Professional Summary

• Enthusiastic and innovative Business Analyst with over 6 years of experience as a Business Analyst with good understanding of Business Requirement gathering, Business Process flow, Business Process Modeling, Data Analysis, Data Mapping and Business Analysis for various industries like Insurance, II Services and Finance.
• Sound knowledge of Software Development Life Cycle SDLC methodologies like Agile, Waterfall, RUPand JAD models. Having thorough understanding of various phases like requirement gathering, gap analysis, design, development, documentation and Testing.
• Adequate knowledge in Health Administration Claims processing auto adjudication , COB, EOB/Drafts, Claims pricing and testing, HIPAA, enrollment, EDI, Medicare, Medicaid, CDHP consumer driven health plans , Banking and Finance.
• Proficient in Technical and Business Writing, Business Process Flow, Business Process Modeling, Business Analysis and Testing.
• Proficient in Business Reengineering, Business and Functional Analysis, Systems Analysis and Design, Quality Assurance, Gap Analysis, Impact Analysis, Use Case Analysis and Design.
• Strong business acumen, strategic thinking, communication, interpersonal and presentation skills, adept at creating, editing, and coordinating extensive communication networks facilitation of joint application development JAD sessions and interviews etc. and resolving issues and conflicts.
• Extensive experience in managing and documenting business requirements BRD , communicating effectively with senior management, developers users.
• Good in understanding Reports of Spotfire and validating and checking data through Tibco Spotfire.
• Skillful at creating and transforming BRD into functional requirements FRS , and designing business models using system / process flow charts using MS Visio, Rational, RTM template other tools.
• Strong experience in conducting UAT and documentation of test cases and test scripts, besides integrated testing.
• Familiar with HIPAA EDI transactions such as 835, 837 P, D, I 276, 277, 278 etc
• Expertise of UML in visualizing and documenting the artifacts using Use Cases Diagrams, Activity diagrams, Data Flow Diagrams, Business Flow Diagrams, Sequence Diagrams using MS Visio.
• Excellent facilitation skills in conducting walkthroughs, surveys, questionnaires, interviews, brainstorming sessions.
• Project Management skills include maintaining Project plan, defining Project Scope, Business Process Analysis, Business Process Re-engineering, Risk and Issue management, Change management, maintain and resolve issues throughout project lifecycle.
• Experience in conducting User Acceptance Testing UAT , SWOT analysis, Cost benefit analysis and ROI analysis
• Exceptional problem solving and sound decision-making capabilities, coupled with excellent communication and interpersonal skills. Good track record for meeting deadlines and submitting deliverables on time.
• Adept at reducing development costs and providing traceability of projects.
• Team player with strong client facing abilities, presentation, written and verbal interpersonal communication skills. Besides, ability to work in a team environment, including user interaction.

SKILL SET

PROFESSIONAL EXPERIENCE

Confidential

Role: Business Analyst

Confidential multinational information technology corporation headquartered in Confidential. It provides hardware, software and services to consumers, small- and medium-sized businesses SMBs and large enterprises, including customers in the government, health and education sectors.Confidential is actively participating and involved to produce an enhanced MMIS Medicaid Management Information System that can be utilized in the delivery process for new business. This project involved facilitating and working with the Ohio State of Medicaid project team and Consultants on supporting the development of business process workflows, use cases, logical data models, functional and non-functional technical, implementation and performance requirements and organization design, provide facilitation and work collaboratively with business unit policy, program and service delivery process owners and subject matter experts through-out the project's life cycle. The role focuses primarily on business requirements, workflows, requirements and leveraging technology to enable and redesign business processes and practices to improve the coordination of the State's operations and access, quality, outcome and cost of services.

