Skills Summary:

• 7 years of diverse experience as Business Analyst with the expertise in business process analysis, business process modeling, business requirements, database design and strategic planning in Insurance and Health Care domains
• Experienced in writing and documenting Business Requirement Documents BRD , and Functional Requirement Documents FRD .
• Functional knowledge of various modules of insurance like channel management, policy servicing, claims management, underwriting, and reinsurance.
• Expert in Business process analysis, Requirement gathering, System analysis, Business Process Reengineering BPR , Functional Design and Documentation FDD .
• Experience in conducting interviews, Joint Application Development JAD sessions and facilitating presentations.
• Expert in Software Development Life Cycle SDLC methodologies like Waterfall, RUP, Agile/ Scrum.
• Developed expertise with ACORD standard Life, Annuity Health data model and data collection requirements, form models and archival stipulations.
• Familiar with current industry standards, such as HIPAA, Six Sigma, and Capability Maturity Model CMM .
• Expertise in EDI and multiple transactions exposure such as Inbound Claims 834-Benefit Enrollment and Maintenance, 835-Claim Payment/Remittance Advise and 837 Health Care Claim Status Inquiry/Response Transactions and testing in Client Server systems and Mainframe Applications.
• Medical Claims 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
• Experience in Risk analysis, Feasibility study, SWOT Analysis and Cost Benefit Analysis.
• Experience in tracing business requirement using Rational Requisite Pro while maintaining customer needs and maintain Requirements Traceability Matrix RTM .
• Efficient in gathering, detailing, documenting and validating business and functional requirements
• Performed Gap Analysis to check the compatibility of the existing systems new business requirements using AS-IS and TO-BE business requirements.
• Proficiency in analyzing and creating Use Cases, Use Case Diagrams, Activity diagrams, Class diagrams and Sequence diagrams using UML methodologies and tools such as MS Visio and Rational Rose
• Experienced in creating Data Flow Diagrams and Business Flow Diagrams
• Understanding of Database Management Systems DBMS , Data Warehousing DW concepts, Business Intelligence Technologies and Data Mapping.
• Created Test Plans, Test Cases and Test Scripts and performed manual/ functional testing activities
• Skilled at reviewing test cases making sure they are in accordance with requirements, and assist the overall testing process and conducting User Acceptance Testing UAT .
• Tracked and maintained user requested enhancements and changes.
• Innovative, excellent team player and possesses great data analysis skills.
• Proven ability to work under pressure, prioritize tasks and meet deadlines. Open to dynamic work environment and ability to work collaboratively with other business analysts, testers, developers and other team members.
• Excellent communication, written and interpersonal skills, leadership qualities, great mentor and able to work independently.

Technical Summary

Professional Experience:

Confidential

Sr. Business System Analyst

Confidential is a group of insurance and financial services companies in the United States. It offers life, health auto insurance and financial services. Its business process is based on the agent system and mission is to help people manage the risk of everyday life.The aim of this project was to build a web based system that would aid the agency system. Hence, customers could either make the choice of talking to the agents directly or using the system to get quotes, make payments and file claims.

Responsibilities:

• Performed requirement analysis by gathering both functional and non-functional requirements based on interactions with the process owners stakeholders, document analysis, JAD sessions, user interviews, creation of user stories and documented those requirements in the BRD and TRD.
• Reviewed activity reports to ensure that personnel achieve sales quotas, processes claims promptly and credit collections to policyholder' accounts
• Analyzed the AS-IS and TO-BE systems to perform GAP Analysis and make recommendation for system enhancement.
• Assessed the flaws in the existing as-is system and made clear recommendations of business process improvements and BPR, and incorporated them in the to-be system design.
• Wrote Business Requirement Documents BRD and Functional Requirement Documents FRD documents as per the business requirements and process flow.
• Making sure current project requirements are being met by using Requirement Traceability Matrix RTM
• Actively involved in the creation of UML Sequence and Activity Diagrams for certain modules of the application in collaboration with design team by utilizing MS Visio and Rational Rose.
• Implemented ACORD for reinsurance industry standards worked in the RUP environment for the elicitation, representation of requirements and in change management.
• Used Rational Clear Quest for all types of change requests, including defects, enhancements, issues and documentation changes with a flexible workflow process.
• Developed and updated data mapping document at each phase of development and logical data modeling.
• Assisted and directly involved with QA team and UAT test strategies, including regression and integration testing, wrote test scripts, end-to-end testing scenarios and test plans, managed testing, defect reporting and change requests.
• Created Use-Cases, BPM, and Requirement documents to document the Business needs.

