SUMMARY

• 7 years of Experience as a Business Analyst/Business System Analyst wif extensive noledge and experience across teh project life cycle in Systems Development Life Cycle (SDLC) in teh fields of Healthcare industry.
• Profound Knowledge of Rational Unified Process (h) methodology, Use Cases, Object Oriented Analysis and Design (OOAD).
• Solid understanding of Business Requirement gathering, Business Process flow, Business Process Modelling and Business Analysis.
• Experience in facilitating Joint Application Development (JAD) sessions wif IT Groups and Conflict Management wif Project team members.
• Expertise in identifying, developing interface and process specifications, documenting them in Business Requirement Documents (BRD), creating Functional Requirements Specifications (FRS), System Requirement Specification document(SRS), and Change Request Specification(CRS).
• Extensively worked on teh various types of Business Requirements Elicitation, Process Modelling, Gap analysis, and development of Functional Specifications
• Experience in development of Process Flow Diagram, Use Case Diagram, Activity Diagram, and Sequence Diagram by using UML methodology using tools such as Rational Rose and MS Visio.
• Extensive experience in developing Use Cases, creating Screen Mock - ups, conducting Gap Analysis, SWOT analysis, and Cost Benefit Analysis.
• Good Knowledge about teh added and deleted functions, and changes in different sections of teh affected EDI transactions834, 820, 270/271, 278, 837(me, D, P), 276/277, 835 as per teh HIPAA 5010.
• Experience in HIPAA ASC X12 transactions. Good Knowledge and understanding of HIPAA 4010. Experience in working wif GAP Analysis between HIPAA 4010 and HIPAA 5010.
• Worked on Data migration, Facets version upgrades
• Good Knowledge on cross walking ICD-9-CM to ICD-10-CM/PCS “forward mapping” & ICD-10-CM/PCS to ICD-9-CM “backward”.
• Expert in Tracking and Managing teh Requirements using Requirement Traceability Matrix (RTM) that controls numerous artefacts produced by teh teams across teh deliverables for a project.
• Involved in Test Planning, Test Preparation, Test Execution and Issue Resolution and Report Generation to assure that all aspects of a Project are in Compliance wif teh Business Requirements.
• Strong Experience in conducting User Acceptance Testing (UAT) and documentation of Test Cases. Expertise in designing and developing Test Plans.
• Extensive experience in creating, executing and data extraction using SQL queries.
• Expertise in teh preparation of ETL Test Plan, Test case Design, Progress Reports and Traceability matrix, responsibilities in preparation and review of Test Cases.
• Data extraction, Data Migration and Data conversion using ETL tools from application front-end wif Oracle databases and data warehouse.
• Worked in cross functional and geographically dispersed team environments.
• Analytical, methodical, and resourceful approach to problem solving, identifying root causes and corrective actions to meet short and long-term business, financial, and system requirements, good understanding of team management.
• Excellent Communication skills wif ability and willingness to work towards teh business and technical requirements of clients and users.

PROFESSIONAL EXPERIENCE

Confidential, Chicago, IL

Sr. Business Systems Analyst

Responsibilities:

• Gathered Business Requirements from teh Subject Matter Experts (SMEs) and documented teh requirements in teh BRD. Utilized data flow diagrams, use case diagrams and process flow diagrams to represent information provided by teh Business Owners.
• Worked in Agile/Scrum environment by assisting in breaking teh requirements out into user stories and sprints.
• Involved in scoping and scheduling meeting wif Project manager, business (sponsors) and delivery manager.
• Performed Analysis of ICD 9 Codes in accordance wif ICD 10 CM and ICD 10 PCS Conversion Compliances.
• Organized meetings and led JAD sessions to ensure legal and compliance deadlines of CMS (Centers for Medicare and Medicaid Services) are met.
• Read and analyzed teh federal legislation to update teh products as per teh mandated provisions of HCR (Health Care Reform).
• Created and maintained Service Level Agreements (SLA’s) and wrote business rules pertaining to teh HIX project.
• Created use cases diagrams and business process workflows using Visio
• Identified and tracked Project Issues and Risks.
• Ensured billing and premium collection are modified to support 820 HIPAA transactions set.
• Implemented HIPAA/EDI Transactions like 820 and 834.
• Got a great exposure to Electronic Medical and Health Records (EMR & EHR)/Automated Health Care Systems.
• Worked wif teh UAT and QA teams to conduct an assessment and determine how TEMPeffective UAT and QA guidelines can help teh company achieve timely completion of projects.
• TEMPEffectively elaborated teh Current process and gave a clear picture of teh proposed process for teh projects in teh organization. Worked aggressively towards timely completion of High Priority Tasks.
• Participation in a HP Quality Center for System Integration Testing support and help finalizing defects.
• Led teh Change Control Process for changes submitted for teh BRD once teh document was submitted to IT department.
• Worked wif IT to resolve issues and clarify Business Requirements from teh Business Owners.
• Wrote test cases, test script and test plan for testing.
• Documented teh UAT Test Plan for teh project and worked wif teh UAT team to ensure every acceptance criteria for teh requirements that has been included in teh UAT task plan.
• Maintained teh Traceability Matrix table to uniquely trace teh identified business requirements from general design to testing as proof that requirements requested have been developed into a solution and that it has been tested and tracked.

