SUMMARY:

• 8+ years of experience as business analyst performing business requirements modeling, risk analysis, software validation and development of Web Based, and Client/Server applications in diverse business domains of Healthcare/Insurance/Financial and Service Industry domains.
• Ability to gather and document Business Requirements, experienced in writing Use Cases. Proficiency in SDLC life cycle, understands the workflow concept, ability to gather and document the 'As - Is' and 'To-Be' processes.
• Requirement gathering through interviews, workshops, JAD sessions with clients, developers and QA Analysts and referring to existing system documentation and procedures.
• Expertise in EDI and HIPAA Testing Privacy with multiple transactions exposure such as Inbound Claims 834 - Membership Enrollment, 837-Institutional, 837-Professional, 835-Claim Payment/Remittance Advise, 270/271-Eligibility Benefit Inquiry/Response, 276/277-Claim Status Inquiry/Response Transactions and testing in Client Server systems and Mainframe Applications.
• Extensive knowledge of different kinds of testing like Back-End Testing, Positive/Negative Testing, Black box Testing, Configuration Testing, Data Driven Testing, User Acceptance Testing(UAT), Integration Testing, System Testing and Regression Testing.
• Created EDI files for test cases and verified those files, debugged the errors and corrected them according to the addenda for respective HIPAA implementations.
• Conducted a session with business, SME and other parties to gather the requirement for the integration of Facets with the providers and other third parties.
• Experienced in gathering and documenting test Scenarios and ability to train users at all levels to translate technical requirements and translate them to a business audience.
• Experience with FACETS solution for healthcare.
• Experience with claims processing, benefits, membership and pricing (Integrated NetworX Pricing)
• Understanding of HIPAA Standards and Compliance issues, HIPAA Privacy policy, opt in/opt out policy.
• Expertise in Claims, Subscriber/Member, Plan/Product, Claims, Provider, Commissions and Billing Modules of Facets.
• Worked in a software development IT shop, created quality documentations such as Requirements Documents, Design Document, Test Plan and User Acceptance Test Plans. Self starter with excellent time management skills.
• Strived to understand not just the technical needs of the client but also gained an understanding of the businesses.
• Writing Use cases, GUI and producing Use Case Model, Analysis model, Behavior diagrams (Sequence diagrams, Collaboration diagrams) and Class diagrams based on UML Methodology & Business process flow diagrams using Visio.
• Using Rational Unified Process (RUP), Rational Rose, Requisite Pro, Software Development Life Cycle (SDLC) processes and methodologies
• Writing & documenting Business Plan, Requirements Document, Functional Specification Document, and Test Case.
• Defining Test Cases, analyzing bugs, interaction with team members in fixing errors and User Acceptance Testing (UAT).
• Interacted with client regarding project status and feedback on UAT anddiscussed the information with the development team.
• Preparing User Requirement Specifications (URS).
• Requirement Analysis and preparing Use Cases.
• Strong knowledge of the Systems Development Life Cycle (SDLC) models such as Water Fall.
• Identifying and documenting critical requirements through analysis of the department’s workflow and information flow.
• Worked with all stages of testing namely, Integration Testing and System Testing using automated test tools and User Acceptance Testing using manual tests.

TECHNICAL SKILLS:

Requirement Management: Rational Requisite Pro, CaliberRM, Rally, DOORS

Methodologies: Agile/Scrum, RUP, Waterfall

Languages: SQL, C, C++, Java, .Net, HTML

Modeling Tools: MS Visio, Rational Rose

Defect Tracking Tools/Change Management Tools: Bugzilla, Rational ClearQuest, Footprints, JIRA

Wireframe/Mockup Tools: Axure, Balsamiq

Mapping Tool: Pervasive PSQL v10

Database: Oracle, MS SQL Server, Teradata, DB2

Testing Tools: HPQC

PROFESSIONAL EXPERIENCE:

Confidential, Miami, FL

BA Analyst

Environment: FACETS, MS-Visio, MS Word, MS Excel, MS-Project, MS Excel, MS Access, MS Sharepoint, Rational Unified Process, HP Quality Center, Rational Rose, Jasper, Windows 7.

