SUMMARY

• Business Analyst with 7 years of industry experience in the domain of Healthcare, Banking, and Finance, with solid understanding of Business and Functional Requirement gathering, Business Process Flow, Business Process Modeling and Reporting. Highly proficient in working with users and stakeholders to Gather Requirements, Analyze them and subsequently use Design Tools to model the requirements.
• Excellent analytical and problem solving skills in Designing, Developing, and implementing innovative Business processes and providing System solutions using new approaches, Technology and Training.
• Fluent with commonly used EDI concepts, practices and procedures within a Healthcare field.
• Knowledge and Experience on Membership, Billing, Claims Payment Processing in relation to HIPAA 4010/5010, EDI X12 Transactions such as 835, 837, 834, 270 and 271, HL - 7, ICD-9 & ICD-10.
• Highly proficient in Project management, Testing, Documentation, Modeling, and System implementation skills and strategic vision to find simple solutions to complex problems.
• Experience in Gathering user requirements, Analyzing, and preparing Project Deliverables, such as Project Charter, Business Requirement Document (BRD) and Functional Requirement Document (FRD).
• Adept at coordinating with Stakeholders, Subject Matter Experts (SMEs) and end users to understand, Analyze, Communicate and Validate requirements through User interviews, Joint Application Design (JAD), Joint Application Review (JAR) sessions.
• Proficient in transforming Business requirement into Functional specifications focusing on Workflow Analysis and Design, User Interface, Business process re-engineering and Process flow modeling.
• Identified and developed Use Cases from the Business and systems requirements. Documented high level and detailed Use Cases to include all the functionalities of the new system.
• Followed the UML methodology to Create UML Diagrams including Use Cases Diagrams, Activity Diagrams, using Rational Rose and MS Visio and thus defining the Business Process Model and Data Process Model.
• Designed wireframes and mockups to communicate the Business and the functional requirements with clients and developers.
• Demonstrated ability to work in different phases of Software Development Life Cycle (SDLC) using Agile Methodologies (SCRUM), and Waterfall methodologies in multi-tier-web-based architecture.
• Extensively used Rational Requisite Pro to gather and manage requirements. Created and managed project templates, use case templates, Requirement Traceability Matrix (RTM) in Requisite Pro.
• Expertise in performing GAP Analysis, creating Work Breakdown Structure (WBS), and Data Analysis.
• Adept at creating Test Cases, Test Plans, Test Reports, and defect tracking when required.
• Good leadership skills and competencies including Issue management, Conflict resolution, Business and Process analysis, Team building and Staff management with synergistic effort.

TECHNICAL SKILLS

Methodologies: Scrum, Waterfall, Agile

Business Analysis: Requirement analysis, Business rules, Data flow diagram, Flowcharts, Business process modeling & improvement, Functional requirement analysis, Source to Target mappings, Gap analysis, Cause and effect analysis, Decision tree, BRD, BRS

Business Modeling Tools: Rational Rose, MS Visio, MS Office Studio, Serena Open Project, Enterprise Architect, Adobe Dreamweaver, Balsamiq Mockup

Project Management: MS Project, Microsoft Office Suite and SharePoint, Requisite Pro

Requirement Management Tools: Enterprise Architect, Rational Suite (requisite Pro, Clear case, Clear Quest, Rose), Caliber RM, Optional Test 5.1, Rally HP Quality Center

Programming Languages: SQL, UML 2.0

Databases: Microsoft SQL Server 2000, Microsoft SQL Server 2005, Microsoft SQL Server 2008, Oracle 10g, QNXT

Operating System: Windows 98/2000, Windows 7, Windows 8, Windows XP, UNIX

PROFESSIONAL EXPERIENCE

Confidential, Warren, NJ

Senior Business Analyst

Responsibilities:

