OBJECTIVE

• Skilled Business Analyst dedicated to provide effective and successful support for business developments and research. Accomplished at assessing and enhancing operational workflow, implementing and developing business processes to specialize the logistics between departments to facilitate the success

SUMMARY

• Sr. Business Analyst/ System Analyst/ Agile Business Analyst with 8 + years of experience in Healthcare, Banking, Financial, Retirement domains through exposure to innovative business processes. I am a conscientious individual have been achieving excellent results through commitment striving to grab every learning opportunity and excel in business performance.
• Involved in participating into Project Kickoff, BRD (As - IS & To-Be Scenarios), FRD, SRD, (UML) diagrams (Use Case Diagrams, State diagrams, Sequence diagrams, Activity diagrams, Collaboration diagrams) using MS Visio, BPMN, data mapping documentation, Requirement Traceability Matrix and weekly reports.
• Expertise and hands on skills on working on Mockups and Prototyping using Balsamiq, Microsoft Visio, RUP and Axure.
• Documentation to developing Test Plan, Test Cases, and conducting QA Testing (QAT) for User Acceptance Testing (UAT), Ad-hoc Testing and supporting project Go-live.
• Collaboration with Product Owners, Project Managers, Architects, Development Leads, Testing Leads, Deployment teams, onsite- off shore team members and subject matter experts (SME’s) in the implementation of full life cycle (Waterfall and AGILE methodology).
• Clear understanding of ICD-9-CM and ICD-10-CM/PCS and well versed with ANSI X12, HIPAA and HL7 standards.
• Understanding of Medicare revenue payment reconciliation solution automates and streamlines payment and account processing for improved adeptness, faster inconsistency resolution and enhanced management reporting.
• Knowledge and expertise on Business Support System (BSS), which is to provide application support to end customer’s for the processing of billing, customer relationship management and call center automation.
• Proficient in MMIS (Medicaid Management Information System), HL7 v2, EMR Interfaces and Care 360
• Knowledge on Healthcare Effectiveness Data and Information set (HEDIS), it is a tool to collect data and compare the performance of health plans.
• Strong skillset to understand the Professional billing (837P), Institutional billing (837I), COBRA Medical billing,
• Knowledge on Obama - Affordable Care Act (PPACA), Small Business Health Options Program (SHOP), Family and Medical Leave Act (FMLA)
• Hands on experience in writing SQL queries to generate reports, extract data from multiple databases for data mapping and analysis.
• Solid Understanding on sitecore customer management system that functionality is to manage web content management and marketing management
• Good Understanding of Operational Support System (OSS), providing application support for the back office activities.
• Extensive Knowledge on 401(a) plan, 90-Age Formula, 403 (b) plan, 408 (b) plan
• Familiarity with suspicious activity monitoring, FACTA compliance,
• Proficient with all phases of Requirement Management including elicitation techniques (brainstorming, focus group, observation, surveys, JAD, Requirement workshop, Document analysis), analyzing and documenting requirements.
• Extensive experience in Healthcare/Claims adjudication and Member enrollment with knowledge of industry compliance standards like HIPAA and EDI X12 transactions (834, 837, 835)
• Hands on experience supporting AWS cloud environment with instances and configured elastic IP and elastic storage.
• Highly knowledgeable in utilizing healthcare integration systems and applications including Trizetto FACETS, NASCO, Metavance, HIPAA Gateway.
• Broad knowledge on Identify Access Management (IAM), it refers to the company’s network system and the user privileges
• Knowledge on IBM Maximo Asset Management operations.
• Extensive experience in Healthcare/Claims adjudication with knowledge of industry compliance standards like HIPAA and EDI X12 transactions (834, 837, 835, 270/271, 276/277)
• Experience in testing Electronic Data Interchange (270, 271, 834, 835, and 837) according to HIPPA Compliance 4010, 5010, ICD-9 and ICD-10.
• Hands on experience in Software Analysis and Modeling of web and client/server based applications.
• Experience on Financial Markets, Financial Assets, types of banking (retail, commercial, personal), cost benefit and return of Investment analysis (ROI)
• Extensive work experience on AEM, Data Analytics such as SAS, Enterprise. Clinical and service level agreements (SLA), Operational level agreements (OLA)
• Strong understanding and Implementation of various Software Development Life Cycle (SDLC), such as Waterfall, Agile/ SCRUM and object oriented methodologies
• Expertise in Performing root cause analysis of issues including debugging ETL code and documenting requirements for development team
• Hands on experience on SQL server, designing and normalizing techniques on the database tables.
• Proven ability to work effectively with teams and independently to achieve project quality goals.
• Business development and business process, strategic planning and forecasting, reporting, documentation, work flow, market place, Scope Creep.
• Key performance indicators, process improvements, project charter, team leadership and stakeholder approach, handling change requests
• Finance and accounting, risk assessment, analysis and risk mitigation, enterprise supply chain management, Investment portfolios and finance data.
• Enterprise Analysis: SWOT, Root cause analysis, GAP analysis, Market Analysis

TECHNICAL SKILLS

Project Methodologies: AGILE/ SCRUM, Waterfall, Rational Unified Process (RUP), Kanban, Iteration, Cross Functional.

