SUMMARY:

• Results - driven, versatile Business System Analyst with more than 8 years of experience and 15 plus years of overall experience in technology-based complex projects.
• Experience in Data mining, Analysis and creating Data transformation requirements for different regulatory reports and Management Reports
• Working experience in Agile and Waterfall Methodologies
• Experience in Oracle PL SQL and SQL server.
• Experience in creating Tables, Stored Procedures, Triggers, Functions and Views using Oracle and SQL server
• Experience in creating Management report and data analysis report.
• Good Health care domain knowledge and experience in working on different modules within healthcare (Encounters, Claims, Enrollment, Healthcare Analytics and Regulatory compliance).
• Experience in working with ANSCI X12 HIPAA HealthCare Transactions: HealthCare Claim/Encounter (X12 837), Claim status inquiry and response (X12 276 and 277), Benefit Enrollment (X12 834), Benefit status enquiry and response (X12 270/271), Functional Acknowledgement (X12 999), Claim Remittance Advice (X12 835)
• Engage in various project management responsibilities to ensure departmental goals are met.
• Ability to work within deadlines and with multiple priorities; ability to adapt to changing priorities
• Extensive experience in writing Business Requirement Document (BRD) and Functional Specification Document (FSD) and creating Business and Functional Use Cases.
• Experience in all phases of Software Development Life Cycle (SDLC) methodology (such as requirement, analysis, design, data modeling, business process modeling, implementation and deployment).
• Extensive experience in conducting Joint Application Development (JAD) sessions for project definition involving analyzing requirements, creating prototypes, user interface, database schema and system design.
• Created Requirements Traceability Matrix to keep the stakeholders informed of the progress of the project.
• Experience in SQL Server Reporting Server (SSRS), SSIS and Crystal Reports.
• Experience in Analysis & design (UML: Use case, Sequence and activity diagrams) and high proficiency in Microsoft excel.
• Experience in User Acceptance Testing, Regression Testing Performance Testing and Functional Testing.
• Experience working on reporting requirements and maintaining their data for analysis on MS Excel.
• Experience in creating functional flow diagram using MS Visio.
• Excellent interpersonal skills, presentation and communication skills

TECHNICAL SKILLS:

Programming: VC, VB, .Net, VB Script, TSQL, PL SQL.

Database: SQL Server, MS Access, Oracle, FoxPro.

Applications: Edifecs Spec builder, TOAD for oracle, Pervasive Data junction, MS office suites, MS Visio, Crystal Reports, MS DTS/ SSRS, SAS.

Document Management: Microsoft TFS, HP AML, Microsoft SharePoint.

PROFESSIONAL EXPERIENCE:

Sr. Business System Analyst

Confidential . Tampa, FL

Responsibilities:

• Understand the report requirements
• Create specification document
• Understand business requirements and current functionalities.
• Create specification document and user stories.
• Serve as a liaison and facilitator between business IT and QA.
• Create Pega clipboard mapping document for reports.
• Provide UAT and assistance to QA team.

Sr. Business System Analyst,

Confidential, Tampa, FL

Responsibilities:

• Understand business requirements and current functionalities.
• Create specification document and user stories.
• Create specification document for building EDI packages for 837, 834,835,270 and 271 formats.
• Collaborate with project management, create bi weekly sprints and allocate Items for each sprints.
• Create project progress reports and resource utilization report to Sr. Management as per company standards.
• Serve as a liaison and facilitator between business IT and QA.
• Analyze existing database and data using SQL server T-SQL and suggest solutions for database and other data issues. Create SQL scripts and generate different reports.
• Analyze EDI files and upload to the system using web services.
• Provide UAT and assistance to QA team.

Sr. Business System Analyst,

Confidential

Responsibilities:

• Understand the Business requirements; define the Scope and vision of the project.
• Work with Project state holders, translate the Business requirements to Functional requirements and keep management informed the status changes and progress of the project.
• Translate the technical and architectural complexities and convey the same to project stakeholders.
• Work with stakeholders to identify current business model, document their requirement and provide improvement suggestions.
• Create business and functional use cases and flow diagrams
• Conduct JAD sessions and Manage requirements.
• Analyze data using SQL Server and Oracle PL SQL. Write stored procedures, Triggers and views as and when required.
• Serve as a liaison and facilitator between Market, business and IT.
• Provide support to developers, QA and UAT; Validate test results by testing solutions and provide training to end users.
• Act as Project Manager and keep track of changes and support on implementation for small enhancements.
• Created requirements and test cases for HIPAA X12 5010 Encounter for institutional and Professional Encounters, 835 Remittance Advice.
• Created mapping document for 837 5010 Prof and inst encounter and HTR.

Business System Analyst,

Confidential, Camarillo, CA

Responsibilities:

• Work with Project state holders, translate the Business requirements to Functional requirements and keep management informed the status changes and progress of the project.
• Translate the technical and architectural complexities and convey the same to project stakeholders.
• Work with stakeholders to identify current business model, document their requirement and provide improvement suggestions.
• Analyze data using SQL Server and Oracle PL SQL. Write stored procedures, Triggers and views as and when required.
• Serve as a liaison and facilitator between Market, business and IT.
• Provide support to developers, QA and UAT; Validate test results by testing solutions and provide training to end users.
• Worked with the SSB Encounter Data Analysis Group (EDAG) team for validating and delivering the Encounter (HIPAA EDI 837) files to CA State Plans- LA Care, County Medical Service Program (CMSP) and Mainstream.
• Report Encounter data submission status to WellPoint Management.
• Analysis of 997 and error reports and Identify potential issues, Write requirements to resolve it and hence improve submission quality.
• Associate with other departments and vendors like Pharmacy, WGS, Doral and VSP to resolve potential encounter issues.
• Involve in Technical design walkthrough, UAT and implementation.

System Analyst

Confidential

• Lead service delivery team, assign task and monitor team’s assignments
• Understand Functional specifications and prepare Technical design Document.
• Coordinate with the team working at client location and make sure the quality of the deliverables.
• Design, Code review and test plan preparation
• Writing stored procedure, triggers, functions and packages based on the requirements