Summary

• Over 7 years of extensive experience in Healthcare, Pharmaceutical and IT Industry as Business Analyst and System Functional Analyst.
• Acquired strong experience in leading all stages of system development efforts, including requirements definitions, design, architecture, testing and support.
• Strong understanding of Industry Standard methodologies like Software Development Life Cycle SDLC , Iterative approach like Rational Unified Process RUP and traditional approach as Waterfall.
• Proficiency in analyzing and creating Use Cases, Use Case Diagrams, Activity Diagrams, Class Diagrams, Data flow Diagrams, Business Flow Diagrams and Sequence Diagrams using MS Visio and Rational Rose.
• Expert in developing BRD Business Requirement Document , TRD Technical Requirement Document , URS User Requirement Document and FRS Functional requirement Specifications following Rational Unified Process RUP methodology.
• Expertise in conducting and facilitating workshops like JAD Joint Application Development for Elicitation and Elaboration of requirements to ensure clear and non-conflicting understanding of requirements.
• Hands on experience in Requirement gathering and analysis, Planning, scheduling and Tracking Projects.
• Experienced in EDI and HIPAA Testing Privacy with multiple transaction exposure such as 837 for submitting claims, 835 for payment, 834 for benefit enrollment, 820 for premium payments to insurance products, 278 for transmitting health care service information, 276/277 for claim status, 270/271 for health care benefits and eligibility.
• Effectively completed GAP Analysis of HIPAA 4010 TO 5010 conversion.
• Strong understanding of ICD 9 AND ICD 10 structures and formats.
• Working knowledge of Medicare and Medicaid Claims Processes.
• Exposure to SQL and database querying tools like FACETS.
• In Depth understanding of the AS-IS and TO-BE business processes.
• Experience in conducting GAP analysis and SWOT analysis.
• Experience in Pharmaceutical industry with emphasis on Validation and Verification.
• Worked extensively on B2B applications and B2C applications in transaction processing and E-Commerce/web-based applications.
• Extensive experience working with large web-based Application development and maintained account Automation functionality which includes New Account opening, Client documentation, preparation, Account Maintenance and upgrades.
• Gathered good knowledge of Medical and Healthcare Standards and Regulatory vehicles such as HIPAA, FDA, ICD, MMIS, EDI, HL7.
• Knowledge of various RDBMS like DB2, Oracle, MS-Access and MySQL Server.
• Thorough knowledge of HP Quality Center and Defect Lifecycle Process.
• Ability to communicate effectively with Business users and Senior Management.
• Capable of managing daily Project activities by accurately documenting and communicating with all the groups and departments involved.
• Worked as productive team member with excellent communication and presentation skills using MS OFFICE AND MS PROJECT.

Technical Skills:

PROFESSIONAL EXPERIENCE:

Confidential

Sr.Business Analyst

Responsibilities:

• Worked on HIPAA 4010 5010 ANSI X12, EDI series Insurance/Health Series INS such as 270/271, 276/277, 278, 834, 835, 837.
• Maintained the insurance record of customers through EDI ANSI ASC X12 standards for better privacy and security, compliant with HIPPA regulations.
• Fair understanding of ICD-9 ,ICD-10 changes.
• Responsible for discussing with business team and technical team various business scenarios and planning solution for meeting business need.
• Responsible for coordinating test data preparation, validating data and ensuring testing cycle is completed with necessary test scenarios reviewed.
• Identified and documented issues, risk and gaps, their descriptions, their impact and provided recommendation and alternatives to develop the application to meet the user requirements
• Worked in a team to develop use cases for their newly added application layout and understood all the business processes related to newly added layout and designed use cases that helped developers to build application
• Interacting with the developers on resolving the reported bugs and various technical issues
• Involved in UAT to confirm that the system under test meets the user needs and provides confidence in its use
• Performed verification tests to validate the data integrity
• UML diagrams such as activity and use case diagram were used to document the requirements and ensure creation of high level business requirements documentationUnderstand rules and regulations of HIPAA as imposed during Electronic Data Interchange EDI .
• Worked cross functionally with developers, QA and project managers to make sure each the data could address their needs
• Performed verification tests to validate integrity of data

Environment: Rational Enterprise Suite, Microsoft Office Suite Word, Excel, Power Point, Visio, Project , Windows, SQL.

