SUMMARY:

• Over 6 years of experience in Different sectors, highly accomplished Business System Analyst of worked on projects in Healthcare and Finance. Experienced in clarifying business requirements, performing gap analysis and Fit Gap analysis between goals and existing procedures/skill sets, and designing process and system improvements to increase productivity and reduce costs. Extensive experience working with Insurance companies in Personal Lines, Commercial lines, Health care in HIPAA standards, EDI. Implementation and implementation of Financial Accounting and Partner Management systems. Performed testing mostly in UAT testing in which I was involved directly with the vendors.
• Has good understanding of Software Development Lifecycle (SDLC) and STLC both from the as well as the maintenance of the application.
• Worked on Agile environment and Waterfall in health care also with the help of training for 3 months on job training for Business analyst from Humana offers BABOK classes to get good understanding for on BA role.
• Proficiency in SDLC life cycle, understands the workflow concept, ability to conduct Gap Analysis and Impact Analysis(the 'As - Is' and 'To-Be' process) and interact efficiently and effectively with users for BA In banking and Health care.
• Have good understanding of CRM.
• Experienced in JAD sessions, Conducted a meeting with IT department and different stakeholders to get more knowledge on a project for 820,837 files and 14.09, 14.06, 14.04, Personal lines, taking the minutes meeting notes.
• Have experience to work on different transactions for health care and performed different types of testing UAT, Regression, and functional Testing UI.
• Extensive experience working as a leadership in health care for Confidential and Confidential American Family, Confidential and worked with different teams and developers.
• Excellent varied domain knowledge of: Health Care Reform, HIPAA, EDI, 820, 837 and 834 transactions, SQL server. Also have experience on Guide wire, Facets, Macro, Claim test Pro.
• Experience in Requirement Gathering through document analysis, interviews, workshops, JAD sessions with clients, developers and QA analysts, and referring to existing system documentation and procedures.
• Expertise in creating Use Case diagrams, UAT testing. Running batches for claims 837,834. Also creating an claim in claim test pro for 837 files.
• Worked on mainframe have good understanding working on mainframe for one life insurance benefit project.
• Have good understanding for processing on claims, UB claim,HICFA tested and validated.

PROFESSIONAL EXPERIENCE:

Confidential

Business Analyst/PM

• I was involved to gather the requirements directly with a clients for web portal and CRM for USDA. Prepared Test Scripts based on the business requirements, executed the Test Scripts and record the results.
• Agile based environment completed 5 sprints for 4 weeks each, Prepared User stories based on the requirements, test cases and test results also created UAT plans with several test cases to ensure that the system runs smoothly after the proposed enhancements or changes have been made. Prepared the Defect and Status Report and submitted to Client.
• Responsible for daily scrum meetings gathered the information from team created Minute of Meetings and delivered to the team for their related tasks responsible for Status report every Friday which I have to create in TFS.
• Created Defect Error Logs, Ensure Testing Complete per Test Plan Delivers particular components of the quality assurance and testing function within a specific project also program. Incorporates QA testing processes.
• Ensured applications are properly developed and implemented into production according to IT standards and customer requirements also assist developers in diagnosing production problems; performed related work.
• Click to edit position description As a BA and PM, I am involved for gathering the requirements also coordinating between teams. Evaluate and decide on an appropriate, target. State approach.
• Provide tactical and strategic solutions to enable target state.
• Developed custom workflow for program management items such as RFI's, Submittals, and Meeting Minutes using SharePoint.
• Performed Requirement Analysis by gathering both functional and non-functional requirements based on interactions with the process owners & stake holders and document analysis, represented them in Requirements Traceability Matrix.
• Came up with test cases from the requirements, validated/exercised those test cases in form of integration and regression tests.
• Transformed Business requirements into functional specifications, focused on user interface design, created mockup screens.
• Analyzed and translated business requirements into system specifications utilizing agile methodology.
• This project is Agile based. Facilitating meetings for daily scrums updating the documents. Responsible for meeting of minutes. Completed requirements, user stories and project is in development for sprint 5.
• Responsible for TFS to make sure our charts are burned down.
• Assign or calculate estimated hours for team with the coordination of technical lead.

