- Over 6 EIGHT Plus years of experience as Business Analyst with expertise in Business Analysis, Joint Application Development, Business Process Analyses, Requirements gathering and management of documentation, Software Analysis and Modeling of web/enterprise wide client/server based applications with strong understanding of software development life cycle.
- Involved in all phases of SDLC with comprehensive knowledge of business requirements analysis, use case modeling, and use case specification.
- In-depth knowledge of Rational Unified Process RUP .
- Expertise in analyzing Business and Development Specifications, Use Cases and detail design to develop requirement gathering, conducting Feasibility studies, document generation and conducting JAD sessions.
- Certified Scrum Master.
- Experience on both Agile and Waterfall Software development methodology.
- Extensive experience in conducting Gap Analysis SWOT analysis.
- Proficient in Claims Processing and Claims in Medicaid and Medicare.
- Experience in ICD-9/ICD-10 codes, CPT, EMR, EHR, PHR, HL7, X12 EDI transactions' 270/271, 276/277, 837/835 queries, testing, and SQL statements.
- Expertise in all X12 EDI transactions.
- Well versed in health care claim engines, claims processing and ITS.
- Contracted with the Medicare Centers and Medicaid Services CMS to provide quick, easy, and affordable access to the health care service of their choice.
- Experience in reviewing Test Procedures, defining Test cases, reviewing and maintaining Test scripts.
- Adept in learning new technologies and quickly adapting to new environment.
- Proficient in the use of Quality Center and Test Director for Test Planning, Test Designing, Test Analysis, Test Execution, Defect Tracking and Test Evaluation.
- Extensive experience in Bug tracking using tracking tools such as Test Director, Quality Center and Team Track.
- Executed SQL queries and stored procedures manually for back-end testing using SSMS SQL Server Management Studio .
- Conducted White box, black box, system, integration, functional, regression, localization, compatibility, security, different reports, smoke and UAT testing.
- Participated in complete life cycle of software development including design, development, testing, technical documentation, and product support.
- Flourished in both independent and collaborative work environments with quick learning abilities and excellent communication skills, presentation skills.
- Proficient in learning new technologies and quickly adapting to new environment.
RUP, UML, Six Sigma, CMM, Waterfall, Agile, Sybase Power Designer, Joint Application Development JAD , Unified Modeling Language UML , Object Oriented Analysis and Design OOAD
Rational Enterprise Suite, Test Director
Change Management Tools
Rational Clear Quest, Test Director.
Business Modeling Tools
Rational Rose, Microsoft Visio.
Version Control Systems
Rational Clear Case.
Microsoft Project, Microsoft Office.
MS Office Suite
MS Word, MS Excel, MS PowerPoint
- Facilitated in Daily stand up meetings to gather team's progress on the project.
- Worked as Scrum Master for the agile team. Implemented the Agile methodology of software development and developed user stories and dashboard for the system.
- Facilitated in Release planning backlog grooming , Sprint review meeting, and Sprint Retrospective Meeting.
- Wrote business requirements for the Health and Statistics Performance customers.
- Facilitated JAD sessions for the requirement gatherings
- Conducted meetings with business users and SMEs to identify and gather various functional and non-functional requirements
- Wrote use case diagrams to facilitate requirements gathering process and ensuring documentation compliance process.
- Functioned as the primary liaison between the business line, operations, and the technical areas throughout the project cycle
- Participated in team meetings to improve overall implementation process.
- Extensively wrote test cases, test scripts, in the Jazz Rational team concert for the clinical and business functionalities.
- Involved in the creation and maintenance of the Workflow plans and artifacts
- Played a pivotal role in planning, testing, and implementing system enhancement requests.
Windows 2000 server, MS Office, Office 365, Agile, UML, Rational Clear Case, Rational Team Concert, Jazz, SQL
- Served as Communication Bridge between non-technical users and technical solution developers.
- Collaborated with project stakeholders throughout all SDLC phases to ensure timely delivery of specified business solutions.
- Implemented the Rational Unified Process RUP methodology of iterative software development and developed user stories and dashboard for the system.
- Participated in the development of project plans, assessing business processes, working with business users and IT to develop system solutions and implementing solutions on a FACETS Platform
- Recognize scope limitations and raise potential scope issues while designing the best system approach.
- Involved in making the Medicare patient profiles being compliant with the HIPAA regulations. Management of patient profile transfer PPT reports created by data team by verifying the associated data.
- Collected Business Requirements and converted them to Functional Requirements in the Facets Platform
- Extensively created test cases for the claims administration and customer service modules like subscriber/member enrollment, adding premium rates, claims, billing and recoveries. Third Party liabilities, benefits. Service authorizations, entity relations.