Project Tracking Tools: JIRA, Rally, Swift ALM, HP Quality Center, IBM RationalClear Quest, HP Quality Center

Microsoft Tools: Microsoft (Front Page, Visio, PowerPoint, SharePoint, Excel)

Database Tools: SQL server 2005/2008R2; Oracle 10g/9i, MS-Access

Business Skills: BRD, FRD, SRD, Project Kick-off, MOM’s, Requirementgather& analyze, Mainframes, Modelling,&Analysis, Competitive Intelligence, Risk Management

EDI Transactions: 834, 835 (remittance), 837p, 837i, HIPAA 4010, 5010, 270271, 276, 277, 278

Version Control Tools: GITHUB, SVN, TFS

CI/CD Tools: Jenkins

Content Management Tools: Content Management, Adobe Experience Manager (AEM),SharePoint, Decision Support System

Testing & ETL Tools: Oracle TOAD, HP-ALM, HP Quick Test Professional,SAP-BO, Oracle 10...11g, Crystal Reports, Micro Strategy

Healthcare: TRIZETTO, FACETS, COBRA, NASCO, HIPPA, FMLA,SUR, EPSDT, TPL, BPA, BIAR, Medicare-caid, Obama Care

Language/ Tool standards: HTML, SQL, UML 2.0..2.5, Shell Scripting, C#, BPMN,ICD 9/10, BPMN 1.0…2.0, Visual Studio, Balsamiq 2.2...3.0,Axure 7.0, ANSI X12, Requisite Pro.Banking/ Finance Laws of Banking, Types of Banking, Financial Assets,Financial Market, Types of Payments, Bank’s balance sheet

Operating System: Linux (Redhat, Ubuntu, Debian, CentOS), UNIX, Windows.

PROFESSIONAL EXPERIENCE

Confidential, Lafayette, Louisiana

Sr Agile Business Analyst

Responsibilities:

• Conducted user interviews, gathered requirements in JAR/JAD sessions with Business team to prepare User Stories & also created the System Design Documentation
• Analyzed the requirements, Created Use Case Survey and System Vision using Rational Requisite Pro
• Researched and understood the claims adjudication and reimbursement systems based on HIPAA X12 4010 and 5010 standards
• Involved to work on HL7 v2 framework to exchange and retrieve electronic health information
• Project is built on UNIX Solaris 9 environment, involved in configure and support.
• Worked on COBRA Medical billing, Small Business Health Options Program (SHOP)
• As a key member of production support team handled various complex issues that come up as part of daily activities.
• Involved to process claims against the authorizations and ensure the successful adjudications with QNXT
• I was worked to enhance the billing and order management using the BSS (business support system) application and MMIS
• Involved to work on Metavance platform for managing healthcare claim process for payers
• Assisted end users and IT staff in the use of data to satisfy informational and reporting requirements and implementing and using SQL and DBMS (Data Base Management System).
• Developed and maintained additional payer adaptability in the Designed UAT test scenarios and wrote corresponding scripts after following through each test condition.
• Wrote SQL queries for database related works such as creating test data, identifying data sources and verifying data integrity.
• Used to edit AEM & CMS guide for developed components/ Templates.
• Involved in translating the requirements into a design document after gaining the clear understanding of the requirements. Helped in the preparation of Functional Design document. Developed project plans and managed project scope.
• Co-ordinate business activities with Subject Matter Expertise (SME) and identify business issues, best practices and performance of other competitors using MS Visio
• Identified opportunities for business process improvement through various meetings with business users and developers and initiated efforts to make improvements
• Conducted Unit and Regression Testing of the application using Quality Center as well as Diamond Claims Processing System
• During 2 week AGILE Sprint, with the help of RTM tracked progress of work in the form of User Stories on JIRA.
• Organized and Participated in HIPPA upgrade JAD sessions and documented the outcomes as business requirements
• Prepared 5010 Gap Analysis documents involved with 837, 835, and 278 transactions in collaboration with other team members
• Extensively worked with Member/Subscriber and HIPAA Privacy Facets application groups
• Worked with developers to test the iterations of the system under development (SUD) to ensure it met the user’s needs
• SOAP UI tool is used for smoke test in QA and performed functional testing using HP UFT 11.5
• Performed impact analysis on 5010 upgrades and ICD 10 conversions
• Reviewed and verified testing procedures for compliance to Interface QA and Development standards and policies for BSQA

