SUMMARY

• Skilled professional with proven track record of over 7+ years as a Business Analyst and have hands on experience in Healthcare Industry.
• Experienced in conducting Joint Application Development (JAD) sessions for requirements gathering, analysis, design, development, testing and Rapid Application Development (RAD).
• Have experience working on all teh phases of Agile/Waterfall software development life cycle (SDLC).
• Managed all phases of SDLC with comprehensive knowledge of business requirements analysis, use case modeling, and use case specification.
• Hands on experience working with HIPAA 4010/5010 x12 transactions such as 837, 835, 834, 278, 270 and 271. Worked extensively on gap analysis and data mapping of ICD - 9 and ICD-10 codes using GEM's.
• Extensive Experience working with teh Affordable Care Act (ACA).
• Good knowledge of HIX, Health Insurance Plans (Medicare Part A, B, C and D), managed care concepts (Medicaid and Medicare) and experienced in determining teh membership eligibility, billing experience within life and disability in health plans.
• Have worked on systems integration testing, Regression testing, Functional testing and User Acceptance Testing (UAT).
• Skilled in Gap analysis, SWOT analysis, Risk analysis.
• Experienced with SharePoint operations to share documents and information with teh team members for teh development of teh application.
• Experienced in business Modeling and Use Case development using UML methodology. Created process flow diagram, system diagram, sequence diagrams and data flow diagrams by using MS VISIO.
• Good Knowledge of SQL and FACET.

TECHNICAL SKILLS

• MS Project
• SQL
• Requirement Traceability Matrix (RTM)
• JAD
• Windows OS
• MS Office
• MS Word
• MS Excel
• MS PowerPoint
• MS Visio
• JIRA
• Share Point
• HP ALM/ Quality Center
• SQL Server .

PROFESSIONAL EXPERIENCE

Confidential

Business Analyst

Responsibilities:

• Facilitated requirements gathering sessions with teh clients and refined teh requirements.
• Involved in all aspects of projects, including documentation of project needs, analysis/ research of needs and possible solutions, documenting and updating business requirements and working with project members to execute teh test plan, recommending preferred solutions, and implementing teh recommendations.
• Gap Analysis for teh functionality, usability and performance of teh existing website/portal.
• Involved in analysis of existing documentations to get teh possible solutions.
• Created test cases on portal and extracted teh data from DDE to check different functionality of teh web portal.
• Created process flow diagram by using MS VISIO.
• Conducted highly interactive requirement gathering sessions with projects stakeholders such as users, QA analysts, and project management team for identifying and resolving issues.
• Involved in writing teh business logics in order to populate teh placemat (Reporting spreadsheet) for teh counts from teh production environment to teh state.
• Created test cases on different scenarios to check if teh coding is correct based on teh business logics for teh extraction of teh count from production Environment.

Confidential

Responsibilities:

• Prepared PPT Slides for E&E (eligibility and enrollment) tower with all teh information incorporated with OPTUM work and how OPTUM deals with CMS, QSSI, ACCENTURE, OPERA and MIDAS; to give an overview to teh vendor.
• Prepared PDD (Process Description Documents) for transition purpose.
• Created teh process flow chart diagrams by using Visio to present teh process to teh vendor.
• Attended and scheduled meetings with CMS, QSSI and teh vendor and scribed teh meetings.
• Assisted teh tower leads of E&E (Eligibility and Enrollment), OC (Office Communication), SLS (Scalable Logical System), EPDS and FM (Financial Management) with all teh documentation as per teh need.
• Helped teh Tower lead with teh shadowing and teh reverse shadowing in transition process.
• Track down teh records of teh meetings and teh transition process.
• Responsible for updating teh tracker accordingly on teh share point and teh documents related to teh transition process as well.
• Used SharePoint to share all teh documents and information with teh team.

Confidential, WI

Business Analyst

Responsibilities:

• Analysis and documentation of existing processes that display products on teh portals (UI) .
• Conducted JAD session to gather requirement
• Involved in teh meeting with teh development team related to teh defects.
• Identification and documentation of areas that will be impacted on teh portals and teh downstream processes with respect to teh changes.
• Worked extensively with ACA Escalated Case Resolution team and developed processes to efficiently handle teh incoming case volumes from teh exchange.
• Requirements Elicitation, Requirements Analysis and Requirements Gathering to propose teh changes that needs to be made on teh impacted areas.
• Created of Functional Requirement Documents for teh changes that needs to be made on teh portals and teh underlying applications.
• Presented progress reports to clients in order to keep them current on teh project status.
• Coordinated with teh application's teams to support and manage teh overall process as an ongoing activity.
• Coordinated with teh Development, Testing and Release Management teams to support and manage smooth implementation of teh changes.
• Developed Use case, diagrams, flowcharts, sequence diagrams, activity diagrams.