Environment: Agile based, Tools: CRM, SharePoint, TFS.

Confidential, Madison, WI

System Analyst Client Support/ Tester

• I have Completed Macro projects which was related to Facets which is an automation tool. I took the requirements from other BA’s and developers. I also write test cases and execute them for UAT testing. Performed gap analysis between facets and Macro member XC and Medical Equal Zero, to process claims. Developed use cases, test cases for business users, developers.
• There was one more Macro project identified impacts and assisted in training users on new claims and procedural changes.
• Conducted JAD sessions with different business users to discuss new policies and procedures for the claims, hospital billing, EOB, special coding requirements and claim processing.
• Responsible for creating claims for UAT environment in CTP (claim test pro) for 837 inbound files and also with SQL.
• Responsible for updating and modifying all the test scripts for the upgrades for Facets new releases all business issues in Annuities, involving analyzing of new or enhanced features to statements, confirmations/letters, contracts, applications, and/or products.
• Analyzed and documented Reinsurance Claims, Billing Collections, Accounting modules of the application for 837 files.
• Provided key initiatives in working with users in defining project and system requirements for epic life insurance created test cases done Regression testing for them. Also worked on back to back entering all the information GCOM (Group Comm) into Mainframe.
• I have worked on state project for Epic life with stars files which is part of state file Data mapping with different state files with mainframe for their employees. Provided inputs in the strategic development of detailed project plans, work assignments, target dates etc.
• Prepared Test scripts for Facets project which is “Missing payee name from the vendor” create test cases and test plan for this project it was one of the production project have to retest after the upgrades.
• Developed Data Flow Diagrams for Macro’s project which helped to describe the flow of the system.
• Completed managing with different sectors for new releases successfully with EPIC life Insurance, Health Insurance division also worked on mainframe for different projects.
• Created business requirement documents and integrated the requirements and underlying platform functionality for all the Macro projects.
• Captured source to target data mapping specifications for Epic life and Facets from the fast tables.
• Facilitated the User Acceptance Testing (UAT) with CTP and Business Users, documented any issues or defects and eventually got sign off from the right parties.
• Exposed to different methodologies.
• Assist in identifying and implementing solutions related to configuration and development that will provide efficient and accurate solutions that meets the business requirements or provides resolutions to issues.
• Create, documents for different projects and establish testing plans and scripts to be executed with regards to regression, functionality, performance load, access/security, and production performance. Provide high level estimates for subject matter expert knowledge and testing.
• Assist testing with third parties and vendor systems to ensure successful system integration.
• Infrastructure support - ensure that the systems remains correctly configured to permit the deployed application(s) to function while meeting all contractual obligations and security requirements and complete updates/changes as needed.
• On Call Support - Analyze and execute appropriate actions to resolve the issue and provide updates to appropriate parties until solution is implemented.
• Access co-ordination - provide support in identifying impact and configuration changes for requests such as new/updated system functionality, software installations, and general requests for service on a departmental level.
• Provide network support to clients according to their business requirements
• Attend and rectify complaints for malfunctioning of systems
• Provide a list of hardware and software to clients for setting up networking systems
• Worked and trained a s a actuarial for claims to provide data for data creation I have used different sources to create data Access, CTP.

Environment: UAT, Prod, Tools/ SBM (Sarena Bussiness Manager), Facets, Macro, CTP (Claim test Pro).SQL, ODS.

Confidential, Middleton, WI

DQA, Quality Analyst

• Trained on a medical device from Accuray University and software related to Tomo Therapy.
• Created test plans with a good understanding of the Software.
• Involved in Dry run test cases and made modifications in rational clear quest tool.
• Created Test cases and test scripts with SYRS high-level requirements with imaging for different body parts.
• Had training on doses to treat the cancer from lasers and had to create plans on the software involved in test cases.
• Utilized corporation developed Agile SDLC methodology. Performed Requirements Gathering and Analysis, interviewed the SME (Subject Matter Experts), and ensured that contributors and all key stakeholders were motivated to complete assigned tasks.

