SUMMARY

• 7 years of experience as a Business Systems Analyst with strong knowledge in Health Care and Banking Industry.
• Developed detailed Requirements specifications through JAD sessions, interviews, on site meetings with business users IT team.
• Expertise in Business Analysis and various Software Development Life Cycle SDLC methodologies like Waterfall, Agile/SCRUM, RAD, Rational Unified Process RUP methodology.
• Possess excellent business writing skills required for documenting Business Requirements Document BRD , Functional Requirements Document FRD , and Non-Functional Requirements Document NFRD .
• Proficient in creating and transforming business requirements into functional requirements by using Use cases diagrams, Activity diagram, Class diagrams, Sequence diagrams, Test Cases, Test Plans.
• Strong experience with analyzing business processes and documenting them using MS Visio, MS PowerPoint, MS Excel, MS Project.
• Documented Traceability to ensure all the features for the project has been captured and mapped back to the requirements in the BRD.
• Good understanding of MMIS, MECT and MITA.
• Worked on different EDI healthcare transactions like 837-Institutional, 837-Professional, 837-Dental, 835-Claim Payment/Remittance Advise, 270/271-Eligibility Benefit Inquiry/Response, 276/277-Claim Status Inquiry/Response Transactions.
• Detail understanding of ICD 9/ANSI/HL7 to ICD 10/ANSI/HL7 coing standards in Medicare and Medicaid domains of the healthcare industry.
• Experienced in working with Business Impact Analysis Template BIAT to analyze and document the effect of proposed changes on the project schedule and costs.
• Proficient in business requirements gathering and writing including the EDI transactions from 4010 to 5010.
• Well Versed on HIPAA regulations and requirements.
• Good Understanding of PPACA HIX and HL7..
• Skilled in Interviews, Joint Application Development Sessions JAD , Focus sessions for requirements gathering, analysis and design with stakeholders, SME's, Developers and system architects.
• Experience with claims process and adjudication in the Medicare, and Medicaid.
• Excellent communication and analytical skills with problem solving capabilities to interface with stakeholders, business representatives and development teams.
• Broad knowledge of testing concepts and hands on experience writing test cases, test plans and planning test strategy using testing tool Quality Center.
• Quick learner, reliable and confident working independently as well as in a team.
• Exceptional track record for meeting deadlines and submitting deliverables on time.
• Highly motivated team leader with excellent communication, presentation and inter-personal skills, always willing to work in challenging environments.

Technical Skills

PROFESSIONAL EXPERIENCE

Confidential

Sr. Business Systems Analyst

Responsibilities:

• Assisted in identifying project scope, to conform to the regulatory compliance related to X12 837 I/P and 835.
• Responsible for soliciting and eliciting requirements for 4010-5010 conversions.
• Involved in building training material and planning material for 4010-5010. Define communication plans and build a project budget for the transition.
• Carried out Risk Assessment, GAP analysis and Impact Analysis for the 4010-5010-conversion project.
• Facilitated JAD and JRP sessions with management, development team, users and other stakeholders to refine functional requirements
• Gathered requirements for impacted system and business areas for ICD-10 and their needs to embrace the changes.
• Used General equivalence Mappings GEM to convert ICD 9 to ICD 10.
• Conducted GAP analysis assessment regarding ICD 9 to ICD 10 conversion and business work flows from legacy system to the detailed financial transaction interface
• Prepared the Business requirement Document BRD and functional requirement document FRD , working with Requirements Traceability Matrices RTM , re-engineering business processes for the enhancement of the existing services.
• Produced for transaction sets 835 and 837 I/P a full gap analysis 4010 vs. 5010 against the documented application 5010 enhancements ensuring the upgraded application included the required changes and additions for 5010 compliancy.
• Involved in up-gradation of 4010 transaction to 5010 by conducting Impact Analysis and Risk Assessment and worked on the mitigation plan to avoid the risks.
• Identified the impact on the existing services of Business Units, local impact of the transition on the organization and forthcoming challenges and issues related to the transition.
• Used Rational Rose/MS Office Suite for creating use cases, workflows and sequence diagrams according to UML methodology thus defining the Data Process Models.
• Played a key role in project planning activities, User Acceptance Testing UAT , and implementation of the system enhancements and conversions.
• Identified the master file changes and builds needed to enable the 5010 format to be utilized.
• Conducted Business Process As Is/To Be sessions with various department directors and staff to ensure the Testing Plan and Test Approach would meet the identified Business Requirements, and the Training Program covered all identified new and changed processes.
• Involved in Data Analysis for data mart system for the process of report generation.