Environment: UML, Windows, Mainframe, SQL, Data Warehouse, Microsoft Office, HP ALM/ Quality Center, Agile, MS Access, MS SharePoint, HTML, XML, Java Script, Java, ASP, DB2.

Confidential, Overland park, KS

Sr. Business Systems Analyst/ EDI Analyst

Responsibilities:

• Working wif trading partners to finalize teh data mapping of teh 270/271, 276/277 and 835.
• Coordinating wif other Service Providers andcreatingRTM for teh requirement.
• Facilitate andinitiatemeetingswif other Application Service Groupsto make sure that all eligibility and benefits are sent wif teh right deductible to teh providers and other trading partners.
• Analyze teh gap between teh current state and"to-be state"& createLogical diagram for current and future state using MS Visio.
• Worked on provider information management of PPO, POS and HMO networks including large institutional networks as well as small providers.
• Extensive use ofBusinessProcess Modeling Notations & Data flow diagramsto represent teh flow of data from external entities into teh system.
• Creating test strategy document, finalizing dates for all teh test deliverables including System testing and integration testing.
• Work closely wifBusinessand trading partnersand drive them through all teh Waterfall Phase fromDesigning, Testingto Release Phase.
• Work wif teh clearinghouses, and gateway providers to schedule monthly eligible member list.
• Test teh environmentto have a successful transaction.
• Analyze and document non-functional system requirements.
• Responsible for entering teh test cases onHP Quality Center (QC).

Environment: MS Office Suite (Word, Excel, Power Point, Visio, Project, Access, Share Point), ETL, Agile, BizTalk, Quality Center, SQL, XML.

Confidential, CO

System Analyst

Responsibilities:

• Gathered Business Requirements from all teh stakeholders and interacting wif teh providers, managers, developers to develop teh business Processes.
• Conducted Risk Analysis and Impact analysis whenever there is any change in teh business requirement and continually updating teh business requirement document.
• Conduction JAD sessions and ultimately reducing teh time spent in moving all teh information from stakeholders and other team members.
• Complete understanding teh business process to determine teh needs of teh business.
• Assisted in teh meetings wif teh technical team as well as teh clients regularly to assess teh current process and how it could be changed in making a better proposed process.
• Provide various strategies to implement HIPAA 4010 in teh new MMIS system and ultimately move to HIPAA 5010.
• Performed six-sigma process during teh project to eliminate any defects in teh process.
• Conducted teh gap analysis and analyze various gaps and develop actions to fill those gaps.
• Develop spike requirements solution for all teh current problems and UI prototypes for capturing teh requirements.
• Helped in developing test cases such as test plans and test scenarios.
• Utilize Rational Unified Process (RUP) and build different phases of software developmental cycle.
• Actively involved in designing EDI transactions using teh new HIPAA 5010 version and ICD -10 codes and analyzing IPAA compliance and EDI transaction.
• Recommending actions against teh action plans during teh ongoing progress of teh project to teh project manager.
• Knowledge of teh software system and teh programs.
• Identification of changes in teh existing Minnesota Electronic Disease surveillance system (CEDSS) to adopt ELR implementation through GAP analysis.
• Created architectural styles such as application architecture, enterprise architecture, and service-oriented architecture wif teh help of Service - Oriented modelling (SOA).
• Creation of project management plans to manage timely delivery using MS project.
• Performed Requirement Tractability Matrix (RTM) to track and maintain stakeholders requested requirements and changes.
• Instrumental in capturing teh requirements from teh clients and publishing them into a requirements document.

Environment: MS Project, Requirement Traceability Matrix (RTM), Rational Rose Test, JAD, RUP, MS Visio, Windows OS, MS Office, SharePoint, Server, Quality Center, ETL, SQL Server.

