SUMMARY

• An organized, creative and innovative Sr. Business Systems Analyst with a wide spectrum of experience in Health Care and Retail/ E - Commerce Industry for more than 7 years.
• Expertise in Sprint Planning, Sprint Prioritization and Scrum Master.
• Conducted Ideation Sessions with Key Stakeholders and UX Representatives.
• Worked as Release Manager. Taking care of Weekly/Bi-weekly release and getting Release Exceptions.
• Experience in conducting GAP Analysis, SWOT analysis, Cost Benefit Analysis, Implementation analysis and Analysis for HIPAA Privacy Business Practice.
• Experience with various mainstream healthcare data standards and vocabularies, including HL7.
• Responsible for gap analysis in upgrading old MMIS and Involved in testing the new MMIS.
• Extensive knowledge of Health Care Reform/Patient Protection and Affordable Care Act (PPACA).
• Expertise in EDI and HIPAA Testing Privacy with multiple transactions exposure such as Inbound Claims 837-Institutional, 837-Professional, 837-Dental, 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.
• Strong technical knowledge of the FACETS system, more specifically the Subscriber/Member application and JIRA.
• Experience with common web technologies (HTTP, REST, Web Services, XML, JSON, etc.)
• Experience in Conversion of HIPAA X12 4010 codes to X12 5010 codes and ICD 9 codes to ICD 10 codes.
• Extensive experience in Methodologies, Process Engineering and Management Tools: Rational Unified Process (RUP), UML, MS Visio, MS Office Tools and Mercury Quality Center (MQC).
• Sound Knowledge of Ruby, Python and PHP.
• Highly proficient in authoring Use Cases, Use Case diagrams, Sequence diagrams, Activity Diagrams based on UML methodology using CASE tools like Rational Rose and MS Visio.
• Excellent ability in technical writing and documenting Business Requirements Document (BRD), User Requirements Specification (URS), System Requirements Specifications (SRS), and Request for Proposal (RFP) and Statements of Work (SOW).
• Experience in EDI automated first-pass claim adjudication, requiring thorough understanding of claim processing, both front and backend operations.
• Experience with ANSI X12N translations that are HIPAA mandated (i.e. 837, 835, 270/271, 276/277).
• Facilitated interviews, workshops, JAD sessions and requirement elicitation sessions with the management, SMEs, Business User Groups and the IT Groups.
• Extensive experience with health insurance claims, enrollment, eligibility verification for members and providers, Web portal enhancements, and backend payment cycle.
• Knowledge of Data Warehouse life cycle, Data Mart design concept.
• Sound Knowledge of Medicaid Management information System (MMIS), PPO, EMR/EHR, CMS, HMO, HL7 standards and HIX (Health Insurance Exchange).
• Extensively worked on some phases of data warehousing and business intelligence projects like data mining, data cleansing, data modeling for data mart, ETL, Indexing, data updating plan, data presentation to business users, auditing, backup and recovery.
• Based on the physical model, developed strategies for Data extraction, Data Transformation and Data Loading (ETL) of the data into the data warehouse.
• Solid ability to work on Agile and SOA project.
• Extensively involved in generating UAT Test Plan, Test Cases and Requirements Traceability Matrix (RTM) across the deliverables of a project
• Have been an active member Technical Support Team to address End Users.
• Comprehensive knowledge of System applications, Change Request Management, Six Sigma, Risk Management, Transaction Code Set Standards and Version Management processes.

TECHNICAL SKILLS

Methodologies: OOAD, RUP, UML, SDLC, JAD, Six Sigma, CMM, RAD, Waterfall and Agile.

Languages: C, C++, Java, C#, XML,JSON, SQL

Operating Systems: Window 2000/XP/Vista/07, Unix/Linux

Change Management Tools: Rational Clear Quest, Test Director

Monitoring Tools: Tealeaf, Gomez, Keynote, Splunk, Site Scope

Business Modeling Tools: Rational Rose, Rational SODA, Requisite Pro, Clear Case, Clear Quest

Project Management: MS Office Suite ( MS Project, MS Visio)

Databases: MS SQL server, MS Access, Toad for Oracle 10.6, NOSQL, SyBase, DB2

Version Control Systems: Rational Clear Case, PVCS, Subversion

Web Technologies: ASP, HTML, XML, Dreamweaver, Flash, REST

Testing Tools: Rational Test Manager, Load Runner, Quick Test Professional

PROFESSIONAL EXPERIENCE:

Confidential

Sr Business Systems Analyst

Responsibilities:

• Worked in Agile and Waterfall Methodology, worked on all phases of software development life cycle (SDLC).
• Was responsible for creating Team cadence to include Daily Standups, Retrospective, Showcases and Technical analysis meeting.
• Expertise in Sprint Planning, Sprint Prioritization and Scrum Master.
• Conducted Ideation Sessions with Key Stakeholders and UX Representatives.
• Worked as Release Manager. Taking care of Weekly/Bi-weekly release and getting Release Exceptions.
• Managing the overall performance and delivery of cross-functionalteam.
• Analyzed Tea Leaf to understand Customer Behavior.
• Publicizing the team's progress and successes to make sure they are highly visible to product owner/ stakeholders.
• Worked with Digital Analytics and Digital Governanceteam to ensure that Reporting is available for the new requirements.
• Worked on tracking benefit for the products over the period of time to track Revenue.
• Worked on Confidential ATG Ecommerce platform with Cart team for increasing conversion rate and adding new functionalities in Cart/Checkout/Payment and simplifying the Digital products that can be downloaded and used by BestBuy customers.
• Worked on increasing conversion rate by understanding customer behavior and understanding data to improve customer experience.
• Have worked closely with different teams and impacted systems to give customer a better overall experience of E-Commerce.
• Keeping the team together all the time to ensure successful sprints.
• Directed and Managed Project Work for Commerce team.
• Helped analyze current system issues and provided a viable solution for the issue.
• Was responsible for end to end application support and acted as a SME on numerous applications.
• Was solely responsible for creating and translating detailed User Stories made in JIRA.
• Kept track of user stories across development teams.
• Worked on DaaS (Data as a Service). It takes Data from Source System and applies business logic and Relevancy.
• Worked on SaaS (Search as a Service). It is used by Omni Channel.
• Experienced in Requirement Gathering from Product Managers, Business Owner/Sponsors, VPs, etc. and created documents: Use cases, Process maps, Data flow diagrams and High Level Design Document.
• Created Product Backlog and analyzed Business Requirement and translated into Features.
• Performed Impact Analysis and communicate to impacted team.
• Analyzed Wireframes and Design Documents to ensure Requirements are met and User interaction is consistent with Omni-Channel Digital Experience.
• Facilitated Solution Sessions with Engineering Architecture Group and ensured requirements are fulfilled in accordance with Retail Digital Experience.
• Presented Business Requirements to Legal and Privacy Team to ensure Compliance and Confidential Standards are met.
• Worked with Product Owner and Product Managers to ensure that new requirements are measured in Key Performance Indicator and have significant Business Value.
• Experience in Project Management. Scoping and Scheduling of the Project.
• Experience with Infrastructure Management. Service Level Agreement and managing changes are communicated to affected teams.
• Worked on Omniture Tool to measure New Feature Performance as well as the whole Product.
• Worked on Business Intelligence tools to mine data sources, look for trends and analyze crucial data.
• Worked on Recommending solutions based on Data Trends and reducing losses and generating more revenue.
• Was responsible for the identification of non-functional and functional requirements.
• Helped with defect-triage and organized and assisted with user testing as well.
• Was involved in Data Analysis, extracting data from different databases using SQL queries.
• Worked with JSON and XML documents to get to the root of the issue and then triaged accordingly.
• Read architectural artifacts to understand business concepts and identify system constraints.
• Got sign offs from all relevant project stakeholders on all project deliverables
• Worked with Offshore Development team in India, China for coordinating different development effort.
• Worked with Offshore Testing team who was located in India, Jakarta, Manila and Philippines whom I worked closely for enormous testing.
• Managing the overall performance and delivery of cross-functional team.
• Experienced in deployment and UAT session.

Environment: JIRA, WIKI, Agile, Waterfall, ATG Dynamo, CDNs (Akamai, Limelight), Monitoring tools (Tealeaf, Gomez, Keynote, Splunk, SiteScope), UNIX/Linux, Web technologies (HTTP, REST, Web Services, XML, JSON, etc.), Oracle/MySQL.

