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Lead Business System Analyst Resume

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Phoenix, AZ

SUMMARY

  • Over 8 years of experience as Business Analyst/UAT tester with emphasis on domain logic, identifying implementation requirements and resolving solutions to business processes based on complex software projects, that includes system development module, business process improvement, tactical planning and policy improvement.
  • Expertise in Software Development Life Cycle (SDLC) including Waterfall, Agile (Scrum), and RUP methodology.
  • Proficient in creating and renovating Business Requirement Documents (BRD), Functional Specification Documents (FSD), and converting business requirement into Software Requirement Specifications (SRS) using MS Word and Rational Requisite Pro.
  • Excellent analytical and problem solving skills in designing, developing, and implementing business innovative business processes using new approaches and technology.
  • Experienced in GAP Analysis, Cost Benefit Analysis, organizing, facilitating and coordinating many Joint Application developments (JAD), Joint Requirement Planning sessions (JRP), and Rapid Application Development (RAD) sessions, weekly meetings, conference calls and other regular project meetings.
  • Worked closely with stakeholders and SMEs to fulfill the project goals and objectives as well as able to manage multiple initiatives, projects and deadlines on time.
  • Goal - oriented professional with excellent Interpersonal Skills with verbal and written communication, presentation skills and flexibility in adapting wide range of work environments by inculcating new relevant skills with ease in a time sensitive frame.
  • Experienced in creating Data Flow Diagrams (DFD), Use Cases, Class Diagram, Activity Diagrams, Sequence Diagram, and UML Modeling methodology using tools such as Rational Rose and MS Visio.
  • Familiarity with White-Box and Black-Box testing techniques such as Load Testing, Regression Testing, Unit Testing, System Testing, Quality Center and Performance Testing.
  • Developed test scenarios and implemented test plans for system testing and user acceptance testing (UAT).
  • Involved closely with the Developer and Testing team during defect resolution phase.
  • Excellent understanding of HIPAA standards (4010 and 5010), HIPAA code sets ICD-9, ICD 10 and HL7.
  • Experience in Process Documentation, Analysis and Implementation in 835, 837IPD, 834, 270/271, 276/277, 999/TA1 (X12 Standards) processes of Medical Claims Industry from the Provider/ Payer side.
  • Captured allHIPAA-relatedEDI datain the repository usingFACETS and supported integrated EDI batch processing and real-time EDI usingFACETS.
  • Proficient understanding of Medicare Part A, Part B, Part C and Part D products and procedures managed care concepts (Medicaid and Medicare) and experienced in determining the membership eligibility, billing experience within life and disability in health plans.
  • Extensive knowledge of Medicaid Management Information Systems (MMIS)/ Replacement Medicaid Management Information System (RMMIS), Medical Information Technology Architecture (MITA).
  • Comprised with Health Insurance Exchange, products develop and successfully release of private HIX and public HIX under Obama Care (PPACA).
  • Experience in RENAISSANCE BILLING SYSTEM which is an integrated web based P&C Insurance billing system.
  • Familiar with RDBMS tools like oracle (TOAD), DB2, IBM Mainframe and MS SQL Server with very Strong SQL skills (writing queries and verifying data). Solid understanding of databases, data ware house, OLTP, OLAP, Data Modeling, Business Intelligent tools like Business Objects.

TECHNICAL SKILLS

Business Skills: Business Process Analysis and Design, Requirement Gathering Use Case Modeling JAD/JRP Sessions Gap Analysis, Impact Analysis.

Methodology: RUP, Agile, Scrum and Waterfall, SDLC, UML, OOAD, JAD, GUI, UAT, RTM.

Business Modeling and Change Management Tools: UML, MS Visio, Rational Rose, Smart Draw, SharePoint, Documentum, Requisite Pro, Clear Quest, ALM.

Language/Standards: JAVA, SQL, PL/ SQL, HTML and XML, HTTP, HIPAA 4010/5010, ICD9/10, ANSI X12, CPT, CMS form.

Applications: MS office suite, Adobe suite, IBM Lotus Notes, Lotus Symphony, IBM Same time, Domino Designer, IBM Blue Pages, communicator, Kick start, Network installation manager, IBM smart cloud meetings.

Testing Tools: HP Quality Center, Win Runner, Load Runner, JIRA, Quick Test Pro, RMT.

Health Care: ANSI X12, HIPAA, EDI, Enrollment/Claims/Benefits/Remittance, FACETS.