Environment: Rational Requisite Pro, SharePoint, Rational Clear Case, RUP, Spec Builder, UML, HTML, MS Project 2000, MS Visio, MS Office Excel, Word .

Confidential

Sr. Business Systems Analyst

Responsibilities:

• Used HIPAA 4010 transactions to support the analysis of current business processes and work with management to improve and implement enterprise solutions to ensure compliance and got involved in designing future state processes for HIPAA 5010 transaction processing EDI's 837,835, 270, and 271.
• Analyzed business requirements, functional requirements, tested high level and low level Use Cases and Activity Diagrams / State Chart Diagrams using Rational Rose, thus defining the Data Process Models.
• Analyzed HIPAA 5010 related to 837,835, 270, and 271. Transactions and performed GAP analysis between the 4010 and 5010.
• Responsible for GAP analysis of ICD9-ICD10.
• Prepared Business Requirement Document BRD and Functional Requirement Document FRD for the enhancement of the existing services.
• Held regular JAD sessions with the system architects, developers, database developers, quality testers during the entire project to assure that the critical as well as the minute details of the project were discussed and issues were resolved beforehand.
• Tracked stakeholder requested enhancements and changes using Requirement Traceability Matrix RTM .
• Involved with ICD10 implementation testing.
• Experience in an outsourced healthcare insurance operations environment and understanding of MECT and MITA.
• Maintained and monitored project progress and status through MS Project.
• Gathered requirements for impacted system and business areas for ICD-10 and their needs to embrace the changes.
• Prepared UML diagrams Activity diagrams, Sequence Diagrams, Use case diagrams for Extensions.
• Implemented the entire Rational Unified Process RUP methodology of application development with its various workflows, artifacts and activities.
• Conducted the FRS and URS reviews and walkthroughs with designers, developers and stakeholders. Also conducted feasibility and adaptability study.
• Worked with QA lead in validating Test Plan and Test Scenarios.
• Executed test scripts in different cycles to get the perfection and logged defects in defect tab of Quality center.
• Used HP Quality Center for tracking Defects and tracing requirement functionality performances.
• Executed test cases manually. Compared and analyzed actual with expected results and reported all deviations to the appropriate individual s for resolution.
• Involved in automation testing using QTP.
• Involved in performance testing using Load runner.
• Assisted Business User during deployment in formulating User Acceptance Testing UAT for customized application and getting confirmation for product Release.

Environment: MS Project, SQL, Rational Unified Process RUP , Rational Requisite Pro, Rational Rose, Microsoft Visio, QTP, HP Quality centre, Load Runner, Rational Clear Quest, Windows, MS Office, XML, TOAD, Ultra Edit.

Confidential

Business System Analyst

Responsibilities:

• Gathered business and Functional requirements from Business Managers, Supervisors, stakeholders, Data Governance Team and the subject matter experts through meetings to understand needs of the system.
• Used the guidelines and artifacts of the Rational Unified Process RUP to strategize the Implementation of Rational Unified Process effort in different iterations and phases Inception, Elaboration, Construction and Transition of the Systems Life Cycle methodologies. Prepared various artifacts for all the phases of RUP.
• Led JAD sessions with stakeholders to analyze system needs and integrate requirement to develop a consistent navigation structure
• Created business workflows on the claims module for the client to get a better understanding of the software and prepared a detailed BRD including all functional and non functional requirements.
• Responsible for gap analysis in changing old MMIS and Involved in testing new MMIS.
• Involved in up-gradation of HIPAA X12 4010 transaction to HIPAA X12 5010
• Responsible for business analysis, requirement specifications, project planning and identifying the resources and implementation of the project.
• Performed the Gap analyses of the earlier systems, generated a detailed Requirements document describing new system architecture through Use Cases and Activity diagrams.
• Worked with the QA Quality Assurance team for designing Test Plan and Test Cases for the User Acceptance testing. Defined test cases, creating test scripts, analyzing bugs, interacting with QA / development teams in fixing errors and User Acceptance Testing UAT .
• Created functional flow diagrams, context diagrams and other high level diagrams for documenting the functionality of separate modules using MS-Visio and UML.
• Implemented Traceability Matrix and Business Requirement Specification Document verified the functionality coverage.
• Used MS Project to maintain the project schedule and track its status.
• Responsibilities involved interface with end-users, obtaining approval, identifying information, procedures and decision flows, evaluating existing procedures, methods and technical documentation.

