SUMMARY

• Over 7 years of extensive experience as a Business Analyst, analytical and technical skills to leverage experience in Health Insurance, Financial Industries.
• Experience as Business Analyst in the Healthcare Industry on various areas like Claim Processing, In - Billing and Out-Billing, and Customer Care. Very strong knowledge of Medicare and Facets.
• Expertise in Claims Processing and have good understanding of Healthcare System in United States.
• Knowledgeable in HIPAA and HL7 Standards.
• Understand rules and regulations of HIPAA as imposed during Electronic Data Interchange (EDI).
• Strong Interpersonal Skills in interacting with SME’s, Stakeholders and Senior Management.
• Excellent Communication and Presentation Skills both oral and written. Proven ability to convey Business requirements and Technical needs in clear, concise, and effective manner.
• Have strong knowledge of Rational Unified Process (RUP) and Agile (Scrum) methods of SDLC.
• Strong knowledge of requirement Elicitation Techniques like Joint Application Development sessions (JAD), Interviewing, Questionnaires, Brainstorming, and Surveys for Medicare and Medicaid features of the Application.
• Prepared Business Requirement Documents (BRD) and Functional Requirement Documents (FRD) for Healthcare feature.
• Created Wireframes, Use Cases, and Activity Diagrams by using MS Visio based on UML.
• Have a good experience in performing Gap analysis.
• Good experience in handling Change Requests by performing Impact Analysis.
• Experienced in writing test queries/scripts for data analysis and QA report testing.
• Experience Working with ETL Developers and Process Analysts in preparing the requirements (data and functional), and writing (documenting) work flows and process flows .
• Experience with conducting assessments and impact/gap analysis concerning State MMIS
• Assisted QA team in writing Test Cases and Test Plans for the Department Director that was used to review and evaluate results of a testing cycle.
• Proficient in creating Risk Analysis documents, Risk Management Plan, User Requirement Specification.
• Participated in business and technical design sessions with DBAs and developers.

TECHNICAL SKILLS

Methodologies: RUP methodology, Agile methodology, Waterfall and SDLC.

Business Processing Tools: Visio, Rational Rose Requisite Pro, Clear Quest and Clear Case

QA Tools: Test Director, aardvark, Rational Test Manager and Load runner.

Case Tools: Rational Rose 6.0.

Languages: UML 2.0, C, C++, Java, Visual Basic 6, HTML, XML, COBOL

Databases: Oracle, SQL Server, MS-Access

Workflow Tools: MS Visio, MS Word 97/2000, MS Excel 97/2000, MS Access 97/2000, MS Project

Platforms: Windows (2000, NT)., Unix (HP, Solaris8.0) AS/400

PROFESSIONAL EXPERIENCE

Confidential, NYC

Business Analyst

Responsibilities:

• Acting as a liaison between business clients and technical personnel to acquire and record requirements for upgrades, enhancements and new projects.
• Followed a structured approach to organize requirements into logical groupings of essential Functional Requirements, Non Functional Requirements, Interface Requirements and Report Requirements andensured that critical requirements are not missed.
• Worked with IT teams regarding Electronic Data Interchange (EDI) transactions such as 835/837, 278 for Claims processing.
• Documented Use Cases, Algorithms, Test Plans, test data and expected results for the Integration, Functional, Performance, and User Acceptance Testing.
• Responsible for creating UML modeling plans, Use cases, process flows, Wire Frames and business requirements documentation using Visio.
• Followed existing CMMI and HIPAA compliant protocols incorporated in daily standard procedures.
• Analyzed and modeled the system using Functional Hierarchy Diagram and Process Development Diagram.
• Responsible for defining the scope of the project, gathering business requirements and documenting them textually or within models.
• Conducted JAD sessions to develop architectural solution that application meets the business requirements, resolve open issues, and change requirements.
• Using GAP analysis, reviewed high level company processes, identified gaps that require operational change in order to optimize the proposed system solutions.
• Performed analysis and reporting of marketing and operational data. Develop and monitor web metrics.
• Directly interacted and assisted Stakeholders, SMEs and Development team to allow compliance with successful implementation of project within time and cost.
• Worked as an Interface between the end users and the different teams involved in the application development for the better understanding of the business and IT processes.
• Interviewing business area experts and SMEs asking detailed questions and carefully recording the requirements and performed data analysis.
• Documented Test Plans and prepare of Requirements Traceability Matrixes (RTM) that contains test scripts, test cases, test data and expected results for the User Acceptance testing.

Environment: HTML, XML, MS Visio, MS Excel, MS SQL, Rational Requisite Pro, UML, Rational Unified Process, SQL.