Environment: Tools: RQM, Clear Quest, and SharePoint.

Confidential, Madison, WI

Analyst, UAT

• Worked on Commercial lines Property and Casualty Insurance including both policy and claim processing and reinsurance.
• Worked with a hybrid methodology
• Conducted Walkthroughs and defect meetings periodically to assess the status of the testing process and discuss areas of criticality. Updated different projects in JIRA to keep status up to date for Project Managers and Business Analysts.
• Responsible for all business issues in Annuities which involved analyzing new or enhanced features to statements, confirmations/letters, contracts, applications, and/or products.
• Involved in Claims releases for Personal lines, Medicare and Medicaid.
• Created business rules documents and integrated the requirements and underlying platform functionality for different projects also worked on as a actuarial for retirement projects.
• Facilitated the User Acceptance Testing (UAT) with Business Users, documented any issues or defects and eventually got sign off from the right parties.
• Performed Requirements Gathering and Analysis, interviewed the SME (Subject Matter Experts), and ensured that contributors and all key stakeholders were motivated to complete assigned tasks.
• Completed Gap Analysis for the as-is and to-be system.
• Performed requirements analysis along with the creation of Use Cases. Manually tested and analyzed Electronic Claims File for periodic functionality and design changes .
• Created UAT plans with several test cases to ensure that the system runs smoothly after the proposed enhancements or changes have been made.
• Executed UAT Test Scripts and recorded defects in Jira.
• Environment Tools: GuideWire, SharePoint, Clarity, MS office, LISA, Jira.

Confidential, Madison, WI

System Analyst/UAT

• Responsible for scrum meeting and reporting daily goals, For Agile based environment
• Worked on different projects 14.09,14.06,14.04 all projects are FFP and HIPAA complined
• Responsible for Mapping between RTM and backlog spreadsheet for the stories, Performed testing in Go-live in production successfully tested the test cases for different flows
• Responsible for updating the stories with the help of VersionOne tool
• Logged defects into squids and was responsible for correspondence between Developing team and business team, IT, Scrum Master
• Responsible for attaining HIPAA validation from Medicare, Medicaid and other payers of government carriers.
• Performed Functional, Regression, System Integration and User Acceptance Testing for the various applications.
• Executing System Test, Regression Test, User Acceptance Test (UAT)
• Performed Test Execution & wrote & Executed Test Scenarios/Test Scripts.
• Writing Test Plans/Test Scenarios/Test Cases/Test Matrix
• Created reports to satisfy user requests, data sampling, project analysis, or testing verification, Worked as a Test Specialist for Testing Management Team
• Tested user interface and navigation controls of the application using Quick Test Pro.
• Involved in writing and executing test cases using QC based on the requirements
• Performed Back-End testing
• Responsible for customer interface, requirements definition, general and detailed design, testing, maintenance and training programs and managed requirements using Rational Requisite Pro
• Participated in User Acceptance Testing (UAT)
• Performed User Acceptance Testing from Product Owner perspective Lead UAT Projects
• Tested all Humana Health Insurance Plans
• Worked as UAT Lead for Health Care Reform (HCR) Project
• Worked with Federal Exchange on Health Care Reform project for Direct Enrollment prepared test scenarios and wrote detailed test cases,
• Reviewed by PO to ensure accurate fully testing everything needed

