Summary:

• Qualified professional with over Seven years of extensive experience in the field of Business Analysis, working with the technical staff to implement management and staff's business requirements into the software application in Healthcare Industry.
• Combined experience in Software Development Life Cycle and Business / System Analysis: experienced in gathering user requirements, documenting requirements, technical writing, business analysis, system analysis, testing, and implementation of projects.
• Extensive experience with Object Oriented Analysis and Design using UML, Rational Unified Process RUP , Waterfall life cycle, Traditional model, and V model.
• Well versed in developing Use Case Diagrams in UML, Use Case documenting using MS Word.
• Very well experienced using Microsoft Office Suite Word, Excel, Access, and PowerPoint.
• Conversant in a broad range of technologies and tools, including business process tools such as ERwin, Rational Rose, MS Visio, Data Analysis and Data Modeling.
• Highly skilled in creating, writing, and executing Test Cases, Test Scripts from Business User Requirement documents and Functional Design Documents.
• Experienced in performing functional tests at various stages of SDLC using manual testing and automated testing tools from Mercury Interactive such as TestDirector, WinRunner, LoadRunner, and Rational Tools such as Rational TestManager.
• Expert in eliciting and gathering requirements, conducting meetings, JAD sessions and performing User Acceptance Testing with stakeholders and end users.
• Strong background and superior understanding of concepts in planning, designing and management of software implementations throughout the software development life cycle.
• Worked in various environments like Windows NT / XP, UNIX, and Tandem.
• Good working knowledge of Claims processing, HIPAA Regulations and 270, 837P, 837I, 837D EDI Transactions for health care industries.
• Ability to handle pressure and meet deadlines coordinating multiple tasks in project environment.
• Team player and a self-starter with excellent communications skills, and interpersonal skills with exceptional ability to build productive relationships with colleagues, clients, and vendors across all functional and technical disciplines.

TECHNICAL SKILLS:

PROFESSIONAL EXPERIENCE:

Confidential

Sr. Business Analyst

• Description: The Pennsylvania Department of Health has been promoting the health and well being of Pennsylvania citizens since 1905. Involved in projects related to HIPAA Policies Procedures Privacy and Security as a systems analyst.
• The project was to work on the Medicare and Medicaid population to achieve HIPAA compliance. This involved analysis of the population bases and working with SMEs to analyze the business requirements in order to make the system HIPAA compliant.

Responsibilities:

• Conducted weekly meetings for deciding the Policies and Procedures to be followed while constructing new sites.
• Performed the requirement analysis, impact analysis and documented the requirements using Rational Requisite Pro.
• Assisting in NIST 800-53 Implementation Plan activities, including development/update and implementation of agency-specific security policies, procedures, and training according to federal and agency requirements
• Analyzed system performance and initiated process improvement measures for mainframe and Web-based applications.
• Conducted Requirements walk- through with the Business Team to ensure that all their needs are met and gathered sign off on the requirements for SOX compliance after the requirements were base lined.
• Built business requirements into the Medicare Advantage MA requirements database and created the Project Requirements Document for the three functional areas.
• Generated test data using X12 generator for transactions 837P/I/D.Conducted Gap Analysis to identify the gaps in the system and regulate the changes.
• Analyzed results and EDI ANSI X12 file mapping and reported on standard analysis spreadsheet.
• Reviewed EDI companion guides for all payers to ensure compliance, edit integrity and maintain up-to-date list of payer contacts.
• Conducted analysis of HIPAA compliance and took part in discussions for designing the healthcare transactions to be HIPAA 5010 compliant.
• Acted as a liaison between client and payer/intermediary. Experienced in payer rules, requirements, governmental regulations and HIPAA compliance.
• Interacted with claims payment and enrollment to review, analyze and document business processes.
• Worked with HIPAA 270,271,835,837 transactions. Performed validation of 270,271,835 and 837 Professional and Institutional format files according to EDIFECS engine.
• Generated test cases in Claims Analyzer Editor Professional to ensure unification with CPT-4 and ICD-9 codes
• Involved in jobs and analyzing scope of application, defining relationship within between groups of data, Star Schema etc
• Created use case scenarios and documented workflow and business process using Rational Rose
• Created Use cases, activity report, logical components and deployment views to extract business process flows and workflows involved in the project. Carried out defect tracking using Clear Quest
• Been a part of Architecture and modeling team and have used SOA Service Oriented Architecture
• Used Query Analyzer, Execution Plan to optimize SQL Queries.
• Meticulously assessed data from various sources and generated conceptual and logical database designs using ERwin data modeling tool.
• Assisted Project Teams in preparing Software Requirement Specifications SRS , User Interface Design, designing of Application Architecture Database Modeling.
• Analyzed trading partner specifications and created EDI mapping guidelines
• Documented the Traceability Matrix for tracing the Test Cases and requirements related to them.
• Developed Data Conversion Strategy for converting data from the existing site to the new site.
• Designed and developed project document templates based on SDLC methodology