Responsibilities

• Facilitated the process for arriving at a common understanding and agreement on the organizational work models for information exchange to strengthen decision support, and developing a new approach to integrated eligibility as a foundation for defining key business requirements.
• Participated in multi-organizational, multi-disciplinary teams to determine, articulate, and document workflows, use cases, logical data models, and functional business and non-functional technical, implementation, performance requirements.
• Good understanding in processing of Medicare and Medicaid eligible claims.
• Working on different area of expertise in Medicaid domain related to various subsystems involving Professional, Dental and Encounter claims.
• Good understanding of CMS 416 Form submission for each fiscal year.
• Key role in conducting JAD session with the State and writing detailed requirements.Performed the requirement analysis, impact analysis and documented the requirements.
• Followed a systematic approach to eliciting, organizing, and documenting requirements of the system.
• Interacted with client and the Technical Team for requirement gathering and translation of Business Requirement to Technical specifications.
• Conducted interviews, meetings and JAD sessions during the process of Requirement Gathering.
• Performed the requirement analysis, impact analysis and documented the requirements.
• Prepared Functional Design Specifications FDS employing Use case scenarios, sequence diagrams and class diagrams.
• Prepared Report using SQL Server Reporting Services SSRS
• Planned and documented procedures for data processing and prepared data flow diagrams for the application.
• Analyzed and translated business requirements into system specifications utilizing UML.
• Collaborated with other team members to work on different Change Orders.
• Communicating the business requirements to the Development and Testing teams for a successful deliverable.
• Writing Test Scenarios and helping in Test execution in Quality Center.
• Documented the Traceability Matrix for tracing the Test Cases and requirements related to them.
• Prepared Demo on SharePoint for various businesses to get new approvals.
• Designed workflows and allocated permissions within SharePoint.
• Participated in User Acceptance testing and documented detailed results.
• Provided input scope, goals, risks, constraints, timelines and interfaces to PM for project planning and control.

Confidential

Role: Business Analyst

Confidential of insurance and financial services companies in theConfidential. The company also has operations in Confidential The group's main business is Confidential, a mutual insurance firm that also owns the other State Farm companies. The corporate headquarters are in Bloomington, Illinois.Provided support for the State Farm MMIS system. Responsible for the development of requirements analysis and systems design documentation, for the Third Party Liability Subsystem, Medicare Part D Billing/ Payments System. Served as a liaison between the State and the Technical Support Group, conducted meetings, and created detail specifications for areas of the subsystem related to TPL and HIPAA, and performed model office and system testing. In addition, worked with the conversion team on creating the source to target mappings and testing the conversion results.My primary role on this project was working on conversion of ICD-9 CM and PCS codes to ICD-10 Clinical Modification and Procedure Coding System codes and conversion of all EDI HIPAA X12N-4010 transactions to HIPAA X12N-5010 version and prepare necessary supporting mapping/crosswalk documents as part of project.

