- Over 6+ years of Industry experience as a Business Analyst with solid understanding of diverse domains such as Healthcare, Insurance, Finance and ERP Solutions.
- Highly skilled in writing Business Requirements Documents (BRD), Functional Requirements Documents (FRD), Request for Proposals (RFP) and Statement of Work (SOW).
- Knowledge of the Software Development Life Cycle (SDLC) phases such as Planning, Analysis/Design, Development and Testing for the system development process.
- Knowledge of SDLC methodologies such as Waterfall, Agile and Rational Unified Process (RUP).
- Proficient in preparing User Requirement Specifications (URS) document, UML Modeling, Use Case Diagrams, Object diagrams, Activity Diagrams, and Sequence Diagrams.
- Extensive knowledge of Medicaid, Medicare, Procedural and Diagnostic codes and Claims Process.
- Exposed to using ICD9 - ICD 10 coding standards in Medicare and Medicaid domains of the healthcare systems and industry for inpatients, outpatients, and Reimbursement methodology.
- Experience in Conversion of HIPAA X12 4010 codes to X12 5010 codes and ICD 9 codes to ICD 10 codes
- Analyzing and understanding ICD 9-CM, ICD 9-PCS to and from ICD 10 -CM and ICD 10 -PCS GEM'S tool.
- Knowledge of EDI for healthcare (837& 835).
- Functional knowledge of Medicaid Management Information System (MMIS).
- Experience in interacting with business users to identify their needs and gathering Business and Functional Requirements, developing Project Plan, Business Requirement document, Functional Specification document, Test Plans, conducting Gap Analysis and Impact Analysis, preparing training manuals and knowledge transfer manuals.
- Experienced in facilitating Joint Application Development (JAD), Rapid Application Development (RAD) sessions, interviews, workshops and requirement elicitation sessions with end-users, clients, stakeholders and development team.
- Experienced in using UML and tools like Rational Rose, Visio, and Requisite Pro.
- Excellent knowledge on industry standards such as Six Sigma, CMM and Electronic Health Record.
- Strong knowledge of Business Process Modeling, Business Intelligence and Business Architecture.
Methodologies: Agile, Waterfall, RUP, UML, SDLC, Scrum, RUP, V-shape modeling. Change Management Tools Rational Clear Quest, Rational Clear Case. Healthcare Enterprise Software and management, Facets
Business Modeling &Versioning Tools: MS VISIO, Rational Rose; Rational Requisite Pro, Rational Clear Case
MS Office: MS Project, MS Word, MS Excel, MS PowerPoint, MS Access
Methodologies: RUP, OOD, SOA and Agile Methodologies such as SCRUM and XP
Programming Languages: Structured Query Language (SQL).
Reporting: Crystal Report, SQL Reporting Service, Active Report
Databases: Databases Access, Oracle, MS SQL Server
OLAP Tools: Business Objects XI, Cognos
Testing tools Rational Robot, Rational Clear Quest Test Manager, HP Quality Center,PROFESSIONAL EXPERIENCE
Confidential, Peoria, IL
Sr. Business Analyst
- Worked in the Agile methodology
- Updated the Design Specification Document (DSD) in SharePoint and linked it in RequisitePro.
- Responsible for creating UML plans, Use cases, process flows, and business requirement documentation using MS Visio, RequisitePro and Clear Quest tools.
- Created Change Request and analyzed defects using Rational Clear Quest
- Responsible for the full mapping, implementation and testing for accurate update in the system.
- Worked on Parallel Testing analyzing the gaps created during the transformation of the system from legacy to enterprise due to which defects were created and resolved.
- Worked on Data Mapping documents explaining the flow of data from one-to-another table for the system enhancement purpose required in the Health Enterprise implementation.
- Analyzed Gaps and studied the existing business process and created AS-IS and To-Be workflow to illustrate the existing system.
- Responsible for identifying and documenting business rules and creating detailed Use Cases.
- Worked on Business Rules Management System (BRMS) to allow properly authorized end users to update and test changes to business rules.
- Worked extensively with different phases of Software Development Life Cycle (SDLC)
- Responsible to meet the information demands of business users by delivering timely, accurate, meaningful and standardized data and reporting.
- Documented analysis, observations and recommendations.
- Attended daily Sprint meetings with the State on strategy, release and iteration on the product conquering the day-to-day deadlines.
- Assisted Business User during deployment in formulating User Acceptance Testing (UAT) for customized application and getting confirmation for product Release.
Environment: MS Office Suite (Word, Excel, Power Point, Visio, Project, Access, Share Point), RequisitePro, Rational Doors, JIRA, Clear Quest, SQL.
- Responsible for identifying and defining detailed product functional requirements and use cases.
