SUMMARY

• 6 years of professional experience as Business Analyst with expertise in Software Development Life Cycle (SDLC) and implementation of business applications.
• Expertise in Software Development Life Cycle (SDLC) process, use cases and Rational Unified Process (RUP).
• Experience in interviewing Business users & subject matter expert providing recommendations to resolve issues for various business/technical groups & defining strategic solutions.
• Experience in Analysis & Design (Use Case, Sequence and Activity diagrams).
• Expertise in documentation: BRD (Business Requirement Document), FRD (Functional Requirement Document) and Non - functional Requirement Document.
• Test Case writing (manual/automated test cases) and Conducting Tests (Integration testing, Regression testing), Black Box/White Box testing, UAT (user acceptance tests).
• Writing Manuals (System guides, training material for business users and Deployment guides).
• Effectively conducted Joint Application Development (JAD) sessions with users, stake holders and system analyst.
• User training on the changes being released and conducting post production activities like getting feedback from users. In case of any issues - doing root cause analysis, prioritizing tasks with business users.
• Experience with data analysis and data mapping.
• Well versed in translating business requirements and user expectations into detailed specifications employing Unified Modeling Language (UML) diagrams using MS Visio and Rational Rose.
• Good knowledge and extensively used Oracle, SQL, T-SQL and PL/SQL.
• Experience with HIPAA compliance and Healthcare systems.
• Good knowledge on different modules within healthcare (Membership, billing, enrollment, claims, capitation, providers).
• Experience providing primary analysis for business processes running on theEDI (Electronic Data Interchange)standard.
• Experience handling HIPAA ANSI X12 (270/271, 834, 835, 837, 276/277), ICD9/10, NDC, DRG codes.
• Experience with health care Systems: FACETS, Medicare Part A, B, C, D and Medicaid systems.

TECHNICAL SKILLS

Process Methodology / Modeling Tool: SDLC, RUP, AGILE & Prototype modeling. Rational Rose/Requisite Pro, Clear Case, Clear Quest, Quality Center & Test Director

Databases: MS Access, MS SQL Server, Oracle

Languages: .NET, JAVA, VBA, UML & HTML

Operating systems: Unix/Solaris, Linux & Windows, Mainframe

Office tools: MS Office 2007+, Word, Excel, Power Point, Visio

Project management: MS Project 2007+

PROFESSIONAL EXPERIENCE

Confidential, NY

Environment: SQL Server Management Studio version 10.50.2500 , FACETS 4.4 & 4.7, Agile, .NET, MS Office Tools, MS Visio,Lotus,Windows XP, UML, Mercury Quality Center.

Responsibilities:

• Worked with a cross functional and diverse team of business users and developers to enable accurate communication of requirements and ensure consensus.
• Analyzed data and created reports using SQL queries for all issued Action Items.
• Performed the Gap Analysis to find the existing gap between the HIPAA 4010 and HIPAA 5010 EDI transactions.
• Developed Data Mapping and Crosswalk documents.
• Involved in preparing several Use Cases, Business Process Flows, and Activity Diagrams using Microsoft Visio.
• Worked on requirements of the 835 HIPPA projects, 276/277, 278, 837, and HIPAA EDI Transactions across enterprise.
• Tested the ANSI X12 Version 4010 / EDI transactions (HIPAA) like 270, 271, 276, 277 P, 837I, 837D, 835 remittances)
• Wrote Test scenarios and test cases for testing the migration of EDI and the processing of member enrollment and benefits, batch jobs corresponding to the claims (837) and real time transactions like 270/271/276/277.
• Worked with multiple teams and coordinated with them to do various releases.
• Did gap analysis for HIPAA P and 835 transactions and HIPAA P and 835 transactions.
• Involved in impact analysis of transaction sets on different systems.
• Re-engineering and capturing of EDI transactions with legacy systems.
• Performed Migration and Validation per SDLC standards.
• Interacted with the Test Team and reviewed Test Plans and Cases.
• Assisted in Regression Test, System Test, and UAT.
• Worked with the business/functional unit to assist in the development, documentation, and analysis of functional and technical requirements within FACETS.
• Co-ordination of front-end changes in multiple development and testing environments.
• Reviewed Test Strategy and Test Plans to ensure that they reflect and include all functional, Performance, Usability and Security requirements.
• Clarified QA team issues and reviewed test plans and test scripts developed by development team and QA team to make sure all requirements have been covered in scripts and tested properly.
• Used MS SQL Manager Studio 2005 to query the MS SQL database.
• Effectively communicated user acceptance test results between users and development team and provided recommendations for change control requests (CCR).