Environment: Windows 2000/XP, Microsoft Office SharePoint 2007, MS Office, SQL Server, Agile, MS Project, MS FrontPage 2003, MS Access, WGS, STAR, EDI, Documentum 2.0., Rational Clear Quest, Rational Clear Case, Rational Requisite Pro, Rational Rose, UML,RUP, Microsoft Excel, Microsoft Word, Microsoft Power Point, Visio.

Confidential

Business Analyst

Member of team that supports the financial portion of the claim payment System for the state of PA Medicaid program. Facilitate meetings with state of PA Medicaid representatives to determine requirements for changes to the financial portion of the claim system that pays over 100 million dollars a week in Medicaid claims. Involved in development of claim management data warehouse to assist claim professionals to analyze and administer the claims in an efficient manner. The operational data came from multiple sources and was then loaded into claim management data warehouse.

Responsibilities:

• Worked closely with the Enterprise Data Warehouse team and Business Intelligence Architecture team to understand repository objects that support the business requirement and process.
• Identified source systems, their connectivity, related tables and fields and ensure data suitably for mapping.
• Created workflow development, designed new process flows and documented the Business Process and various Business Scenarios and activities of the Business from the conceptual to procedural level.
• Performed extensive data modelling to differentiate between the OLTP and Data Warehouse data models
• Gathered requirements and helped design the GUI using IRise
• Involved in creating automated Test Scripts representing various Transactions, Documenting the Load Testing Process and Methodology. Created meaningful reports for analysis and integrated the Performance Testing in the SDLC.
• Apply UML notations and methodology in developing models that accurately represent the business process reengineering and workflows and clearly communicate them to the stakeholders.
• Prepared Logical Data Models that contains set of diagrams and supporting documents containing the essential business elements, detailed definitions, and descriptions of the Entity relationships between the data elements to analyze and document business data requirements.
• Designed and developed, Use Cases, Activity Diagrams, Sequence Diagrams, Visio and Business Process Modeling
• Assumed ownership of Use Case Diagrams, Use Case narratives and other various artifacts.
• Relieved pressure off the PM by maintaining artifacts and portions of the project binder.
• Worked extensively with the QA team for designing Test Plan and Test Cases for the User Acceptance Testing.
• Conducted Gap Analysis, and Gathered User Requirements by Interviews, user meeting, JAD session, and Requirement Elicitation Sessions.
• Developed business case, objectives, cost analysis and budget for implementation clinical and financial business systems.
• Assisted the PM in setting realistic project expectations and in evaluating the impact of changes on the project plans accordingly and conducted project related presentations.
• Assisted with user testing of systems, developing and maintaining quality procedures, and ensuring that appropriate documentation is in place.
• Conducted User Acceptance Testing UAT .
• Functioned as the primary liaison between the business line, operations, and the technical areas throughout the project life cycle.
• Performed task decomposition, delegated tasks and monitored project milestones using MS Project.

