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Sr. Business Systems Analyst Resume

Professional Summary:

  • 9 years plus experience as Business Analyst in Healthcare and Insurance sector with an understanding and ability to work independently and in cross functional teams.
  • Extensive knowledge of Software Development Cycle (SDLC) and quality control methodologies such as Waterfall, Agile & RUP.
  • Proficient in creating BRD (Business requirement Document), TRD (Technical Requirement Document), FSD (Functional Specification Document) and UAT Documents, Use Case Narrative & Use Case Diagram.
  • Comprehensive understanding of HIPAA Standards (4010 & 5010) and Compliance issues, Medicare, Medicaid, ICD9, ICD10 and Claims adjudication process.
  • Proven track record of creating and transforming business requirement into functional requirements and non functional requirements.
  • Well versed with GEM’s (Data Mapping)
  • Analytical, methodical, and resourceful approach to problem solving, identifying and documenting root causes and corrective actions
  • Performed Gap Analysis to check the compatibility of the existing system infrastructure with the new business requirements
  • Expertise in broad range of technologies, including business process tools such as Microsoft Project, MS Access, MS Visio, technical assessment tools, Data Warehousing concepts and web design and development.
  • Exceptional presentation skills including verbal and written skills, and flexibility in adapting to new relevant information and changes.
  • Demonstrated an exceptional ability to adapt to new developments in the world of technology and working environment. Ability to prioritize and schedule multiple tasks on a day-to-day basis
  • Extensive hands on experience with tools such as Req Pro, Clear Case, and Clear Quest & SharePoint.
  • Carried out systematic problem identification, analysis, and resolution
    Analysed and reduced complex problems into simple, manageable components HIPAA EDI compliance and validation, defect analysis, and reporting.

Business Analysis Skills:

  • Business Requirement Gathering (Functional & non- functional).
  • Comprehensive GAP & Impact Analysis.
  • BRD, FSD and UAT documents.
  • JAD and RAD (Rapid Application Development) Sessions.
  • Used Visio and flow diagrams extensively for writing pictorial use cases
  • Comprehensive understanding of Health and Insurance Industry.

Technical Expertise:

  • Operating Systems:
  • MS Windows98/2000/XP/VISTA/7.
  • Project Methodologies:
  • SDLC, Agile, Waterfall, RAD, RUP.
  • Business Modeling Tools:
  • MS Visio, Rational Rose.
  • Project Management:
  • Microsoft Project, Microsoft Office.
  • Requirement Management:
  • Requisite Pro, HP Quality Center & SharePoint.
  • Documentation Tools:
  • MS word, MS Excel, MS PowerPoint S
  • Data Reporting/Analysis:
  • Toad for Oracle 11.6
  • Hipaa Validations Tools
  • Ingenix claredi/IBM WTX/Edifecs RampManagement/Trizetto EDM(Encounters Data Management
  • Databases
  • Oracle, MS SQL Server

Professional Experience

Confidential

Sr. Business Systems Analyst

Responsibilities:

  • Worked with Customers/Business and gather Functional Requirements for Encounters and claims support applications. Liaise with Lead Programmer/Analysts to understand and meet customer requirements and design specifications.
    Analysis & Testing
  • Carried out systematic problem identification, analysis, and resolution
    Analysed and reduced complex problems into simple, manageable components.
  • DC Charter: Data Warehouse Development, QA and Production Support
  • HIPAA EDI compliance and validation, defect analysis, and reporting.
  • Leaded the Lacare line of business , the Medicaid program for the state of Louisiana
  • Initiated system modifications, system expansions and many new systems releases
  • Worked with the encounters team on creating an 837 for our subcons
  • Created the FRS for the technical team and successfully got the final sign-off
  • Reviewed business process and Functional requirements
  • Receiving ,validating, and submitting 837 files to the state
  • Making 837 file corrections if necessary ,and resubmitting them to the state
  • creating reporting requirements, assisting with report design/layout, and testing/data validation
  • Analyzing the 835 on a weekly business
  • Created detailed reports to the state , upper managements and to the subcons
  • Wrote SQL queries in Oracle for data manipulations Worked with SQL queries for data manipulations Conducted UAT.
  • Deep technical background and solid working knowledge of SQL Server Data warehouse systems

Confidential

Sr. Business Analyst

Responsibilities:

  • Worked as a liaison among stakeholders in order to elicit, analyze, communicate and validate requirements for changes to business processes, policies and information systems.
  • Interacted with the Business users, SME’s, Developers, PMs and ETQA teams to better understand the business processes and application knowledge.
  • Contributed in implementation of 4010 to 5010 transition in accordance with HIPAA standards.
  • Met with Supervisors and business users and defined the scope of the project, gathered business requirements, and conducted gap analysis
  • Created Business Requirement Documents (BRDs), Use-Case Narratives including business process workflow diagrams and Requirements Traceability based on any of the projects need.
  • Conducted Requirements Walk-Thru JAD Sessions and resolved all issues/findings.
  • Successfully received Sign-Offs by utilizing Clear Quest tool for all projects on time after resolving all open questions.
  • Lead & Facilitated numerous meetings to help answer any question on requirements during Design, Development, Testing and Implementation phase.
  • Communicated with all the key stakeholders, business teams, contributors, operations and technical experts to ensure help and involvement in completing the assigned task.
  • Developed business requirement updates while working with different concerned authorities to define priorities concerning business requirement.
  • Organized brainstorming and JAD sessions with stake holders, business users, technical teams, testing team to analyze and validate the business requirements, system life cycle and explained the key performance indicators and documented the specifications.
  • Coordinated with users in doing UAT and conducted UAT testing.
  • Hand on tools Such as HP Quality center: Requirement tracing and for logging bugs and following up on them

