• Over 6 years of comprehensive experience as a Business Analyst in Healthcare and Retail E-Commerce industry.
• Proficient in all phases of software development life cycle SDLC from Inception to Post Implementation Phase and methodologies such as Waterfall, Agile, and RUP.
• Solid Experience in developing Scope/Vision Documentation, Project Plan, tracking Project Process, and managing resources to ensure successful delivery.
• Experienced in facilitating JAD sessions, Scrum sessions, requirement elicitation sessions, Interviews and Focus Groups.
• Proficient in documenting BRD, FRD, FSD, Use Case document, Test Plan, Test Case document, UAT document as well as User Manuals.
• Created Activity diagrams, Sequence Diagrams, Wireframe Diagrams, Swim Lane Diagrams, Use Case Diagrams, Context Diagrams and Data Flow Diagrams.
• Ability to quickly gain expertise in a business unit s as well as, an understanding of the IT organization's systems and capabilities to understand their strengths and weaknesses to determine opportunities to automate processes and functions.
• Solid understanding of health insurance claims processing including Enrollment, Authorizations, Claim edits, pricing, and reporting.
• Demonstrated knowledge of EDI transaction sets for healthcare including 820, 835, 837, 270/271, 276/77, and 998/999.
• Ability to function under minimal direction, formulate and define system scope and objectives based on both user needs and a good understanding of information technology, business processes, and industry requirements.
• Actively worked on data analysis and data mapping with respect to ICD10 impact.
• Assisted the QA team in Functional, Unit, System Integration and E2E testing.
• Experienced managing workload s with competing priorities in order to complete tasks in a timely manner.
• Highly motivated, organized and target oriented team player who enjoys working with multi-functional teams.

Confidential

COMPUTER SKILLS

PROFESSIONAL EXPERIENCE

Confidential

Sr. Business Analyst

The project was to migrate the current proprietary claims processing system to Facets. The migration impacted data areas that needed to be migrated to Trizetto Facets.

Responsibilities:

• Provide projects with pre-project planning expertise high-level and detailed project definition, as well as acting as the primary liaison between IT and Business Partner s on a daily and project basis.
• Created baseline business workflow documents to ensure an accurate understanding of the steps needed to complete data migration for each business area.
• Interacting with the Subject Matter Experts SME's and Stakeholders to get a better understanding of client business processes and gather business requirements.
• Conducting JAD sessions regularly with various stakeholders at various phases of the project lifecycle to discuss open issues and resolve them.
• Conducted several business process re-engineering dialogues AS-IS/TO-BE with business area to incorporate their specific process changes to be documented as reporting requirements in Facets.
• Maintaining proper communication with the developers so that they addressed the modifications and requirements as well as monitored the revisions.
• Assisted the project management team with duties as necessary including research, documentation, training/education support, and validating release material.
• Was responsible for creating mapping documents to ensure migrated data would accurately capture all existing information from the data warehouse.
• Coordinated and performed UAT User Acceptance Testing to assess if the system could support day-to-day business and user scenarios and ensure the system was sufficient and correct for business usage.

Environment: Waterfall, DB2, MS Visio, MS Office, MS PowerPoint, HPQC and SharePoint.

Confidential

Sr. Business Analyst

The project's main purpose was to increase the efficiency and throughput on payments from carries. In addition the scope was expanded to improve the tracking processes for medical claims submitted to the carriers.

Responsibilities:

• Conducted GAP Analysis to understand the reason for delays in submitting claims to the carriers and documented findings.
• Organized JAD sessions with stakeholders to get a better understanding of claims business processes and gathered requirements to create the Business Requirement Document BRD and the Functional Requirement Document FRD .
• Defined views and details of various reports to view Claims status.
• Conducted user interviews to analyze the requirements and managed changes by implementing a formal change management methodology using SharePoint.
• Created current and future state Process flow diagram using MS Visio and conducted walk-through sessions with the vendor and client to validate them.
• Tracked stakeholder requested enhancements and maintained changes using Requirement Traceability Matrix RTM .
• Continually interacted with the business and technical teams to ensure consistency in requirements and testing.
• Prioritized and assigned tasks to the QA team by working with the users and QA lead.
• Coordinated and performed UAT User Acceptance Testing to assess if the system could support day-to-day business and user scenarios and ensure the system was sufficient and correct for business usage.

