SUMMARY:

• Over 13+ of experience as a Business Analyst in Health Care, Finance, E - commerce and CRM domains.
• Very strong in the Software Development Life Cycle (SDLC) including Requirements, Design, development, Testing & Implementation (Agile, Waterfall and Rup).
• Excellent skills in Business Analysis, Data Analysis, Requirement Analysis, Business Modeling and Use Case Development using UML methodology.
• Expert in various Software Development Life Cycle (SDLC) Methodologies including Agile, Waterfall and Rup
• Strong understanding of Software Testing Techniques especially those performed or supervised by BA including Black Box testing, Regression testing, Ad hoc testing, ETL testing and UAT.
• Proficient in using UML for Business Process Modeling, Use Cases, Activity Diagrams, Sequence Diagrams, Data Flow Diagrams, Collaboration Diagrams, Class Diagrams, Wireframe, Prototypes and documenting them using Microsoft Visio.
• Experience in analysis of as-is business process and to-be design processes (Gap analysis).
• Expert in Test driven development & Unit testing methodologies for performing UAT, System Integration testing (SIT), and Business Acceptance Testing (BAT).
• Participated with QA team in different phases of testing such as System testing, Functional testing, Regression testing and Integration testing for Quality Analysis.
• Experience in database modeling and development of Entity Relationship Diagrams (ERD).
• Excellent interpersonal skills in listening, mentoring, coaching, negotiation, mediation, influencing, conflict resolution and strong communication, written and presentation skills.
• Worked as a Process Engineer; Researched, planned, defined, and implemented, ISO … Quality Management System, CMMI Maturity Level 3 and Maturity Level 2, managed QMS during transition from ISO … to CMMI ML 2 and ML 3
• Strong focus on teamwork and achieving team goals, result oriented, quick learner.
• Experience with Visual Source Safe (VSS) and VSTS (Visual studio team Suits - TFS).
• Excellent Communication and Interpersonal Skills.
• Ability to work independently and without close supervision
• Extensive knowledge and experience in business products in the area of banking and capital markets specializing in finance such as, fixed income, equities, bonds, derivatives(swaps, options etc.) mutual fund and mortgage with a sound knowledge of a wide range of financial instruments
• Highly experienced on implementing HIPAA standards.
• Good Knowledge of Health Insurance Plans(Medicare Part A, B, C and D),managed care concepts(Medicaid and Medicare) and experienced in determining membership eligibility, billing experience within life and disability in health plans with through understanding of CPD coding, CMS -1500 claim forms and reimbursement forms.
• Experience in writing Medicaid and Medicare requirements as per the Centers for Medicare and Medicaid services (CMS) guidelines
• Taught Google Analytics seminar to 15 employees.
• Strong Experience in Claims, Claims Intake Process, Claims Adjudication Process and Claims scrubbing in HMO,PPO, POS, Medicaid and Medicare
• Good knowledge in CMS Policies, Procedures and CMS files
• Experience in EDI … transactions.
• Worked on healthcare standards such as HIPPA 4010, 5010, DICOMM, CPT, ICD-9 and ICD 10
• Expertise in ICD-9 to ICD-10 Conversion.
• Highly experienced in 4010 to 5010 conversion
• Expertise in Maintaining, Supporting and troubleshooting applications.

PROFESSIONAL EXPERIENCE:

Confidential, Saint Paul, MN 

Healthcare Business analyst

Responsibilities:

• Facilitated sessions to collect User Requirements and Business Requirements
• Business/User/Functional/Technical Requirement Specification using MS Project, MS Word and MS Visio that provided appropriate scope of work for technical team to develop prototype of the overall system
• Created Use Cases, various UML Diagrams and Data Flow Diagrams to determine the data flow via various systems
• Proposed the change and reengineering of the 'AS IS' Business processes into the 'TO BE' process flow
• Involved in the day-to-day implementation of the Agile methodology of application development with its various work flows, artifacts and activities.
•  Gathered requirements from the administrative staff and business rules for determining member eligibility and successfully converted them into functional requirements for the developments team.
• Have played a role of Project Manager in the absence of assigned project Manager and have lead monthly/Quarterly review sessions on project status with Vice President - PMO
• Responsible for resource planning, cost benefit analysis and risk analysis and present the same to senior management.
• Able to take a large conceptual problem or project, break it into components, establish plans and a critical path, achieve incremental goals and deliver project on time and at or below budget.
• Created web Page mock ups for clients using wireframes.
• Developed and maintained the Requirement Traceability Matrix (RTM) for the project deliverables using Rational Requirements Composer
• Analyzed if the system abides HIPAA regulations as portal displays member's private information.
• Reviewed and approve technical recommendations related to software and hardware proposals from technical team.
•  Participated in leading and executing user acceptance test scripts.
• Assisted BI developer to build and maintain SQL queries for data extraction and analysis
• Assisted in designing test plans, test scenarios and test cases for integration, regression and UAT to improve overall quality of the Application.

