SUMMARY:

• 7 years of experience in IT with 6 years as a Business analyst having solid understanding of Business Requirement elicitation techniques, and experience in envisioning, representing and translating the product vision from the business sector to the software development. A motivated, sincere, committed, quick learning, multi-tasking, detail-oriented team player with excellent communication, analytical, interpersonal, problem solving and leadership skills.
• Exposed to all processes involved in software development life cycle.
• Served as a Liaison between client requirements customers and IT organizations in the development of new IT system requirements.
• Excellent understanding of HIPAA transactions and code sets.
• Experience in implementing EDI transactions 835, 270/271, 276/277 and 834.
• Understanding of Facets and NASCO Claim processing.
• Efficient in MS Project for planning and status reporting.
• Involved in developing the source to target mapping documents.
• Experience in gathering and interpreting the requirements to prepare the business requirement document and functional requirement document for major healthcare claim processing enhancements
• Extensive Experience in Requirements Analysis using Waterfall, Rational Unified Process, Agile Methodologies.
• Extensive experience in documenting the Business Process in accordance with the Business needs.
• Strong knowledge in Black Box, White Box, Functionality and Regression Testing.
• Seasoned in testing analyst and oversight of testers creating Use cases, Activity Diagram, Sequence Diagram, Requirement traceability matrix.
• Actively involved in developing executing and managing User Acceptance Testing UAT .
• Experienced in writing SQL queries.
• Excellent problem solving and conflict management skills including the ability to manage conflict and find mutually acceptable resolutions.
• Ability to handle multiple tasks and work independently as well as in a team.
• Ability to meet deadlines and handle pressure coordinating multiple tasks in project.
• Both a strategic and tactical mindset to enable the development of a general high level design and to enable detail reviews of Technical Detail Designs
• Team player and self-starter with excellent communication, coordination, documentation, project planning and interpersonal skills.

TECHINCAL SKILLS:

BUSINESS SKILLS:

• Translating business requirement into system requirement.
• Business Process Analysis Research
• Use Case Modeling Analysis
• Usability Study for web based applications
• Detail oriented.

PROFESSIONAL EXPERIENCE:

CONFIDENTIAL

Business Analyst

• Main responsibility included working with pool of Business Analysts, Project Managers, and Subject Matter experts in implementing new CONFIDENTIAL Claims Adjudication Rules along with altering existing Claims Adjudication Rules
• Authored requirements for RUMBA,CBM,CRT,ESD and E-Catalog Information Systems
• Integral member of system integration team charged with integrating and consolidating disparate Claims Adjudication systems between Medco and ESI. Mapped all processes and amalgamated both disparate systems arising from Medco acquisition
• Liaised closely with Technical Support team to investigate Level III production bugs Verified and document aforementioned system defects, assessed impact both in terms of volume and financial impacts and worked with PMO to include system defects in future releases
• Participated in multiple projects involving Waterfall SDLC methodologies to deliver new UI designs and enhance complex, large mainframe based applications and Web based systems for system integration and claims processing.
• Involved in coordination of requirements discussion between several development teams and ensured no gaps existed.
• Processed hands-on project management skills including time and scope management and reviewing the Project Management Plan.
• Lead prototype creation and coordinated usability testing. Presented UI mock ups to users to generate feedback.
• Drive Federal, Medicare and new HIPPA projects to support existing applications and develop new systems for leading pharmacy benefit manager PBM and nation's largest mail order-pharmacy operations.
• Responsible for leading various projects based on different methodologies to develop applications with the help of both cross functional and offshore teams.
• Main Responsibility for training the offshore Business Analyst on User stories, requirements and reviewing their work to ensure it is up to mark.
• Co-ordinate and communicated effectively between end users, business owners, technical leads, QA testers and product owners to understand system requirements from their unique perspectives.
• Created Process flow diagrams, UI wireframes, data flow diagrams, service requests as part of the supporting documents for the User stories.
• Strong experience with Gap analysis.
• Worked with Product Owners and SME's to elicit requirements through various mediums: JAD Sessions, One on One sessions etc.

CONFIDENTIAL

Project Scope: CONFIDENTIAL is an American managed health care company currently serving the needs of more than 65 million people. Worked on single sign on projects for various clients to enable them have seamless access to various ESI applications. The goal of the SSO process is to securely transmit member-related information across the internet, so that Express Scripts can use it to authenticate both the sender clients and the member.