Environment: Waterfall, MS Visio, MS Share Point, MS Office, Oracle and QTP.

Confidential

Business Analyst

The project aimed at re-deploying the web portal with new enhancements and integrated various internal systems, processes, and SOPs with it to achieve a higher level of efficiency in assuring a rich, satisfying experience for external, as well as internal users.

Responsibilities:

• Assisted the Program/ Project Manager in defining, documenting, and implementing success milestones for the Project's critical path, and target-dates for the complete SDLC.
• Analyzed and mapped the AS-IS business processes, compare them to the To-be state, thereby defining the Gap, and then create the new Process flow diagrams, which would result into the desired data-flow.
• Gathered requirements for, and created an enterprise-wide data mapping document, to facilitate the identification and fixation of any mismatches in the desired data being sent to the target applications.
• Coordinated between teams to clarify GAPs, and find resolutions conflicting issues by investigating and highlighting the discrepancies when found.
• Prioritized testing activities revolving around the web portal after collaborating with the QA and UAT teams, Solution Architect and Developers for SIT and UAT.
• Actively helped the business lead in conducting smooth and successful UAT. The process involved in writing Use Cases when needed for the functionalities under test, in collaboration with the Business SMEs.
• Created UAT scenarios, UAT scripts and monitored the results.
• Assisted in the identification of, and coordination with, the PMO/ Project Managers, UAT resources, QA, DBA, and the development teams.

Environment: Agile, Axure, CaliberRM, JIRA, Java, SQL, Quality Center, MS Project and

MS Office

Confidential

Business Analyst

This project involved creating the medical claims processing system for Amerisource. It consisted of different modules like payer, member, provider, and group module. The project involved transitioning from HIPAA 4010 to 5010 and upgrading the claims processing platform.

Responsibilities:

• Collaborated with project stakeholders throughout all SDLC phases to ensure timely delivery of specified business solutions.
• Analyzed existing business processes, systems/applications and their interfaces with their capabilities through open-ended discussions, brainstorming and JAD sessions.
• Gathered business requirements through meetings, interviews and interactive design workshops in a collaborative discussion with cross-functional teams that included compliance, SMEs and IT.
• Interacted with the SMEs to gather information about the health care enrollment, billing and healthcare claims processing.
• Analyzed implementation guidelines for EDI transaction sets including: 270, 271, 835, and 837 to propose strategies to implement HIPAA 5010 standards.
• Created mapping document for EDI 834, 270, 271, 837I and 837P.
• Documented and maintained all the Project Change Request PCR documents and updated them accordingly.
• Created and maintained the Requirement Traceability Matrix to trace requirements between the business requirements document and other artifacts such as design documents and test plans.
• Worked closely with the test data management team to create test cases based on business requested scenarios.

Environment: RUP, Requite Pro, Clear Quest, MS Suite, SQL Server, DB Visualizer and SharePoint.

Confidential

Business Analyst

The project scope was to make changes to the web component to provide additional features and functionally enhance the online facility to its customers. The project aimed at facilitating the viewing of Audi.com and maintaining the functionality of the website.

Responsibilities:

• Conducted feasibility study and performed GAP and impact analyses for the proposed enhancements.
• Closely interacted with web designers and developers to understand application functionality and navigational flow.
• Developed application mock ups for presentation of product configurations capabilities and enhancements.
• Performed Gap analysis for new functionality requirements, as well as prioritized them based on actual business needs to align them with the product release roadmap.
• Created Use Case Diagrams, Wireframe Diagrams and Activity Diagrams for interactive web portals to increase turnaround time and streamline processes.
• Worked with User Interface UI team to create web mockups from wireframes to ensure functionalities were captured and presented on the front end.
• Created the Business Requirements Document BRD , Functional Requirement document FRD and Use Case Specifications.
• Coordinated with the PM, web designers, software development team and the testing team to enable seamless working across groups and ensure on time delivery of project objectives.
• Assisted the QA team in developing test plan and test case documents based on business use cases and functional requirements.
• Created and managed project templates, requirement types and traceability relationships in Requirements Traceability Matrix RTM .
• Prepared and presented weekly project reports on the project cycle, testing progress, and test results summary to senior management.

Environment: Waterfall, MS Office, SharePoint, MS Visio, SharePoint and Quality Center