SUMMARY

• Overall 8+ years of experience as a Business Analyst, knowledge of Domain expertise in Finance & Health care insurance and Retail Ecommerce, CRM, Media &Telecom Billing.
• Excellent understanding of Agile methodology, Involved in analyzing risk metrics, risk Issues, and risk reporting and also experience in agile methodology (created Product Backlog, Sprint Backlog and managed User stories). Participated in sprint planning, daily scrums, testing, retrospectives and sprint reviews.
• Strong regulation knowledge of both HIPAA 5010 transaction set and ICD - 10 initiatives. Excel at handling multiple projects simultaneously within stringent time frame/budgetary constraints, schedule resources and monitor project activities.
• Professional experience managing enterprise implementations of healthcare information and EMR systems.
• Delivering quality healthcare depends on capturing accurate and timely medical data (EMR), Medical coding professionals fulfill this need as key players in the healthcare workplace.
• Experience in medical claims examining, medical claims processing, medical collection, business administration, relationship management, and customer service.
• Ability to create and design information architectures, wireframes, using users-centric design techniques. Strong ability to identify Risk and develop change strategies, establish cultural change and monitor efficacy of changes.
• Very good in Process engineering, Reverse engineering, Change Management and Production support.
• Effective problem solving, facilitation, collaboration, negotiation and influencing skills.
• Designing the test plan and conduct unit testing, regression testing, and stress testing.
• Strong knowledge of Databases, Microsoft SharePoint, Microsoft Project Server, SAP BI/BO.
• Well versed with all document management standards including quality standard on ISO 9002 and process improvement on CMMI.
• Excellent understanding of SDLC (Software Development Life Cycle) having work experience on methodologies including Spiral, Agile (Scrum) and Waterfall Model.
• Effectively deliver change strategies, build relationships, inspire stakeholder engagement, train staff and encourage cultural change at different operational levels. Strong ability to provide robust leadership during times of change and transition.
• Good knowledge of HIPAA (Health Insurance Portability and Accountability Act) transaction codes such as 270/271 (inquire/response health care benefits), 276/277 (claim status), 470 (benefit codes), 835 (payment or remittance advice), 837 (health care claim) and 834 (benefit enrollment).
• Well versed with HIPAA, Facets, claim adjustments, claim processing from point of entry to finalizing, claim review, identifying claims processing problems, their source and providing corresponding solutions.
• Mastery of core Business Analysis competencies and corresponding skills with experience in working with variety of stakeholders using structured techniques for Requirement Planning, Elicitation and Analysis, Gap analysis, Feasibility study, Solution Proposal, Assessment and Validation, Process Mapping, Risk Analysis, Mitigation and Impact Analysis.
• Extensive experience with key deliverable for a project such as Business Case document, Solution Proposal Presentations, Requirement Specification document (RSD), Functional Specifications Document (FSD), Interface Design and Specifications, Test plans and scenarios for QA and UAT that in corporate business rules to provide flexible & pragmatic software solutions.
• Solid business communications and presentation skills. Adept at creating and coordinating extensive communication networks facilitation of joint application design (JAD) sessions. Management of detailed project plans to provide Business and Technical consultation to PM. Well versed with Project Management Knowledge areas and tools.
• Experience with management consulting in the areas of Change Management. Participate in professional development, training, workshops and project management knowledge areas and maintain awareness of new technologies.

TECHNICAL SKILLS

Methodologies: Rational Unified Process (RUP), Rapid Application Development (RAD), Agile, Navigator Iterative Framework (NIF), Capability Maturity Model Integration (CMMI), Extreme Programming (XP), Waterfall Development, Object Oriented Analysis & Design (OOAD)

Object / Business Modeling Notations and Tools: Unified Modeling Language (UML and UML 2), Entity Relationship (ER) Model Rational Rose, MS-Visio, TIBCO Business Studio, Smart Draw, Sparx Enterprise Architect:

Business Process Management: Six Sigma, Tibco iProcess Suite

Documentation Tools: Rational Requisite Pro, Clear Quest, MS Project, Word, Excel, PowerPoint, SharePoint, Testing Tools Mercury Win Runner, Load Runner, Quality Center, Test Director, Quick Test Pro (QTP), Rational Functional Tester, Test Manager, and Clear Case