Responsibilities:

• Involved in gathering requirements as per the consensus meetings between Humana and providers.
• Created domain models and made them an integral part of multiple FRDs that I created for various aspects of the project.
• Interacted with the stakeholders, Subject Matter Experts (SME), internal and external users to get a better understanding of client business processes and gather business requirements.
• Utilized survey assessment results of ICD-10 to create listing constraints, processes, projects and systems, applications and vendor software to be impacted by the ICD-10 Conversion Project.
• Developed Use Case diagrams and process flow diagrams using Rational Rose and MS Visio.
• Analyzed HIPAA 4010 and 5010 standards for 837P EDI X12 transactions, related to providers, payers, subscribers and other related entities.
• Worked on NetworX Pricing for Price validation between Qual and Prod environments.
• Actively prioritized and managed requirements throughout SDLC with all key stakeholders
• Supported QA in the definition and execution of integration and system testing.
• Negotiated and managed multiple priorities, project plans, time frames and trade-offs while ensuring the clinical and administrative staff understood the final results of the projects, sharing detailed vision of cost-benefit analysis.
• Provide input to estimates for project management and change management activities through analysis of requirements effort, resources, and technology.
• Worked on EDI 834, 835,837 as per HIPPA guidelines.
• Performed the detail comparison between 4010A and 5010 especially in regard to EDI 837.
• Help in preparing the training material of the providers and insurance companies using the software supporting ICD 10.
• Created the data models for thedata ware houseusing the star schemas and validated data models.
• Used the Rational Unified process methodology for the application development and created Use cases, activity diagrams and drafted UML diagrams using the Rational Rose.
• Created Meeting of Minutes documents that would cover all the important issues and decisions taken internally as well as with the client.
• Worked on cross-functional team to deliver software systems as per the customer expectations.
• Updated the requirements and prepared comprehensive Business Requirements Document (BRD) that provided the appropriate scope for the users and management to make appropriate decisions.
• Developed associated project documentation, schedule, design specifications, test plan, test scenarios/scripts, performed gap analysis, and test tracking reporting/monitoring for all phases of testing including B2B user acceptance testing.
• Involved in creating mappings for conversion of EDI X12 transactions code sets version 4010 to 5010 and translation of ICD 9 codes into ICD 10 codes.
• Worked with business leaders to translate business requirements and processes into test cases according to FACETS package requirements and subsequent effective FACETS configuration
• Created Data Flow Diagrams (DFDs) and ER diagrams for domain modeling.
• Involved in the testing of claims module andNetworXmodule ofFacets.
• Played a key role in planning UAT and implementation of system enhancements and data migration and conversions.

Confidential, Richardson, TX

Business Analyst

Responsibilities:

• Facilitated JAD sessions with SMEs’, Product owner, Product Sponsor, and Development managers to understand the business process, gather business requirements and identify enhancements for the web based application.
• Assisted in the development and update of project plans, schedules, estimates and timelines.
• Worked with the IT Team to establish deadlines for completion of project deliverables.
• Documented User Stories and have created Business Requirements document.
• Created BRFR (Business Rule Functional Requirements) to document functional and non functional requirements.
• Performed GAP analysis (AS IS- TO BE state) between EMS 1 and EMS 2 application.
• Facilitated the projects meetings, provided walkthrough to the Business, IT team whenever required.
• Created UI Prototypes, Wireframes, and UML diagrams like Use Case Diagram, Context Level Diagram, Activity Diagram, and Process Flow Diagram using MS Visio.
• Worked on multi vendor atmosphere and have interacted with Business, Enterprise Architect, IS Team, Development/QA team very closely.
• Worked very closely with Development Team to ensure that the functional requirements were clear and then provided clarifications whenever required.
• Worked closely with QA Team to create and review Test Cases and Test Matrix.

Environment: Visio, RxCLAIM, HPQC 10, SharePoint, Outlook, Java, DB2, Agile, Balsamiq.

