Chronological Summary of Experience

Sr. Business Analyst

Confidential

• Conducted JAD sessions with NASCO, TMG and PEGA. Focus groups and individual interviews to facilitate elicitation with regards to analysis, specifications, and design of the relevant business processes and systems.
• Conducted workflow, process diagram and gap analysis to derive requirements for existing systems enhancements
• Modeled functional requirements using MS Visio to create Use Case Diagrams, Activity diagrams, Sequence Diagram and logical Class Diagram for interaction between the various actors and system and to supplicate the Workflow Models.
• Researched on the medical disciplines and documented Business Requirement Document.
• Traced High level into Detailed Requirements in Functional Requirements Document FRD .
• Working on the activity diagrams, File Transfer Specification FTS , Required Repository Template RRT in Coordination of Benefits, Benefits translations, Utilization Management, Referrals.
• Aided in workflow analysis and process design.
• Conducted joint discussion sessions with business users, stakeholders to understand the requirements in more detail.
• Developed project plans and managed project scope.
• Interacted with Data Warehousing team in Metadata Modeling and gathering requirements for product catalogue data load specifications for Data mapping and Data Modeling.
• Gathered requirements and prepared business requirement documents BRD .
• Created RRTs for the claims migration pricing process.
• Also, helped in determining the routing flow activity diagram of several certain sections of claims.
• Helped in determining and documenting the remark codes being applied on the claims.
• Determining the correct route to correspondence claim letters as to how the letters are to be retrieved and processed and sent to the provider/member.
• Acquiring the business rules related to web based portal system where the claim letters are processed.

Environment: MS Office Excel, Word, PowerPoint, MS Project, MS Visio, UML, Rational Unified Process RUP , Rational Suite Requisite Pro, Rational Rose, Windows XP, HTML, PHP, XML.

Sr. Business Analyst

Confidential

• Facilitated User meetings to gather requirements, Workflow Analysis, Business Process Models and Functional Design Definitions and High Level Analysis and Designs
• Creating the requirements and updating in JIRA for conversion process
• Conducting meeting with ETL developers, Data modelers, DBA and business users for understanding the data mappings for conversion process
• Coordinating with testing team to validate the source target databases after ETL conversion.
• Creating MS-ACCESS views to perform UAT with the client the data conversion activities
• Performed Use Case Analysis and Documentation written as part of the project's design in developing Workflow and Business Models and coordinated efforts between external and internal project teams.
• Created the requirement as user stories and prioritized the requirement and defects
• Worked closely with business and development to resolve any requirement deficiencies for the integrating applications.
• Created and updated Master Test Plan facilitated with teams and business to get sign-off.
• Created, updated and maintained conceptual and detailed test cases, test scripts, test steps and test sets based on business and system requirements and uploaded to Quality Center.
• Reviewed test cases in the Quality Center with business to assure complete test coverage for Integration and system testing.
• Created test data requirements and partnered with data teams to load required data in the Test, QA, and UAT environments for production fixes, regression, integration and system testing.
• Created and update test entrance and exit criteria checklists reviewed with business for various testing.
• Trained resources to follow strictly SDM process for test processes documentation and test execution.
• Responsible to determine which test environment to utilize and communicate requirements and expectations to stakeholders
• Conducted Impact analysis on complex systems flows for the enhancements and product support issues.

Environment: QTP, Quality Center, JIRA, ASP.Net, VB.Net, VB Scripts, Java Scripts, Windows XP.Net, Web Logic, DB2, TOAD, Remedy, Informatica, JBehave, Selenium, SOAP UI, ITKO LISA

Business Analyst

Confidential

• Gathered information on inherent systems clinical, administrative, laboratory, pharmacy to have understanding of the business processes and EDI.
• Responsible for GAP analysis of ICD-9 to ICD-10.
• Performing Impact analysis for readiness of ICD-10 conversion.
• Working with SAS on retrieval, reporting writings and remote computing.
• Facilitating continuous enhancement, refinement and maintenance of the analytic models using SAS.
• Conducted JAD sessions for understanding and refining of requirements in coordination with multiple teams, defined scope, financial projections and Cost/benefit analysis.
• Progressed from problem statement to well-documented design, created Mockup screen for business and end users review.
• Good understanding of HIPAA standards and EDI transaction syntax.
• Created and maintained the RTM to trace the progress throughout the project.
• Organizing reports created by data team by verifying the associated EDI data from repository using FACETS.
• Involved in the Daily Standup Meetings.
• Drafted the End-to-End flow of transactions along with the Functional specifications and Use cases.
• Conducted walkthroughs, assisted in change and defect management.
• Assisted QA team by reviewing test cases and identifying issues, clarifying requirements to ensure complete coverage of analysis according to EDI implementation guide.
• Provided training to users, and involved in conducting UAT sessions to gain user confidence and approval.