Operating System: Windows, Mac, UNIX (Sun Solaris and AIX), Linux, DOS

Languages: C, C++, C#, Java, HTML/DHTML, PHP, XML, Max Plus, Prolog, LISP, OpenGL, Mat lab

Database and ETL: MySQL, PL/SQL, TOAD, MS-SQL, MS Access, Oracle, Apache, Tomcat, Domino, IBM DB2, Informatica, Pervasive Data Integrator, Integration Manager

Internet and Design Tools: Dream Weaver, Flash, Photoshop, Live Meeting, MS FrontPage, SnagIT

Reporting Tools: Crystal Report, True Information, Business Object

Enterprise Incentive Management Tools: Callidus Software - True Comp, True Analytics

Tools: Apogee (Insurity), TiVA, Charles River IMS

PROFESSIONAL EXPERIENCE

Confidential, OH

Sr.Business Analyst

Responsibilities:

• To support the LRI suite of applications which comprise the Corporate and Treasury LOB functions. This role involves both the BA and people management aspect of moderate to highly complex projects.
• Co-ordinate with Project Managers, businesses and Application Engineering team to develop and deliver technology/products strategies and plans.
• I follow an extremely light and efficient agile process, adapted to be most easily applied, and with that you may pursue and at any time change a project plan; and others, battle-proven, easy and fast, to prioritize among projects and manage a program in an agile manner. Also methods of convincing stakeholders and winning them over.
• Participated in Sprint Planning, Daily Scrum Stand Up, and Sprint Retrospective meetings.
• Participated in the development and grooming of Project Backlog Stories (Requirements) with business and technology partners.
• Assisted in closing gaps and TARs for associated Stories in each individual Sprint. Assisted in entering and updating Issues (Epics, Stories, and Tasks) onto JIRA Agile application. Assisted in the development of Project Impact and Process Control Plan documents. Assisted in testing associated Sprint Stories for Acceptance Signoff, using Archer RSA (Configuration Management System).
• Assist in development of requirements strategy, direction, scope and priorities in partnership with the business and technology teams.
• Assist in defining plans through a rigorous process of defining business requirements and project specifications
• Assist Manager in project planning, and task assignment with clear roles, milestones, budgets and measures of success.
• Conduct project meetings (virtual and in-person), communicating with project team members in business and technology organizations.
• Act as a key point of contact for applications in scope. Maintain contacts with source business and technical team and clients. Coordinate and report on project progress
• Partner with the businesses and Application Engineering team and other Business Delivery teams
• Facilitate resolution and communication of cross-organization decisions, standards, risks and issues.
• Developed detailed Business Requirements and functional specifications.
• Facilitates requirements and design sessions with both LOB and IT Community, Capture business requirements at a level that can be used to create function requirements with complete traceability.
• Support additional off hour activities; implementations, production issues on average of 3-4 times per month.
• Contributes to continuous improvement and proactively supports knowledge sharing within the team and across Technology.
• Contributes to continuous improvement and proactively supports knowledge sharing within the team and across Technology.
• Application support acting as L2/L3 subject matter expert to a global team of full time and contingent employees supporting all system and user generated events across both FID and Equities CapitalMarkets.
• Work together with Source data and LISA validation as per ICD Layout structure, and also provided test data to all the testers including SIT/UAT Business Edge team and UI testing team.
• Worked together with the development team and the Project Coordination Team to ensure client satisfaction.

Confidential, MA

Business System Analyst

Responsibilities:

• Did requirement gathering and analysis throughJADsession and interview. Worked withUse-Cases, sequence diagram, activity diagram andmaintained them inRequisite-ProandRational Rose. Assisted in closing gaps and TARs for associated Stories in each individual Sprint.
• Assisted in entering and updating Issues (Epics, Stories, and Tasks) onto JIRA Agile application. Assisted in the development of Project Impact and Process Control Plan documents.
• Analyze the legacy system and worked on Phase II, where it support the ICD-10 engagements, evaluations of ICD-10 points of contact. Analyze the impacted different agencies functional areas and external partners as related to assessment, remediation and implementation of the ICD-10 initiative.
• Analyze, identify impacts, issues and drive solutions for the ICD-10 initiative. Conducted impact analysis of technology changes on business processes and existing technology.
• ImplementedTraceability Matrix and User Requirement Specification Document (URS)verified the functionality coverage and maintained the traceability matrix in Mercury Quality Center.
• Worked with IT teams to design/document IT processes, data models and data migration processes.
• Worked withHIPPAcompliance5010and EDI transaction set 270/271/276/277/997.
• Worked on Medical Billing837(I/P), UB04, CMS 1500in compliance withHIPAA 5010.
• Developed detailed plans involving the update and conversion to various internal tables, extensions, back end technical considerations and internal and external interfaces for the client.
• Developed gap analysis and risk assessments for theFACETSupgrade project including effects on internally developed extensions and third party software for pricing and contract configuration.
• Worked on customizing the claim module ofFACETSfor reprising Nursing home claims.
• Worked directly with CMS and client business units to insure compliance with CMS guidelines and regulations as they apply to current Medicare offerings of the plan. Managed the creation and submission of 4Rx, COB, COB-C, RAPS and Accretion-Deletion data.
• PerformedDefect TrackingandChange Control ProceduresusingRational Clear Quest, andConfiguration ManagementandVersion Controlusing Rational Clear Case.
• Involved in the peek review ofTest Plans, Test Caseswith theQA teamto verify implementation of new features and enhancements.
• Have extensive knowledge with implementation and configuration withALL scripts EMR.

Confidential - NY

Business System Analyst

Responsibilities:

• Translated business requirements into functional requirements and approaches for developers.
• Used rational Rose to create UML diagrams, translate high level requirements into technical requirements using use case, activity, sequence, class and component diagrams
• Provided management support to the off-shore End to End integration/ Regression Test Team.
• Workflow documentation and comprehensive training to the healthcare clients.
• Analyzed corporate healthcare business processes to develop customized solutions.
• Facilitate daily scrum, sprint planning and sprint retrospectives meeting
• Identify and remove obstacles that will keep the team from achieving their goals
• Support the product owner in maintaining the product backlog and scheduling next release
• Ensured effective implementation of agile process
• Responsible for architecting integrated HIPAA, Medicare solutions, Facets.
• Was involved in managing the Daily Standup meetings and also ensured that quality standards were enforced as per the build-release schedule.
• Was involved in managing the Daily Standup meetings and also ensured that quality standards were enforced as per the build-release schedule.
• Developed a detailed test plan and test cases to cover all the requirements.
• Analyzed data architecture, documented and delivered data mapping, performed risk analysis.
• Frequently communicated with developers to resolve technical issues.

Confidential, NY

Business Analyst

Responsibilities:

• Utilized RUP to configure and develop process, standards and procedures.
• Interfaced with business users to prepare and update Business Process Requirements for the new release of Healthcare tools.
• Perform software analysis and design for ICD-10 Coding Simulator, and bringing legacy product functionality to current solutions
• Prioritized outstanding defects and systems problems, ensuring accuracy and deadlines were met.
• Worked with the management for improving and giving new ideas for designing future processes of the HIPPA transactions dealing out with EDI’S 271, 276 and 270, 470, 835, 837, 834, HIPAA 4010, 5010, claim adjustments, claim processing from point of entry to finalizing, claim review, identifying claims processing problems, their source and providing alternative solutions using best practice model and principles and also well versed with ICD10, Facets.
• Performed GAP analysis of business rules, business and system flows, user administration and requirements.
• Set up new /follow-up patient accounts. Accurately apply payments to patient accounts.
• Post and reconcile insurance and patient payments. Research and resolve incorrect payments, and other issues with outstanding accounts.
• Interact with insurance companies and biller for claim process and work out.
• Insure accuracy of insurance claims. Verify correct ICD-9, CPT codes and E-MODIFIERS codes for a variety of specialties.
• Set-up practice management software for submission of electronic claims to clearinghouse. Work with clearinghouse to resolve file compatibility issues
• Monthly processing of Patient statements. Answer and resolve patient billing inquires
• Follow up on Insurance and patient aging. Re-submit insurance claims as necessary. Knowledgeable in timely filing restrictions
• Follow software methods of modeling techniques UML; Create visual models using set of graphic notations using MS Visio.
• Documents the steps or activities of a process flow or work flow using swim lanes.
• Developed, Implemented and managed system, such as preventive and predictive maintenance to improve efficiencies and reduce operation expenses.
• Responsible for assessing the overall organizational units affected by the change management system
• Identify Risks on healthcare reforms and develop risk plans and document.
• Responsible for implementing strategies for corrective action to achieve full organizational adoption to change. Coordinate with project teams to support them to integrate the projects with change management initiatives undertaken by the organization
• Handle the tasks of overseeing the development and operation of change management methodologies and procedures to guide the adoption process.
• Very much involve in UAT and production support.