BI Tools: Cognos 8.4/8.3/8.2/ 8.1 and Microstrategy, OBIE, Business Objects (Designer, Dashboard), Informatica, Crystal Report.

Database/RDBMS: Oracle 10g/9i/8i/DB2, TOAD, MS SQL Server, Teradata, Sybase.

Operating System: UNIX, Windows XP/ NT/2000/ 95, MS-DOS.

Microsoft Office tools: MS Office (Package), MS Project, MS Front Page, Visio, Excel, Word, Outlook, PowerPoint.

PROFESSIONAL EXPERIENCE

Confidential, Phoenix, AZ

Lead Business System Analyst

Responsibilities:

  • Responsible in providing Business Requirement Document (BRD) and Functional Requirement Document (FRD).
  • Analyzed inpatient and/or outpatient medical records using International Classification of Diseases, Ninth Revision (ICD-9/10) and Update ICD-9 and CPT code changes.
  • Maintained reimbursement summaries from third parties and compare with clinic fees, Updated reimbursement regulations, Notified Business Manager of significant changes, conduct periodic medical record audits to ensure documentation is consistent with billing.
  • Well-defined and produced inclusive, accurate conversions of ICD-9 codes into equivalent ICD-10 codes with the option to adjust system application for ICD-10 specificity.
  • Assisted with the User Interface (UI)prototypes to capture and validate requirements and spike solutions to the occurring problem.
  • Expertise in SAP Business Objects Analysis, gaining insight business data and make intelligent decisions that improves corporate performance.
  • Performed performance tuning of Informatica Mappings, sessions for Informatica 8.x workflows, transformations and cache optimization for loading, creating the batches and optimizing batches to load in the production environment.
  • Tested claim billing processes as well as other healthcare processes such as enrollment, eligibility, andclaims-to-remittance adjudication processes.
  • Performedproviderimpact analysis and work with trading partners, clients, management, technical and non-technical personnelto createrequirements,use cases and system validation artifacts and testing documentation, medical coding testing.
  • Worked with providers and Medicare/Medicaid entities to validatehealthcare processes, including end-to-end claims processing, payment processes and eligibility where special focus on procedure and diagnosis coding.
  • Created technical documentation,reviews, analysis, and evaluations ofbusiness systemsfor end user needs, including Companion Guides,business process reengineering,GAP analysisandmedical forms processing andworkflows.
  • Worked on Unit Testing, trading Partners for connectivity issues, liaisonbetween client and corporate staff.
  • Worked onClaims and Remittanceprojects, including syntax and business rulesfor HIPAA4010and 5010validation for loops, segments, elements, qualifiers and code sets.
  • Created EDI Export and Import processes and worked with EDI Trading Partners, Payers/Vendors.
  • Used SDLC (System Development Life Cycle) methodologies using Agile and RUP.
  • Performed a range of telecommunications processes, including FTP, Dial-up, TCP/IP, Web transfers.
  • Created Testcases, testplan and Companion Guide from stage to production.
  • Performed UAT testing for ICD10 and legacy testing for HIPAA 4010 and 5010 projects for HIPAA requirements and compliance mandates.
  • Performed Unit testing documentation developed using Excel and created Artifacts and listing for UAT validation,and writing and validating Use Case Documents.
  • Managed financial Processingwhich serves as primary lead for corporate financial systems, including accounting processes for accounts receivable and accounts payable systems. Manage financial spread sheets and vendor accounts. Spearhead collection processes and manage accounts receivable personnel.
  • Complete knowledge in Medicaid and Commercial entities which include claims, enrolment testing, as well as NPI and medical coding and ICD-9 EDI testing.
  • Captured allHIPAA-relatedEDI datain the repository usingFACETS and supported integrated EDI batch processing and real-time EDI usingFACETS.

Environment: Share Point 2010, MS Visio 2010, Rational Rose, GAP Analysis, UML, Use Case Analysis, SQL Server, Microsoft Office Suite, Quality Center, JSP, Java Script, XML, HTML, Agile, and Scrum Master, test Director, Rational Unified Process (RUP), MS Access, and DB2.

