- Business Systems Analyst with 7 years of extensive experience across Industry verticals i.e. Healthcare, Pharmaceuticals and Insurance.
- Business System Analyst with diverse experience in Information Technology with focus on Business Analysis, Business Modeling, Requirement Gathering, Technical Documentation, Software Validation and Web Application Services.
- Proficient in all phases of Software Development Life cycle and understanding of various application development methodologies i.e. Waterfall, Step, AQMS, Method1, Iterative, Agile etc.
- Hands on experience in leading all stages of system development efforts, including requirements definition, design architecture, testing use of Quality Center and application deployment.
- Proficient at drawing Business Process Diagram, Workflow Diagram, Swim Lanes using Visio.
- Experience in Mapping ICD 9 codes with corresponding ICD 10 Diagnosis and Procedure Codes.
- Worked with different Business Areas like Claims and Enrollment to document proposed ICD 9 10 Code changes.
- Excellent business writing skills in creating business requirements document BRD , use-case specifications, functional specifications, and systems requirements specification SRS .
- Experience in Maintaining Reference Data Management System and Master Data Management System with Service Oriented Architecture SOA .
- Extensive experience in Relational and Dimensional Data modeling for creating Logical and Physical Design of Database and ER Diagrams using multiple data modeling tools like ERWIN, ER Studio and Sybase Power Designer.
- Strong Testing Experience in HIPAA X-12 EDI Insurance/Health Series INS such as 270/271, 274, 276/277, 278, 820, 834, 835, 837, and Version 5010 of this transactions.
- Strong knowledge of current industry standards, such as HIPAA, CAQH, 21 CFR part 11, 21 CFR part 820, cGMP, CAPA.
- Knowledge of CPT, ICD 10, IDC-9, DRG, and NDC coding.
- Experience with Iterative Software Development Life Cycle Process as per Rational Unified Process RUP , involved in inception, elaboration, construction transition phases using rational tools like RequisitePro, ClearCase, ClearQuest during various phases of RUP.
- Knowledge in the ETL Extract, Transform and Load of data into a data ware house/date mart and Business Intelligence BI tools like Business Objects Modules Reporter, Supervisor, Designer, and Web Intelligence .
- Expertise in broad range of technologies, including business process tools such as Microsoft Project, MS Excel, MS Access, MS Visio, technical assessment tools, MicroStrategy Data Warehouse Data Modeling and Design.
- Knowledge of regulatory requirements Sarbanes Oxley Specifications Sox , SOA Service Oriented Architecture and OOM Object Oriented Modeling .
- Coordinated key project and service activities including full project lifecycle and project management monitoring and control activities risk plans, issue logs, change logs, quality reviews, tollgates, etc.
- Worked extensively with the team to meet business requirement and analyzing workflow.
Business Modeling Tools
Rational Rose, MS Visio, Word, Excel, PowerPoint, ibm business process modeler, UML
Test Director 7.5, QTP, and HP Quality center.
Configuration Change Management tool
Rational Clear Case VOB, Rational Clear Quest, Rational Requisite Pro
Requirement Mgmt Tools
Requisite Pro, Doors,
Microsoft Project, Microsoft PowerPoint, Open Office
RUP, Agile, Scrum, Waterfall
Oracle 9i, MS Access, DB2, UNIX
Data warehousing Tools:
Informatica, Business Objects, Cognos, Erwin
TCP/IP, HTTP, FTP, SOAP over HTTP, POX
Cognos, Jasper, SQL Server Analysis, Business Objects, Hyperion Solutions, Oracle Business Intelligence Suite Enterprise, Informatica
Business Systems Analyst
- Worked with a cross functional and diverse team of business users and developers to enable accurate communication of requirements and ensure consensus.
- Involved in Service Oriented Architecture SOA of the claims processing system
- Participated in review and analysis of business requirements, adding additional cases as needed, insuring they are complete and testable.
- While working on requirements of the 835 HIPAA project, jumped half way in the 820 report project, continued working on 835, 276 / 277 and HIPAA EDI Transactions across enterprise, meanwhile new project initiation of 4010 to 5010 migration began.
- Initiated with a comparison report of migration of 4010 to 5010. 270 Eligibility, Coverage or Benefit Inquiry V4010X092A1 vs.270 Eligibility, Coverage or Benefit Inquiry V5010X279
- Tested the ANSI X12 Version 4010 / EDI transactions HIPAA like 270, 271, 276, 277, 837P, 837I, 837D, 835 remittances
- Wrote Test scenarios and test cases for testing the migration of EDI 4010 to 5010 and the processing of member enrollment and benefits, batch jobs corresponding to the claims 837 and real time transactions like 270/271/276/277
- Exposure towards the DSS to analyzing the system impacts for the DSS included determining the impact of 5010 and ICD 10 on extract files produced from the MMIS system and loaded in the DSS.
- Worked with SOA meta- model, SOA governance and SOA reference architecture and maintained SOA standards.
- Managed requirements throughout project lifecycle leveraging links and multilevel traceability using DOORS
- Did the forward and reverse data mapping between the fields in mainframe and QNXT.
- Tested the changes for the front end screens in QNXT related to following modules, test the QNXT batches member load, Billing, Provider, etc .
- Worked with HIPAA Team for RIMS Companion Guide of X12 ANSI 270/271 and 276/277 Companion guides for Professional and Dental claims. Cross-functional team member in the implementation of the ANSI X12 involving 837 HIPAA compliance and 835 Remittance Advice.
