Summary

• Over 7 years of extensive experience in Business Analysis, Software Validation and business process re-engineering, with proven ability to articulate business values.
• Experience with HIPAA Industry standards, with the knowledge of MMIS and understanding of DRG's Diagnostic Related Groups .
• Experienced with Medicare Advantage Programs, HIPAA 4010 and 5010 EDI transaction codes such as 270/271 Inquire/response health care benefits , 276/277 claim status , 834 Benefits enrolment , 835 Payment , 837 Health care claims .
• Functional experience with concentration on Use Case modeling using UML, Change Management, Technical Training, Software Development methodologies, QA testing, and Systems Testing of client server and web-based systems.
• Experience in conducting joint application development JAD sessions with end user, Business intelligence team, IT SMEs and QA team for project meetings and all stakeholders.
• Strong Business Analysis Skills including knowledge of Software Development Life Cycle SDLC , having thorough understanding of various phases like Requirements, Analysis/Design, Development and Testing using Rational Unified Process RUP and Agile.
• Extensive experience with Rational tools such as Clear Case, Clear Quest, Rational Requisite Pro, and Rational Rose.
• Proficient at creating and transforming business requirements into software requirement specification SRS using Rational Requisite Pro and designing Class Diagrams, Activity Diagrams, Sequence Diagrams and Collaboration Diagrams in MS Visio.
• Experience in writing Test Plans, Test Cases, and Test Scenarios and performed various System testing like Regression/Integration/Functional/Black Box/UAT by both manual and automated techniques.

Skill set:

MS Visio, MS Project, Rational Requisite Pro, BizAgi, Windows XP/2000/98/95/NT, Business Objects, UML, HTML, Access, SQL Server 2005, Microsoft Word, Power Point, Excel, Outlook.

Confidential

Business System Analyst

Responsibilities:

• Worked with Medicaid Management Information System MMIS , Health Insurance Claims Processing system and Reporting/Analytics.
• Worked on Process Work Flows, Functional Specifications, and responsible for preparing Software Requirement Specifications SRS , Functional Specification Document FSD and Use Cases.
• Established a business Analysis methodology around the SDLC, helped to develop use cases, project plans and manage scope for clinical Applications.
• Created Process Flow diagrams, Use case diagrams UML using MS-Visio for clinical Applications and worked on EDI transaction like 834, 835,837 .
• Worked on Medicaid Enterprise Certification Toolkit MECT and Information Technology Architecture MITA .
• Involved in development documentation of Software Requirements Specification SRS and extensively performed requirement analysis including data analysis and gap analysis.
• Worked with data reporting tools, Business Object, Cognos, and Crystal Report.
• Worked on ICD 10 Remediation Testing and ICD 9 to ICD 10 conversion projects.
• Developed implementation plans, produce user documentation and training materials. Conduct end user and staff training.
• Monitored and supported end users in resolving issues with navigation, troubleshooting, patient plan care information and other on-site issues.
• Worked on Data Warehousing and Mining: Concepts, Methodologies, Tools, and Applications.
• Case study follow up, review information obtained from FDA, HIPAA, IRB and other regulatory compliances, recourses management, cost procurement.
• Developed the test plan to be used in testing based on business requirements, technical specifications.

Environment: Agile, Scrum, UML, Oracle 11i, Claims, Medicaid, ETL, Windows, MS Visio, Informatica, DB2 UDB, MS Paint, MS Office Suite.

Confidential

Business System Analyst

Responsibilities:

