PROFESSIONAL EXPERIENCE:

Confidential, Chicago, IL

Sr. Business Analyst 

• Organized and lead requirements gathering sessions for several key business areas including premium billing and COBRA administration to gather business requirements.
• Worked with client specialist to create process flows, business requirements and use cases to define and get sign - off on business needs.
• Lead internal JAD sessions to define functional requirements and high-level technical solutions, based on system updates needed to the centrally distributed claims adjudication system.
• Created and maintained enhancement specifications documenting system changes and new functionality needed to support business needs.
• As lead financial BA, responsible for capturing and clarifying the financial needs for the state run Health Information Exchange (HIX).
• Since the Healthation Core System was selected a s the financial system for the HIX, I was responsible for defining the functional requirements and integration points within the HIX for SHOP (small business) and Individual premium billing, commissions calculation and distribution, carrier payments and fees collection and non-payment/late payment processing
• Coordinated and lead JAD sessions both on-site, in Denver, and remote, via Webex, to capture business and system requirements.

Confidential, Chicago, IL

Sr. Consultant

• Manage user acceptance testing (UAT) and final business sign-off on concurrent releases and projects for both the web based Enterprise Front-End (EFE) and mainframe claims processing system (BlueChip) for all HIPAA 5010 related releases for the 4 HCSC BlueCross Plans (IL, OK, TX and NM).
• Coordinate with the business unit, development, consultants and management; then partnered with the SME's to interpret and document requirements functional and non-functional for ICD-10 and HIPAA 5010.
• As ICD-10 BA, responsible for decision making based on present state and future state documentation of processes that impact the program. This included impact analysis for 837 front end edits and impacts to BlueCard national business.
• Create 837 transactions for test data including 837I, 837P, Dental, Medicare and other COB transaction then verified compliance utilizing Edifecs.
• Created, maintained and executed automation test scripts using QuickTest Professional for web and mainframe applications increasing test coverage by 70% and decreasing time to run regression from 2 days to less than 1 hour.
• Coordinate and execute UAT and operation test for vendor HIPAA 5010 implementation testing including; GHI, Availity, NEBO and others.
• Managed test execution and defect resolution including prioritizing test case execution and defect resolution and working closely with other project team members (e.g. development, project management, SMEs).
• Responsible for test strategy, test plan and any other testing documentation including daily defect reports and testing status.

Confidential, Chicago, IL

SR. Analyst III

• Primary point of contact for the migration assessment and design of client Plan ‘to-be’ architecture.
• Used IBM Rational Unified Process (RUP) to define high level architecture, prioritize business requirements, created system use cases, functional specifications and supplemental specification for the PX Self-Service Portal, a GUI application designed to help end-users perform common production and test support activities via hosted java based application.
• Created and implemented procedure and standards documents for customer migration to the PX platform. This included procedures for networking, database migration, production procedures (including help desk), test procedures, file naming standards, change managements and communication plan.
• Utilized MS Visio to design and implement production and test process flows including integration points and production job flows.
• Primary point of contact for all help desk tickets submitted by client Plans on the PX platform. Manage, resolve and respond to an average of 50 client tickets each month with a 99% closure rate within SLA level 1 (72 hrs) and 100% closure rate within SLA level 2 (5 days). Tickets consist of enhancement request, processing request, and production and test support.
• Created and manipulated test data using SQL queries run on DB2 tables and Max Utility for flat files to update data for testing needs. This includes changing data in the Submission Format (SF) for ITS which is based on the HIPAA 4010-837 format for Institutional, Dental and Professional claims.
• Completed all necessary HIPAA training for production support and handling of PHI for handling of health related claims.

  Confidential 

 QA Analyst II

• Primary point of contact for the Inter-Plan IT Strategy QA Team, a board approved multi-year initiative developed by BCBSA staff, in cooperation with Plan staff, to support the National Account Strategy . Responsible for communicating issues, risk and status, work planning and estimates.
• Utilized MS Project to manage the resources, scope, timeline and budget of QA activities.
• Created, reviewed, and executed test cases for both mainframe (ITS) and web-based (Blue2) applications.
• Lead team of full-time IT professionals and manage the CSC vendor relationship to ensure the successful implementation of the IT Strategy initiative, which accounts for $96.2M or 35% of BCBSA annual revenue.

Confidential,  Chicago, IL

Consultant

• Facilitate project planning, design, coding and testing processes to accelerate the 50 state, 12K+ agent implementation of the Enterprise Life Application, decreasing the rollout schedule by 2 yrs.
• Manage team of client, third party vendor and Confidential resources to develop and implement a modular based automation testing approach using Segue SilkTest, decreasing testing time by over 70% and increasing test coverage by over 60%.
• Responsible for the project plan, conceptual and detailed design, coding and testing of the Enterprise Life Application automated testing effort.

Confidential

 QA Test Coordinator

• Lead team of 30+ QA specialists consisting of client and Confidential employees to successfully system test Confidential ’s first US deployment of its customer based policy management system.
• Coordinated team of 20+ onshore and offshore testing resources to meet daily execution goals. Confidential, Barcelona Spain, Testing Specialist
• Assisted Barcelona team in the unit & integration testing, enhanced testing processes and acted as a testing and technical liaison between the Barcelona and Erie teams, to decrease testing time and meet project milestones.

Confidential, Washington, DC

Information Technology Specialist

• Assessed the Department of Defense IT management controls for developing and implementing a suitable Enterprise Architecture for its Financial Management Systems by comparing the architecture to guidance and industry best practices.
• Audited the process for funding and approval of federally funded state IT systems to determine the extent the process hindered or delayed the system lifecycle and helped write testimony to report findings to Congress.