Environment: SAS 9.0, Rational Suite Tools, MS-Word, MS-Visio, MS-Project, Informatics, Windows NT 4.0, UNIX, Oracle 8i, PL/SQL, UNIX Sequential Files, MS Access, Dot Net Framework, Java.

Confidential

Sr. Business Analyst.

Confidential is a leading property/casualty and life/health reinsurance company and is a wholly owned subsidiary of The assignment was a major up gradation project. It involved retirement of a host of legacy applications with a third-party Policy Administration system called One Shield Dragon and was planned for implementation in 2 phases, Release 1 2. Release 2 was divided into 3 categories viz. Product requirements, Non-Product requirements and Integration. Non-product needs are those that support business architecture changes. As a Business Analyst, was involved with 4 modules within the Non-product requirements namely Workflow Enhancements, Name Clearance, Ceded Re-insurance and Automated Policy Numbering.

Responsibilities:

• Documented the artifacts in required formats namely Business Requirement Document, Functional Requirement Document and Business Scenario Document.
• Responsible for gathering requirements through interviews and status meetings with Business users and SMEs from the Operations, Underwriting Property Casualty , BPO and the MGA fronts.
• Conducted JAD sessions to discuss requirements and resolve conflicts between stakeholders
• Capturing requirements in informal and formal sessions while maintaining scope and change control to provide the best quality in all of the assigned jobs and get mutual satisfaction of the business partners/sponsors.
• Responsible for Product Management, Business Process flow, Business Process Modeling and Business Analysis with Document and Records Management.
• Analyzing and translating user-level requirements into a logical design, using UML diagrams, Use Cases and Activity diagrams.
• Performed data mapping, logical data modeling, created class diagrams and ER diagrams.
• Created screen mock ups based on the requirements put forth by the SMEs.
• Participated in working sessions with the PM and SMEs which involved white boarding the scenario flows for gaining better clarity on the requirements.
• Able to bridge the difference between the end user's non-technical point of view and the developer's technical point of view to clarify uncertain requirements.
• Held elicitation workshops and attended demo sessions along with Business Analysts to do the Feasibility study and understand the existing capabilities of the Policy Administration system before customization.
• Performed Gap Analysis to check the compatibility of the existing system infrastructure with the new business requirements.
• Involved in creating the targeted questionnaire for SMEs and Business users for elaborating and getting clarity on requirements.
• Participated in interactions with the Subject Matter Expert, Project Manager, Developers, and the End-Users.

Environment: Waterfall, MS Word, MS Excel Definition Workbooks , MS PowerPoint, Lotus Notes 8.5, E-room and MS Visio.

Confidential

System Analyst

Confidential Corporation provides health care and related benefits in the

Confidential. The Health Care segment offers insured and self-funded medical, dental, behavioral health, vision, and prescription drug benefit plans health advocacy programs other products and services that provide individuals with health care benefit programs and disability and life insurance products, as well as operates retail pharmacies. This project aimed at streamlining and standardizing of the claims process specifically 834, 835 and 837 transactions which was achieved by incorporating the business rules to increase automation, enhanced interfaces for seamless integration with back-office systems and claims tracking system.

Responsibilities:

• Defined the scope and business rules of the project, gathered business requirements and documented them textually or using models.
• Conducted Interviews, user meetings, JAD sessions, and Requirement Elicitation Sessions for open and pending issues to develop specifications.
• Experienced in interacting with business users to identify their needs, gathering requirements and authoring Business Requirement Documents BRD , Functional Requirement Document FRD and Software Requirement Specification SRS across the deliverables of a project.
• Analyzed trading partner specifications and created EDI mapping guidelines.
• Created Use-Case Model, Sequence Diagrams and Activity Diagrams after accessing the scope of the Project and understanding the business processes.
• Performed gap analysis to identify and document the gaps between the existing system and new system.
• Schedule meetings with technical personnel to determine technical parameters for EDI and other related processes, including communication, security, and privacy. Create transaction sets requirements, usually with Microsoft Excel, for transactions such as: 834, 835, 837- I, P, D , 835 Remittances and others.
• Documented Requirement Traceability matrix in Requisite Pro for traceability of requirements through test cases.
• Reviewed test cases written by QA team and made modification for better execution of test cases.
• Performed User Acceptance Testing UAT with the stakeholders and business users fixed the discovered errors and verified it through regression testing.
• Served as the primary point of contact between business and technical staff at all levels.
• Created Use Case diagram, Sequence diagram and Activity diagram for understanding the business processes.

Environment: Windows, MS Office MS Word, MS Excel, MS PowerPoint, MS Visio , MS Access, UML, RequisitePro, Agile, Rational Rose, Quick test Professional QTP

Confidential

Business Analyst

Confidential insurance is involved in various forms of insurance, which range from General insurance to Life insurance. The project sought to improve the online claims system for auto insurance. Functionalities here were reporting of claims online, uploading photographs and using templates to describe the accident. Also included in the functionalities were checking of claims status as well as statues of repair, in photographs.