Confidential, CA

Healthcare Business analyst

• Developed various use cases to come up with the front end application design.
•  Worked with AML analysts, SME's and high level regulatory managers to identify data elements and report types.
• Performed GAP analysis and analyzed EDI 837 (Health Care Claim) transaction from 4010 to 5010.
• Developed crosswalk between ICD-10 and ICD-9 to assist with transitioning to ICD-10 and identify the differences between the two versions.
• Conducted JAD sessions involving SME's, business users, data administrators, system architects, managers and development team in order to create a good business process model.
• Identified the project scope, business objective, feasibilities and risks based on Scope/Vision documents.
• Used Requisite Pro to organize and catalog requirements.
• Created Data Flow Diagrams and process diagram using MS Visio.
• Developed Business flow diagrams, use cases and activity diagram; assisted developers in creating sequence diagrams and collaboration diagrams.
• Generated Functional Requirement specifications (FRS) and User Requirements Specifications (URS) that helped to guide the design of the application.
• Maintained Requirement Traceability matrix throughout the project.
• Reviewed test plans and test scripts developed by development team and QA team to make sure all requirements have been covered in scripts and tested properly.
• Functional testing of the application was performed as per the ICD10 changes.
• Identified bugs during the test phase and reported them using ALM.
• Helped in conducting User Acceptance Testing (UAT), Unit and System Integration testing (SIT).

Environment: MS SQL, RUP, MS VISIO, MS PROJECT, ALM, Windows.

Confidential, NJ 

Business analyst

• Requirement Gathering, ensuring code delivery on time, testing approval and Production support
• Identify opportunities for process improvement / enhancement or automation
• Onsite Representative leading the offshore development center
• Participated in data modeling, planning, designing, and implementation of the final system and conducted testing. Produced data mapping and data definition documentation.
• Implementation and post-implementation support
• Operations support and quality assurance was an extended part of the job where we streamlined the support systems.
• Hands on experience with Oracle PL/SQL, Reporting
• All documents were worked on with the proprietary framework in mind (ICE), essentially Novartis’s brand of 6 Sigma
• Single Point of contact in terms of project delivery and providing status to business stakeholders
• Handled change management in an effective way to meet business expectation with delivery constraint

Confidential, MD 

Business analyst

Responsibilities:

• Analyzed existing reports and defined business requirements and business process flows.
• Conducted JAD sessions with PM, SMEs; facilitated interviews with end users and hospital administrators to collect business requirements.
• Built a business process model using Microsoft Visio.
• Gathered detailed business and technical requirements and participated in the definitions of business rules and data standards.
• Facilitated SME interviews and assisted in identifying and analyzing the possible technical solutions.
• Performed requirement analysis, went through use cases according to the flow of the patient data and rules of security sharing.
• Conducted manual and user acceptance testing with the development and QA team.
• Participated in all phases of the development life cycle for assigned projects and coordinated business issues resolution throughout each project.
• Maintained proper communication with the developers ensuring that the modifications and requirements were rightly addressed & revisions were monitored.

Confidential, NY 

Business analyst

• Interacted with business heads to finalize the Business Requirements for the application.
• Worked with the business users and with different levels of management to identify requirements, use cases and to develop functional specifications.
• Identified, researched, investigated, analyzed, defined and documented business processes
• Created Business Requirement Document (BRD), Functional Requirement Specification (FRS) document, User Requirement Specification (URS) and Change Request (CR) document for system application development.
• Interacted with the ETL team, developer(s), management, and account holders to get the requirements, document them, design templates, and write specifications.
• Developed UML Use Cases using Rational Rose and developed a detailed project plan with emphasis on deliverables.
•  Managed changing requirements which included establishing a baseline, keeping track of the history, determining dependencies that are important to trace, tracing relationship between related requirements and maintaining version control.
• Responsible for attaining HIPAA EDI validation from Medicare, Medicaid and other payers of government carriers
• Data mapping, logical data modeling, created class diagrams and ER diagrams and used SQL queries to filter data.
• Trouble shoot file transmission problems and assisted customers with EDI and Medicaid Insurance claim related inquiries explained and enforced guidelines in the X12 Implementation guides (837P, 837I, 837D, 270/271).
• Analyzed the existing claims process and specific business rule logic will be applied in the ACP model.
• Obtained Data requirements, identified data sources, determined the content of data fields and created Data Mapping Documents and performed Data Extraction and Data Compilation using SQL queries.

