SUMMARY:

• 5+Years of industry work experience in business processes in health care and financial industries.
• Thorough understanding of the Software Development Life Cycle (SDLC) and Agile (Scrum) methodologies including but not limited to the various concepts such as Requirement Gathering.
• Operations, Design, Product Implementation, System Maintenance, Production Support and Testing in IT services industry and troubleshooting business scenarios and issues on technical and business perspective.
• Involve in both business development support work and in holding business discussions with clients.
• Possess a detailed - oriented nature with excellent communication, interpersonal, problem solving skills, and recognized for being a valued team player.
• Complete knowledge of Insurance Policy Life cycle in Homeowners, Auto and Workers Compensation
• Policy Administration, Rating, Billing and Reporting Modules. He has extensive experience in interpretation of periodic circulars provided by ISO, Actuaries, State bureaus and handle system updates for regulatory requirements.
• Detailed understanding of the bureau reporting requirements as mandated by NCCI and Independent state bureaus and successfully implemented the required system changes in PICS and Unit Statistical reporting modules.
• Using Change Management tools like EZ tracker & implementer and testing tools like Test Partner to perform regression testing.
• Able to meet & deliver quality work on tight schedule and demonstrate sound business judgment
• Excellent communication skills - oral & written
• Advanced level proficiency with MS Office, Visio, VBA, Excel, Tableau, Looker, Salesforce, Google Analytics, Adobe Analytics, Data Meer, and Hadoop
• Ability to develop collaborative partnerships across departments, business units and achieve results to improve performance
• Ability to adapt quickly to changing business and technology needs
• Ability to facilitate meetings and accurately and effectively translate business requirements to system specifications
• Ability to conducts analysis of business and users’ needs and revises existing systems as needed

CORE COMPETENCIES & TECHNICAL EXPERTISE:

(SDLC) Process: Inception, Elaboration, Construction and Transition.

Documenting Requirements: Document analysis, Interface analysis, conducting interviews, surveys focus groups and JAD sessions

Requirement Documentation: Business Requirement Document (BRD), Functional Requirement Document (FRD), test requirement gathering.

Testing Process: Test strategy, test planning, test execution, analyzing whole test result and process Regression/Integration/White-black box/Performance testing

Diagrams: UML Diagrams (use case, activity, sequence, state, class)

Methodologies: Scrum, Waterfall, Agile Methodology, RUP (Rational Unified Process)

Management & business Tools: MS Project, MS Visio, MS Office

Platform: Windows XP, Windows 7, Windows NT, Windows server 2003/2008.

Database: MS Access, MS SQL- Server, SQL Server/PL SQL, Oracle SQL Developer

PROFESSIONAL EXPERIENCE:

Confidential

Business Analyst

Responsibilities:

• Reviewing the claim as per the policy terms and conditions.
• Provided assessment of the claim for payment and verification of the information on the claim forms and other documents like medical equipment receipts etc.
• Adjust assigned claims in accordance with company claims handling policies and procedures.
• Communication and verification with hospitals/ registered care givers for more information on the claim to ensure proper amounts are being paid.
• Annual File Review of the Claims
• Approving the claims for the value up to $5000 monthly benefits for batch review

Confidential, Newark, NJ

Business Analyst

• Prepared workflow for AMT Employers who qualify for Small Employer Exception (SEE) program
• Chaired weekly, triage and core team meetings for project tracking purpose.
• Interacted with Business to ensure project dates were in sync and provided Planning /
• Approximation estimates for all Work Orders in flight.
• Participated in SIT Testing / UAT for CSRs 651, 653 and 792 reviewing TRDs, Test Strategy,
• Test Cases and Results: Documents for NPS and MTV systems.
• Prepared Missing SSN process flow for MRM UI (Informatica / Java) front end application.
• Informatica was used to translate the Business requirements into mappings and to load data Into Data Warehouse

Confidential, NY

Business Analyst

• Conducted initial data gathering and analysis by conducting JAD sessions.
• Performed GAP analysis and AS-IS To-BE methodology employed to recommended a modular design approach to the new system in the handling the data
• Acted as a liaison between IT Dept, Data Analysts, QAs, DBAs and Development teams
• Designed Project plans, reports and performed other project management functions for a fixed budget time-sensitive project, considering resources and probable issues with respective buffers.
• Developed Project processes and workflow based on the On Site, Off Site and Offshore Development methodology.
• Developed high level business requirement documents (HLRD), Mappings and Logic sheets to support the design, development and implementation of the new system
• Created CMRs on a weekly basis to address any changes in the above.
• Aligned the new system with the processes and rules followed by the NY DOH.
• Conducted training session for the new users to employ the new systems.
• Used RUP with most of its supporting tools, which automate large parts of the process, which are used to create and maintain the various artifacts such as visual modeling using UML through Rational Rose Real Time
• Participated in the design and analysis of the data model.
• Analyzed the problem domain, specified features, developed the project plan, and risk analysis
• Handed all the Verbiage to the QA team then reviewed quality with respect to the requirements based on reliability, functionality & performance with the help of QA testing team.
• Defining Performance Requirement was always considered in Business Requirement.
• Worked with the design specification specialist for the look-and-feel of screens.
• Extensive interaction with the Internal End-users, Business User, Project Manager, and QA Team.
• Closely monitored development team to make sure, the software application fits within the architecture and has the required behaviors.
• After successful development and testing of the product, participated in product release and deployment to end-user.

Environment: MS Visio, MS Excel, MS Access, SQL Navigator 5, Oracle 10.2, Visual Cactus, UML, Project Management