SUMMARY

• Business Analyst with over 8 years cross - functional experience in complete lifecycle of leading-edge technologies Software Development Life Cycle (SDLC); including gathering user requirements, business analysis, system analysis, design, development, testing, change control and implementation of projects in business systems and applications.
• Designed and reviewed various documents including the System Requirement Specifications (SRS), Business requirements document (BRD), Use Cases, Functional Specifications (FSD), Systems Design Specification (SDS), Requirement Traceability Matrix (RTM) and testing documents.
• In depth knowledge of UML in visualizing and documenting the artifacts using Use Cases diagrams, Class diagrams, Sequence diagrams, and Collaboration diagrams in Rational Rose and MS-Visio.
• Experienced in facilitating Joint Application Development (JAD), Rapid Application Development (RAD) and Joint Requirement Planning (JRP) sessions, interviews, workshops and requirement elicitation sessions with end-users, clients, stakeholders and development team Knowledge of Claims Processing and HIPAA regulations
• Experience with writing SQL queries.
• Extensive Knowledge of Medicare, Medicaid, procedural and diagnostic codes
• Knowledge of EDI and HIPAA Testing Privacy with multiple transactions exposure such as 837, 834, 835, 277, 270, 271
• Experience in Conversion of HIPAA X12 4010 transactions to X12 5010 transactions and knowledge of ICD 9 - ICD 10 conversions
• Working Knowledge of Client-server Architecture and Application Servers
• Facilitated project meetings, reviews, walkthroughs, and customer interviews to gather requirements and relevant information for Business analysis
• Generated Requirement Traceability Matrices to ensure that all the requirements were met in each phase of the Software Development Life Cycle
• Experienced in handling Change Management, writing Test Plans and executing Test Cases
• Experienced as BA/QA analyst in Defect Tracking and extensively involved in User Acceptance Testing (UAT)
• Exceptional Problem Solving and Sound Decision Making capabilities, along with the ability to resolve difficult situations
• Creative and aggressive self-starter with integrative thinking skills and capable of communicating creative ideas through Graphical Modelling

Analysis Methodologies: RUP, UML, Six Sigma, Agile methodology, Waterfall methodology, CMM

Operating Systems: Win 95/98/NT/2000/XP/Vista/6

Languages: SQL

Change Management Tools: Rational Clear Quest, Test Director

Business Modelling Tools: Rational Rose, Microsoft Visio.

Requirement analysis and Management: Rational RequisitePro, Test Director

Reporting: Crystal Reports, MS Project, MS Visio

Project Management: Microsoft Project, Microsoft Office

Testing Tools: Rational Enterprise Suite, Test Director, Quick Test Pro

Quality Management: ISO 9000

Project Management: MS Project

Office Tools: MS Word, Excel, Power Point, Project, Outlook

PROFESSIONAL EXPERIENCE

Confidential, New York, NY

Sr. Business Analyst

Responsibilities:

• Applied RUP methodology with its various workflows, artifacts and activities to manage life cycle from Inception to Transition phase.
• Acted as liaison between external clients and SMEs to generate and standardize product requirements specification documents such as URS/FRS/UseCases.
• Employed UML methodology in creating UML Diagrams such as Use Cases, Sequence Diagrams, State Diagrams, Activity Diagrams and business process and workflows.
• Was engaged in applying CMM standards which provided guidance for improving organization’s processes and the ability to manage the development, acquisition, and maintenance of products or services Cigna was providing to its clients.
• Assisted JAD sessions to identify the business flows and determine whether any current or proposed systems are impacted by the EDI X12 Transaction, Code set and Identifier aspects of HIPAA. Involved in GAP analysis, mapping, implementation, and testing for processing of Medicaid Claims. Worked on EDI transactions: 270, 271, 835, 834 and 837 (P.I.D) to identify key data set elements for designated record set.
• Involved in designing & determined 3-tier architecture for the claim processing system. Assisted team lead in developing Requirements Traceability Matrix (RTM) to trace the relationship between business and functional requirements to test cases. Prepared and executed different Test Cases and Test Scripts.
• Involved in conducting Functionality testing, Integration testing, Regression testing and User Acceptance testing (UAT). Provided analysis and insight to QA Team in defects and bugs tracking.
• Conducted in-depth research as well as gap analysis on claims, provider & member information on the internal claims adjudication system called Xcelys.