- Analyzed the front end Customization requirements on QNXT applications Member, Group/Subgroup application, Member maintenance, etc
- Conducted extensive analysis on migration and conversion of Provider and Member data, Group configurations, plan codes, benefit set-ups, fee schedules, provider pricing, capitation set-ups, etc from Legacy system AIM to QNXT.
- Did gap analysis for HIPAA 4010 837P and 835 transactions and HIPAA 5010 837P and 835
- Involved in impact analysis of HIPAA 5010 835 and 837P transaction sets on different systems
QA Analyst / Systems Analyst
- Analyzed business and functional requirement to develop Test Plan and wrote Test Scenarios and Test Scripts for Integration testing of the application and Business Objects Reports
- Associated use-cases to Requirements and Requirements to Test Cases.
- Created the Test Strategy document that defines the test environment, phases of testing, time lines of different phases of testing, entrance and exit criteria for different phases of testing and resources required to conduct the testing effort
- Documented the traceability between Requirements and its specifications and test cases and wrote scripts.
- Executed the Integration and Package test scripts and performed regression testing of the Application.
- Responsible for data warehouse, dimensional data mart, and enterprise report testing
- Performed Package and Integration System testing of most of the Business Objects reports
- Reported, recorded and Tracked defects using JIRA
- Performed extensive back-end testing to pinpoint, analyze and identify reporting issues
- Generated SQLs to Validate the report generated data and to check for Data accuracy and Data Integrity on the reports
- Presented detail walk through of Functional Specifications, Detail Design and VISIO work flow process diagrams to Business, EDI , MQSI, HIPAA project managers and HIPAA project regulators.
- Developed SQL queries/scripts to validate the completeness, integrity and accuracy of data within an ETL process testing cycle.
- Involved in testing security setup of Business Objects Users Groups, validated permissions set on reports, report Objects and universes and validated visibility rules set for users for their respective business Objects profiles.
- Replicated the transformation logic used in the ETL process so that the target data warehouse can be validated against the original data source.
- Perform baseline HIPAA readiness and GAP analysis for the 837, 276 and 277 transaction sets, develop through understanding of claims, payment, enrollment.
- Wrote SQL joins and Store Procedures to retrieve the data to test the validity of the reports generated through Business Objects.
- Communicated and recorded test results effectively and worked with other teams responsible for supporting test issue resolution
Business Systems Analyst
- Worked closely with Business end-users, developers, project managers, customers to ensure effective delivery of application. Used UML/RUP to develop requirements.
- Analyze derivatives, equities, fixed income, and support traders using the system
- Responsible for creation of Collaboration Diagrams, Activity Diagram, Project Flow Diagram, and Use case diagrams in MS Visio.
- Presented detail walk through of Functional Specifications, Detail Design and VISIO work flow process diagrams to Business, EDI , MQSI, managers and HIPAA project regulators.
- Used DOORS to document requirements.
- Responsible for integrating SAS applications with other SOA compliant applications using SAS Web Services
- Prepared Use Cases, Sequential Diagrams with detailed screen layouts with regards to displaying the interactions of the system and users in functions such as purchasing stock options.
- Performed cost-benefit analysis at the initial level in order to fulfill the business case on feasibility standards.
- Created Test Plans that contains test scripts, test cases, test data and expected results for the User Acceptance testing.
- Presented discovery documents to the IT activities for acceptance into the integrated and point releases via Statement of Business Requirements documents using MS Word, MS Excel, Telelogic DOORS, and Visio tools.
- Prepared Business Requirement Documents BRD's after the collection of Functional Requirements from System Users that provided appropriate scope of work for technical team to develop prototype and overall system.
- Helped prioritize implementation of Work requests to meet SOX compliance.
- Involved in Data validation for different applications related to the project.
- Complete and thorough testing for the entire SDLC, including version and change control using rational clear quest and rational clear case.
- Actively involved in Underwriting the rules for the Property Casualty Insurances
- Developed a file of ACORD Forms used as the standards in all Property and Casualty markets, for both Personal and Commercial Lines of Business.
- Been a part of Architecture and modeling team and have used SOA Service Oriented Architecture .
- Business Architecture: Working with end users to identify business requirements
- Perform requirement sessions with Business users. Writing functional specifications
- Exclusively used SQL and T-SQL for designing, modifying and maintaining tables, views and stored procedures accordingly
- Supported Unit testing and User Acceptance testing and performed Assembly, System Integration and User Acceptance testing. Dedicated a good portion of time with QA team in front-end and back-end performing Regression testing.
- Involved in the meeting with Business Process Owners, SME subject matter experts and Marketing Team for Requirements gathering in Definition Stage.
- Perform requirement tracing during the SDLC using the Requirements Traceability Matrix.
- Involved in all phases of software development life cycle in RUP framework.
- Analyzed, documented, and managed all project requirements and changes to requirements throughout the software development lifecycle using RequisitePro.
- Conducted workflow, process diagram and GAP analysis by identifying existing technologies, documenting the enhancements to meet the end state requirements
- Assisted in building a Business Analysis Process Model using Rational Rose and Visio.
- Participated in UAT and worked with Mercury Quality Center for bug and defect tracking.
- Conducted user interviews, attended JAD Joint Application Development sessions, and documented analysis in requirement gathering.
- Identified the use cases from the gathered requirements and prepared a comprehensive Use Case Specifications document.
- Worked in all the different processes of Claims processing from Claim Online editing /processing /Adjudication /Payments systems
- Assisted the project manager in preparing the project schedules, milestone tracking, resource allocation using MS project.
- Extensively interacted with both user group and development team in coming up with structured charts, class and sequence diagrams.
- Created Use-Cases and Business Use-Case Model after accessing the status and scope of the project and understanding the business processes