Environment: MS Office Excel, Word, PowerPoint, MS Project, MS Visio, UML, SDLC, Rational Unified Process RUP , Rational Suite Requisite Pro, Rational Rose, Windows XP, HTML, PHP, XML.

Business Analyst

Confidential

• Created UML diagrams for data capture activities which required working with SMEs to ensure consistency and accuracy of data during the data loading process and that the data passes validation and integrity constraints with corporate database repositories.
• Clear understanding of Medicare Part A, Part B and Part D and Medicaid benefits as well as business processing.
• Involved in process analysis and defined executed data migration plans for local data for global applications.
• Worked with UB92/UB04, CMS 1500 claims and HIPAA 834, 835,837, 270/271, 276/277, 278 transactions.
• Database support that includes activities required correcting, deleting or summarizing medical history of members as well as provider information.
• Experience in CMS and MMA Guidelines.
• Collaborated on the development of user requirements and design specifications using standard UML techniques such as use case, activity, sequence, and class diagrams.
• Conducted JAD sessions, Focus groups and individual interviews to facilitate elicitation with regards to analysis, specifications, and design of the relevant business processes and systems.
• Thorough understanding of health benefit products, assisted in consolidating the summary of Benefits.
• Executed Smoke, Functional, Integration, End-to-end and Regressions Tests in each environment by tracking the test status in Quality Center Test Director .
• Applied advanced Excel skills pivot tables, macros, lookups, charts and Access database querying skills in streamlining and automating accounting processes.
• Documented detailed business, functional, and User Interface system specifications using standardized company templates for the business, development, and QA team.
• Build relationships with Information Systems and other relevant business partners, balancing practicalities with innovative and efficient business systems solutions.
• Helped developers with the following list of HIPAA-EDI Transaction Code sets: 837, 835, 270/271, and 276/277 .
• Created test cases and performed manual testing of the functionality of the application by inserting varying data on different test runs.
• Documented Requirement Traceability Matrix in Requisite Pro for traceability of requirements through test cases.
• Developed Forms using MS Access using Forms and Reports for reporting.
• Produced clear user manuals training guides for User Acceptance Testing UAT and deployment for end-clients with step-by-step instructions and created appropriate GUI screenshots.

Environment: SQL Server, UML, Rational Requisite Pro, Test Manager, Clear Quest, Windows XP, MS Visio, MS Access, MS Project, UAT, JAD, UML Diagrams, MS Visio.

Business Analyst

Confidential

• Responsible for gathering requirements through interviews and detailed sessions with business area experts.
• Responsible for creating, maintaining the timeline of the project using MS Project.
• Capturing requirements in informal and formal sessions while maintaining scope and change control.
• Requirements and Functional Specifications documentation within specified time frame.
• Able to bridge the difference between the end user's non-technical point of view and the developer's technical point of view.
• Analyzing and translating user-level requirements into a logical design, using UML diagrams, Use Cases and Activity diagrams.
• Prepared Workflow diagrams to analyze AS IS and TO BE scenarios, designed new process flows and documented the business process and various business scenarios.
• Created Use Case Document, user interface design document to elaborate user experience taking into account the business objective.
• Interacting with the developers and QA Team on resolving the reported bugs and various technical issues.
• Interacting with users and assigning roles to users for user acceptance testing and taking feedback from them.
• Responsible for adhering to project timelines while anticipating and resolving issues.
• Acted as a liaison between stakeholders: system users, clients and Project Managers.

Environment: Windows, HTML, SQL Server, MS Office.

Business Analyst

Confidential

• Conducted interviews/group discussions with SMEs for detailed domain knowledge.
• Worked with production staff to identify and map detailed current processes, identify gaps and failure points, perform root cause analysis and develop functional requirements that supported overall strategy, goals and objectives.
• Worked with sales and marketing team and documented validation rules, workflow rules, complex formula fields, custom settings and look-ups.
• Troubleshoot issues and identify bugs using HP Quality Center in code.
• Developed conceptual models and detailed UI design specifications for web-based applications based on the requirements. Verified functional aspect as per the Business Process and validated the UI.
• Hosted user training and held interactive feedback sessions to resolve problems. Documented specific workflows and functional requirements.
• Analyzed Business requirements and also wrote Use Cases and System specifications.
• Involved in writing test cases and test script for GUI, Functional, Security, Recovery and Performance.
• Acted as a resource in understanding how systems carried out business functions and assisted in ensuring timely and effective implementation.
• Supported the Marketing team by providing visual design support in the creation of images, demonstrations and presentations.

Environment: Rational Requisite Pro, UML, Rational Unified Process RUP , MS Office.