Confidential

Analyst

Responsibilities:

• Emphasized on agile operations with a DevOps culture.
• Quickly assessed a problem and resolution with the ability to demonstrate creative thinking, advanced problem solving and troubleshooting skills.
• Provided exceptional customer service and end-user support for application systems by independently and collaboratively analyzing, diagnosing, troubleshooting, escalating, and driving issues to resolution with minimal supervision.
• Took ownership and deliver high quality solutions for issues and requests.
• Worked on ATG Dynamo.
• Gained experience with CDNs (Akamai, Limelight) and Monitoring tools (Tealeaf, Gomez, Keynote, Splunk, Dynatrace, SiteScope, Nagios)
• Ensured the applications exceed goals for availability, capacity, efficiency, scalability, and performance.
• Supported and maintained health of applications. Ensure application performance is consistently up to par through performance and availability monitoring.
• Had to multitask among concurrent problems, including issue triage and prioritization.
• Acted as a SME for the following applications: Cargo, Clipper, Commerce: Shipping and Fulfillment, CORAL, SiteControl, KRAKEN, Enterprise Product, GeekSquad, Search, Spark, Stormtroopers, Autobot, OLS DB and OMS.
• Worked as a JIRA/Confluence/Wiki admin.
• Worked independently and collaboratively within a large team environment to analyze, diagnose, troubleshoot, escalate, and drive issues to resolution with minimal supervision.
• Gained comprehensive knowledge on web applications and architecture and also on Java based applications.
• Gained hands on experience with common web technologies (HTTP, REST, Web Services, XML, JSON, etc.)
• Worked with XML and JSON to clearly understand different APIs.
• Communicated effectively with engineers, stakeholders and end users, describing problems succinctly.
• Continually discovered ways to improve processes and operational effectiveness and efficiency.
• Created support documentation for both technical and business use.
• Provided subject matter expertise on associate facing applications, assisting in assessing project impact on existing systems and business processes.
• This role also required participation in a 24/7 on-call rotation schedule.

Environment: ATG Dynamo, CDNs (Akamai, Limelight), Monitoring tools (Tealeaf, Gomez, Keynote, Splunk, SiteScope), UNIX/Linux, Web technologies (HTTP, REST, Web Services, XML, JSON, etc.), JIRA, Oracle/MySQL.

Confidential, Eagan, MN

Sr. Business Systems Analyst

Responsibilities:

• Wrote Business Requirement Documents for EFT and ERA web app.
• Worked on Electronic Enrollment Requirements Document to get big brands like Whole Foods, Chipotle, Hewett Packard, etc enrolled in the system.
• Extracted the data from Confidential ’s System and sent it to Confidential on a weekly basis.
• Created File Transfer Specification (FTS) to automate the extract, translate, and load process of DeCare’s data.
• Actively participated in the Open Enrollment phase and gained hands on experience with EDI 834 files.
• Captured requirements and worked with Confidential ’s SMEs and Solution Architects in alignment process.
• Captured Action Items, Issues, Risks and Dependencies during the JAD Sessions and coordinated with Lead and PM to manage and resolve.
• Performed UAT for both EFT and ERA functionalities.
• Reviewed and analyzed current reports, finalized matching reports and captured requirements for new reports for Actuarial and EDI track.
• Created Detailed Functional Requirements documents, Use Case Specification documents and Activity Diagrams.
• UsedSQL queriesfor the arrangement of customerdata.Created and maintained end-to-enddata mapping and data conversion spreadsheet.
• Ensured that the deployed solution met the business requirements and also ensured that the business requirements are supported fully by the deployed solution.
• Implemented and incorporated all the HIPAA standards, Electronic Data Interchange (EDI 834, 835, 837) transaction syntax like ANSI X12.
• Used JIRA for tracking bugs and issues.
• Involved in Requirement Modeling which helped in increasing the workflow.
• Worked with leadership and team to ensure tracking and reporting needs are executed.
• Worked with Project Manager, internal and vendor development teams as well as the deployment team to ensure that solutions being selected, implemented and deployed meet the required business processes.
• Made sure that we are in compliance with HCR guidelines.
• Work as a member of a virtual development team where members of the team were physically located in different parts of the world.
• Implemented Traceability Matrix and Business Requirement Specification Documents and also verified the functionality coverage.
• Used agile systems and strategies to provide quick and feasible solutions, based on agile system, to the organization.
• Ensured a smooth handoff of artifacts/deliverables and knowledge transfer to as part of project close-out.

Environment: Microsoft Office Suite 2007 (MS Project 2013, MS Visio 2013, MS Word, MS Excel, MS PowerPoint, MS Access), JIRA, Rational ClearQuest, ClearCase, Lotus Notes 8.5, SQL Server, FileZilla, UltraEdit, Merant Tracker and DDS Portal.