Responsibilities:

• Involved in all the phases of Software Development Life Cycle.
• Interviewed the client to understand their business and functional requirements, gathering their future needs and transforming them to functional specifications.
• Elicited and documented business requirements, perform data and transaction mapping, complete a GAP analysis and document the impact of the migration from HIPAA 4010 to HIPAA 5010 on current business processes and applications.
• Involved in HIPAA assessment and HIPAA X12 EDI transactions 835,837,270/271 mapping and identified changes that needed to be done to comply with HIPAA regulations.
• Worked with HIPAA complaint ANSI X1 837 formats.
• Worked on data mapping to map FACETS data.
• Documented Meeting minutes, Business Requirement Document and System Requirement Specification Document.
• Created design and behavioral elements through, flowcharts, storyboards and interaction design specs
• Worked closely with Usability Team to ensure all the usability standards and procedures for the application where correct.
• Reserve engineered, created, and developed project documentation including: entity relationship diagrams, use cases, data flow diagrams, business processes, project scope etc.
• Prepared status reports and submitted to management on an ongoing basis.
• Developed user flow diagrams and user acceptance test plans and serve as an expert to the Information's Systems staff providing the quality assurance effort.
• Created UML diagrams including use case diagrams, activity diagrams using MS visio.
• Helped testing team in developing Test Plans, Test Scenarios, Test Cases and updated the test cases using Quality Center which acted as repository.
• Traceability Matrix, UAT, document and status report.
• Interacted with Business Analysts, Programmers to understand detailed technical and business process flows, managed testing assets in Quality Center.
• Using software testing tools for Defect Tracking and testing.
• Created Mockups to show the basic webpage.

Environment: HTML, Java, Java Web Services 2.0, J2EE, Rational Requisite Pro, MS Visio, MS Access, UML, MS Office, MS Project, Test Director, HP Quality centre, Sharepoint, DOORS.

CONFIDENTIAL

Business Analyst

Project Scope: CONFIDENTIAL Application is a web based application used to help Enrollment Center Examiner of the Insurance Company to renew the Caller's Medicaid insurance policy. There are various criteria which are taken into account while renewing the insurance policy for a caller by the ECE such as the demographic details, budget, financial decision and others.

Responsibilities:

• Identified and created different test requirements based on design documents, business and feature requirements.
• Worked extensively with the QA team for designing Test Plan and Test Cases for the User Acceptance testing.
• Assigned the task of User Acceptance Test UAT coordination, this involved monitoring of business UAT testing and interfacing with the development team regarding defect status and fixes and the monitoring of the availability of the testing environment on a daily basis using RAD sessions.
• Assisted Project Manager in solving Tickets opened due to various production issues.
• Worked along with the Business Project manager in handling end-to-end issues, managing team meetings and making statically presentation for various Business Works.
• Involved in solving different Production Issues raised by Developers, testers and other end users.
• Accumulated customer requirements from various end users through surveys, interviews and JAD sessions
• Defined scope of project along with vision statement
• Understand and articulate business requirements and then convert them into technical specifications.
• Managed Change Control Requests CCR and updated the scope with the new changes.
• Review, analyze and underwrite insurance policy to meet state compliances and standards.
• Suggesting improvements and recommendations subject to insurance policy underwriting guidelines.
• Created User Case templates.
• Created UML diagrams such as use case diagrams, activity diagrams, and sequence diagrams for the detailed analysis of business objects.
• Assisted in creating application user manuals and training materials.
• Provided user training and help desk support for the application.

Environment: ASP.Net, C .net, Windows 2003 Server, SQL, PL/SQL, Rational Requisite Pro, MS Visio, MS Access, UML, MS Office, Rational Clear Quest, Test Director, DOORS.

CONFIDENTIAL

Business Analyst

Project Scope: CONFIDENTIAL is a Software product engineered to facilitate EDC Electronic Data Transfer and Management. Rave allows the data to be entered at clinical research sites such as offices, clinics, and hospitals through an entirely web based system, accessed via the internet from a client computer with a web browser and access to the worldwide web.

Responsibilities:

• Prepared the Business Requirements Document for the RAVE application.
• Developed, delivered and institutionalized ITIL processes to mature organization monitor and report on change management activities.
• Conducted Joint Application Development JAD sessions with stakeholders throughout SDLC to resolve open issues.
• Assisted project manager in laying out project plan for the project using MS project.
• Used RUP methodology in the implementation of the system.
• Working with Cross Functional Teams and interacting with all levels of management for requirements, resources, and project status and delivering custom applications in phases.
• Designed and customized dataflow diagrams to make it suitable for the developing team to understand and to configure according to the requirements.
• Analyzed requirements and created Use Cases defined business rules and created UML diagrams activity diagrams, sequence diagrams etc using MS Visio.
• Prepared Business Process Models that depicted modeling of all the activities of the process from the conceptual to procedural level.
• Modeled functional requirements, converted business requirements into technical specifications.
• Created and managed project templates, use case templates, requirement types and tractability matrix.
• Created mockup screens and Wireframes for the application using MS Visio.
• Managed Change Control Requests CCR and updated the scope with the new changes.
• Performed Manual testing of different modules of Rave application
• Involved in Regression testing, Functional testing using QTP. Performed Backend Testing using SQL.
• Developed test plan, test scripts and executed system test cases for systems testing and User Interface Acceptance testing.
• Experience with Data Mappings including HIPAA 4010 ICD9 and ICD-10 implementation guidelines electronic formats including for institutional, professional, and commercial claims.
• Actively participated in creating the Test Summary Report.
• Assisted in creating application user manuals and training materials.