Confidential: Tampa, FL

Sr. Business System Analyst/ Data Analyst

Responsibilities:

• Prepared business requirements document (BRD), which involved market risk analysis and credit risk management like continuous time finance& asset pricing and documentation.
• Assisted project manager in conducting GAP analysis and SWOT analysis.
• Facilitated Joint Application Development (JAD) Sessions for communicating and managing expectations.
• Responsible for analysis, design, development and implementation of enterprise content management and business processes.
• Directed daily operations for retail bank, including branch sales, business development and credit card analysis
• Worked w.r.t Financial markets (Primary, Secondary and Capital Markets), Mutual funds
• Identified processes for developing and documenting detailed business requirements. Data was collected from end-users, and analysts.
• Constantly worked with business users to understand changing requirements, worked with developer team to develop prototypes/Mockups, demonstrated prototypes to the business users as and when required.
• Involved in data management (MDM)
• Adapted COTS Implementation to address the challenges by emphasizing working functionality of the application
• With the UI team worked on CMS that allows to customize the front end of page
• Created Use-Cases and Requirements documents to document business needs.
• Requirements were gathered through interactions and meetings and periodic walkthroughs with loan analysts, credit analysts and other potential users of the application.
• Conducted Use-Case reviews and identified gaps, leading to improvements/enhancements in the same.
• Ensured Use-Cases were consistent and covered all aspects of the Requirements document.
• Managed and tracked Defects using Rational Clear Quest.
• Prepared requirement traceability matrix for tracking the project updates.
• Worked directly with software engineers to ensure clear communications on requirements and defect reports.
• Functioned on IAM that securely controls the access of AWS cloud (NetIQ).
• Designed and developed scenarios based on business requirements.
• Involved to work on account receivable reporting enhancements and reconciliation procedures of bank transactions
• Performed risk analysis with the requirements to identify the key business risk areas for the project and prioritized the application development and testing.
• Followed the RUP methodology for the entire SDLC.
• Created reports using SAP BO functionalities like combined queries, slice, drill down, cross down, Master data
• Prepared Mockups and Prototyping to present the GUI representation using BPMN
• Used the guidelines and artifacts of the Rational Unified Process (RUP) to strategize the implementation of Rational Unified Process effort in different iterations and phases (Inception, Elaboration, Construction and Transition) of the Software Development Life Cycle.
• Customizing the IBM Maximo objects and writing the queries at the development phase.
• Used SQL queries to for pulling out files and reports as required for the project upgrade.
• Performed functional and regression testing on QTP.
• Worked closely with UI team to ensure deliverables are as per the business requirements.
• Designed and executed test plans, test scripts, tracking defects and getting them resolved to ensure that business requirements and functional specifications are tested and fulfilled.

Confidential

Sr. Business Analyst/ Knowledge Analyst

Responsibilities:

• Involved in gathering the requirements that were critical to the business process flow and using those requirements for the Business Requirements Document (BRD), for the implementation of the NPI in EDI X12 transactions as mandated by the Federal Regulation.
• Conducted JAD sessions with Subject Matter Experts (SME’s) to obtain domain level information, interviewing and asking detailed questions and carefully recording the requirements in a format that can be reviewed an understood by both business and technical team
• Responsibly handled HIPAA EDI validation from Medicare, Medicaid and other payers of government carriers Created documents that incorporated both the technical and functional details.
• Involved in creating documents and diagrams for Enrollment according to the HIPAA 834 Compliance Standards for Enrollment
• After JAD session worked with development teams to build the collaborative portal and web content management solutions using SPS 2003 by analyzing user requirements and processes
• Understanding on Adobe Experience Manager (AEM), it is a server side program that runs on various platforms (Windows, Mac or Linux)
• Worked on HL7 v2 framework
• Worked with user to define user acceptance test cases. Involved in UAT testing (User Acceptance Testing) and Implementation
• Worked on NASCO for claims adjudications for individuals, small and large group members.
• Responsible for making LIMS Development System (It is to manage data & manage Inventory)
• Involved in HIPAA/EDI Medical Claims Analysis, Design, Implementation and Documentation
• Entered numerous claims for testing purposes to ensure accurate and quality adjudication and implementation of business and operational requirements
• Conducted Data analysis using SQL on the backend databases for producing mapping documentation and transformation rules for developers
• Analysis of existing data requirements using SQL to document functional requirements.
• Worked on Data Mapping to map Facets billing data to outbound eligibility extracts
• Wrote complex SQL queries to extract and validate the data from the Facets database
• Designed Activity, Sequence and Process Flow Diagrams using MS Visio to simplify and elaborate certain selection criteria and filter conditions.
• Performed complete and accurate data entry of qualifying services into HEDIS.
• Involved to prepare a visual representation of flow charts using BPMN
• Documented requirements using Use Case (UC) analysis for the development team. Also, stored the documentation in a common SharePoint Repository for version control
• Facilitated the User Acceptance Testing (UAT) with System Administrators and Business Users, documented any issues or defects and eventually got sign off from the right parties
• Assisted in development of User Interfaces and prepared screenshots to get business’s buy-in on the requirements
• Used Rally to track requirements and to maintain different versions of the project documentation

