- Over 7 years of professional experience as Business Analyst with expertise in Software Development Life Cycle (SDLC) and Business Process Reengineering in Health Care Sector.
- Excellent customer service, attitude, communication and multilingual (English and Spanish) skills.
- Worked extensively in all major IT roles (Analysis, Design, Development and Testing).
- Proven ability to assess current workflow processes and help business to develop better software in order to reduce time and improve performance.
- Extensively involved in documentation of Use Cases, Functional requirements.
- Extensively involved in designing Use Cases, activity and sequencing diagram using UML Modeling.
- Extensively involved in building mock up screens using I-Rise.
- Assisted in System and User Acceptance testing
- Experience with PMO techniques such as Rational Unified Process (RUP), Agile & Waterfall life cycle
- Experience with different modules within healthcare (Sales, Membership, billing, enrollment, claims, capitation, and providers).
- Experience in Medicare, Medicaid & commercial insurances in HIPAA ANSI X12 4010, 5010 formats including 270,271, 276, 277, 835, 837, 997, NPI, ICD 9, ICD 10, NDC, DRG, CPT, NCPDP codes & NSF formats for interfaces & images to clearinghouses/ trading partners applications.
- Good knowledge and extensively used Oracle, SQL, and PL/SQL along with MS SQL administration, SQL Enterprise Manager, Data analysis and reporting.
- Methodology Waterfall, RAD, RUP, Agile
- Project management tools Microsoft Project, Microsoft Office, Share Point
- Modeling tools Microsoft Visio, Rational Rose, I-Rise
- Databases Oracle, MS Access,
- Languages SQL, PL/SQL using SQL navigator, HTML, XML Schema.
- Change Management Tools Rational req. Pro., JIRA
- Internet Tools Java-script, Java-Servlets, JDBC.
Roles and Responsibilities
- Prepared the Business requirement Document (BRD) and functional requirement document (FRD) for the enhancement of the existing services
- Analysis and Design of existing transaction sets, and modification of these transaction sets to ensure HIPAA compliance
- Did gap analysis between ICD 9 and ICD 10.
- Conducted JAD sessions with business units and stakeholders to define project scope, to identify the business flows and determine whether any current or proposed systems are impacted by the new development efforts
- Created workflow diagrams, UML diagrams, process models, activity diagrams, use cases, for incorporating design changes in the order creation/ management system
- Coordinated the upgrade of Transaction Sets 837P, 835 and 834 to HIPAA compliance.
- Involved in claim adjudication process of facets application
- Did gap analysis for HIPAA 4010 837P and 835 transactions and HIPAA 5010 837P and 835 transactions
- Utilized Agile Methodology to configure and develop process, standards and procedures
- Involved in forward mapping from ICD 9 to ICD10 and backward mapping from ICD10 to ICD9 using GEM
- Did gap analysis and impact analysis for the facets up gradation system.
- Worked on developing the business requirements and use cases for Facets batch processes; automating the billing entity and commission process
- Attended daily SCRUM and guided QA and Developer regarding the defects, Technical Specification Documents and Mapping Documents
Environment: Agile, Requisite Pro, MS Access, MS Visio, MS office, MS word, MS excel Clear Case, Clear Quest, Quality Center, SQL, Oracle 9i, DB2, JAVA , windows 7.
Roles and responsibilities:
- Interact with the SME, business and IT team during the JAR sessions to gather the business requirements.
- Created detailed system use cases and activity diagrams using UML.
- Developed use case functional design documents for sales and enrollment of members.
- Assisted UI designer in creating mock up screens.
- Assisted in System and User Acceptance testing.
- Assisted in the fast resolution of any issues raised.
- Assist in user acceptance testing.
- Created Functional specifications for the 834 enrolment files.
Environment: MS Visio, Rational Requisite Pro, Rational Rose, RUP, I rise, UML, Oracle 9i, SQL, PL/SQL, Quality Center MS Office, MS Project, Windows 2000.
