SUMMARY

• A proficient committed and in detail oriented Business Analyst having 6+ years of diverse experience in Healthcare Industry.
• Good knowledge of Software development Life Cycle (SDLC) and Rational Unified Process (RUP) including requirement elicitation, analysis, design and development.
• Strong analytical and problem solving skills have helped initiate successful strategies and methodologies in various business areas.
• Experience in Business and Technical Analysis along with Project Management and Software Validation on client - server and web based applications; worked in structured and unstructured environments
• Conducted communication between the client and IT department, involved in eliciting, analyzing, and documenting Requirements.
• Understand the Business Rules and can effectively implement them in Business Process Flow
• Have experience in healthcare industry in working with various modules which include claims processing using EDI X12 transactions like 837, 834, 835 and 999(acknowledgement) which fall under the HIPAA compliance
• Experience in using requirement management tools, such as IBM Requisite Pro, HP Quality Center, Microsoft Word and share point for document management.
• Possess a detailed-oriented nature with good communication, interpersonal, problem solving skills, and recognized for being a valued team player

TECHNICAL SKILLS

Methodologies: SDLC, RUP, Agile, Waterfall

Modeling Tools: MS Visio, MS PowerPoint, MS Word, Rational Rose

Requirement Management Tools: Quality Center (QC), Rational Requisite Pro, MS-Word, MS-Excel

Testing Tools: Quality Center (QC), Rational Test Manager

Database: SQL, PL/SQL, MS Access, Oracle

PROFESSIONAL EXPERIENCE

Confidential, Deerfield, IL

Sr. Business Analyst

Responsibilities:

• Worked with a cross functional and diverse team of business users and developers to enable accurate communication of requirements and ensure consensus.
• Develop a Referral Web Portal for providers and members to view their referral information.
• The process consisted of gap analysis, compilation of results, impact assessment and designing new screens for secured web portal.
• Implemented an integrated RUP solution with complete line of trace ability for all the artifacts of web development projects.
• Worked in Agile methodology by closely integrating with the developers and business users.
• Designed and developed Use Cases and UML models using Rational and developed Sequence Diagrams, OOD using UML.
• Create test data for the controls developed by retrieving the data from the source and target tables by writing SQL and using some shell scripting and data formatting techniques to populate the data in the source and the target tables.
• Checked the data flow through the front end to backend and used SQL queries to extract the data from the database.
• Gathered GUI requirements from end-users and stakeholders and translated those requirements into wireframes in MS Visio, obtained sign-off at the end of the process
• Working with clients to better understand their needs and present solutions using structured SDLC approach.
• Lead JAD/JAR Sessions periodically with various Subject Matter Experts at various phases of the Development Life Cycle to discuss open issues and resolve them.
• Worked closely with business users for documenting the BRDs for reports and letter of claims, authorizations, quality improvement, marketing and customer service departments.
• Maintained documents as per Project Management Methodology (PMM).
• Was involved in QA the reports/letters before user testing and was communicating with developers if correction needed.
• Facilitated User Acceptance Testing (UAT) with the stakeholders and the business users, and the errors discovered were fixed and then verified via regression testing.

Confidential, CA

Business Analyst

Responsibilities:

• Gathered analyzed, documented business and technical requirements from both formal and informal sessions and validate the needs of the business stakeholders.
• Responsible for the full HIPAA compliance lifecycle from gap analysis, mapping, implementation and testing for processing of Medicaid Claims.
• Coordinated the upgrade of Transaction Sets 837P, 835 and 834 to HIPAA compliance.
• Documented Current State vs. Future State for a Referral Web Portal.
• Created user stories describing provider and member access to the web portals.
• Prepared product backlog working with product owner and other SME (Subject Matter Experts).
• Prioritize user stories and assigned to different sprints.
• Facilitated daily stand ups and managed task board with user stories and board.
• Prepared and tracked burn down charts and velocity charts for timely delivery of projects.
• Utilized corporation developed Agile SDLC methodology used SCRUM work pro and Microsoft office software to perform required job functions.
• Experience in designing and defining User Interface Requirements (UIR) and visual patterns by creating wireframes, screen mockups and story boards.
• Ran reports using Excel and Business Objects to compare and verify data.
• Conducted Business Requirements walkthrough with the business owners as well as the Technical Stake holders.
• Documented, tabulated and reviewed methods of valuation in effect, using SQL (to continue working on prototype developed by self)
• Perform various SQL data extractions for downstream systems, 3rd parties and for internal use
• 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.