• Designed and developed project document templates based on the scope and plan for the project.
• Gathered Business Requirements, Functional & Nonfunctional requirements by interacting with the internal team, stakeholders, development team, Project Manager and SMEs to have a better idea about the project.
• Followed the Waterfall SDLC methodology throughout the project. Analyzed all the functional and technical requirements and put it together in Rational Requisite Pro to convert them into Requirement Document.
• Mapped out timelines, milestones, communication processes, Q&A sessions, MS Excel based query tracking. Communicated with business and other functional stakeholders for all JAD sessions to derive and execute action plans, meeting deadlines and standards
• Identified & documented Software Requirements Specification (SRS) by using UML, created Use Case Diagrams, Sequence Diagrams, Activity Diagram and Dataflow Diagrams with the use of Enterprise Architect
• Performed GAP analysis and responsible for finding out breaks in current process, suggesting new process. Created a well-defined As Is and To Be process for both project roadmaps as well as for final deployment.
• Maintained Requirements Traceability Matrix and assisted in creating and reviewing test plan & test cases and conducted User Acceptance Testing (UAT).
• Created document which kept track of Internal/External business rules that project would have to follow due to new Healthcare regulations, developed quality procedures documentation adhering business rules.
• Collaborated with Sales and Marketing teams, external ad agencies, third party distributors in order to facilitate communication about various reporting formats for a better understanding, accountability and hence make the project a more profitable one.
• Performed Risk analysis of existing strategies and carry out Cost Benefit analysis based on that.
• Experience in extensive sales figure analysis from data mapping to converting the same into final business strategy.
• Prepared custom reports and performed SQL query, data analysis and verification on MS Access.
• Prepared the UAT Test scripts and uploaded into HP Quality Center. Performed unit testing and UAT and documented test results and defects in Quality Center.
• Interacted with client and the technical team for requirements gathering and translation of Business requirement to technical specifications.
• Assisted in ETL of data into a data warehouse/data mart and Business Intelligence (BI) tools. Developed graphs and pie charts utilizing Business Objects for presentation of project results
• Wrote SQL queries to extract data from data warehouse.

Environment: QNXT, Leap frog, Symantec DLP, MS SQL Server 2008, SQL, Rational Requisite Pro, Dreamweaver, MS project, Enterprise Architect, JIRA, MS Office, MS Visio, HP Quality Center.

Confidential, Trenton, NJ

Business Analyst

Responsibilities:

• Prepared Business Requirements Documents (BRD) and Functional Requirement Documents (FRD).
• Worked extensively with developing business rules engine enabling the business rules such as referral, prior authorization, eligibility, claims processing and billing essential.
• Utilized Agile Software Methodology using Scrum framework.
• Actively participated in creating the user stories and prioritizing user stories along with tracking of burn up, burn down charts to estimate sprint delivery.
• Performed GAP analysis by performing the system analysis between the scheduling systems and documented the gap items.
• Conducted JAD sessions, meetings, workshops to gather requirements from various stakeholders and SMEs.
• Facilitated all Aspects of scrum framework, including product backlog, release backlog, sprint planning session, daily scrum meeting, sprint reviews and sprint retrospectives.
• As scrum master communicated dependencies and potential risk to the completion of the sprints including resources, costs and systems.
• Created data mappings to transform the data according to business rules.
• Developed Test Cases for unit testing, prepared spreadsheet for testing criteria, including regression, positive and negative testing, process flow testing and screenshot for test results to complete expected and actual results.
• Prepared various diagrams by using MS Visio.
• Prepared documents for the wireframe and prepared a data dictionary for the same.
• Coordinated with the PMO group in defining timelines & schedules for the project.
• Managed testing for various functionalities using Quality Center tools.
• Worked closely with QA and Developers to clarify/understand functionality, resolve issues and provided feedback to nail down the bugs.
• Maintained a close and strong working relationship with teammates and management staff to achieve an expected QA result for the project team.
• Conducted project related Presentations periodically to the management and end users during various phases of Software Development Life Cycle (SDLC).