Roles and responsibilities
- Responsible for capturing the existing capabilities of the current Application X-Pack
- Prepared a Reverse Engineering Business Process Document
- Communicated with Business Stakeholders for Requirement Gathering
- Established the JAR sessions with Clearinghouse System SME
- Contributed in Technical Deep Dives for understanding the Business Processes involved in Clearinghouse System
- Used SDLC methodology for the project
- Prepared session with X-Pack developers to demonstrate the future X-Pack functionality
- Used MS-Visio to draw Sequence and Activity Diagrams
- Worked on ASC X12 Transactions like 270,271, 835, 277 and 837 (Data Mapping)
- Wrote the Vision and Scope of the Project
- Performed GAP analysis of as-is and to-be System
- Checked the data flow through the front end to backend and used SQL queries to extract the data from the database.
- Involved in writing SQL queries to extract the data from Oracle database
- Performed UAT manually till user satisfaction.
- Documented Business Processes involved in Clearinghouse System
- Created Summary Use Cases for next phase of Forward Engineering
- Extensive used of UML to draw Business Process Flow, Use Cases Modeling, Sequence, Sequential Diagram and Activity Diagrams
- Conducted various sessions for UAT during last month.
- Wrote Test Cases, performed unit testing and integration testing
- Extensively used simple and nested SQL statements for testing purposes
- Analyzed test planning data using reports and graphs generated in Quality Centre
- Worked on Quality Centre in setting up and Customizing Project entities for Defect Module Screens.
- Worked as a Liaison between Stakeholders and IT department to fill the Gap by Using Simple UML Diagrams
Environment: MS Visio, MS Project, MS Office, SQL, Oracle, & PowerPoint, MS Word, MS EXCEL, Windows.
Roles and responsibilities
- Analyzed existing data and used tools available to successfully forecast the pricing models.
- Responsible for addressing, diagnosing, and resolving issues that arise on a day-to-day basis for the team. Also responsible for documenting the causes, analysis and final resolution to the issues/errors.
Roles and responsibilities
- Performing Stakeholder Analysis to identify key players for project success and stakeholder management to communicate effectively with the right stakeholders.
- Facilitating pre-scoping and scoping sessions with all relevant stakeholders.
- Identifying and involving all key stakeholders in the project and ensuring that contributors are motivated to complete assigned tasks within the parameters of project plan.
- Drafting Business Requirements Document, validating business requirements with project stakeholders and conducting walkthrough meetings.
- Facilitating JAD sessions and scheduling meeting with developers and testers to collaborate resource allocation and project completion using MS Project.
- Providing implementation assessment for Rational Requisite Pro, Rational Rose, UML and RUP
- Participating in providing user training, conducting user acceptance testing, recording and resolving issues and validating test scenarios with business users.
Environment: Oracle SQL Developer, Oracle, RUP, Rational Requisite Pro, Rational Rose, Quality Center, MS Word, MS Excel, MS Visio, UML, Test Director, Win XP.
Jr. Business Analyst
Roles and responsibilities
- Played pivotal role in preparation of BRD. Interacted with various business owners to understand their requirements.
- Extensively used the concepts of Business Process Reengineering.
- Managing client communication unmistakably. Organizing the status calls and review calls for understanding and communicating the daily problems faced by the team members and taking remedial actions and risk mitigation.
- Developed Requirement Traceability Matrix (RTM).
- Worked on functional requirements to be inculcated in the project.
- Negotiated various deliverables with the stakeholders.
- Wrote Use cases skillfully. Developed Activity diagrams and process flow diagrams. Developed Business Processes. Helped process engineering. Conducted many sessions with client to figure out actors and cases.
- Identified and assisted to create Test Data for execution of Test Cases.
- Mentoring and training other business units.
- Coordination in writing test cases for UAT.
- Followed Agile & RUP methodology.
- Conducted JAD sessions with management, SMEs (Subject Matter Experts), vendors, users and other stakeholders for open and pending issues to develop specifications.
Environment: Rational Suite (Rose, Requisite Pro), Rational Unified Process (RUP), Windows XP/2000, MS-Project, MS-Office Suite, MS Visio, MS Word, MS Excel, MS Access, MS Outlook.