Confidential, Dallas, TX

Business Analyst

Responsibilities:

• Performed Requirement Gathering & Analysis by actively soliciting, analyzing and negotiating customer requirements and prepared the requirements specification document for the application using MS Word.
• Coordinated the end to end testing efforts of HIPAA compliance and EDI transaction 837
• Identified opportunities for business process improvement through various meetings with business users and developers and initiated efforts to make improvements.
• Gathered requirements, organized team meetings requirements from business users, generated business process models, & use-case models, and created business requirements document (BRD) & functional requirements document (FRD).
• Developed the project plan with assistance from the management, and included provisions for project scope changes and issues and initiated efforts to make improvements.
• Conducted project kick off meetings with team members to explain roles / responsibilities, relationships with other groups, deliverables, timelines, assignments and status reporting.
• Created RUP activity diagrams and sequence diagrams to analyze the requirements and recommend solutions.
• Prepared scenarios, Use Cases & UML State Diagram for scenarios using Rational Rose.
• Prepare presentation slides in MS Project, which was extensively used in different JAD sessions and to track progress.
• Created Macros from MS Excel and imported Data from SQL server.
• Maintained a centralized data base (SQL Server) to store the entire source to target mappings (Data Mapping Repository).
• Used Test Director and Mercury Quality Center for updating the status of all the Test Cases & Test Scripts that are executed during testing process.
• Participated in the bug review meetings, updated requirement document as per business user feedback and changes in the functionality of the application.
• Organized meetings to discuss outstanding issues with QA and developers.
• Wrote test scripts for User Acceptance Testing (UAT).

Confidential - Richmond, Virginia

Business Analyst

Responsibilities:

• Gathered user and business requirements through interviews, surveys, prototyping and observing from portfolio managers and UI (User Interface)
• Organized, conducted JAD sessions for requirements gathered. Prepared Business Requirement Documents and Functional requirement Documents.
• Worked extensively on MS Project to develop Work Flow, Resource Planning, Activity Network diagrams, using PERT techniques.
• Worked with reconciliation system for the daily cash transactions checks between the Confidential and the financial institutions and prepared summary report on it
• Created Requirement Traceability Matrix to maintain all the requirements extracted from the Users, Stakeholders, made sure all the documents are being accounted for.
• Developed process flow diagrams Context Diagrams, Wireframes, Swim Lane Diagrams, which helped in Rapid prototyping and pinpointing potential problems early in the process.
• Coordinated with Project Managers, Developers, SME’s to design, create Work Flow Diagrams using MS VISIO.
• Reconcile daily transactions against generated reports, balance sheets, and general ledger accounts and post and prepare journal entries (J.E.).
• Process and apply loan payments (checks/wires) in the application and also provide information to the government-assigned and internal auditors.
• Calculate pay-offs and collect on delinquent accounts from financial institutions. And Provide vault custodians with instructions for securities that are being canceled and shipped.
• Generate ad hoc queries and monthly financial reports. And Distribute billing statements to borrowing institutions.
• Wrote SQL queries in MS Access for data manipulations.
• Revise user guides, procedures, and checklists semi-annually to ensure methods and practices are in line with county, state, and federal regulations and conducted UAT.
• Attend and participate in conference calls, status meetings, planning sessions and provide recommendations

Confidential, Harrisburg, PA

Business Analyst

Responsibilities:

• Converted the Business Requirements (BRD) into Technical Requirements (TRD) for the IT Department.
• Gathered and documented requirements for health insurance carriers.
• Served as subject-matter expert for payer and HIPAA ANSI transaction and code set
• Performed GAP Analysis, walkthroughs and acted as liaison between the business users, stakeholders and the team to perform requirements, quality and risk analysis.
• Developed Mapping rules, specifications and use cases for HIPAA 837, 270/271, 276/277, 835, 824, 275 and others. Worked on multiple 837s and 270/271’s.
• Maintained and tracked Stake holder’s requested enhancements and changes using Requirement Traceability Matrix (RTM).
• Worked with PMO group in defining timelines and schedules for the project.
• Documented and reported the progress to the Management on an ongoing basis.
• Organized and facilitated meetings like JAD sessions with the management and development teams.
• Schedule one- on-one meetings with technical personnel to determine technical parameters and processes including communication, security and privacy.
• Capable of writing basic SQL queries
• Interacted with development team to explain to them the various design documents like Business Use Case Model, Detailed Uses and Vision Document.
• Created detailed design of the system with the project team including class diagrams, activity diagrams and sequence and collaboration diagram.
• Coordinated daily activities with the IT Developers, QA and Product teams along with the project management group.
• Assigned problems to the appropriate software development team for fixes.

Confidential, Windsor, CT

Business Analyst

Responsibilities:

• Analyzed the Business Modules and their impact on the current system.
• Worked extensively on the Life Insurance, Fixed Income products like Annuities and Account Opening Modules, categorized customer base with the extensive services provided by Lincoln Financials.
• Created Requirement Specification Documents after conducting Interviews with End Users, JAD Sessions and analyzed their current systems.
• Used UML for modeling the business requirements
• Understand end-user requirements, their strategies, and their goals to create Requirement Specification Documents, Use Cases, and Work Flows in Microsoft Visio.
• Created standards / guidelines for business process modeling, Use Cases, Work Flows, Data Dictionary, and requirements specifications.
• Involved in Requirement Scoping and analyzing high priority requirement for implementation.
• Mentored end-users on requirements specifications techniques and the software development life cycle.
• Designed the test cases in generic manner so that test case can cater to the various types of tests required for the web site.
• Worked closely with UAT personnel to both ensure that their needs are met, and to provide sufficient understanding for the UAT test teams to own the automated system by the end of the project.
• Designed and created data reports and reporting tools to help business executives in their decision making.