Errors Application to the Applied Suspends and Dual Enrollment Applications SDS. Have knowledge of Capitation, Medicare, Vendors, Billing & Enrollment, ID Cards, Claims processing and Automated Renewals process.
• Document all the changes for the enhancements and recommended changes.
• Analyze the current state and recommended changes for the future state of the products.
• Prepare and Reporting test cases for requirements
• Participate in analyzing business requirements, Data Model Design, Data flow from various Sources to Target.
• Develop Business Process diagram to understand the whole workflow.
• Use TOAD to execute all SQL queries.
• Analyze system requirements and develop detailed Test Plan for System Testing.
• Facilitate the requirement changes and fixes along with the release management team.

Environment: FACETS, ALM, Oracle SQL, SQL Server 2008, MS Access, MS Outlook, Sharepoint, MS Visio, JAVA, MS Word, MS Excel, WebEx.

Confidential, Baton Rouge, LA

Business Analyst

RESPONSIBILITIES:

• Analyzed and collected business requirements identified system interfaces and created the system requirements specification documents.
• Identified Use Cases from the requirements. Created UML Diagrams including Use Cases, Activity/State Charts, Sequence and diagrams, Data Flow Diagrams and ER Diagrams using Rational Rose and MS-Visio thus defining the Business Process Model and Data Process Model.
• Conducted JAD session with different stakeholders while developing user interface and web services.
• Performed requirement analysis by gathering both functional and nonfunctional requirements based on interactions with the users, stakeholders, document analysis, user interviews, and documented those requirements in the BRD.
• Performed data mining on Claims data using very complex SQL queries and discovered Health care claims pattern.
• Performed Quality Assurance testing on a web-based applications and mainframe
• Involved in 837 (I, P, D), 834, 835, 820, transactions.
• Analyzed the member/eligibility information on claim to that in Facets.
• Created test plans and detailed test cases for web tests to be performed
• Consistently utilized MS-Project for planning and project tracking purposes.
• Involved in understanding of department workflows and process flows with respect to applications.
• Developed Test plans and mapped them to Requirements with QA team.
• Gathered requirements through interactions, meetings, and periodic walkthrough with SME’s.
• Developed and updated Requirements Traceability Matrix (RTM) using Rational Rose, mapped the developed Test Cases to the requirements to ensure that the requirements were fully tested and implemented according to the specifications.
• Performed Usability testing and Validation testing on the browser created and on the final application developed.
• Evaluated and tested the new and modified software application to verify that programs function according to both technical and business requirements.
• Developed, executed, and validated user acceptance test plans (UAT) and implementation support.
• Performed GAP Analysis to figure out what we have and what we ought to have, to be better-off.
• Developed project schedules, conducted project status meetings, and managed resources during all phases of the SDLC.
• Created and maintained the Requirements Traceability Matrix (RTM).
• Interacted with Developers and Users in resolving risk factors and other issues.

Environment: MS Visio, SQL, Java, Oracle, SQL, PL/SQL, Load Runner, MS Project, MS Office, MS Visio.

Confidential, Philadelphia, PA

Business Analyst

RESPONSIBILITIES:

• Performed a project analysis on new projects, including requirements, personnel, and costs.
• Involved in gathering clinical data and supported application development. Data includes patient’s admission status, discharge details and transfers. Also tested claims and diagnosis reports of the patient.
• Provided reports and other documentation on projects to client and internal staffs, as needed.
• Worked with team leaders and supervisors to ensure project and organizational deadlines are met.
• Coordinated updates with client's staff and implement efficiencies in documentation maintenance.
• Extracted and maintainedSASdata sets from the raw data created by the data management group.
• Involved in 835 files validations for HIX at Claim level, Line level, Service level and Transaction level.
• Extensively involved in Batch interfaces andMMISbatch jobs in setting up, running, and debugging job runs.
• Identified/documented data sources and transformation rules required populating and maintaining data warehouse content. Tested and delivered Inbound/Outbound FACETS interfaces.
• Organized and conducted extensive JAD sessions with users to identify and understand requirements.
• Extensively used SQL queries and procedures for data validation in both source system and target system.
• Responsible for doing the gap analysis for the interfacing system.
• Documented the System Requirement Document, Business Requirements Document (BRD) and the Functional Specification Document (FSD).
• Reviewed various customer transactions using theFACETSapplication.
• Coordinated with the different teams distributed at different geographic locations for various releases.
• Identified Actors, Activities, Artifacts, and Workflows and developed use case diagrams using MS Visio.
• Worked on FACETS to terminate or reinstate health coverage for the subscriber.
• Implemented automated COB processing of Medicare claims into Facets
• Handled the queries regarding XML and troubleshoot problems.
• Developed UAT test cases associated with the functional requirements.
• Participated in developing test plan, test scripts, and test scenarios and designed user documentation.
• CreateData Flow diagramsandUser Interface designs.
• Performed with data modeling and defining the conceptual and logical model of the data warehouse.
• Developed detailedTest plan, Test Cases, Test scriptsfor testing the functionality, GUI,andsecurity testing.
• Managed the entire UAT set up & UAT testingeffort with the Business users.
• ConductedUser Acceptance Testing (UAT)and verifying performance, reliability, and fault tolerance issues.
• Participated in weekly status meetings to present status and in corporate any digressions from the original scope.
• Carried out a thorough target organization assessment and risk analysis.
• Analyzed the“As is”and“To be”system documents to show the current and proposed functionalities of the system using MS Visio.
• Worked with the clients on the final signing process in the User Acceptance stages.

Environment: Windows, UNIX, Oracle,Requisite Pro, MS Visio, HIX,Facets,SQL, XML, MS Office, Visio.