Environment: ASP.NET, C .Net, Windows 2003, SQL, PL/SQL, Business Objects, Oracle Clinical 4.0, Oracle Portal, Crystal Reports, MS Office 2003, MS Project, MS Visio 2003, Rational Requisite Pro, UNIX shell scripting, Rational Clear Case.

CONFIDENTIAL

Business Analyst

Project Scope: The scope of the project is to implement a web based claims processing and management application to manage health insurance claims electronically. This software is a web-based electronic claims processing solution providing real-time patient insurance information. The application connects the organization to the largest all-payer network of commercial and government health plans nationwide to provide a wealth of real-time patient benefit information. Data is automatically translated to meet HIPAA compliance standards and the privacy of transactions is protected with the highest level of internet-based security.

Responsibilities:

• Basic responsibilities involved the analyzing end user requirements and communicating and modeling them to the development team.
• Took critical part in formulation of the Project Plan.
• Initiated JAD sessions with End Users through one on one and group interviews to better understand the user requirements.
• Created extensive use case, activity, sequence diagrams of the required system to enable clear project idea and goals.
• Worked with Medicare Plans in claim processing.
• Created System Specification Document using RUP Methodology, Requirement Specification Documents, Use Case Models, and Work Flows.
• Detail knowledge and experience working on HIPAA and transformation of ICD- 9 to ICD-10.
• Change and Traceability Matrix was maintained throughout the project to keep track of changing user requirements and alterations made by the team.
• Involved in UAT testing and made documentation for Test Cases.
• Met with technical/development team on weekly basis to determine the project structures such as Privacy protection, communication, and security and explain them the various changes made to the system that needs to be tested before implementation
• Helped the testing team in making up the test strategies and test plans to be used in the testing process
• Created Use Case scenarios and interfaces using UML methodology.

Environment: Rational Unified Process RUP , MS Project, SQL, Rational Requisite Pro, Rational Rose, Clear Quest, Microsoft Visio, Windows 2000/XP, Mercury Test Mercury Centre.

CONFIDENTIALJr. Business analyst

Project Scope: CONFIDENTIAL was a web based order entry application. Users will be able to enter the orders for all the market segments along with the order types. Oracle was the database server used for this application and the front end was in html and java script. Whenever a user entered an order, basic validations were checked by the java script and the order was submitted to the Oracle database if there were no errors found in the order.

Responsibilities:

• Participated in user session in requirements analysis phase.
• Created test plan, test cases and test scripts.
• Actively involved in Analysis Design walkthroughs.
• Used regression testing to make sure that new functionality is not impacting existing functionality in the system.
• Performed Back-end testing using SQL Queries.
• Participated in implementing new software in to the productions.
• Involved in User Acceptance Testing UAT by providing test data for users and by testing UAT defects in Test Environment before new code gets moved to UAT environment
• Ran validations in the production after the product is implemented.

Environment: Windows NT 4.x, EJB, Web logic 6.0, JSP, JavaScript, SQL Server 7.0, Microsoft suite.

CONFIDENTIAL

Manual Tester

Project Scope: This system allows the user to enter various sales orders according to the purchases placed by the customers. It validates the sales order by considering various factors like Quantity in hand, order price, delivery date etc. There is a provision in the system for automatic tax generation. This system generates reports like invoices, Delivery Receipts etc.

Responsibilities:

• Involved in analyzing the applications and development of test cases.
• Applications are tested manually.
• Tested Various Modules manually.
• Identified the test requirements based on business requirements.
• Responsible for doing System testing of the entire applications along with team members
• Analyzed Results with Business Analysts.
• Worked with technical analysts to develop functional specifications for the features and Functions defined in the requirement document.
• Working with different tracks to understand the process flow of the data.

Environment: Test Director, Rational Clear Quest, VB 5.0, SQL Server, MS-Word, Ms-Excel, DB2, Windows98