Confidential, RI

Sr. Business Systems Analyst

Responsibilities:

• Worked as a key BSA on the HPES Healthcare Provider Portal Enhancement team.
• Captured requirements and worked with HP’s SME’s and Solution Architects in alignment process.
• Captured Action Items, Issues, Risks and Dependencies during the JAD Sessions and coordinated with Lead and PM to manage and resolve.
• Got EDI and HIPAA Testing Privacy with multiple transactions exposure such as Inbound Claims 837-Institutional, 837-Professional, 837-Dental, 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.
• Created Business Assessment documents and SOWs.
• Performed SWOT and Gap analysis for the new functionality requirements.
• Facilitated numerous JAD (Joint Application Development) sessions utilized for the creation of design documents and system specifications for applications.
• Documented the Use Cases and prepared the Use Case, Activity, Sequence diagrams and Logical views using MS Visio, MS Office and Rational Rose for a clear understanding of the requirements by the development team.
• Documented Requirement Traceability Matrix in Requisite Pro for traceability of requirements.
• Implemented Traceability Matrix and Business Requirement Specification Documents and also verified the functionality coverage.
• Coordinated with the Data Team regarding MMIS table changes for 837 Encounter and NCPDP Post Adjudication Utilization remediation.
• Responsible for gap analysis in upgrading the legacy MMIS and was also Involved in testing the upgraded MMIS.
• Involved in modification of the MMIS claims adjudication process to accept 837 Encounter and NCPDP Post Adjudication adjusted utilization claims.
• Responsible for the mainframes that receive the HL7 message in pre-approved format from the middleware as disclosed in the documentation.
• UsedSQL queries for the arrangement of customerdata.Created and maintained end-to-enddata mapping and data conversion spreadsheet.
• Created Business Process Flows (Current State & Future State), Flow Chart diagrams, Data Flow Diagrams, Use Case diagrams, Activity Diagrams using MS Visio Pro 2010.
• Used Agile Methodology with sprints and scrums.
• Played an important role in the support team and dealt with end users after the Web Portal was successfully rolled out.
• Extensively worked with PEGA Development team (turning requirements into use cases).
• Reviewed Test results pertaining to the specific desired functionality of the application. Recorded & reported defects & produced daily Test Status Reports.
• Used Toad for Oracle 10.6 for data mapping and querying.

Environment: Microsoft Office Suite 2010 (MS Project Pro 2010, MS Word, MS Excel, MS PowerPoint, MS Visio Pro 2010, MS Access), MS Outlook, Rational Rose, UML, SQL, PHP, PEGA, Toad for Oracle 10.6.

Confidential, Dallas, Texas

Sr. Business Analyst

Responsibilities:

• Performed SWOT and Gap analysis for the new functionality requirements.
• Worked with HIPAA rules and regulations to draft business rules and claim processes.
• Interacted with the client and the Technical Team for requirement gathering and translation of Business Requirements to Technical specifications.
• Facilitated numerous JAD (Joint Application Development) sessions utilized for the creation of design documents and system specifications for applications.
• Documented the Use Cases and prepared the Use Case, Activity, Sequence diagrams and Logical views using MS Visio, MS Office and Rational Rose for a clear understanding of the requirements by the development team.
• Created and maintained Use Cases, visual models, including activity diagrams, logical Business process models, and sequence diagrams using UML.
• Involved in preparing project plans and identifying major milestones for each stage as per the SDLC model (RUP Methodology).
• Used SoDA and created product documentation including online help, printed user manual, and training materials.
• Involved in Requirement Modeling which helped in increasing the workflow.
• Based on the physical model, developed strategies for Extraction, Transformation and Loading (ETL) of the data into the data warehouse.
• Performed unit testing, point-to-point testing and integration testing to confirm ETL code integrity.
• Documented Requirement Traceability Matrix in Requisite Pro for traceability of requirements.
• Implemented the HIPAA privacy and security regulations to enhance the capabilities of the systems to process new products.
• Used MS Project for various planning and budgeting activities.

Environment: Rational Unified Process (RUP), UML, SQL Server, Rational Test Manager, Windows, MS Office and HTML.

Confidential, Richmond, VA

Business Systems Analyst

Responsibilities:

• Conducted one to one interview sessions with prepared questionnaires, brainstorming sessions, research with the business, underwriters, marketing and sales to track, analyze, review and document clear, concise and feasible detailed business requirements in BRD.
• Tracked requirements in a Requirement Traceability Matrix (RTM) capturing Req ID, BRD Number, BRD high level description, BRD grouping ID, SRS ID, Design element, Implementation Module, System Test Case ID, UAT Test Scenario and Deployment Module.
• Involved in Requirement Modeling which helped in increasing the workflow.
• Created System Requirement Specifications (SRS) documents entailing business.
• Analyzed, reviewed and conducted EDI 837 I, P, D and Xover claims adjudication and enrollment checks for New Medicare advantage members.
• Responsible for the full HIPAA compliance lifecycle from gap analysis, mapping, implementation and testing for Medicaid Claims.
• Responsible for gap analysis in changing old MMIS and Involved in testing new MMIS. Also, accountable for Medicaid Claims Resolution/Reimbursement for peach state health plan using MMIS.
• Followed the UML based methods using Rational rose to create Use Cases, Activity Diagram, Sequence Diagram, Collaboration Diagram that include Functional and Non-Functional specifications to hand off to development teams.
• Created Business Process Flows (Current State & Future State), Flow Chart diagrams, Data Flow Diagrams, Use Case diagrams, Activity Diagrams using MS Visio.
• Played a key resource as Business Analyst, Systems Analyst & Data Analyst during the entire SDLC phases of the project.
• Reviewed Test results pertaining to the specific desired functionality of the application. Recorded & reported defects & produced daily Test Status Reports.

Environment: Microsoft Office (MS Project, MS Word, MS Excel, MS PowerPoint, MS Visio, MS Access), RUP, UML, Rational Requisite Pro, SQL and Mercury Quality Center.

Confidential - NY

Business Analyst

Responsibilities:

• Aided in the collection of User Requirements and Business Requirements to create the Business Requirement Documentations (BRDs), using MS Word and MS Visio that provided appropriate scope of work for technical team to develop prototype and overall system.
• Incorporated and implemented all the HIPAA standards, Electronic Data Interchange (EDI 835,837,270,271) transaction syntax like ANSI X12, ICD-9, ICD-10 coding and HL7.
• Worked on designing Crystal reports from a wide range of data sources. Also worked on NASCO framework.
• Worked in Micro focus COBOL as an intermediate. Also worked on Meta Data cataloging.
• Involved in the analysis of HIPAA compliance and EDI transaction sets and actively participated in the designing of the EDI transactions using the new HIPAA 5010 version also including the use of ICD-10 codes, conversion of ICD9 codes to ICD 10 codes. Experience in General equivalence mapping (GEMs).
• Conducted and facilitated Joint Application Development (JAD) sessions to reduce time spent in moving information between stakeholders and team members.
• Wrote test cases and test plans for the related and assigned scripts according to the test strategies defined in the project and testing team guidelines in Quality center.
• Conducted the AS-IS and TO-BE analysis of the business process using GAP analysis.
• Recommended corrective actions, if necessary, along with the progress against Development/Action Plan routinely to the Project Manager.
• Tracked and maintained Stakeholder requested enhancements and changes using Requirement Traceability Matrix (RTM).
• Strong technical knowledge of the FACETS system, more specifically the Subscriber/Member application.
• Identified critical areas of business risk and modified business processes to reduce risk by using the Risk-Management Process.
• Knowledge of the complete EDI format used in electronic documentation, which was part of the knowledge transfer program to the vendors as per the requirements.

Environment: MS Office, Quality Center, SQL Server, Facets 4.21, Server, Unix, J2ee, Java, XML, Rational ClearQuest, ClearCase, Windows XP

Confidential, Tampa, FL

Sr. Business Analyst

Responsibilities:

• Interacted with business users of FACETS and gathered the gaps faced by them in the existing applications.
• Prepared Scope Document for the entire project. Identified and resolve key issues and risks.
• Prepared basic overview documents comprising of the detailed business process flow of FACETS and its interaction with claim management system.
• Prepared the BRD documents of FACETS upgrade from 2.96 to 4.31.
• Developed Use cases for all the surrounds interacting with the enrollment system. Also assisted Testing Team in coming up with appropriate test cases.
• Assisted the technical team in understanding and developing the appropriate functionality.
• Identified the client/organizational needs and provide suitable agile system based solutions.
• Make certain the user stories are good, comply with acceptance criteria, have sufficient business value and selling points.
• Delivered SRS documents for extensions and surrounds interacting with FACETS.
• Conducted JAD sessions with the concerned team members and business users.
• Prepared UML diagrams (Activity diagrams, Sequence Diagrams, Use case diagrams) for Extensions and Surrounds.
• Worked extensively with technical analysts while defining classes and preparing class diagrams.
• Responsibly identified business logic and converted the high-level use cases into detailed use cases.
• Developed Design Documents for GUI applications.
• Analyzed codes to understand the functionality of the applications and production and come up with relevant documentation necessary for their reverse engineering.
• Developed System Design Specifications (SDS) in the design phase for reverse engineering PowerBuilder Applications to C#.

Environment: IBM Rational Software Modeler V6.0, IBM Rational ClearCase, Serena CM, C#, UML 2.0, Lotus Notes 6.5, MS Office and Oracle.