Confidential

Business Analyst

Responsibilities

  • Conducted interview sessions with users and different levels of management so as to extract requirements to understand the functional specifications of the AS IS system.
  • Did the GAP and IMPACT analysis to design the TO BE system.
  • Responsible for the execution for the project life cycle (SDLC), including requirements gathering, design, testing, implementation and documentation, as required.
  • Facilitated smooth completion of project by providing insurance subject matter expertise to the team and utilizing subject matter know-how for quality assurance purposes.
  • Gathered and documented business requirements in order to describe the business needs in terms of the main deliverables.
  • Actively involved in creating/updating Work Breakdown Structure (WBS), preparing deliverable tasks in the project plan.
  • Provided issue resolution recommendations by ensuring that there is regular and effective communications of issues and corrective actions between teams.
  • Identified Actors, Activities, Artifacts and Workflows and developed use case diagrams.
  • Assisted clients during UAT Environment.
  • Performed Requirement Analysis and developed Use Cases, Activity Diagrams using Rational Rose.
  • Completed the documentation of Claims Scenarios for the source system.
  • Helped in designing and implementing deployment process, and thus maintaining the application in post deployment process.

Confidential

Business Analyst

Responsibilities:

  • Gathered business and system requirements from various departments like accounting, Fund Management, Legal and Human Resource through focus groups, surveys, interviews, and JAD sessions.
  • Analyzed data to generate information about clients and their attributes, and drafted a data requirements document.
  • Held meetings with users and stakeholders to identify problems, resolve issues and improve the process to ensure a stable and accurate solution.
  • Prepared Business Workflow models and process diagrams depicting how business processes are accomplished.
  • Created Activity Diagram, detailed Data Flow Diagrams, Use Cases, business process flowcharts for the As-Is and To-Be process.
  • Actively involved in creating/updating Work Breakdown Structure (WBS), preparing deliverable tasks in the project plan.
  • Created Use Cases to identify automated processes and the actors (vendors, systems) involved in the project to ensure reliable results of implemented business/functional needs.
  • Involved in feasibility analysis and risk analysis of the project.
  • Gathered and documented business requirements in order to describe the business needs in terms of the main deliverables.
  • Facilitated meetings with Subject Matter Experts (SMEs) to create the process requirements, process improvements and to proper explain the development team the flow of future data modules.
  • Functioned effortlessly and efficiently, as a liaison between four work streams and its task leads, SMEs, development team, and management group. Actively participated in Joint Meetings with the various teams involved in the development process.
  • Helped in designing and implementing deployment process, and thus maintaining the application in post deployment process.
  • Assisted System Architects and Quality Assurance Analysts in creation of various tests.
  • Assured that all artifacts are in compliance with corporate SDLC policies and guidelines.
  • Assisted in deletion of defects and bugs, in order to meet specific requirements and deadlines for successful execution of the project.
  • Coordinated UAT of the product with Business Users.

Confidential

Hoboken, NJ

Business Analyst

Responsibilities:

  • Obtained business requirements from business users and stakeholders using JAD sessions, brain storming sessions, focus groups and personal interviews to get a better understanding of the client’s business process.
  • Worked with the business to document and develop formulas for the calculation of premiums and losses statistics in the marts (e.g. Written Premium, Earned Premium, Unearned Premium)
  • Elicited, documented, modelled, validated and prioritized functional and non-functional requirements using interviews, data analysis, and different modelling tools.
  • Actively involved in preparing and writing the business requirement documents, functional requirement documents and data mapping documentation.
  • Performed in depth data analysis identifying data issues in legacy system and worked with business to develop resolutions to those issues.
  • Used MS Project for status reporting and planning.
  • Utilized MS Visio for designing Use Case Diagrams, Activity Diagrams and Sequence Diagrams, after accessing the status and scope of the project and understanding the business processes.
  • Analyzed the as-is and to-be state of the project and performed Gap analysis, Impact analysis and SWOT analysis.
  • Created data mapping documents for the movement of data from production databases to the warehouse and from the warehouse to the policy and claims marts.
  • Used the guidelines and artifacts of the SCRUM methodology for project implementation and development.
  • Assisted System Architects and Quality Assurance Analysts in creation of various tests.
  • Assured that all artifacts are in compliance with corporate SDLC policies and guidelines.
  • Assisted in deletion of defects and bugs, in order to meet specific requirements and deadlines for successful execution of the project.
  • Worked as an SME for identifying the scope of End-to-End testing with different teams.
  • Coordinated UAT of the product with Business Users.

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