Responsibilities

• Involved in full system Development Life Cycle of the project.
• Studied business requirements and conduced User Interviews to identify and document the data discrepancies and their sources as related to Government Contract Compliance GCC , Government Disclosures, Government Pricing, Customers, Products, Product pricing.
• Prepared Test Plans for each release, written Test Cases and executed them as part of Functional Testing. Prepared Test Reports and Deliverables and submitted for version releases.
• Performed In-Depth analysis of systems and business processes of Medicare Part D as per CMS rules and procedures.
• Responsibility included modifications to a customer's mainframe system to support new product features or regulatory requirements and, in some cases, involved a system upgrade
• Converted Business Requirements to the Functional Specification and Conducted JAD Sessions to develop an architectural solution that the application meets the business requirements, resolve open issues, and change requests.
• Enhanced test cases using GUI checkpoints, Database Checkpoints, Text checkpoints and Bitmap checkpoints
• Involved in preparing the Automation Design document, identifying the test cases to be automated for Regression Testing using QTP.
• Performed Functionality testing during the various phases of the application and analyzed the results using QTP.
• Created VB test scripts for functional and regression testing using QTP.
• Experience with recovery scenario in QTP.
• Inserted Check Points to check the broken Links, Text, and standard properties of objects using QTP
• Performed data driven testing and parameterization using QTP.
• Involved in creating output values using QTP.
• Worked with the vendor CompasSoft and Prodiance in understanding the COTS architecture and mapped the requirements to the tool specifications.
• Involved in the scope defining process of ICD 9-10 conversion.
• Worked with in the areas of Clinical, Corporate and Finance, Pharmacy, Sales, Provider Network and identified the use of ICD 9 codes and prepared documents for the conversion of ICD 9-10 and vice versa.
• Gathered requirements and developed Use Cases by interacting with different Functional Groups for ICD 9-10 Conversion.
• Used gap analysis framework to identify AS-IS processes of claims transactions of HIPAA X12 4010/4010A standard and TO-BE processes ICD-10-CM and ICD-10-PCS compliance requirements of 5010 standard
• Involved in creating sample mappings for the conversion of EDI X12 transactions code sets version 4010 to 5010 and translation of ICD 9 codes into ICD 10 codes.
• Performed impact analysis for deadliness of ICD-10 conversion.
• Assist coders to be competent in using ICD-10-CMS/PCS
• Created Functional Specification Documents for the Agency and Membership system
• Reviewed EDI companion guides for all payers to ensure compliance, edit integrity and maintain up-to-date list of payer contacts.
• Excellent knowledge in Component-based Development CBD and Commercial Off-the-shelf COTS .
• Assess and evaluate potential COTS applications that meet the desired functionalities of an optimal Desktop AND Server Management system to meet the needs of remote software deployment
• Collaborated with various Operational Groups and Development Teams to put together a concrete Business Case to support the initiative to acquire a COTS solution.
• Wrote use cases, prepared use case diagrams using Rational Rose UML and followed Agile at every stage of the processes
• Developed the business crosswalks for 837 P, I, D , 835, 834 and 276/277 according to HIPAA implementation rules
• Responsible for customer interface, requirements definition, general and detailed design, testing, maintenance and training programs and managed requirements using Rational Requisite Pro
• Conducted analysis of HIPAA compliance and took part in discussions for designing the healthcare transactions to be HIPAA 5010 compliant
• Analyzed the impact of new HIPAA standards on targeted systems, processes, and business-associate relationships
• Identify Member, Provider, Coverage, Medicare, and Medicaid
• Provider inquiry about the status of claims. This involved checking the MMIS claims subsystem to see the status of claims sent and informing the providers if the claims have been suspended / denied or paid.
• Played key role in defining test automation procedure and standards, creating Win Runner and QuickTestProfessional scripts for all the modules, which reduced the regression cycle drastically and improved the testing efforts for daily builds.
• Created automated Load test scripts using Load Runner.
• Conducted GUI and functionality testing using QTP.
• Responsible for Lotus Notes Server installation, configuration and troubleshooting on the UNIX Server.
• Documented Requirements for Management Reporting out of Clear Quest using Crystal Reports.
• Worked on Client/Server tools like SQL Server Management Studio to administer SQL Server.
• Data mapping, logical data modeling, created class diagrams and ER diagrams and used SQL queries to filter data within the Oracle database.
• Conducting requirement sessions and successfully translating of those requirements into Use Cases and GUI wireframes.
• Planned and defined system requirements to Wire Frames with Use Case, Use Case Scenario and Use Case Narrative using the UML Unified Modeling Language methodologies.
• Managing overall testing process and project to production change management life-cycle.
• 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.
• Designed workflows and allocated permissions within SharePoint.
• Involved in setting up different configuration environment for compatibility testing and manual testing.
• Used MS Sharepoint for the purpose of managing documents and for hosting websites which was used to access shared work spaces and documents.
• Evaluated testing results for each potential release build using Test Director, Quality Center and Bugzilla reports, listing summarized bug information in priority sequence, recommended viability of release for production.

Role: Business Analyst

Confidential insurance company is one of the health insurers in the Confidential. A web application was reengineered to make it compliant with the EDI standards. Integration of this web application with the third party administrators applications TPA was achieved. The developed application is complaint with the HIPAA standards.

Responsibilities:

• Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Medicaid Claims.
• Upgraded the existing Test Scripts and created new scripts for client application to be able to work for new versions and patches, which improved product quality.
• Provider inquiry about the status of Remittance Vouchers RVs . This involved checking the MMIS provider subsystem and checked the setup of their Remit Media
• 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.
• Accumulated system requirements from various departments through surveys and interviews.
• Performed Data mapping, logical data modeling, created class diagrams and ER diagrams and used SQL queries to filter data
• Conducted JAD sessions with management, SME, vendors, users and other stakeholders for open and pending issues.
• Created Use Case Diagrams, Activity Diagrams, Sequence Diagrams and ER Diagrams in MS Project.
• Assisted in the development, design and implementation of new relational or multi-dimensional databases, including the analysis of user needs.
• Created and managed project templates, Use Case project templates, requirement types and traceability relationships in Requisite Pro.
• Involved in writing the detailed Test Plan using Mercury Quality Center, after analyzing business requirements and software/functional requirement artifacts.
• Worked extensively with MS Excel and MS access
• Performed data analysis by using SQL queries using the DB Artisan tool
• Suggested measures and recommendations to improve the current application performance.