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 improved business process.
• Worked closely with Business Users to gather and understand requirements for streamlining the Claims Processing System. Prepared business requirements documents BRD and functional requirements FRD .
• Involved in claims and records data mapping and data modeling with technical teams.
• 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. 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 .
• Helped the PM in initiating the project, preparing the Business case and planning it.
• Interacted with the SMEs and stakeholders to get a better understanding of client business processes and gather business requirements.
• Prepared and maintained Requirement Trace ability Matrix RTM in Rational ReqPro.
• Assisted in locking bugs, in order to meet specific requirements and deadlines for successful execution of the project.
• Created Business Intelligence reporting, Performed analysis data/report integration provided functional specification to development team for better understanding of business process and data.
• Created use cases, process flow models, data flow diagrams and logical flow diagrams using UML for various integrations.
• Gathered requirements from the end-users and acted as a liaison between the end-users and the development team and QA team.
• Created QA and UAT test strategies, including regression and integration testing, wrote test scripts, end-to-end testing scenarios 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, RUP, HP Quality Center, Dot Net Framework, Java.

Confidential

Business System Analyst.

Confidential Healthcare Solutions is a leading provider of Health Care Informatics Confidential is a publicly traded American company that provides physician practices, hospitals, and other healthcare providers with practice management and electronic health record technology, including electronic prescribing, care management, and revenue cycle software.The project was to develop a Provider Desktop module for the EHR Electronic Health Record System with the objective to improve productivity and patient care. It serves as a central dashboard for providers to access crucial information such as Patient appointments, Clinical results, Messages, Electronic lab orders and Patient encounter notes anytime anywhere. The project was implemented securing patient privacy and health information conforming to HIPAA standards and guidelines.

Responsibilities:

• Interacted closely with the Business users along with the administration and management to gather business requirements and analyze the functionalities to be incorporated into the system.
• Attended demo sessions to understand existing system functionalities.
• Followed the Agile methodology during the entire SDLC
• Arranged interviews with all the stakeholders to review and understand the gathered business requirements.
• Formulated Data Mapping Guide for the technical team.
• Coordinated with system architects and developers to convert business requirements into system requirements.
• Conducted meetings to document Change Requests for new requirements.
• Analyzed business requirements and segregated them into Use Cases. Created Use case diagrams and documented Use case specifications.
• Maintained various versions of the documents generated during the project using Rational Clear Case.
• Was responsible for creating and updating project schedule and managing resources and timeline using MS Project.
• Worked with the ETL development team for migrating the data from the old data mart to the new IDW Insurance Data Warehouse and to validate the data integrity.
• Prepared the project status reports and represented the BA team in the PMO meetings.
• Participated in UAT along with Business SME's.

Environment: RUP, MS Visio, MS Project, MS Office Suite Word, Excel, Access, Power Point, Outlook .

Confidential

Business Analyst

The project was to implement a powerful CRM solution for its sales team to manage the relationship with their potential customers and to enhance customer satisfaction. Being a Business Analyst my project was to implement Salesforce CRM to offer a web-based interface for account management, contact management, reports generation and tracking sales lead.

Responsibilities:

• Worked as a Business Analyst to review the project plan and formulated schedule to gather requirements from business users
• Designed use-cases and use-case models to further refine the requirements and understand the business processes. Worked extensively in Rational Requisite Pro to organize and catalog requirements, documents, and use-case documents.
• Interacted with Traders, Developers, Project Manager and Process Analysts to understand the business processes, identified enhancements and gathered business requirements.
• Prepared Business Requirements Document BRD
• Performed Requirements Analysis and Documentation using Requisite Pro.
• Worked as a team with ETL Developers and Process Analysts in preparing the requirements, and writing work flows, process flows
• Performed Feasibility, Adaptability and Risk Analysis to identify business critical and high-risk areas of the application
• Created UML diagrams such as Use Case Diagrams, Activity Diagrams, Data-Flow Diagrams using Rational Rose and MS Visio to define the Business Process and Data Process model
• Used MS Project for managing schedules, resources and collaboration
• Used Rational Unified Process RUP for managing the SDLC
• Used Rational Clear Quest to track bugs and system enhancements
• Conducted JAD sessions to discuss requirements and resolve conflicts between stakeholders
• Involved with the QA team to develop and review Testing Strategies and Test Plans
• Actively involved in walkthroughs and meetings with development team to discuss related issues

Environment: RUP, MS Visio, MS Project, MS Office Suite Word, Excel, Access, Power Point, Outlook .