- Used Use Case diagrams during analysis to capture the requirements diagrams and Sequence diagrams so that the development team and other stake holders can understand the business process.
Windows 2000 server, MS Office, RUP, UML, Rational Rose, Power Designer, SQL
- Participated in creation of Business Process Workflow Diagrams with Stakeholders.
- Involved throughout the business solution Development Life Cycle SDLC .
- Conducted meetings with business users and SMEs to identify and gather various functional and non-functional requirements.
- Conducted GAP analysis of the different reports that are being presented to clients to accommodate their requirements.
- Utilized Rational Unified Process RUP to configure and develop process, standards, and procedures to create a Business requirement Document BRD .
- Created artifacts such as Use Cases, Activity Diagrams, and Sequence Diagrams using MS Visio.
- Participated in team meetings to improve overall implementation process.
- Knowledge of HIPAA 4010A rules to store the transactions.
- Monitored all the HIPAA transactions through the gateway.
- Played a key role in planning, testing, and implementing system enhancement requests.
- Adopted Rational Unified Process RUP methodology with emphasis on its six best practices for iterative and incremental development.
- Planned all the RUP iterations and documented the artifacts throughout various phases.
- Conducted JAD sessions during the various stages of upgrading the matching system and discuss the current system preference.
- Helped identifying reports for decision support system and interacted with database designers and architect for gathering the requirements for reporting.
- Worked closely with the Lead Business Analyst to monitor progress, and the deliverables for the project.
- Reviewed System Test Plans, wrote test scripts and worked with business folks to validate and execute the test scripts.
- Functioned as the primary liaison between the business line, operations, and the technical areas throughout the project cycle.
MS Office MS Word, MS Excel, MS PowerPoint, MS Visio , MS-Project, Windows 2000, SWOT analysis, Clear Case, Clear Quest.
- Part of team to elicit, organize, and document required functionality and constraints by engaging in iterative requirements gathering sessions with the various business users in the projects, including company employees, brokers, and analysts.
- Facilitated requirements meeting, group discussions with business users and subject matter experts SME to elicit requirements.
- Functioned as the primary liaison between the business line, operations, and the technical areas especially with the stakeholder's team, which provided the web-based underwriting solution.
- Worked with different business users and analysts by conducting interviews to collect requirements and business process information.
- Designed and implemented HIPAA 835 Payment Advice Transaction, 837 Health Care Claim Transaction. Populated ICD-9, NDC Disease code sets as per the standards. Experience with transaction sets 835, 837, 270, 271, 276, 277 and 5010.
- 388 HIPAA compliant billing transaction with appropriate Logical Observation Identifier Names and Codes LOINC . 388 logical maps to convert LOIN codes to CPT codes submitted to billing purpose. Considered HIPAA rules while data validation and testing.
- Gathered Business requirements. Interacted with the End users, Designers and Developers, Project Manager to get a better understanding of the Business Processes.
- Used Rational Portfolio for project plans, process templates and work products. Assisted project managers with the development of project schedules, Cross-Functional Meetings, JAD Sessions, and Project Presentations and manage scope using MS Project and Excel.
- Experience in working with application developers, QA Testers and User Acceptance Testers.
- Responsible for creating UML modeling plans, Use cases, process flows, Wire Frames and business requirements documentation using Define IT, Visio.
- Analyzed and modeled the system using Data flow Diagrams, Functional Diagram and Process Diagram.
- Proposed an object change management system to support object-oriented system design.
- Analyzed business requirements from user interviews and then convert requirements into Technical specifications using Rational Requisite Pro.
- Systems Documentation included Business Process Document BPD , Functional Requirements Document FRD and test plans using MS Visio.
- Bridged the gap between AS-IS and TO-BE business process flows, Integration of process flow diagrams to show one end-to-end business model and process mapping exercise including swim lanes.
- Responsible for application functionality improvement and coordinate process through the Program Management Office PMO .
- Conducted technical review sessions and facilitated cross functional project meetings as required.
- Documented Database/Stored procedures specifications and defined the database constraints.
- Consulted with management and designed and developed several SOA processes and data management tasks related to the project, whilst developing all phases of the application.
- Documented Maintained all the Project Changes Request PCR and Work Product Review WPR documents and updated them accordingly.
- Participated in all the phases of testing, documented the User Acceptance Test scripts and participated in Regression testing sessions, verified the Business Scenarios on new builds to allow extended testing by the QA team once the system was in testing environment.
- Assisted in development of training materials for new technology and process improvements.
Mainframe, HIPAA, DB2, FACETS, PMO, MS Office Suite Word, Excel, Access and PowerPoint , MS-Project, MS Visio, Windows XP, Lotus Notes, Clear Case, MS-Excel.