Environment: Windows NT/2000, MS SQL Server, Rational Unified Process (RUP), CMM, UML, Rational Rose & RequisitePro, Mercury Quality Center & Test Director, Clear Quest, MS Office Tools, MS Outlook, Java.

Confidential, Providence, RI

Sr. Business Analyst

Responsibilities:

• Extensively involved in gathering requirements from clients and created Business Requirement Document (BRD) and facilitated in creating System Requirement Specifications (SRS) Document.
• Acted as a Liaison between IT Team and Business Client, analyzed Business Requirements and segregated them into high level and low level Use Cases, Activity Diagrams, State Chart Diagrams using Rational Rose according to UML methodology
• Applied RUP methodology with its various workflows, artifacts and activities throughout the software development life cycle from Inception to Transition phase
• Facilitated JAD sessions with different stakeholders on their objectives and closely worked with the developers and testers throughout the project
• Identified the business flow and determined whether any current or proposed systems are impacted by the EDI X12 Transaction, Code set and Identifier aspects of HIPAA
• Analyzed the As Is system and developed the To Be system concept, thus performed GAP analysis. Worked on EDI transactions: 270, 271, 835, and 837, NCPDP to identify key data set elements for designated record set
• Maintained proper communication with the developers ensuring that the modifications and requirements were addressed and monitored
• Involved in compatibility testing with other software programs, hardware, Operating systems and network environments
• Assisted the team lead in developing Requirements Traceability Matrix (RTM) to trace the relationship between business and functional requirements to test cases.
• Prepared and executed different Test Cases and Test Scripts
• Involved in conducting Functionality testing, Integration testing, Regression testing and User Acceptance testing (UAT)
• Provided analysis and insight to QA Team in defects and bug tracking.

Confidential, Minneapolis, MN

Business Analyst

Responsibilities:

• Worked with business representatives to understand requirements and priorities and ensure that software development work is appropriately aligned
• Involved in the meeting with Business Process Owners, SME (Subject Matter Experts) and Health Centre users for Requirement gathering in Definition Stage using Rational Requisite Pro
• Facilitated Joint Application Development (JAD) Sessions, as well as weekly client & team meetings
• Interacted with the Subject Matter Experts (SME) and stakeholders to get a better understanding of client business processes and gather business requirements
• Performed Gap Analysis to identify the deficiencies of the current system and to identify the requirements for the change in the proposed system
• Manage Scope and change throughout the SDLC process of the product
• Responsible for writing Functional Requirement Specifications (FRS)
• Participated in user meetings, gathered Business requirements for the Data- warehouse design
• Work responsibilities primarily involved understanding the business logic, designing requirements, communicating them to the developers, generating documentation, designing use cases, creating various diagrams like State Diagrams, Sequence Diagrams as part of project.
• Maintained Traceability matrix throughout the project.
• Created standards / guidelines for business process modeling, Use Cases, Work Flows, Data Dictionary, and Requirements specifications.
• Mentoring end-users on requirements specifications techniques and the software development life cycle.
• Assisted with building the EDI 837(I, D, P), 835, 277-U, 270/271, 276/277, 278, 820 and 834 transactions processing flow from the Trading Partners to the translator to the Mainframe and back to the Trading Partner.
• 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: HIPAA 270/271, 276/277, 835, 837-(I, P, & D), 835 Remittances and others. Resource for UB92 and HCFA1500 billing format, transaction sets requirements, EDI development and Design, X12 protocols through Version 4010 A1 and newer, conversion needs and understanding of legacy EDI formats, such as UB92 Versions 4, 5, 6 and NSF.
• Gathered and analyzed requirement for ICD 9 to ICD 10 changes
• Involved in up-gradation of HIPAA X12 4010 transaction to HIPAA X12 5010 and ICD 9-CM (Clinical modification) to ICD-10-CM/PCS (Clinical modification/procedure coding system) simultaneously.
• Knowledge of industry billing and coding compliance requirements
• Converted the Business Process Requirements (BPR) into System Specification Requirements
• Created various Use Cases and workflow diagrams, sequence diagrams, and Class diagrams using MS Visio and used UML methodology to define the Data Flow Diagrams (DFD)
• Used IBM Rational ClearQuest as Version Control/Change Management Tools
• Created requirements analysis and design phase artifacts using Requisite Pro and MS Visio