Confidential, Schaumburg, IL

Business Analyst

Responsibilities:

• Involved in complete cycle of SDLC and lead the team when needed.
• Maintained functional and non-functional requirements for web-based application.
• Created Wireframes, Use Cases and documented them in functional specification document (FSD).
• Worked on new implementations and migration projects.
• Assisted in release plan and iteration plan for the project while working with the stakeholders.
• Worked on eligibility; EDI transactions like 270, 271, 278, 834, 835, and 837 to identify key data set elements for designated record set.
• Worked on ICD 9 (4010)- ICD 10 (5010) conversion and interacted/interviewed with business users, vendors and technical teams.
• Performed GAP analysis (AS IS- TO BE state).
• Involved in periodic testing with QA team and have worked on business process mapping and enterprise content management system (ECM).
• Facilitated pre-planning meetings, demos and daily stand ups.
• Assisted to create UI prototypes, Wireframes and Mockups.
• Wrote test cases and test scripts for the User Acceptance Testing (UAT).
• Good knowledge in BI (Business Intelligence) tools like SSIS, SSAS and SSRS to perform ETL.
• Analyzed and Prioritized permission levels based on roles of user and created blueprint of system architecture for the web-based application created for internal users.
• Prepared graphical depictions of use case diagrams and process flow diagrams.
• Tracked daily issues and dependencies and coordinated with common team to work on the impediment list.
• Worked with change control board to initiate/manage change requests.

Environment: Agile, Windows XP, MS Office suite, PowerPivot, MS Project, XML, SharePoint, Oracle Application server, T-SQL, MS Visio, Access Database, Quality center, Pervasive, RxCLAIM (AS400), MS Project 2007/2010, FootPrints

Confidential, Long Beach, CA

Business Analyst

Responsibilities:

• Worked with stakeholders to understand and document business requirements.
• Gathered and analyzed business, functional and non-functional requirements for understanding and translating these needs into Business Requirement Document (BRD) and System Requirement Specification (SRS) documents.
• Worked closely with CVS/Caremark, a PBM company representing Confidential for claim adjudications.
• Used Microsoft Dynamics CRM to streamline administrative tasks and business process.
• Created and managed requirements using DOORS.
• Facilitated Joint Application Development (JAD) Sessions and weekly client and team meetings.
• Created UML artifacts like activity, sequence and use case diagrams.
• Interacted with the Subject Matter Experts (SME) and stakeholders to get a better understanding of client business processes and gather business requirements.
• Worked as the primary liaison between the business user and the developers throughout the project life cycle.
• Performed and documented Gap Analysis (current and future state).
• Created RTM (Requirement Traceability Matrix).
• Managed CRs (Change Requests) and provided training to end-users.
• Used HP Mercury Test Director for Requirements and defects management.

Environment: .Net, C#, SQL, HTML, XML, J2EE, Crystal Reports, RUP, SharePoint

Confidential, New York. NY

Business Analyst

Responsibilities:

• Experience from Front to back office, worked with fund managers, financial advisors and technical team members.
• Interacted with Fixed Income business heads to finalize the Business Requirements for the application.
• Wrote SQL statements to extract data from the Tables
• Planned and defined system requirements to Wire Frame with Use Case, Use Case Scenario and Use Case Narrative using the UML (Unified Modeling Language) methodologies.
• Assisted with project team in the whole project lifecycle phases including scope analyzing, requirements gatherings, developments and quality assurance.
• Produced functional specifications and led weekly meetings with developers and business units to discuss outstanding technical issues and deadlines that had to be met
• Documented Requirements for Activity management, Fixed Income, Asset Management Services, property and casualty, Client portfolio management, Order management system, Performance, Equities, Reconciliation, Transaction capture/Execution and reporting requirements for the user interface.
• Conducted interviews with various business users to collect requirement and business process information using MS Visio.
• Documented existing and proposed process flow, analyzed current and target system, and conducted GAP analysis.
• Extensively involved with the trading activities of Credit Derivatives, Credit default swaps, Interest Rate Derivatives, FX Derivatives, Equity Derivatives and Commodity Derivatives; and Futures including Commodity Futures Contracts and Financial Futures
• Designed and developed project document templates based on Scrum Methodology
• Identified, researched, realized, investigated, analyzed, defined and documented business processes and Use Case Scenarios
• Involved in Managing Data modeling project from Logical design and implementation of Sybase Database
• Designed and developed all Use Cases and UML models using Rational and Visio
• Collaborated in building a business analysis process model using Rational Rose, Requisite Pro, and Visio.
• Prepared detailed design documents to translate business process effectively for developers and product managers using MS Visio.
• Played a key role in the planning, testing, and implementation of system enhancements and conversions
• Extracted data from Oracle database with MS Access, and performed SQL query, data analysis and verification.
• Assisted in system and User Acceptance Testing, performed client presentations.
• Provided technical support relating the messaging (Microsoft Outlook and Exchange). The candidate will be responsible for troubleshooting problems and advise on the appropriate action.
• Supported to escalated helpdesk tickets pertaining to Messaging (including Exchange/ Outlook/ Lync / Mime cast) in person, via phone, electronically.
• Participated in entering and tracking system defects in Rational Clear Quest.
• Worked with developers and designers of BPM System to make sure development understands business process and detailed technical requirements.