Environment: Ascential DataStage 7.5, Designer, Director, Manager, Parallel Extender Debugger, DataStage BASIC language Expressions, SQL Server, Visual Basic, Windows NT 4.0, Sybase, UNIX, Oracle 8i, PL/SQL, IBM DB2, Dbase3, Erwin, MS Word, MS PowerPoint, MS Access, MS Visio, XML Files, GIS Tools, MVS, IMS.

Confidential

Business Analyst

The Scope of the project is about claim processing and accumulator display in FACETS. The accumulator display application allows health plans to indicate, by product, the specific deductible and/or limit accumulators in the FACETS database that will display when users access accumulator information via FACETS. The EDI gateway from FACETS will route 5010 transaction during the conversion period for small group

Responsibilities:

• Gathered functional and non-functional requirements in collaboration with end clients and internal project managers as well as SME s .
• Created detailed business scenarios and writing master use cases which covered step by step process of interaction between user and system.
• Designed granular Visio diagrams to show the flow of events for the benefit of offshore developers.
• Created wireframes using Prototype software based on collaboration with use cases and Visio flows.
• Designed detailed storyboards based on the client template.
• Tracked the project progress and made sure that everything was going to be done on time by creating various trackers and keeping it updated, based on daily agile stand up meetings.
• Identified system's bugs and deficiencies by doing production clean up and data fixing.
• Conducted GAP analysis to find out what needs to be done for the next step
• Communicated with the project's PMO to make sure all deliverable are consistent with the clients' templates and expectations.
• Analyzed client's data and information by using their templates and tools and translate them to various requirements and use cases as well as wireframes to be used by offshore developers
• Reviewed the clients' comments and feedbacks for each deliverables and try to resubmit the documents on time and get them signed off.
• Assigned action items within each JAD sessions and war rooms and following up with the client to get the right response.
• Worked on membership and enrollment Using 834, 270 and 271 and scenarios such as Initial Enrollment, Re-Enrollment, Termination, Reinstatement, and Pre-enrollment.
• Created 834 transactions for implementation guide
• Worked on both Member and Plan Enrollments.
• Worked on 837 Institutional, Dental, and Professional , 835, 270/271, 276/277 EDI Transactions
• Documented interface requirements for ANSI X12 /EDI Version of 5010 transaction
• Queried the IMS/DB2 database in Mainframe for the proper validation of the claims into the Database.

Environment: Doors, Wireframes, ALM/ Quality center, JIRA, facets, Oracle, XML, MS office, Excel,

MS Project, SQL, Microsoft Visio, MS Visio

Confidential

Business System Analyst

Headquartered in San Francisco, Union Bank of California UBOC is the third largest bank in California with over 36 billion in assets, 245 banking offices in California, and 15 international facilities.

Responsibilities:

• Involved in Source Data Analysis, analysis and designing mappings for data extraction also responsible for Design and Development of SSIS Packages to load the Data from various Databases and Files.
• Gathered and documented business requirements for existing and future business systems.
• Acted as a liaison between business staff and technical staff to articulate needs, issues and concerns.
• Data modeling and design of data warehouse and data marts in star schema methodology with confirmed and granular dimensions and FACT tables. Used the DataStage Designer to develop processes for extracting, cleansing, transforms, integrating and loading data into data warehouse database.
• Conducted project review meetings and gathered Business Requirement Documents BRD .
• Managed Scope and change throughout the SDLC process of the product.
• Performed extensive data modelling to differentiate between the OLTP and Data Warehouse data models
• Created different artifacts such as Business Requirements Documents BRD , Functional Requirement Document FRD , Use Cases and Traceability Matrix
• Designed, developed and implemented a concurrent processing scheme for checkpointing and restart/recovery. This involved the partitioning of certain application dependent Mainframe DB2 tables.
• Created Data Stage jobs to extract, transform and load data into data warehouses from various sources like relational databases, application systems, temp tables, flat files etc.
• Designed and developed use cases, activity diagrams, and sequence diagrams using UML.
• Converted various SQL statements into stored procedures thereby reducing the Number of database accesses.
• Involved, both technically and administratively, with a project that converted the banks on-line teller system from an IBM mainframe based system to a client/server system.
• Used Query Analyzer, Execution Plan to optimize SQL Queries
• Ensured that all Lines of Business specifications were consistent in form and function to the Diamond Base System. Worked closely with the Enterprise Data Warehouse team and Business Intelligence Architecture team to understand repository objects that support the business requirement and process.
• Ensured that project requirements are properly tracked and documented.
• Used MS-Visio for flow-charting, Use- Case process model and architectural design of the application.
• The tests also included GUI testing: Testing for validation and display of screens