Environment: HTML, Rational Software Architect, RUP, MS Project, SQL Server 2000, MS Access, MS Excel, MS Word, MS Power Point, XML, Rational Requisite Pro, MS Visio

Confidential, Cleveland, OH

Business Analyst

Responsibilities:

• Performed Gap analysis for the modules in production, conducted feasibility studies and performed impact analysis for proposed enhancements
• Gathered Business Requirements, interacted with the stakeholders, developers, Project Manager and SME’s and facilitated JAD sessions to formulate Business Processes.
• Conducted interviews with various business users to collect requirement and business process information and documented them using MS Visio.
• Worked with project management to analyze change requests to determine what is being requested and did the required.
• Acted as the primary liaison between the business stakeholders and technical teams to make communication and development efforts more effective
• Developed functional specifications for the existing WEDI software enhancements (enhanced security & privacy rules, transaction standards, code sets, identifiers) ensuring the system is HIPPA complaint
• Involved in daily scrum meetings and implemented Agile methodology
• Created Business Requirements Documents (BRD) and Functional Requirements Specifications (FRS) documents.

Environment: Windows NT/2000, MS SQL Server, Rational Unified Process (RUP), UML, Rational Rose & Requisite Pro, Mercury Quality Center, Clear Quest, MS Office Tools, MS Outlook.

Confidential, Virginia Beach, VA

Business Analyst

Responsibilities:

• Gathered business requirements by driving user-group meetings and working with various global, cross-functional and virtual teams
• Interacted and arranged meetings with Business and End users to gather business requirements for changes triggered by Government regulations and HIPAA, Business needs and Process improvement.
• Prepared User Requirements Document (URD), Business Requirements Document (BRD) and Functional Requirements Document (FRD).
• Worked closely with project manager in setting realistic project expectations and in evaluating the impact of the changes of the organization and plan accordingly
• Received the Client and Business users appreciation for the implementation of Prescriber NPI update and E-prescribing changes
• Developed Flowchart and process diagram using Microsoft Visio
• Performed Unit Testing and User Acceptance Testing and documented detailed defects.
• Developed Test Cases to validate the requirements and documented the Traceability Matrix for Test Cases and Requirements
• Followed the RUP based methodology to create Use Case, Activity/ State Chart, Sequence, and Collaboration Diagrams.
• Worked on Required Traceability Matrix (RTM) for traceability of requirements.
• Conducted GAP analysis by understanding the AS-IS system and the TO-BE system requirements with the support from SME’s
• Ensured the accuracy and consistency of the data during the data loading process
• Was in regular contact with Business partners on the status of issues, action plans and timeframe for resolution throughout the development cycle

Environment: Windows, MS Office (MS Word, MS Excel, MS PowerPoint, MS Visio), MS Access, MS Project, Rational Rose, Community Manager, BPML, SQL, Clear Case, Agile

Confidential, New York, NY

Business Analyst

Responsibilities:

• Interacted with client to assess needs, identify key challenges, and define project Scope and deliverables
• Analyzed software requirements specification (SRS), prepared functional specification document (FSD), and designed documents as per standards
• Conducted group JAD sessions with business units and stakeholders to define project scope and deliverables
• Extensively used the UML methodology to create various use case diagrams.
• Responsible for creating artifacts for Rational Unified Process (RUP) - use cases, system architecture document, supplemental requirements document, architecture diagrams; verifying technical production infrastructure; designing and executing performance tests; and documentation
• Review architectural templates, process flow diagrams, cross walk documentation for the current systems
• Assisted Quality Assurance (QA) team in writing test plans, defining test cases, test scenario and data sets
• Developed Process flow charts which helped in better understanding of the system
• Performed integration testing, product testing, User Acceptance Testing (UAT) and data driven testing
• Facilitated different development and testing groups to ensure smooth flow of information

Environment: Rational Rose, Rational Requisite Pro, MS Project, MS Access, MS Excel, MS PowerPoint, WINDOWS NT, WINDOWS 2000.