Environment: UML, RUP, MS-SharePoint, MS-Project 2000, MS-VISIO, CMMI, TestDirector7.6, WinRunner7, windows 2000,EDI, HIPAA compliances.

Confidential

Business Analyst

Responsibilities:

• Writing the detailed user needs, Gathered business, functional requirements during inception phase, documented and delivered functional specification documents, and assisted architecture analysis and design using UML and Rational tools.
• Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams, and OOD Object Oriented Design using UML and Visio.
• Identified, researched, investigated, analyzed, defined and documented business process and Use Case scenarios.
• Conduct workflow, process diagram and GAP analysis to derive requirements for existing systems enhancements.
• Led JAD sessions with stakeholders to analyze system needs and integrate requirement to develop a consistent navigation structure
• Worked on insurance data related to Medicare, Medicaid, and Insurance claims.
• Worked on HL7 to provide framework to carry out transfer of electronic healthcare information.
• Helped manage risk analysis and mitigation plans, status reports, and client presentations prepared business process models, defined milestone deliverables, and established critical success factors.
• Prepared and maintained requirements traceability matrix RTM throughout the project lifecycle.
• Functioned as the primary liaison between the business line, operations, and the technical areas throughout the project cycle.
• Formulating the systems of project to parallel the business strategies.
• Analyzed research on operational procedures and methods and recommended changes for improvement with an emphasis on automation and efficiency.
• Wrote SQL queries in MS Access for data manipulations.
• Assist with user testing of systems, developing and maintaining quality procedures, and ensuring that appropriate documentation is in place.
• Develop the test plan, test conditions and test cases to be used in testing based on business requirements, technical specifications and/or product knowledge.
• Used Test Director with QA team for testing.
• Interfaced with SME's to prepare BPR documents for ongoing projects.

Environment: RUP, MS Project, ANSI X12 EDI, Rational Rose, HP Service Desk, MS Visio, MS Word, MS Excel, Medicare, Medicaid, Rational Requisite Pro, SQL.

Confidential

Business Analyst

Responsibilities:

• Interface effectively with business, technical staff and SME's of the various applications to gain an understanding of the business and process flow and available functionality of the individual applications and subsequently document and support requirements clarifications.
• Facilitated JAD sessions to collect requirements from system users and prepared business and functional requirement that provided appropriate scope of work for technical team to develop prototype and overall system.
• Identified processes for developing and documenting detailed business requirements including process and data flow analysis and modeling. Data was collected from end-users, and analysts.
• Created different Traceability views to maintain the Traceability of the requirements.
• Conducted review sessions with the CRM team to upgrade the system by introducing an online chat system with the customer care group and help desk in the corporate website.
• Maintained the Business Impact Analysis Template BIAT to analyze and document the effect of proposed changes on the project schedule and costs.

Environment: Agile Scrum , Windows XP, MS Visio 2003, SharePoint, PeopleSoft, MS Word 2003, MS Excel 2003, Oracle, HP- Quality Center, , Web sphere , XML, SQL and Java

Confidential

Business Analyst

Responsibilities:

• Relationship management with all existing and prospective clients.
• Conducted extensive interviewing at manager and user level understanding the AS-IS business processes and systems analyses to capture the business and system level requirements for the new systems.
• Acted as an interface between clients and in-house development team.
• Client presentations on proposed technical software solution.
• Working with sales manager on commercial and technical proposals.
• Clientele included various telecom service providers.

Environment: MS Office Suite MS Word, MS Excel, MS PowerPoint, MS Visio , UAT, JAD, UML Diagrams.