Environment: Windows, Oracle, SQL, MS Visio, HTML, PHP, MS Access, UML, Quality Center, Web Logic, Cognos, Requisite pro, Rational Clear Quest.

Confidential, Charlotte, NC

Business Analyst

Responsibilities:

• Observed the present system and gathered requirements by conducting interviews and prototyping.
• Successfully conducted GAP analysis and Impact analysis in order to understand the drawbacks in the present system.
• Documented critical business processes. Wrote Use Cases, functional specifications and business rules.
• Captured complete Use-Case models.
• Led the team in Use Cases, analysis, general design and design patterns.
• Identified all the business requirements of the management and ensured that all these requirements are traced to the Use Cases identified.
• Created Requirements Traceability Matrix in MS Excel to ensure collection of all essential requirements.
• Led & conducted JAD sessions to identify the flows and processes involved in the content.
• Analyzed system requirements and developed Test Plan and Test Cases for testing the functionality and security.
• Documented Requirements for Activity management, Fixed Income, Asset Management Services, property and casualty, Client portfolio management, Performance, Equities, Transaction capture/Execution and reporting requirements for the user interface.
• Validated all the issues returned from developers and performed regression testing on new builds.
• Coordinated with development team for all the issues related to deployments and defect tracking.
• Used Test Director for defect tracking and reporting the defects.
• Participated in walkthroughs and team meetings to discuss the issues arising out in testing.

Environment: Windows Server, Rational Rose, Requisite Pro, Rational Clear Quest, MS Visio, UML, HTML, MS Project, MS Excel. Erwin, Test Director, RUP.

Confidential, Melville, NY

Business Analyst

Responsibilities:

• Responsible for defining the scope of the project, gathering business requirements, doing gap analysis and documents them textually or within models.
• Created use case scenarios and documents work flow and business process.
• Prepared the UML Use Cases using Rational Rose.
• Supported IT unit creating functional specification documents for the design, development and implementation of strategic projects.
• Interacted with the stakeholders by interviewing them, by preparing questionnaire and getting feedback.
• Supported the assigned project manager with creating detailed project plans assisting in developing, scheduling and tracking project timelines.
• Analyzed and documented Business requirements and detail design of the software for full understanding of the business.
• Documented Requirements for Activity management, Fixed Income, Asset Management Services, property and casualty, Client portfolio management, Order management system, Performance, Equities, Reconciliation, Transaction capture/Execution and reporting requirements for the user interface
• Gathered and documented the requirements that are critical to the business mission and using those requirements to design application software.
• Gathered requirements for generating account balance and transactions reports for a full year.
• Analyzed the requirements for linking the card payment system to the centralized payment system.
• Used Requisite Pro to document requirements, associated change requests with requirements and connected requirements with Use cases.
• Documented business workflows textually as well as in UML diagrams according to RUP for the stakeholder review.
• Conducted JAD sessions to allow different stakeholders to communicate their perspectives with each other, resolve any issues and come to an agreement quickly.
• Involved in maintaining and managing different versions of Documents using Rational Clear Case.
• Conducted FRS and URS reviews and walkthroughs with the designers, developers and stakeholders.
• Performed feasibility, adaptability study and risk analysis to identify the business critical areas from the user perspective.

Environment: Rational Suite, Microsoft office, RUP, UML, MS-Visio, Java, Oracle, UNIX.