SUMMARY

• Senior Business Analyst with over 7+ year experience in Business Process Modeling, Business Requirements gathering, and Business Process flow.
• Cross - functional domain expertise including Healthcare, Insurance, Banking and Pharmaceutical domain.
• Strong experience in working in SDLC for various methodologies including Waterfall, RUP, Agile/SCRUM.
• Excellent knowledge of industry standard methodologies like Software Development Life Cycle (SDLC), Iterative Software Development Life Cycle Process as per Rational Unified Process (RUP), CMM (Capability Maturity Models) and Rational Tools used during various phases of RUP.
• Extensive experience at writing business requirement documents (BRD’s), defining project plans, preparing system requirements specification, and delivering project reports.
• Proficient increating flow charts, data flow diagrams, structure charts, use case diagrams, sequence diagrams, entity relationship diagrams, activity diagrams, process flow diagrams, wireframe prototypes, requirement traceability metrics andbusiness process models.
• Utilized Rational Clear Quest for change requests, enhancement requests, system defects and issues. Handled repository management for release, review and technical documents using Rational Clear Case to provide accountability and version control.
• Adequate knowledge in EDI/HIPAA health information & health care services regulatory environment working knowledge and compliance experience along with proficiency in using ICD10/ CPT/ANSI/HL7 coding standards.
• Excellent in HIPAA EDI transactions such as 834, 835(medical claim payments), 837 (medical claims), 276 (claim status), 277 (claim status response), and 278(Health care service review information).
• Experience in facilitating Joint Requirement Planning (JRP) sessions with Business User Groups, conducting Joint Application Development (JAD) sessions with IT Groups and Conflict Management with Project team members.
• Technical experience with data analysis, report design, web design, development, client interface design and experience with different databases like Oracle, SQL Server, DB2 and MS Access.
• Experience with building reports-SSRS, Crystal Reports, dashboards for analytics - Performance Point Services and collaborative team sites (using Microsoft SharePoint Server 2010).
• Involved in Test Planning, Test Preparation, Test Execution, Issue Resolution and Report Generation to assure that all aspects of a project are in compliance with Business requirement.
• Adept in maintaining Test Matrix and Traceability Matrix for functional requirement.
• Expert in preparing Test Cases, Logging and Tracking Defect / Bugs.
• Extensive experience in developing Use Cases, creating Screen Mockups, conducting Gap Analysis and Impact Analysis, SWOT Analysis, PESTLE, MOST, Cost Benefit Analysis, Risk Analysis.

TECHNICAL SKILLS

Business Analysis Tools: MS Office Suite (Word, Excel, PowerPoint, Visio)

SDLC Methodologies: Agile/SCRUM, Waterfall, Spiral, RUP Process and Prototyping

Internet Languages/ Web Applications: XML, UML, HTML

Databases and Tools: SQL Server 2005/2008, My SQL, Distributed DB, Oracle 9i/10/11g, MS Access, PL/SQL

Quality Management: IBM Rational Manual Tester, Quality Center, QTP, Load Runner

Project Management: Microsoft Project Professional

Operating Systems: Windows XP/7/8, Windows Server 2003/2008/2012 , Unix, Linux (Ubuntu)

Change Management: Rational Clear Quest 7.1, Rational Clear Case, Team Foundation Services

Languages: C/C++, Java, Shell Scripting, Python, VB.NET, JavaScript, JSON, CSS, VB6, PHP, Perl, ASP.NET, C#.NET

Business Intelligence / Reporting: SQL Server Reporting Services (SSRS), Performance Point Services, SOAP

Content Management System: Microsoft SharePoint Server 2010, MS CRM Dynamics 2013

Others: Visual Source Safe(VSS)

PROFESSIONAL EXPERIENCE

Confidential, Cranbury, NJ

Sr. Business Analyst

Responsibilities:

• Managed Project scope, milestones, risks and user acceptance tests with internal and external stakeholders.
• Conducted meetings with users and other stakeholders to elicit, organize and document the requirements and also created project status reports and feasibility reports for stakeholders.
• Gathered and analyzed the requirements and converted them intoBusinessRequirement Specifications (BRS) and Functional Requirement Specifications (FRS) for the designers and developers and QA Team to understand them as per their perspective.
• Designed and developed use cases, activity diagrams, and sequence diagrams using Net Beans.
• Extensively facilitated meetings/conference calls with stakeholders, project managers, developers, QA Analysts and other end users based onsite/offshore to deal withbusinessand technical issues and to resolve the issues.
• Created "As-IsBusinessModels" to understand the existing claim settlement process flow through interacting with SMEs, underwriters and Finance department.
• Shared knowledge by performing Impact Analysis on transition from ICD 9 - ICD 10, made suggestions on UI and other changes required to be met during transition.
• Worked intensively with Medicare & Medicaid claims and claims processing for HIPAA transactions.
• Involved in requirements gathering and preparing the technical system design and System Design analysis of the flow of EDI transaction sets 834, 835, 997.
• Performed Gap Analysis for new functionality requirements, as well as prioritized them based on actualbusinessneeds so as to align them with the product release roadmap.
• Involved in testing the conversion of the application by generating test scenarios in test plan document.
• Validated data at the back-end to ensure that all the Claims related data had been loaded to the corresponding Data Sets in the back-end and the pricing for these Claims was completed as per the Standards.
• Analyzed the results, generated reports and tracked the defects using Quality Center.
• Created and maintained the Test and Traceability Matrix.
• Conducted System, Integrated and Regression testing to the application usingBusiness, Functional, User Acceptance and Usability testing.
• Prepared test data in HIPAA compliant X12N format for both inbound and outbound healthcare EDI transactions.
• Trained implementation managers to work on the new application.
• Generated SQL scripts for Development and testing purposes.
• Actively participated in all phases of testing lifecycle (Design, Planning, Development and Results).

Environment: Windows Server 2008, SQL Server 2008, Oracle 11, PL/SQL, MS Excel, MS Visio, MS Project, .NET, Java, JavaScript, JSON, SOAP, UML, Agile, Quality Center.

Confidential, Jacksonville, FL

Sr. Business Analyst

Responsibilities:

• Involved in the analysis of the functional, technical specifications, data mapping document and conceptual diagrams.
• Wrote system requirements specification (SRS) and functional requirements specification (FRS) and Data Requirement Matrix (DRM) documents as per the business requirements and process flow.
• Documented user stories and modeled use case diagrams by utilizing MS Visio.
• Conducted Joint Application Development (JAD) sessions to develop and agree upon a system that focuses on a Business Requirement.
• Created Use Case Models,Wireframes & Mock-ups,, Analysis Models, Design Models, Use Case Diagrams, Behavior Diagrams (sequence diagrams, activity diagrams) based on UML methodology
• Wroteprocess flow andbusinesscase documentsof existing processes.
• Actively involved in design of wireframes for the different UI’s with UX architects by mitigating the requirement and business validation rules.
• Defined frameworks for the application development and analyzed the areas of improvement
• Highly interacted with the development team and claim settlement experts making sure that the development of the project is meeting the business requirements.
• Jointly responsible for monitoring the progress of the system development by preparing status reports.
• Conducted daily interaction with the development team, stake users, business executives and Quality assurance to coordinate all the engineered process.
• Analyzed the security implementation of the application with respect to user’s perspective.
• Worked with the data architecture and data analyst team in designing the model and in creation of the data mapping documents.
• Worked on MS CRM Dynamics for handling the customer claim inquiries, Validation and case creation.
• Prepared test data for the functional test cases, manual test planning and creation of the test cases based on the user expectations.
• Evaluated test results and prepared test summary reports. Performance testing analysis was also done by analysis the results from balance and load tests.

Environment: Agile, SharePoint Server 2010, Dynamics CRM 2013, JAVA, MS Office, MS Visio, SQL Server 2008 R2, .NET Framework 3.5, JSON, PL/SQL, QTP, VSS

Confidential, Alpharetta, GA

Sr. Business Analyst

Responsibilities:

• HIPAA Transactions mapping experience and in-depth knowledge of HIPAA framework. Strong experience transacting with Healthcare EDI standards - ANSI X12 v, 835/837, 270/271, 276/277 and HR-XML formats.
• Participated in the initial Impact Analysis (ICD-10) for all the critical functions, i.e., Membership & Enrollment, Claims Processing, Utilization Management, Medical Policy, Reporting, Vendor Management.
• Used MDM for collecting all the data from their current system which is in ICD 9 and used to upgrade to ICD 10.
• Using Master Data Management providing processes for collecting, aggregating, matching, consolidating, and quality-assuring, persisting and distributing such data throughout an organization to ensure consistency and control in the ongoing maintenance and application use of this information.
• In the course of transformation and normalization, administrators adapt descriptions to conform to standard formats and data domains, making it possible to remove duplicate instances of any entity. Such processes generally result in an organizational master data management repository, from which all requests for a certain entity instance produce the same description, irrespective of the originating sources and the requesting destination.
• Performed impact analysis on 5010 upgrades and ICD-10 conversions.
• Performed Gap Analysis between ICD 9 and ICD 10.
• Participated in ICD 9 to ICD 10 codes conversion requirement gathering sessions and created high level business requirement document.
• Prepared product backlog working with product owner and other SME.
• Prioritize user stories and assigned to different sprints.
• Prepared and tracked burn down charts and velocity charts for timely delivery of projects.
• Prepared 5010 GAP documents involved with 837 and 835 transactions in collaboration with other team members.
• Defined ICD-9 to ICD-10 mapping process using GEMs (General Equivalency Mapping) crosswalk file.
• Created custom mapping between ICD-9 and ICD-10 codes.
• Change Control Process - Led the Change Control Process for changes submitted for the BRD once the document was submitted to IT department.
• 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
• Maintained the Traceability Matrix table to uniquely trace the identified business requirements to general design to testing as proof that requirements requested have been developed into a solution and that it has been tested and tracked.