Confidential, Hartford, CT

Business Analyst

Responsibilities:

• Interacted withstakeholdersto get a better understanding of clientbusiness processesandgatheird requirements.
• Conducted requirement gatheringsessions with teh purpose of creating and defining theBusiness Requirement Document(BRD) and theFunctional Requirement Document(FRD).
• DevelopedUseCasesfor each of teh Service Types for each of teh application - Inpatient, Outpatient.
• Responsible for teh UAT testing of teh ICD 9 to ICD 10 Diagnostic and Procedure codes while reviewing teh information to ensure accuracy.
• Developed (UAT) User Acceptance Testingplan to guide a select group of key end-users in testing teh user interface and functionality of teh application.
• ConductedFields Mappingby explaining each column name in teh backend database tables..
• Develop Test analysis report fromQuality Centerafter test execution.
• DevelopedUAT Test Casesto cover overall quality assurance testing.
• ConductedJAD sessionsto allow different stakeholders to communicate their perspectives with each other,resolveanyissuesand come to an agreement quickly.
• ClarifiedQA team issues and reviewed test plansdeveloped by QA team to ensure that allrequirementshave been in scope and tested accordingly.
• ExecutedSQL queriesto test teh databasefor records for functional acknowledgement and remittance advice in teh claims application in FACET

Confidential, MN

Business Analyst

Responsibilities:

• Analyzed and Designed of HIPAA X12 834 EDI Transactions for Health Insurance Exchange (HIX) .
• Created Test Case and Test Scenario based on X12 834 E2E Functional Testing.
• Created Process Flow Charts, Business Requirements Documents, and FunctionalSpecification Documents.
• Facilitated requirements gathering sessions.
• Acted as primary liaison between project business staff and technical staff.
• Responsible for gaining a detailed understanding of components of teh business and translating that knowledge into teh requirements for systems or processes.
• Used SOAPUI tool for Web-service Testing (Send X12 834, Receive 999 / TA1's).
• Designed process flows of EDI Transactions (Portal -->HIX --> Carriers) using MS Visio 2010.
• Created 834, Transport Layer Specification and Master Mapping Document (MMD) stating loops and segments.
• Generated, Edit and Analyze EDI X12 transactions using Oracle Spec builder 6.6.1 powered by Edifecs.
• Very good understanding of ORACLE B2B Health Care Adapters (HIPAA EDI X12 834 )
• Workedon SOA Web Service testing, watching HBE Enroll Web Service and Carriers Enroll Web Service interaction, using SOAPUI to test web service request and response between to ends..

Confidential, Dallas, Texas

Jr. Business Analyst

Responsibilities:

• Worked with teh SMEs (Subject Matter Experts), IT managers, software architects to identify teh key changes pertaining to HIPAA, and participated in Health Management to communicate TEMPeffectively with them.
• Performed Requirement Gathering & Analysis by actively soliciting, analysing and negotiating customer requirements and prepared teh requirements specification document for teh application using MS Word.
• Produced Gap Analysis documents for HIPAA 5010.
• Conducted weekly meetings for deciding teh Policies and Procedures to be followed while constructing new sites.
• Performed teh requirement analysis, impact analysis and documented teh requirements using Rational Requisite Pro.
• Identified opportunities for business process improvement through various meetings with business users and developers and initiated efforts to make improvements.
• Worked on project life cycle and SDLC methodology of Agile.
• Developed teh project plan with assistance from teh management, and included provisions for project scope changes and issues and initiated efforts to make improvements.
• Worked with Designers to create data warehouses and/or reporting solutions using ETL.
• Conducted project kick off meetings with team members to explain roles / responsibilities, relationships with other groups, deliverables, timelines, assignments and status reporting.
• Extensive use of Excel to create Functional Specification Documents & Templates
• Prepare presentation slides in MS Project for JAD sessions and to track progress.

Confidential, New York City, NY

Jr. Business Analyst

Responsibilities:

• Analyzed and documented teh system specifications, Business requirements and detail design of teh software for full understanding of teh business .
• Conducted JAD sessions for communicating with all teh project directors and stakeholders. Created process workflows, functional specifications and project initiation artifacts.
• Managed all project requirements and change to requirements throughout teh software development lifecycle using Requisite Pro.
• Created full life cycle documentation from product requirements in teh developmental stage to functional specifications for teh completed modules of application components.
• Created Use-Cases, Sequence and Collaboration Diagrams to demonstrate software architecture and interaction of system components before prototyping. Used Rational Rose, Requisite-Pro for requirement traceability.
• Managed GAP analysis around teh identification of business rules, business and system process flows, user administration, requirements and assumptions.
• Developed test cases and scripts based on business requirements for teh GUI, functional, User Acceptance & System Back-end testing.
• Worked closely with QA and Developers to clarify/understand functionality, resolve issues and provided feedback to nail down teh bugs.
• Reviewed and evaluated all teh modules of teh software before delivery to user’s to confirm its meeting teh standard criteria.