Confidential

Operations Business Analyst

Responsibilities:

• Defined scope of the projects by drafting and distributing scope documents
• Liaison between the client and cross-functional teams by documenting defects discovered during UAT testing
• Interacted with LOB’s to understand the Major Incidents happened in the fiscal year and documented the root cause and collaborated with operations team to rectify the defects in the system
• Project is designed to work on AGILE SCRUM and JIRA is used to track the stories
• Created and generated reports using SSRS, research and analyze data and reports trends to management/Business partners
• Handled multiple projects at a time and conducted meeting to execute test cases
• Worked on Problems of moderate scope to high scope where analysis of situation to data requires a review of a variety of factors
• Review risks identified throughout the system development life cycle and assist the team to determine the best mitigation strategy based on the risk level
• Created 810 (Invoice), 850 (Purchase Order), 855 (Purchase Order Acknowledgement), 856 (Shipment Notice/ Manifest), 894 (Delivery/ Return Base Record), 997 (Functional Acknowledgement) translation and custom compliance maps for retail purchases and shipments
• Worked efficiently and effectively with EDI administration to implement maps and EC Gateway processes
• Conducted Gap analysis to decrease the cost and increase the efficiency of P3 issues. Detailed analysis has been conducted and the efficiency has been increased from 36% to 93% over a period of 2 months. Cost reduction has been done by automating the repeating issues and also by conducting root analysis.
• Served in Nokia Mobile Development project as Functional Analyst for new content delivery channel
• Determined scope of data fields, functional services required by Business Product Leads
• Authored Business Rules for Requirements Specification Matrix (RSM)

Confidential

Jr Business - Knowledge Analyst

Responsibilities:

• Responsible for gathering requirements from the Quantitative Analysts and Portfolio Managers to produce Business and Functional Requirements for a Risk and Tax Management Applications
• Review auto finance loan applications of credit to determine if a relationship continues to provide course of actions on accounts.
• Participate in primary and secondary research in the identification of user’s specifications
• Conducted various research works on Financial Risk Assessments, Financial assets and various risk associated in calculating the worth of Investments
• Worked with respect to the Investment Manager.
• Conducted requirement gap analysis and design walkthroughs with the designers, developers and management
• Produced Process Maps, System Diagrams, Logical Data Models, Business Requirements, Report Specifications, Workflows and other documentation as required for Project Analysis, enterprise content management, Planning and Design
• Facilitated Focus Group sessions (Homogeneous & Heterogeneous groups) with size of 8-10 members to help the project team create Prototypes and ensured stakeholders’ agreement by conducting structured walk through
• Prepared and Reviewed Business Requirement Documents and the Technical Specifications.
• Participated in Risk Assessment studies in conjunction with Senior Project Managers and Departments heads
• Analyzed and prioritized business requirements in each phase of Loan Lifecycle
• Ensured that relevant UML diagrams and Tools (Requisite Pro, Rational Rose) were used in all requirement documents e.g. Business Requirements and Functional Specifications
• Prepared Use Case Models based on Business Requirement documentation gathered through interaction with users
• Conducting one to one schedules to train users by the stakeholders on the IBM Maximo 7.5 database in order to develop UI experience.
• Prepared Flow Diagrams and Sequential Diagrams using MS Visio
• Conducted JAD Sessions for understanding the workflow
• Project is AGILE SCRUM and used JIRA to track the stories
• Involved in writing test plans in accordance with the business requirements.
• Worked with user to define user acceptance test cases. Involved in UAT testing (User Acceptance Testing) and Implementation
• Utilized technical Flow Charts, Network Diagrams to effectively map and manage critical paths and bottlenecks in conjunction with Project Tracking Reports and Project Data Sheets for Senior Management.