• Used the Agile methodology guidelines to carry out the steps of business production-planning modeling process.
• Took part in discussions to gather the requirements directly from the business and discussed the possible solutions with the IT.
• Elicited demands from the business and analyzed them for consistency, flexibility and completeness in regards to GFE .
• Attended the daily hyper care meeting with project manager, application leads and team members to provide the status of risk, design related issues, latest business requirements and prioritize demands.
• Gathered the functional and data requirements, analyzed workflow and created Use Cases.
• Worked closely with the production and management team to understand the flow of the products from the factory to the warehouse, gained proficiency in Electronic commerce side of the business managing the orders and checking the sequence of order payment along with understanding the Vendor Sales environment, leading to gaining proficiency in purchase of merchandise making payments.
• Reviewed the pricing of the merchandise while making new orders to the factory, which involved browsing through the tool competitors websites, entering prices listed by the planning team and finally writing the Purchase Orders
• Worked on retaining the archive/ historical data and then successfully embedding it in the new system, worked closely with the IT team to test the archive data once it was uploaded in GFE from GFE.
• Worked closely with the retail team to gain knowledge about Sales force APPTUS, in order to gain the correct numbers for the future purchase orders.
• Defined the business model using BPM for CHAPS, from the first day of them using GFE , till the final hyper care support day. Followed it through out and finished the implementation in the designated time frame.
• Performed Volume testing, Performance testing and System testing to validate if the system breaks down under any circumstances.
• Performed Stress testing to check the durability of the system after the implementation of new requirements.
• Wrote the test scripts and test sets for business to perform the User Acceptance Testing.
• Performed Regression testing and tested the application from end to end to make sure no defects and bugs are found.
• Worked in SPIRA Testing tool , to test the application and then record the defects or bugs found.
• Provided floor support to Chaps Men's team for immediate clarification of queries and better understanding of the functional changes made in the new GFE .
• Logged the issues faced by business on daily basis in hyper care Log, to keep a record of the pending and resolved issues.
• Lead the Report testing, by creating the test scripts for the testers to test, assigning the reports to the testers and evaluating the progress daily by generating a progress report.
• Helped in Conversion testing Converting Materials Plans from Legacy systems to current GFE . Even converted the materials and Assortment Plans from legacy to the current GFE
• Performed the front-end validations and worked with the IT lead overseas.
• Performed the volume testing and tried to create scenarios to check the breaking point of the system.
• Lead the compiling of the test scripts, syncing in the latest changes from Release 4 5, thus keep the scripts updated.
• Wrote the test scripts for Release 6 in December and tested them against the system.

Environment: MS office suite 2010, E-Commerce interactions, GFE , SPIRA, Agile methodology, Rational Requisite Pro, HP Quality Center, SQL Server 2000.

Confidential

Business Analyst

Responsibilities:

• Conducted interviews, live Meetings and JAD sessions with business users and subject matter experts to gather information to create Business Requirement Documents.
• Designed and developed Use Cases, Activity Diagrams, Data flow diagrams and Sequence Diagrams using UML.
• Gathered information from reference manuals to understand the changes and differences in ICD 9 and ICD 10 and created requirement documents for the coders.
• Extensively worked on the ICD code conversion from ICD 9 to ICD 10, assisting and leading various teams by complying with already going works in the health care domain and work with the conversion of HIPAA 4010 to 5010
• Conducted Risk Analysis of the Requirements and Traceability focus areas of the various projects and worked with the project team to help them identify the high-risk areas.
• Worked on both inbound and outbound transactions, creating requirement for multiple transaction types including EDIX12 837, 834, 835, 270 271
• Gathered requirements of future state processes for HIPAA 5010 transaction processing EDI's 837,834, 835, 270, and 271.
• Created reports from the enterprise data warehouse for the management for quarterly comparison.
• Assisted with user testing of systems and maintained quality procedures and ensured appropriate documentation is in place.
• Maintained Requirement Traceability Matrix RTM and Utilized Clear Quest for change requests and defect tracking.

Environment: UML, MS Office 2010, Rational RequisitePro V7.1, Rational Clear Quest V7.1, Quality Center, SQL, SharePoint

Confidential

Business Analyst

Responsibilities:

• Analyzed user/business requirements, functional specifications and Use Case System documents and collected requirements for Credit risk calculation Engine.
• Worked with the Business Users through interviews and JAD sessions.
• Used the consolidated Databases from EAD to find the calculated Risk Weight of the bank.
• Responsible for defining the scope and business rules of the project, gathering business requirements and documenting them textually or using models.
• Reconciliation of ACH Wire Transfer/Rejects, SWIFT Rejects, and daily processing files.
• Managed all requirements in DOORS, making them available to all team members.
• Conducted user interviews and organized workshops to understand and articulate business requirements and converted requirements into technical specifications.
• Conducted application testing for financial products markup language an industry standard protocol for complex financial products.
• Responsible for writing Functional Requirement and User Requirement Specifications.
• Performed GAP analysis to identify mismatch between system functionality and business requirements and segregated those into high/low level Use Cases and Activity Diagrams using Rational Rose.
• Maintained test notes and requirement using DOORS.
• Conducted the FRS and URS reviews and walkthroughs with designers, developers and stakeholders, and performed feasibility and adaptability study.
• Actively involved in User Acceptance Testing UAT and training of the end users.

Environment: Microsoft Office suites Word, PowerPoint, Access, Excel, Project, Visio , Windows, Mercury Test Director v9.2 , UML, Object Oriented Analysis and Design, PL/SQL, SQL.