Environment: Squids, MS Office, Windows XP, Clarity, VersionOne

Confidential

Systems Analyst

• Served as a business systems analyst and performed detailed gap analysis, updated and managed guidelines per HIPAA.
• Tested and migrated partners and analyzed partner compliance and performance in production business rules.
• Worked with 820 transactions and 834 transactions. Worked on Test Plan test cards, High level of Scenarios
• Accumulated system requirements from various departments through surveys and interviews.
• Conducted JAD sessions with management, SME, vendors, users and other stakeholders for open and pending issues.
• Planned and defined system requirements to wire frames with use case and use case scenario.
• Prepared “BRD” business requirement documents for 820.
• Produced for transaction sets 820 and 834 (I/P) a full gap against the documented application 820 enhancements ensuring the upgraded application included required changes and additions per compliance.
• Conducted gap analysis and developed systems specifications document to define the impact of new requirements on the existing system.
• Validated business rules and all artifacts with users and obtained approval and sign off.
• Followed UML methodology using Requisite Pro and Rational Rose to create and maintain use cases, activity diagrams and sequence diagrams.
• Worked on ANSI EDI 820 and 834 per HIPPA guidelines.
• Facilitated “JAD” sessions to understand detail requirements and performed GAP analysis.
• Created use case narratives, user stories, state chart diagrams to adequately describe the business domain.
• Monitored the data movement between systems and validated business requirements.
• Adhered to the “SDLC” and performed UAT.
• Attended status report meetings and interacted with developers to discuss technical issues.
• Tested the professional, institutional claims processing and adjudication and validated data.
• Researched, tracked, parsed and interpreted EDI files 999 and transaction acknowledgement records.
• Executed testing of data to check HIPAA implementation and performed database testing by writing SQL queries.
• Interacted with client to accommodate any new change in requirements and to discuss project status.
• Gathered requirements, developed process model and detailed business policies and modified the business requirement document.
• Collaborated with business clients and other infrastructure groups to resolve business and systems issues.

Environment: Quality Center, XML, MS Office, Visio, SOAP UI, Visio, SQL

Confidential, Owings Mills, MD

Business Analyst

Responsibilities:

• Involved in the meeting with Business process owners, SME (subject matter experts) and Marketing Team for Requirements gathering in definition stage.
• Worked on Agile Scrum Methodologies
• Prepared Use Cases and detailed screen layouts
• Created Test plans per the business and technical requirements.
• Facilitated Joint Application Development (JAD) sessions, as well as conducted interviews of appropriate business/technical stakeholders.
• Responsible for streamlining business processes through analysis, design, and documentation of new processes and applications including risk assessments and mitigations, and creation of process flows (VISIO flow design) and change enabling quality controls.
• Worked with other teams through teleconferences, meetings, etc. to resolve various issues.
• Standardized the testing approach for projects/releases.
• Ensured that the QA environment is identical to production in terms of configuration, software and hardware.
• Followed the UML based methods using MS Visio to create Use Case, Activity/State Chart, Sequence, and Collaboration Diagrams.
• Evaluated business requirements for enterprise business applications integration while delivering new/modified enhancements.
• Implemented automated test solutions to existing manual processes.
• Maintained a standardized QA process to ensure that production risk is properly evaluated and reduced.
• Ensured the process is thorough enough to encompass all core types of testing and has agreed upon checkpoint to ensure that project managers can monitor test results.

Environment: Web-Based application, Windows XP, HP Quality center, QTP, XML, SQL, MS Visio, MS Word, Excel, PowerPoint, Access .

Confidential

Business Analyst

• Worked as a BA in financial industry, Project was on mortgage based, and Data.
• Worked on problems of moderate to complex scope
• Have experience Exercises independent judgment within defined practices and procedures to determine appropriate action.
• Follows established guidelines and interprets policies for multiple projects
• Evaluates unique circumstances and makes recommendations for project based.
• Analyze and identify solutions for assigned Change Requests (CRs), working with assigned technical resource.
• Developed and maintained effort estimates for all assigned CRs.
• I was responsible for determining and documenting business requirements and business designs for assigned CRs, used approved project processes and procedures.
• I was responsible for defining, writing, and executing all test cases for assigned CRs, through the test phases specified for assigned project.
• In coordination with technical resources, identify implementation impacts and resolve issues for assigned project.
• I was responsible for release and project leadership apprised of status, issues and obstacles that prevent on - time, in-budget completion of deliverables.
• . I have Updated release documentation and participate in reviews of release documentation.