Confidential, NY

Sr. Business Analyst

Responsibilities:

• To drive internal portal adoption across multiple organizations. Perform analysis and identify gaps on impact processes.
• Create user stories to assist with the development of a new Global Seed Field Management system that provides support to commercial and parent seed production for all crops worldwide. Integrate key seed field information such as estimated inventory, actual harvested inventory, and associated seed field cost into SAP/R3 systems.
• Guide the development teams to break down large and complex user stories into simplified versions for execution. Test the user stories for accuracy and compliance to ensure undisputed acceptance and validation of stories
• Coordinate project initiatives with software developers, stakeholders, project managers and software testers.
• Responsible for translating BRD into functional specification document (FSD), to coordinate with both business users and developers for arriving at a mutual acceptable solution.
• Conduct JAD sessions to define the project and to reduce the time frame required to complete the deliverables.
• Introduced agile methods to this slipping project and produced the first working version of the product three weeks.
• Utilizes available personnel and computer system resources to analyze, design, and modify information, applications, methods, systems, and procedures related to e-commerce to determine the most useful solutions for the company.
• Used MS-Project to prepare schedules, and deliverables and track the project timelines etc.
• SQL reporting at the various phases of the project life cycle to fulfill client’s requirement of data needs.
• Responsible for PL / SQL Scripting and integrating scripts with application for Customized reports.
• Writing Release rollout documentation as part of the deliverable to the client on rollout as well as knowledge base for inside use.
• Handle the tasks of ensuring that the Pre-UAT activity is performed accurately and efficiently. Handle the tasks of identifying defects and perform root cause analysis by analyzing data quality issues
• Created Change Management Plan. Outlined timing of specific impacts. Itemized Change Management issues and created a comprehensive Change Management plan.

Confidential

Business Analyst/Co- Lead

Responsibilities:

• Developed, implemented and documented software development processes.
• Configured and administered Version One as the team's agile management tool.
• Provided Version One training to the software development team and business stakeholders.
• Developed the product backlog along with Product Owners
• Participated in sprint planning, daily scrums, testing, retrospectives and sprint reviews.
• Facilitated "three amigos" work sessions between developers, product owners and business analysts.
• To drive internal portal adoption across multiple organizations. Perform analysis and identify gaps on impact processes
• Define plan / approach on Change management. Hold regular forum to update senior leadership team / communication update to stakeholder.
• Communicated and interacted on a regular basis with the stakeholders and technical team.
• Ensure that all the artifacts are in compliance with corporate SDLC policies and guidelines.
• Prepared business requirement document (BRD) and converted into functional specification document using requirement management tool.
• Create UML techniques and graphic notation diagrams such as Structured and Behavior Diagrams.
• Designs DFD's, ERD's and web page mock ups using modeling tools.
• Prepared business Process Models that depicted modeling of all the activities of the business from the conceptual to procedural level.
• Used Prototypes to demonstrate and verify the behavior of the system. Monitor and control the project work and resources activities. Strategically negotiate with vendors to secure cost effectiveness services.
• Define project team training programs to ensure the quality of the project.
• Document quality management plan, schedule management and cost management plan & user manual.
• Define communication protocol and document communication management plan.
• Provide technical and procedural support for User Acceptance Testing (UAT).
• Responsible for UAT project planning like creating testing scenario, test plans, and test scripts.