- Assisting in writing efficient and effective Test Plans, Test Strategy, System testing, End-to-End testing and User Acceptance testing.
- Participating in the planning, development, coordination and presentation of specific testing needs as appropriate to the quality assurance needs of the end user.
- Assisting business users in defining UAT test cases and plans; Established and maintained test cases and test data in Quality Center.
- Coordinated with the QA Team for testing activities across multiple systems and managed Conversion test execution.
- Helps in conducting Gap Analysis (GAP), User Acceptance Testing (UAT), and System Integration testing (SIT) and SWOT analysis.
- Involved in implementation of HIPAA EDI Transactions ( 835,837)
- Facilitated Electronic Data Interchange.
- Performed GAP Analysis for HIPAA 4010 and 5010 transactions.
- Used EDI tools to verify mapping to X12 format.
- Recommend changes for system design, methods, procedures, policies and workflows affecting Medicare/Medicaid claims processing in compliance with government compliant processes like HIPAA/ EDI formats and accredited standards ANSI.
- Analyze HIPAA EDI transactions in X12 responses and of 837, 835, 277CA and 999 and looked for defects.
- Do data analysis for various version changes of EDI messages on different sub-systems.
- Providing the required test data for the developers in order to fix the defects.
- Participating in QA team meeting and bug tracking meetings.
- Setting up and maintaining the Requirements Traceability Matrix.
- Worked closely with the other business analysts to understand current capabilities and identify customer requirements.
- Assist in translating requirements and use cases into test conditions and expected results for product, performance, and user acceptance testing.
- Conduct product testing, trading partner testing, user acceptance testing and other system testing.
- Transitioning the requirements and use cases to the technical developers ensuring a clear and complete understanding of the system.
Environment: User Acceptance Testing (UAT), Rational Clear Quest, MS Access, Windows, Rational Test Manager, MS Office.
Confidential, Reno, Nevada
- Analyzed the Business Modules and their impact on the current system.
- Responsible for going through SCRUM with Agile Methodologies and UML Processes for Creation of Documentation to be used by IT Team.
- Gathered requirements and analyzed the federal legislation to update products as per the provisions of Health Care Reform system.
- Created Requirement Specification Documents after conducting Interviews with End Users, organized JAD Sessions for documenting AS-IS and TO-BE scenarios for Electronic Health Records project and analyzed their current systems.
- Created Use Cases, Use Case Models, Work Flows and System Specification Document using RUP Methodology.
- Understand end-user requirements, their strategies and their goals to create Requirement Specification Documents and Use Cases.
- Worked with SQL for database design and management for the consolidated database due to EHR.
- Used Component business modeling for improving strategic planning and efficiency.
- Assisted with building EDI 837(I, D, P), 835, 270/271, 276/277, 278, 820 and 834 transactions processing flow from the Trading Partners to the translator, mainframe and back to the Trading Partner meeting HIPAA 5010 standards.
- Worked on Automated system data migration interface requirement and formulated Test Plan for testing the functionality, navigation and integration testing of the application.
- Work responsibilities primarily involved understanding the business logic, designing requirements, communicating them to the developers, generating documentation, designing use cases, creating various diagrams like State Diagrams, Sequence Diagrams as part of project.
- Maintained Traceability matrix throughout the project.
- Created standards / guidelines for Business Process Modeling, File Transfer Document, and Interface Requirement Specification document, BRD, FRS and Report Requirement Specification.
- Worked with Government data security protocols for internet transactions
- Involved in creating requirements that comply with HIPAA, HL7 and ANSI X12 format regulations to protect the privacy of the employee insured under any policy.
Business Heath Executive/ Consultant
- Creation of the Business and Functional Requirements Documents.
- Interacted with SME’s to gather system requirements for building the new Trading Platform.
- Coordinated with teams within the project to collect the high level estimates and release requirements.
- Conducted JAD sessions to gather requirements from the clients for web interface built.
- Documented system requirement document.
- Documented Business Plan and Test Plan based on gathered requirements.
- Interacted with underwriters from both PFG and Merrill Lynch to come to common policy premiums.
- Involved in writing and execute test scripts based on requirements, design, and use cases
- Used Quality Center to keep track of the requirements and the Test cases related to the requirements.
- Involved in executing existing test scripts, writing and updating new test scripts, and writing test plans
- Played a vital role in Data analysis, which involved in date transfer process between Merrill Lynch Client and PFG.
- Involved in testing the newly built up applications and making the clients test the newly built applications.
- Involved in UAT for the newly developed Trading Platform.
- Played a major role in resolving the defects that developed in the transitions phase.
Environment: MS Word, MS Excel, MS Project, MS Visio, Rational RequisitePro, Manual testing, Quality Center, SQL Server2000-2005, Test track.