Confidential

Business Analyst

Environment: Facets 3.1, DB2, Agile, Requisite Pro, SQL, Share point, .NET, MS Access, MS Visio, MS Project, MS Word, MS Excel, Ms Power Point, Clear Case, Clear Quest, Quality Center.

Responsibilities:

• Gathered documents regarding HIPAA compliance, Local County and state compliance regulations.
• Developed and maintained additional payer adaptability in the.
• Designed UAT test scenarios and wrote corresponding scripts after following through each test condition.
• Performed Scalability, Performance and Load Testing using Load Runner (System Analysis, Creating Virtual User Scripts, Defining User Behavior, Running Load Test Scenario, Monitoring the Performance, Analyzing Results).
• Prepared Business requirement document (BRD) using Rational RequisitePro.
• Tracked and maintained stakeholder requested enhancements and changes using Rational RequisitePro.
• Created use cases after accessing the scope and status of the project and understanding the business processes from USER perspective.
• Conducted preliminary Gap analysis based on user requirements.
• Prepared cost and time estimates for all stages in the project life cycle.
• Coordinated with end-user or for UAT testing over several cycles and oversaw sign-off.
• Recommended and ensured appropriate training available for end users.
• Assisted Project Leads in all phases of the Project to review project deliverables for completeness, quality and compliance.
• Created Requirement Specification Documents after conducting Interviews with End Users for the purpose of creating and defining the business and functional requirement documents. Worked in Agile Environment.

Confidential, NJ

Business Analyst

Environment: MS Office Tools, Windows XP, Oracle, SQL, Rational Clear Quest, Rational Clear Case, ERWIN, Requisite pro, Microsoft Visio, COBOL, C++, FACETS.

Responsibilities:

• Understanding business requirements for Medicare Part D file required for CMS (Risk Management, RAPS and suspect management).
• Defined Business Process that aligned with Company goals and existing HIPAA regulation to communicate with CMS Programmatically from Amisys system.
• Created Project Charter to clearly define the scope, objectives of the project to the stakeholders.
• Responsibilities spanned through all phase of the project life cycle from inception through post-implementation.
• Conducted one-to-one interviews and group meetings with the Subject Matter Experts (SME’s) to gather the business requirements.
• Created Entity Relationship diagram (ERD’s) and process flow using UML and Microsoft Visio to clearly communicate the business requirements.
• Translated the business needs, wants and objectives into requirement and created Business Requirement Document (BRD) and Functional Requirements Specification (FRD) using RequisitePro.
• Prepared Test Data for the UAT as per the specifications of the FRD.
• Developed Requirements Traceability Matrix (RTM) to track requirements against test cases during the QA Phase.
• Facilitated formal defect review meetings with project teams and developers to report, demonstrate, prioritized and suggest resolution of issues discovered during testing
• Performed risk analysis of the requirements to identify key business areas for the project.
• Played a key role in the planning, testing, and implementation of system enhancements and conversions.
• Trained non-technical Business Analyst in presentation, process analysis, and data modeling.

Confidential, Arlington, VA

Business Analyst

Environment: Rational Rose, Rational Requisite Pro, RUP, Test Director, MSOffice, UML.

Responsibilities:

• Gathered requirements and documented Use Cases for the applications that used SSN and DOB as unique identifiers.
• Created Requirements Document for all the affected processes due to the truncation of the SSN and DOB fields of the Claimants' Information.
• Created new application and introduced the On-line Referral System for the Customer Sales Representatives.
• Responsible for handling new conversions for the company so that Claims can be matched and Billing records should not create mismatched records despite belonging to the same patient.
• Analyzed Business Requirements, developing tracking and enhancing them into functional requirements using Rational Requisite Pro as a requirements tool.
• Assisted User Acceptance Testing (UAT) - Carried out UAT activities associated with each project and presented the results to the Business Stakeholders.
• Successfully conducted JAD sessions which helped synchronize the different stakeholders on their objectives and helped the developers to have a clear cut picture of the project.
• Documented Business Requirements using Rational Requisite Pro for the application.