Confidential, Baltimore, MD

Sr. Business Systems Analyst

Responsibilities:

  • Analysed and collected business requirements identified system interfaces and created the requirements specification documents.
  • Identified Use Cases from the requirements and created UML Diagrams including Use Cases, Activity/State Charts, Sequence diagrams, Data Flow Diagrams and ER Diagrams using Rational Rose and MS-Visio thus defining the Business Process Model and Data Process Model.
  • Performed requirement analysis by gathering both functional and non-functional requirements based on interactions with the users, stakeholders, document analysis, user interviews, and documented those requirements in the BRD.
  • Consistently utilized MS-Project for planning and project tracking purposes.
  • Developed Test plans and mapped them to requirements with QA team.
  • Developed and updated Requirements Traceability Matrix (RTM) using Rational Rose, mapped the developed Test Cases to the requirements to ensure that the requirements were fully tested and implemented according to the specifications.
  • Evaluated and tested the new and modified software application to verify that programs function according to both technical and business requirements.
  • Used the Rational Unified Process (RUP) methodology for the project.
  • Developed, executed and validated user acceptance test plans (UAT) and implementation support.
  • Performed GAP Analysis to figure out what we have and what we ought to have, to be better-off.
  • Developed project schedules, conducted project status meetings and managed resources during all phases of the SDLC.
  • Created and maintained the Requirements Traceability Matrix (RTM)
  • Part of Health Insurance Exchange (HIX) product team and experience in handling Private and Public Exchange solution.
  • Requirements were gathered through interactions and meetings and periodic walkthroughs with SME’s.
  • Interacted with Developers and Users in resolving risk factors and other issues.
  • Experience with conducting assessments and impact/gap analysis concerning State Medical Management Information System (MMIS).
  • Involved in the testing of web portal of MMIS System.

Environment: MS Visio, SQL, Java, Windows 2000/2003, MS Project, MS Word, MS Excel, Rational Requisite Pro, ALM, Rational Rose, and RUP, Share Point, Quality Center.

Confidential, Charlotte, NC

Sr. Business Analyst/UAT Tester

Responsibilities:

  • Conducted analysis studies that serve as input to the strategic planning, goal setting, and approach to achieving the goals.
  • Involved in gap analysis workshops to facilitate the proper requirements strategy and defined existing business process (BPM-Business Process Modeling) and identified the gap (Gap Analysis) between the existing and improved business process.
  • Worked closely with Business Users to gather requirements for streamlining the Claims Processing System. Prepared business requirements documents (BRD) and converted it to functional requirements (FRD).
  • Experience in RENAISSANCE BILLING SYSTEM which is an integrated web based P&C Insurance billing system. This application with Insurance billing modules like Account / Policy Billing, Third Party (Agency) Billing, List/Group Billing was a complete billing system for P&C Insurances.
  • Analyze and define system requirements for IVR applications to meet business requirements.
  • Involved in claims and record data mapping and data modeling with technical teams.
  • Facilitated the administration of increasingly complex benefit plans and regulations.
  • Provided an outstanding platform for data exchange between client and vendors.
  • Explained the solution model, analyzed functional requirements, prepared Use cases, defined user profiles, defined supplementary requirements, defined assumptions and prepared traceability matrix and validated requirements.
  • Conducted Joint application development (JAD) sessions by convening project sponsors, end-user representatives, SME’s. Also, used Brain storming, Document analysis, and user task analysis for various reporting types like CLUE (Comprehensive loss underwriting exchange, Change Report, Claim Count, Claim summaries).
  • Interacted with the SMEs and stakeholders to get a better understanding of client business processes and gather business requirements.
  • Prepared and maintained Requirement Traceability Matrix (RTM) in Rational Requisite Pro.
  • Assisted in locking bugs, in order to meet specific requirements and deadlines for successful execution of the project.
  • Createduse cases, process flow models, data flow diagrams and logical flow diagramsusingUMLfor various integrations.
  • Prepared diagrams using Rational Rose and developed test plans, test cases to analyze and match results.
  • Gathered requirements from the end-users and acted as a liaison between the end-users and the development team and QA team.
  • CreatedUATtest strategies,including regressionandintegrationtesting, wrote test scripts,end-to-end testingscenarios and test plans, managed testing, defect reporting and change requests.
  • Assisted Quality Assurance (QA) Analysts in creation of various tests by using Quality center.
  • Followed the Agile methodology during the entire SDLC.
  • Assured that all artifacts are in compliance with corporate SDLC policies and guidelines.

Environment: Visual Basic, Oracle 11i, MS-Project, MS-Visio Windows 2000 Server, Windows 2000, Rational Tools, HP Quality Center, Dot Net Framework, Java, Agile with XP.