Confidential, Lake Forest, IL

Business Systems Analyst

Responsibilities:

• Assisted project manager to prepare business document, project schedules, resource allocation, project duration and cost by using MS Project.
• Facilitated sessions wif senior agency staff to identify teh business flows and determined whether any current or proposed systems are impacted by teh EDI X12 Transaction Code Sets and Identifier aspects of HIPAA.
• Produced reports through Impact Analysis on system, data, technology, providers and clearing houses, enabling recommendations and best practices for becoming HIPAA compliant.
• Involved in developing Project Plan, detailing teh tasks and effort required to achieve HIPAA compliance.
• Validated teh following: 837 (Health Care Claims or Encounters), 835 (Health Care Claims payment/ Remittance), 270/271 (Eligibility request/Response), 834 (Enrollment/Dis-enrollment to a health plan)
• Communicated Project Requirements, Business Issues, Solutions and made recommendations.
• Created Wire Frame and Swim Lanes using MS Visio
• Monitored teh UML based methods to create: Use Cases, Activity Diagrams, and Swim lanes
• Created use case diagram, Process Flow Diagram (PFD), Data Flow Diagrams (DFD), various different type of wireframes Setup meetings wif Quality Analysts and Development teams/vendors to clarify questions on teh requirement documents.
• Created System Requirement Specifications (SRS) document entailing business rules, conditions, calculations, triggers, visual representation, type of text (smart text, static text, free text, special formatting, metrics) of various dynamic elements present wifin teh reports.
• Performed Extensive Data Analysis on Oracle and MS Access Databases.
• Created Report Mock-ups.
• Coordinate wif client and manage their business needs. Developing teh Proto type and preparing teh Process flow diagram using iRise.
• Gathered user and business requirements through interviews, surveys, prototyping and observing from portfolio managers and UI (User Interface)
• Coordinated wif different team in order to develop teh web service.
• Working directly wif Project managers, Business Team, Technical team, QA Team to analyze and eliminate errors.
• Involved in all phases of system development including requirement gathering and analysis, Designing, Development, Testing, Implementation, deployment, maintenance.
• Worked wif relational database models, schemas & Entity-Relationship Diagrams (ERMs) to create technical/system design documents
• Carry out SQL queries to analyze teh data in collaboration wif DB team during data mapping, warehousing, normalization, and meta-data analysis for Medicare
• Involved in coordinating wif teh database design team, using SQL to Query databases and providing inputs in finalizing teh data model, report layouts.
• Gathering Requirements from business, created BTRDs, BRDs, TDD and supported technical and testing team.
• Documenting all system changes and request for changes (RFC) for user access using change management forms.
• Used MS Excel to create test cases and import teh data to Quality Center.

Environment: Rational Requisite Pro, Data Warehouse, RUP, Microsoft Project, MS Excel, MS Word, Power Point, Clear Quest, Quality Center.

Confidential, Indianapolis, IN

Business Analyst

Responsibilities:

• Involved in gathering end to end design requirements for line of business, software/hardware developers and vendors.
• Involved in developing Project Plan, detailing teh tasks and effort required to achieve HIPAA compliance.
• Responsible for teh full HIPAA compliance lifecycle from gap analysis, mapping, implementation and testing for processing of Medicaid Claims.
• Participated in Business Modelling by understanding teh needs of teh business, and also documenting Business Use cases as well as System Use cases.
• Liaising wif users and me.T. in both locations and producing a full migration plan wif all tasks attributed to owners, indicating any conditional tasks and provisional start and completion times.
• Worked closely wif business partners to define strategies for technical solutions, determine requirements, and develop functional designs based on teh analysis of line of business needs, objectives and existing systems infrastructure.
• Work closely wif developers and testers to ensure requirements and functional designs are translated accurately into working technical designs and that test plans and scripts serve customer needs.
• Participate in Data Analysis and Design wif teh Data analyst in defining data sources and required data content for teh data warehouse component. Work on teh integration of data from various sources, created comprehensive data mapping and dataflow diagrams.
• Gathered business requirements through interviews, JAD Sessions, prototyping and observing Line Of business.
• Performed gap analysis of current state to desired state and document requirements to control teh gaps identified.
• Used MS Visio to represent system under development in a graphical form by defining use case diagrams, wireframes and workflow diagrams.

Environment: Rational Requisite Pro, RUP, Microsoft Project, MS Excel, MS Word, Power Point, Clear Quest, Quality Center.