Environment: Windows Server 2008, SQL Server 2008, MS Excel, MS Visio, MS Project, .NET 3.5, XML, Java, JavaScript, JSON, SOAP, UML, SDLC/Agile, Quality Center, UAT.

Confidential, Columbia, SC

Business Systems Analyst

Responsibilities:

• Interviewed Business Users to gathered Requirements and analyzed the feasibility of their needs by coordinating with the project manager and technical lead.
• Collected requirements from department managers and users for enhancements. Acts as liaison between clients and development. Facilitates sessions to bring business requirements and functionality into system development and enhancement.
• Prepared Business Requirement Documents (BRDs) after the collection of Functional Requirements from System Users that provided appropriate scope of work for technical team to develop prototype and overall system.
• Created relationships in Requirement Traceability Matrix linking Business Requirements to Functional requirements and Functional Requirements to Systems Requirements.
• Interacted with users for verifying User Requirements, managing Change Control Process, updating existing Documentation.
• Identified documented data sources and transformation rules required to populate and maintain data warehouse content.
• Tested Performance Accuracy related queries under SQL Server.
• Identified and created all necessary Business Use Cases from requirements, created UML Diagrams including Activity Diagrams and Sequence Diagrams using Microsoft Visio.
• Conducted issues resolution sessions to allow regional stakeholders to communicate their perspectives with each other, resolve any issues and come to an agreement quickly. Understood the business logic, User Requirements and test-objectives to develop test plans, test cases, and test case execution using Test Director.
• Managed UAT Release for major software releases with regional users & IT team. Performed UAT for various projects, and identified defects/bugs in the software and tracked them to successful resolution
• Liaised between the IT team and Business Users to resolve the gaps, defects/bugs identified during the course of UAT.
• Designed and implemented basic SQL queries for testing and report data validation.
• Ability to write test scenarios and test cases and involved in maintaining test matrix and Track Product backlog.

Environment: Microsoft Office Suite(MS Word, Excel, Power point, Visio), Agile/SCRUM, Windows 8, SQL Server 2008, Load Runner, Quality Center, .NET framework.

Confidential, New York, NY

Business System/Analyst

Responsibilities:

• Facilitated JADbusiness process sessions, and authored theBusiness Requirements Document, Business Process Traceability Matrix, and the System Architecture Specification documents.
• Aligned requirements to project scope, objectives, and deliverables.
• Coordinated with the Project Manager to prioritize outstanding defects in Quality Center or enhancement/system requests based on business requirements and available human resources, allowing sufficient time to ensure accuracy and consider deadlines.
• Successfully gathered, documented business requirements and obtained sign off from business users / sponsors.
• Prepared use case models based on Business Requirement Document (BRD) gathered through interaction with users and the stakeholders.
• Implemented RUP, which included requirements, specifications, design and analysis.
• PreparedRational Suite (Clear Quest and Requisite Pro) training materials for user and administrators and trained nearly thirty of them in the branch office.
• Documented project plans, process flow, timelines and other requirements.
• Facilitated meetings and Joint Application Development (JAD) sessions with business stakeholders and technical units.
• Implemented best practices, facilitated meetings between business users and third party application vendors.
• Created and maintained the Requirements Traceability Matrix (RTM).
• Worked with the Project Manager on various Project Management activities like keeping track of Project Status, Deadlines, Environment Request, and Compliance Issues.
• Identified and analyzed the data requirements for the various site teams and made sure that the required data is available in the testing environment.
• Worked directly with software engineers to ensure clear communications on requirements and defect reports.
• Was involved in Functional System Testing, Integration Testing, Regression Testing, and User Acceptance Testing before releasing the application.
• Validated the scripts to make sure they have been executed correctly and meets the scenario description.
• Involved in project status meetings, QA review meeting, and System Test meeting.
• Developed test scenarios based on business requirements and technical specifications.

Environment: Quality Center, QTP, SOA, Web Services, PHP, Web Sphere, DB2, Oracle, Actuate Reports, SQL, XML, HTML, DHTML, JavaScript, MS Office, UML, RUP and MS Visio.