Confidential, Franklin Lakes, NJ

Sr. Business System Analyst/ UAT Tester

Responsibilities:

  • Involved in gathering, analyzing and documenting business requirement and data specification.
  • Involved in constructing an integrated IVR CRM application to provide system access to real time customer data and information.
  • Worked with the compliance and audit team to make sure we were following correct HIPAA guidelines/protocols throughout the project lifecycle.
  • Included in selection committee for the selection of a code mapping tool.
  • Created and reviewed business requirements, functional specifications, project schedules and documentations.
  • Created use case models, analysis models, implementation models, authorized use cases, use case diagram, behavior diagrams (sequence diagrams, activity diagram) based on UML methodology using Rational Software Modeler and MS Visio.
  • Conducted Joint Application Development (JAD) and interview sessions to elicit requirements from the users and subject matter experts.
  • Prepared and maintained requirements traceability matrix (RTM) throughout the project lifecycle.
  • Documented the UAT plan for the project and worked with the UAT Team to ensure every acceptance criteria for the requirements has been included in the UAT task plan.
  • Involved in designing and developing Data Models and Data Marts that support the Business Intelligence Data Warehouse.
  • Involved in SWOT analysis of project plan.
  • Performed Gap Analysis to identify the gap between the optimized allocation and integration of the inputs, and the current level of allocations.
  • Created diagrams using Rational Rose and developed test plans, test cases to analyze and match results.
  • Reproduced, verified and validated issues documented in a defect tracking system and wrote tractability matrices based on use cases and business requirements (BRDs).
  • Extensive experience with Business Process Management (BPM) system.
  • Involved in UAT sessions to test and validate the system with stakeholders.
  • Analyzed the test results from QA teams using Performance Studio Analysis to create various scenarios.
  • Prepared schedule work flow, following agile methodology in SDLC.
  • Included in selection committee for the selection of code mapping tool.

Environment:, UML, Windows XP, Business Objects, Informatics, MS Project 2000, MS Word, MS Excel, MS Visio, SharePoint, Agile, and waterfall.

Confidential, Boston, MA

Business Analyst

Responsibilities:

  • Conducted User interviews, gathered requirements and analyzed the requirements using Rational Unified Process (RUP) methodology and managed the requirements using Rational Requisite Pro.
  • Created Business Requirement Document (BRD), Functional Requirement Specification (FRS) document and Change Request (CR) document for system application development.
  • Conducted Joint application development/ Joint requirement planning (JAD/JRP) sessions acting as a facilitator to gather requirements from the business area and to discuss different critical success factors of the project like Operational Feasibility Analysis, Technical Feasibility Analysis and Cost Benefits Analysis.
  • Authored various UML diagrams such as Use Cases and activity diagrams using MS Visio and defined the Data Flow Diagrams (DFD)
  • Performed GAP analysis for the modules in production, conducted feasibility study and performed impact analysis for proposed enhancements.
  • Coordinated JAD session with system analysts, developer’s team, project manager for application development and Pre- validation specifications.
  • Coordinated/ Assisted in different testing such as User Acceptance Testing (UAT), system testing, Integration testing and functional testing.
  • Authored test plans, test cases for various test scenarios and helped testing team to better understand the scripts, and live environment constraints.
  • Used Mercury Quality Center to manager defects and issues log during the testing phase.
  • Worked as a User/Customer advocate and negotiated with user as well as the technical team and management staff to resolve any outstanding requirement conflict during the whole SDLC process.

Environment: MS Visio, MS Project, My SQL database, Windows, MS Visio, MS Project, MS Access, Rational Requisite Pro, Mercury Quality Center, Agile, and waterfall.

Confidential, San Francisco, CA

Business Analyst/Web Analyst/UAT Tester

Responsibilities:

  • Gatheringand updatingrequirements for new web interfaces, handling defects and security audits.
  • Coordinated work plan between project manager and client with Microsoft Project, implemented and managed migrationprocess and developer fixes, retested fixes, scheduled and tracked progress for team members of project through completion.
  • Was part of the security audit team in designing Integration security architecture tounderstand each of the interfaces being developed.
  • Worked in cross-functional agile development teams with teammates who were developers, quality-assurance specialists, and business analysts. Also responsible for working through usability design, mock up-generation, and full-scale interactive design.
  • Performed integration testing, product testing, data driven testing, and User Acceptance Testing (UAT).
  • Enhanced web applications by search engine optimization, performance tuning and load balancing forwebapplications.

Environment: Rational Rose, Rational Requisite Pro, Quality Center 8.2, DB/SQL, MS Project, MS Visio, Rational Clear Quest, XML, JAVA, Microsoft SQL Server.

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