Confidential

Business Analyst

Responsibilities:

• Converted the Business Requirements BRD into Technical Requirements TRD for the IT Department.
• Performed GAP Analysis, walkthroughs and acted as liaison between the business users, stakeholders and the team to perform requirements, quality and risk analysis.
• Developed Mapping rules, specifications and use cases for HIPAA 837, 270/271, 276/277, 835, 824, 275 and others. Worked on multiple 837s and 270/271's.
• Maintained and tracked Stake holder's requested enhancements and changes using Requirement Traceability Matrix RTM .
• Worked with PMO group in defining timelines and schedules for the project.
• Documented and reported the progress to the Management on an ongoing basis.
• Organized and facilitated meetings like JAD sessions with the management and development teams.
• Schedule one- on-one meetings with technical personnel to determine technical parameters and processes including communication, security and privacy.
• Interacted with development team to explain to them the various design documents like Business Use Case Model, Detailed Uses and Vision Document.
• Created detailed design of the system with the project team including class diagrams, activity diagrams and sequence and collaboration diagram.
• Coordinated daily activities with the IT Developers, QA and Product teams along with the project management group.
• Assigned problems to the appropriate software development team for fixes.

Environment: Rational Unified Process RUP , UML, Rational Test Manager, Rational Clear Quest, Windows, MS Office, HTML, Windows

Confidential

Business Analyst

Responsibilities:

• Accurately documented best practices of HIPAA requirements with UML Diagrams and Use Cases.
• Involved in requirement gathering, understanding and producing Business Requirement Document BRD and translating it into Functional Requirements FRD and Technical Requirement Documents TRD .
• Participated in designing of Claims Processing 837/835 and Claims Validation and Verification Process.
• Involved in GAP Analysis of AS-IS and TO-BE processes as per changes made to Medicare and Medicaid program.
• Resolved and documented issues related to EDI transactions including 837.
• Facilitated JAD sessions with SMEs and Business Departments.
• Organized one-on-one meetings to identify business and system requirements.
• Maintained Requirement Traceability Matrix RTM to request change and track defeats.
• Analyzed the impact of change request on the application in regards to Project Plan, Project Scope and Project Schedule.
• Actively interacted with Developers, User Representatives and participated in the product design process including specifications and other document reviews.
• Worked as a Primary liaison between Business, Operations and the Technical areas throughout the project cycle.
• Generated various Use Case Diagrams, Sequence Diagrams, and Business Objects using MS Visio to describe Process Flows with Power Point Presentations.
• Participated in development and design of test plans and test cases with quality assurance team.
• Conducted Final testing reviews for usability testing to verify whether all the user requirements were satisfied.
• Created Full life Cycle documentation from Project Requirements during development stage to Functional Specification.

Environment: Rational Suite, Windows, MS Visio and MS office

Confidential

Business Analyst

Responsibilities:

• Assisted and maintained Clinical supporting documents to meet SDLC standards.
• Work closely with Users, Developers and Administrators to resolve ongoing Production Problems by reviewing design changes made to production systems and made corresponding changes to Siebel Analytics Repository.
• Conducted workflow, process diagram and GAP analysis, ROI analysis to derive requirements for existing systems enhancements.
• Maintained the Requirement Traceability Matrix RTM and participated in development of the Test Validation Methods for writing Performance Qualification specifications PQ .
• Facilitated business requirements gathering sessions with the client and overlooked the creation of Use Cases/ Activity Diagrams, Functional Specifications using UML/Visio.
• Implemented FDA guidelines to avoid non-compliance, delays in production and increased costs.
• Conducted user interviews, gathered requirements and analyzed the requirements.
• Worked on LIMS for core analytical laboratory management, inventory solution tracking and reporting.
• Working knowledge of regulatory requirements HIPAA, 21 CFR PART11 and audits.
• Participated in JAD sessions and interacted with technical leaders from various departments Clinical trial, Drug Discovery and Pharmaceutical Development
• Updated and wrote several SOPs for day-to-day functioning of the system as well as emergency operation system recovery, back-up, etc.

Environment: MS Project, MS Office, Rational Team Test Suite, Windows, Java, Siebel, HTML, MS Visio, UML