Environment: Agile Scrum, MS Office, MS Visio, MS Project, JIRA, SharePoint, Rally, UML, SQL

Confidential, San Francisco, CA

Senior Business Analyst

Responsibilities:

• Performed the requirement analysis, impact analysis and documented Business Requirements Document (BRD) and Functional Specification Document (FSD) using Rational Requisite Pro.
• Prioritized deliverables, identified gaps, tracked defects,defined software requirements, created artifacts for testing and development.
• Gathered knowledge on HL7, HIPAA rules and regulations.
• Mapped EDItransactions for837: healthcare claims and 835: payment advice transactions.
• Administered benefits and provider contracts on a QNXT system accurately analyzing configuration needs for processing claims.
• Collaborated efforts with technical staff and subject matter experts to establish the technical vision of product and analyze triple constraint tradeoffs.
• Analyzed Business processes, requirements, and data necessary to provide detailed logic for ETL development.
• Produced detailed source-to-target mappings for data warehouse/data mart objects.
• Created UML diagrams- Use Case Diagrams, Activity Diagrams, Sequence Diagrams and ER Diagrams in MS Visio.
• Documented the Traceability Matrix for tracing the Test Cases and requirements related to them.
• Conducted GAP Analysis of current state (As-Is) ICD 9 and proposed state (To-Be) ICD 10 situations and represented the same on MS Visio.
• Supported development of UAT cycle test scripts, Review User Acceptance Test Plan (UATP) and attended walkthrough.
• Recommended changes for system design, methods, procedures, policies and workflows affecting Medicare/Medicaid claims processing in compliance with government compliant processes like HIPAA/ EDI formats and accredited standards like ANSI.
• Managed the planning / test process for Medicare Part D Pharmacy Claims (PBM).
• Analyzed, maintained and updated FAQ knowledge base in SharePoint for better data accuracy and better timely data availability.

Environment: MS PowerPoint, Requisite Pro, MS Visio, QNXT, Adobe Dreamweaver, MS Excel, MS Access, Oracle, Clear Quest, Waterfall SDLC.

Confidential, Santa Ana, CA

Business Analyst

Responsibilities:

• Organized meetings and discussions with client and end users to understand the project requirement.
• Initiated JAD sessions and open-ended discussions to identify, clarify and simplify requirements with client and team.
• Created WBS, RBS and Gantt charts using Open Source Serena.
• Performed Gap Analysis with As Is -To Be Process flow diagrams using MS Visio.
• Created and updated the Burn down chart along with the scrum master.
• Created wireframe and mockups using Balsamiq and Adobe Dreamweaver.
• Assisted the scrum master to manage resources and facilitate for the team.
• Communicated and collaborated with diverse teams in the organization to understand the products, services, and the culture.
• Gathered the basic requirements from client and end users and discussed them with the team for the first sprint cycle.
• Researched, initiated and introduced new functionalities that could add value to the Business.
• Assisted the scrum master to communicate the team's progress on project.
• Conducted functionality tests with the team and end users to track defects using QC.
• Hands on branding overhaul to drive adoption, usability and consistency.
• Automated Business processes management and forms processing through out of the box workflows, SharePoint Designer workflows combined with InfoPath solutions.
• Supported cross functional group collaboration sites, secure team collaboration sites, executive blogging, help desk ticketing systems on-boarding and adoption.
• Supported a large project management portal that spans several site collections.
• Met with users, document requirements, estimate work effort and duration, configure application, unit test and draft change management communications.
• Support departmental site owners, end users and other content managers to ensure they have the training, materials and support for optimal use of their respective sites.

Environment: Scrum, HTML, MS Visio, Quality Center, Adobe Dreamweaver, Balsamiq, Open Source Serena, MS SharePoint, Oracle, MS Excel.

Confidential

Healthcare Business Analyst

Responsibilities:

• Gathering requirements for a data collection and reporting system.
• Researching various topics, scheduling meetings and documenting meeting minutes.
• Analyze patient accounts and clarify any information needed to correctly answer patient’s questions regarding their account.
• Performing application support monitoring system interfaces, generating reports, researching data issues, documenting support requests.
• Performing Business process support reviewing user questions, making data updates, providing one-on-one user training, identifying process improvements.
• Managed multiple Patients Accounts across various platforms.
• Provided good customer service to the patients by proving answers to their question in a timely and courteous manner.

Environment: MS Office, Windows, UML, MS Visio. MS Project, Java