Confidential

Business Analyst

Responsibilities:

• Wrote Business Cases after conducting meetings with business users, risk team and finance team. Acted as IO Analyst and worked closely with IO Manager, BU Sponsor and BU Contact. Measured business opportunity, description of solution and scope. Measured and documented Labor and Material Detail, Skill Set, Budget /Cost To Achieve (CTA) Summary, Inflow Summary and Economic Analysis.
• Develop, design and implement department plan to operationalize new FACETS integrated processing system, to include but not limited to workflow, management oversight and performance analysis.
• Conducted JAD sessions and created functional and technical requirement specification for application development based on Solution Delivery Process.
• Coordinated end to end testing efforts of the HIPAA Compliance and EDI Transactions.
• Ran queries monthly to verify tie-outs for the business prepared by the technical resource to provide support for applications & solutions supported by the Reporting and Analytic Finance team with emphasis on the Corporate Finance Cognos Planning Models.
• Performed Impact Analysis and Gap Analysis.
• Recommended changes for improvement after analyzing operational procedures and methods.
• Documented issue list and risk list pertaining to various projects.
• Creation of Gap/Impact Analysis and Operational Analysis Document for Medicaid Subrogation
• Wrote use cases and verified that they match every single requirement of the application.
• Prototyped the application, provided screen shots for better visualizations.
• Coordinated and collaborated the business, operations and the technical areas throughout the project life cycle.
• Create presentation style reports with chart and graphs which can be used to access any type of data source
• Presented reports to management and provided user and acceptance tests.
• Performed manual testing and recorded results in Clear Quest and used SQL queries for enhancements.
• Performed the user acceptance testing.

Environment: AUP, Test Director, MS Office, MS Excel, MS Visio, MS Project, Rational Clear Quest, Rational Clear Case, PL/SQL, Oracle Enterprises Business Suite, JAVA.

Confidential, Bloomington, MN

Business Analyst

Responsibilities:

• Facilitated Working sessions, articulated requirements, make recommendations for process andbusinessflows, develop consensus on requirements, performed analysis of requirements, by developing use cases, andcollaborating with users to reduce project risk and to increase quality.
• Independently analyzed and defined solutions for complexbusinesssituations that will include all aspects of life and healthbusinessincluding Actuarial, Underwriting, Valuations, Reinsurance Administration and Technical Accounting.
• Produced functional specifications and lead weekly meetings with developers and business units to discuss outstanding technical issues and deadlines that had to be met, used RequisitePro for gathering the requirements, Clear Quest to track the business process and Rational Rose to create UML Diagrams.
• Conducted Joint Application Development (JAD) process with Stakeholders to analyze deliverables and system constraints.
• Developed test plans, test cases for Quality Assurance and developed root-cause analysis reports, ensured proper placement of business controls, re-engineered business processes, implemented performance measures, presented project presentations to executive management, provided user, and performed a variety of ad-hoc project.
• Managed project risk management and business process analysis reviews over the implementation of different applications.

Environment: MS Office,MS Excel, MS Visio, MS Project, Rational Clear Quest, Rational Clear Case, PL/SQL, JAVA.

Confidential, Oakland, CA

Business Analyst

Responsibilities:

• Defining Software Development Lifecycle (SDLC) and planning the entire process using MS Project.
• Defining functional requirements and specifications for use by the development team.
• Conducting Joint Application Development sessions for communicating with the all project leads and stakeholders the proposed process workflows.
• Creating design document (UML diagrams) using Microsoft Visio for proposed system.
• Identified Use cases from the requirements and wrote Use Case Specifications.
• Used Rose to carry out the business modeling and object modeling effort to develop the business architecture for the application for rapid and controlled Application development. Responsible for creating the Gap Analysis of As -Is and To-be process using Rose.
• Participated in meetings with Developers, Project Managers and Quality Analyst to discuss business requirements, test planning, resource utilization, and defect tracking.
• Tracking and managing requirement changes using Requisite Pro.
• Involved in walkthroughs and meetings with development team to discuss related issues.
• Used Rational Rose to visually determine the proper structure, key elements and optimal design for your database and to aid efficient creation of tables, stored procedures.
• Wrote clear, concise detailed System requirements specification (SRS) documents and user documentation in accordance to guidelines and standards of a level where developers can interpret, design and develop the application with minimum guidance.
• Verified the functional aspect as per the Business Process and validated the interfaces with the other systems and data conversion from the legacy system.
• Performed Back end testing, performance testing and load testing via navigation and workflow of the Application.
• Used Rational Clear Case, Configuration Management tool, to maintain different builds of the application with descriptions about all changes and versions.

Environment: RUP, Windows 2000, MS Visio, ASP, C#.Net, SQL, PL/SQL, Oracle 8i, SQL server 2000, Requisite Pro and Rational Rose

Confidential

Business Analyst

Responsibilities:

• Interacted with the software development team and executive team to liaison the business requirements to ensure that the application under development confines to the business requirement.
• Served as a liaison between the business and technical team.
• Perform analysis and reporting of marketing and operational data. Develop and monitor web metrics.
• Directly interacting and assisting project manager and team members to allow compliance with successful implementation of project within time and cost.
• Managed project risk management and business process analysis reviews over the implementation of different applications.
• Work with Oracle databases to create data objects necessary to analyze and report findings, including tables, functions, stored procedures, views, and indexes.