Confidential, DC 

Business analyst

• Scheduled meetings with developers, system analyst and testers to collaborate resource allocation and project completion using MS Project, MS Visio.
• Provided technical and functional consulting to corporate and divisional users for Cognos.
• Implemented Agile methodology, and chaired status calls with other analysts and reported the status to management.
• Analyzed business requirements and segregated them into high level and low level Use Cases, developed activity diagrams and chart diagrams using UML, defining the Data Process Models.
• Used IBM Rational RequisitePro tool to maintain the requirements and track traceability between requirements and test cases.
• Overall responsibility of the four applications in the project and owns one of the applications to prepare system requirements for the same.
• Handled change control in the project for requirement changes and take it through different levels of approvals.
• Performed Functional, Regression, System and User Acceptance Testing for verifying application functionality.
• Conducted Requirements Walk-Thru JAD Sessions and resolved all issues and findings.
• Worked with Architect to prepare the Conceptual Design Document for the project.
•  Resolved conflicts within the team and proactively identified the gaps in the process and fill them.
• Documented the Requirement Traceability Matrix (RTM) for tracing the Test Cases and requirements in MS Excel.
•  Helped in creating the project plan with emphasis on deliverables using MS Project.
• Identified process bottlenecks in the team and implemented new and improved processes.

Confidential, NY 

Senior Business / Systems Analyst

• Analyzed the scope document and the current business processes to gain better understanding of the project.
• Interviewed Domain Experts asking appropriate questions and carefully documented their requirements thus forming a communication link between the business and technical units.
• Conducted GAP Analysis after analyzing AS-IS business process and the TO-BE business process.
• Experienced in grooming product backlog and release backlog when there is a change, feedback or technical debt.
•  Wrote down the requirements in the form of user stories and helped the product owner prioritize them in the product backlog.
• Involved in resolving impediments that affected the performance of the Scrum Development team.
• Updated the sprint burndown chart and product burndown chart to calculate the velocity of the team during the sprint.
• Assisted product owner in re-prioritizing the product backlog during the sprint review meeting and velocity calculation.
• Ensured that the respective scrum artifacts were visible to the product owner and the team.
• Facilitated Scrum planning meeting for effort estimation and prioritization of user stories using Planning Poker, T-shirt sizing as measurement technique and Moscow as prioritizing techniques.
• Worked towards research and business analysis for client services and system enhancement by continuously interacting with the business users.
• Engaged in task allocation and issue tracking, user story management/ and requirement traceability using JIRA 6.0.
• Worked with the Project Management Team to track and maintain project plans, budgets, resource usage, forecast and actual, in enterprise tracking system.
• Documented Test Cases and assisted the QA Team with the Test Plans and performed user acceptance testing and documented detailed results.
• Developed and executed Test scenarios, Test cases and documented bugs and ensuring UAT issues are identified, tracked, reported and resolved to achieve project timelines.
• Involved in exploratory testing on POS CVS Website.
• Developed and executed Test scenarios, Test cases and documented bugs and ensuring UAT issues are identified, tracked, reported and resolved to achieve project timelines. 

Environment: Agile (Scrum), JIRA, RDBMS (MS SQL Server, T-SQL, SSRS), Microsoft Office SharePoint 2010, MS Office, Visual Studio Team Foundation Server.

Confidential, PA 

Business Analyst

• Interacted with business heads to finalize the Business Requirements for the application.
• Performed the requirement analysis and documented the requirements using Rational Requisite Pro.
• Used the requirement attributes (priority, effort, and risk) as the basis for negotiating the inclusion of the requirement, to manage the scope of the system efficiently.
• Developed UML Use Cases using Rational Rose and developed a detailed project plan with emphasis on deliverables.
•  Successfully conducted JAD sessions, which helped synchronize the different stakeholders on their objectives and helped the developers to have a clear-cut picture of the project.
• Used SDLC (System Development Life Cycle) methodologies like the RUP and the waterfall.
• Understand the As Is system and develop the To Be system concept and also prepare the System Process Maps.
• Managed changing requirements which included establishing a baseline, keeping track of the history, determining dependencies that are important to trace, tracing relationship between related requirements and maintaining version control.
• Prepared and documented System Requirements and workflows for the Content Management Application tool.
• Responsible for the management of two Application portfolios, both central to client business, involving the maintenance and production support within a mainframe environment.
• Responsible for integrating with Facets .Designing test scripts for testing of Claims in Development, Integration and production environment.
• Checked Business Readiness and determined activities of flow.
• Developed & executed several Optimized queries in SQL on this data.
• Designed and implemented basic SQL queries for testing and report/data validation
• Performed Unit Testing and User Acceptance Testing and documented detailed defects.
• Wrote Procedure Manuals and was responsible for continuity preparedness.
• Managed various tests, stored test information, reviewed and analyzed test results.
•  Conducted presentations of the Q/A test results with analysis to the stakeholders and users and documented modifications and requirements.
• Helped in writing Training manuals and helped business with the Training on a one to one sessions.
• Employed Rational Clear Quest for effective Change Management (Requirements Creep) and bug tracking during the testing lifecycle.