Role: Business Analyst

• Confidential one of the largest private banking businesses in the world, provides the wealth creators in today's global economy with a full range of finance, banking, investment, trust and advisory services. Its
• Clients rely on the bank for comprehensive solutions, including access to capital, sophisticated investment
• Strategies and liquidity management, as well as expertise from Citi Markets Banking.
• Confidential migrated its wealth management platform from Morgan Stanley Smith Barney MSSB to Pershing. The subset of Personal Wealth Management, Citi Private Bank, and International Private Bank currently receive variable Financial Advisor compensation via MSSB's FA compensation system. So a comparable Citi-retained
• Compensation system needed to sustain variable compensation for CPB, IPB, and CPWM Financial Advisors.

Responsibilities

• Identify the business requirements though FA Comp Plan, and define the scope.
• Validate the defined scope through reengineering of MSSB data.
• Maintain Issue log for gaps/conflict parts and to discuss with stakeholders.
• Identify the de-scope items and record in the BRD
• Identify the various stakeholders and get business requirement sign off from them,
• Create Process flow diagrams to represent the process in a pictorial form.
• Conduct walkthrough sessions for the requirement documents created with all the Stakeholders, SMEs and Tech team.
• Review the FRD and follow-up with FRD Sign Off.
• Create power point presentations for explaining the requirements to the Business side.
• Worked on Pershing NetX360 system to verify customer details, trade details and FA details and
• Other information's flow through Citi compensation system.
• Conduct follow up meetings with Business people, SMEs and Tech team.
• Manage all project related documents in the SharePoint and support for Audit Review.
• Performed IST Integration System Testing and reviewed the results through SQL Developer.
• Conduct walkthrough session to UAT team to brief about the requirements and review the UAT test conditions.
• Review the UAT Results through SQL developer, support UAT Testing Team and provide analytical solution.
• Maintain the Issue log during the IST / UAT phase.
• Command Center Support during the Post production live.
• After the conversion, performed data analysis on Mutual Fund Trails to verify all the FA's receiving the trails compensation through Fund companies as per the guidelines.

Role: Business Analyst

Cofidential. was established in Cofidential with the primary objective of meeting a social need of encouraging home ownership by providing long-term finance to households.The Business need for this project was to develop an automated web based system for the process of recording and maintenance of reports from the credit card companies. The system generates Credit reports of individuals based on the data provided by the various agencies after the credit risk analysis. The system also maintains a record of any information obtained to an individual's report and updates the database.

Responsibilities:

• Collaborated with project manager to define ProjectScope, Risks and determined appropriate methodologies to apply based on Vision Documents
• Facilitated discussions involving key stakeholders from both business side and IT side to elicit High Level Requirements and estimate project Feasibility.
• Documented Business Requirements, Functional Specifications using UML Models including User Case Diagram, Activity Diagram, and Sequence Diagram.
• Analyzed existing system and performed Gap Analysis.
• Communicated requirements to key users and business stakeholders to keep a common understanding of business scope and solution scheme.
• Communicated with software architects and developers to ensure that the applications conform to the requirements.
• Worked in executing several Optimized queries in SQL on this data.
• Established traceability matrix using Rational Requisite Pro to trace completeness of requirements in different SDLC stages.
• Managed changes requests controlled, tracked and monitored changes request using Rational Clear Questto enable successful interactive development.
• Assisted in Monitoring software testing reported test result and area to improve to management teams worked with QA team and develop team to make improvements.
• Conducted UAT, documented and reported user feedbacks to management team.

Role: Business Analyst

operations in Cofidential are finance and accounting, sales and marketing analytics, customer services, financial services collections, supply chain, information technology and actuarial and other insurance services with learning content development.The project involved creation of a separate Fixed Assets module within the existing accounting software Cofidential. Prior to implementation of the module, data was maintained in excel spreadsheets.

Responsibilities:

• Responsible for end to end support to client.
• Collaborating with the accounting team and IT team to document business requirements.
• Executing entire task related to MS excel advanced formula, pivot table, charts etc.
• Technical expertise with analytical reporting using Advanced Excel VBA.
• Assessing and reporting the process delivery metrics to the leadership team.
• Responsible for overall communication, quality and delivery of results.
• Dashboard, report and presentation creation showcasing all the results of the analysis with the insights, recommendations and suggestion.