Environment: Microsoft Office 2003 Professional Outlook, Word, Excel, Visio, Access, etc. , Microsoft SharePoint 2003,UML, RUP, UAT, db2, Mercury Test Director, SQL, .NET, Clear Case

Confidential

Business Systems Analyst

Currently involved the development and certification projects of teller assist terminals for Diebold, NCR, Hyosung, and Wincor. Acted as IT liaison to development and business groups. Worked with IT developers to ensure user requirements are met. Provide guidance to programmers. Provide production support for ATM acquiring and transaction processing provided this support in all roles at First Data . Played an integral role in major ATM conversions and projects for PNC Bank, National City Bank, Key Corp, Citizen Bank, Bank of the West and others provided this support in all roles at First Data . Developed vendor relationships with multiple vendor partners including Diebold, NCR, Hyosung, Wincor, Triton and others over the past 26 years . Provide research and technical analysis for new product offerings and product road maps over the past 26 years .

Role Achievements:

• Interacted with users for verifying User Requirements, managing Change Control Process, updating existing Documentation. Performed Gap Analysis to check the compatibility of the existing system infrastructure with the new system requirements.
• Develop IST and UAT plans and test cases for deposit processing, IVR, ATM, bill pay and teller applications.
• Develop and maintain sales reporting using in MS Excel queries, SQL in Teradata, and MS Access. Assigned tasks among development team monitored and tracked progress of project following agile methodology.
• Delivered BRD, CR documents, UML diagrams as required to the development team on and off-shore.
• Gathered requirements and modeled the data warehouse and the underlying transactional database. Measured performance of the As-Is process and collected metrics such as defect resolution rate and cycle time.
• Prepared Business Requirement Documents BRD's after the collection of Functional Requirements from System Users that provided appropriate scope of work for technical team to develop prototype, Use Cases, UML diagrams for overall system.
• Created system use case, functional FRS and technical specifications for trading system.
• Extensively involved in the modelling and development of Reporting Data Warehousing System.
• Analyzed marketing programs and results using all applicable technology solutions to maximize ROI and to help the E-Commerce department meet its overarching goals of increasing sales, acquiring new customers, driving repeat site usage and increasing web site registrations.
• Co-mentored team with PM in establishing war room environment and agile tasking approach. Developed templates, procedures, design documents including Database Structure and Created/ maintained Data Dictionary.
• Design BRD, TSD, Process flows, and Testing/UAT documentation for a Migration of software in a company that was obtained by Stewart.
• Supported PMO by mentoring specific projects in application of the new SDLC based on the Agile Unified Process, especially from the project management, requirements and architecture perspectives.
• Functioned as the primary liaison between the business line, operations, and the technical areas throughout the project cycle.
• Establish documentation for agile methodology for implementation with a very water-fall-centric development team.
• Adept at performing all teller and cash handling activities, including the facilitation of deposits, withdrawals, traveler's checks, money orders, cashier's checks, and loan/mortgage payments.
• Used Test Director and Mercury Quality Center for updating the status of all the Test Cases Test Scripts that are executed during testing process. Worked on Documentum for Version Controlling, to maintain up to date changes in the Documents.
• Assisted to develop the Test Plan, Test Cases and Test Scenarios to be used in testing based on System Requirements, technical specifications and/or product knowledge.
• Conducted User Acceptance Testing, gathered and documented User Manuals and System Rules

Environment: Microsoft Office Suite, Microsoft Visio, MS project, SQL Server, Documentum, RUP,SDLC, SAS, UML, Test Director, LoadRunner.