SUMMARY:

• Over 8 years of extensive experience in the IT Industry as a Business Analyst.
• Experience in Business Requirement gathering, Business Process flow, Analysis, and writing Business /Technical Requirements Documents using MS Visio/Rational Rose.
• Experience in all phases of the Software Development Life Cycle (SDLC), Rational unified process (RUP), agile methodology.
• Experience in conducting Joint Application Development JAD sessions, workshops etc. to resolve open issues, and change requests.
• Experience in performing Gap Analysis to check the compatibility of the existing system infrastructure with the new business requirements.
• Experience in implementation of HIPAA 4010 and HIPAA 5010 changes in the existing claim processing integrated system.
• Proficient in ICD - 9-CM and ICD -10-CM coding and claims processing.
• Knowledge of Medical Management Information Systems (MMIS), Medicaid, Medicare, Procedural and Diagnostic codes and Claims Process
• Excellent knowledge of Health Insurance Portability and Accountability Act (HIPAA) transaction and code set rules such as 837 for submitting claims, 835 for payments, 834 for benefit enrollment, 270/271for health care benefit sand eligibility, 275 for patient information, 276/ 277 for claims status and 278 for transmitting health care service information.
• Knowledge of EMR/EHR, Health Care Reform and Patient Protection and Affordable Care Act (PPACA).
• Experience in writing Test Plan, Test Scripts and Test Cases for Functional, System, Integration, UAT, and Regression Testing based on the Design Document and User Requirement Document for the Functional, Security, and Performance Testing.
• Involved in training of end users and Documenting Training Manuals.
• Focused troubleshooter and a team player with excellent interpersonal and communication skills. Ability to work cohesively with developers, other team members, and testers.
• Analytical, methodical and resourceful approach to Problem Solving, Root-Cause Analysis, Conflict Resolution, Negotiation Strategies and providing corrective actions to meet business requirements.
• Proven record of Leadership skills. Excellent Presentation skills in regards to communicating with both business and technical teams.
• Experience with mockup
• Expert in developing BRD (Business Requirement Document), TRD (Technical Requirement Document), URS (User Requirement Document) and FRS (Functional requirement Specifications) following Agile methodology.
• Hands on experience in Requirement gathering and analysis, Planning, scheduling and Tracking Projects.
• Excellent written and verbal communication.
• Strengths include quick learner, problem-solving capability, and ability to work as team player and lead the teams. Consistently demonstrated ability to achieve tight deadlines.

TECHNICAL SKILLS:

Operating Systems: Microsoft Windows, UNIX, Mac

Languages: SQL, HTML, XML,VB, ASP.Net, SAS v9.1

Databases: Oracle, MS SQL server, MS Access

Tools: MS Word, Excel, Access, Power Point, Project, Visio, Rational Rose, ClearCase, Clear Quest, Load Runner, HP Quality Centre, Test Director

PROFESSIONAL EXPERIENCE:

Confidential, Albany, NY

Sr. Business System Analyst

Responsibilities:

• Captured requirements for business stakeholder to do seamless integration between multiple platforms for agents, businesses, and agencies to register and use the system.
• Captured requirements and generated mockups and wireframes for consolidated intake form, common business profile, and one contact center for support.
• Worked on common idea across the board to generate a system that will be a one-stop shop to issue, renewal and support of over 1,400 different business and occupational licenses issued by 44 agencies.
• Provided extensive support and work ideas to manage scope and resources by planning, initiating and successfully completing phases in the project and planning future phases.
• Generated business rules, functional processes, and requirements for transaction system.
• Created a process map to incorporate NY rules and government mandates for transaction sets thus creating a system that would allowan agency a sound process and location that has a consistent entry format for all the transactions.
• Created data dump and batch file process to capture, store and archive transactions from all the agencies to the new data warehouse.
• Extensively worked on ETL process by documenting and enhancing extraction rules, transformation requirements and load procedures from business and systems side.
• Conducted GAP analysis for the current system and future system to assure correct integration points and structure.
• Did As-is and To-be analysis for data points and key integration parts to assure a fully functional system once the work was completed.
• Organized and facilitated JAD sessions and extensive goal driven workshops to capture current and future needs of the key Stakeholders.
• Worked on multiple key documents throughout the project lifecycle to capture knowledge, get approvals for requirements from key stakeholders and passing information over to development team and testing team for future work on project.
• PreparedBusiness Requirement Document bycapturing information via multiple channels like stakeholder interview, JAD sessions, Workshops, SME immersion sessions etc. covering all key facets of the project.
• Worked extensively on logical data gathering process, by capturing agency data, arranging them in logical sets and creating business and IT logic documents.
• Worked on systems part of the project by capturing data elements, data attributes and data values.
• Used the data components captured and generated data mapping documents, data analysis document and source to target data map.
• DocumentedBusiness Rules and system rulesfor the display of data elements on the website.
• Generated mockups, wireframes and dummy user interfaces to clarify business needs to the development team.
• Created functioning wireframes and dummy interfaces to display the end product to the SME’s, stakeholders and key business team members.
• Used Visio and Balsamiq to create the mockups, dummy functional user interface, journey maps and wireframes.
• Worked and developed use cases, swim lane documents, process flow diagrams etc. to relate to business processes and existing business scenarios.
• Heavily involved with process analysisand documenting current and future process flows and scenario documents.
• Worked with key business stakeholders and SME’s to prepare Business Intelligence Strategy
• Worked on developing performance managementreporting to track the improvement in the project as an assisting Project Manager during resource shortage.
• Worked on NYBE payment model for customers to use the new portal for various payments for processes.
• Worked with the IVR team and the call center SME’s to reduce the work load and call volume by creating self serve portal in the website that can assist the users with simple tasks.
• Created process plan and migration plan and map to retire the current legacy system and move it over to the new platform.
• Analysis the workflow of different NY State agencies for efficient business process re-engineering.
• Conducted meeting and sessions with Project Managers, developers, testers for status reporting and allocationtheir needs in the project.
• PreparedCommunication Plan, a workbook that outlines the communication protocols for the NYBE.
• Generated, maintained and updated Status reporting - detailing work accomplishment, open issues, open risks, and key project decision an the NYBE Projects
• Manage multiple processes - Evaluate status information from agency systems to determine overall workflow status and potentially trigger additional workflows

Environment: MS Visio, UML, SQL, MS Office, Oracle, XSLT, XML, JAD, Adobe Report Builder, MS SQL Server, Agile, Scrum, UAT, SSIS, SSRS

Confidential, New York City, New York

Sr. Business Systems Analyst

Responsibilities:

• Gathered requirements and prepared Business Requirement Documents (BRD), System Requirement Specification (SRS) by interviewing Business Users/SME's.
• Documented the Business Process Flows, Business Use Cases, System Use Case, Business Rules and Use Case Realization following the Rational Unified Process (RUP) methodology.
• Interacted with the project team to help define the Business and System Objectives, confirmation of scope, identify constraints and the measures of success for the system to be developed.
• Conducted Joint Application Development (JAD) sessions and walk in interview with the business users to gather requirements.
• Analyzed the business requirements for Medicare claims Part A, B, C and D determining the membership eligibility for Enrollment and Claims processing.
• Adhered data transition of the payment and remittance advice as per the EDI 835(for payments).
• Maintained Requirements Traceability Matrix in Rational Requisite Pro and used Clear Quest to manage change requests and track defects.
• Developed an implementation guide for Partners for EDI X12 transactions such as 837 (medical claims), 835 (medical claim payments), 270 (eligibility inquiry), 271 (eligibility response), 276 (claim status), 277 (claim status response), 820 (enrollment), and 834 (premium payments).
• Developed storyboard, mock up to communicate design ideas.
• Worked with PMO group in defining timelines and schedules for the project.
• Scheduled meetings with Developers, Testers and System analysts for status reporting and resource allocation planning using MS Project.
• Worked closely with Developers, User Representatives and participated in the product design process including specifications and other document reviews.
• Used SoDA - Software Documentation AutomationSoDA is a flexible, powerful documentation tool that can help you publish project documents by retrieving information from software tools i.e   IBM Rational UML modeling products and use the information to generate customized documents and reports using Microsoft Word and created product documentation including online help, printed user manual, and training materials.
• Created and maintained the Requirement Traceability Matrix between the requirements and other products such as design documents and test plans.
• Actively involved in generating test cases for each phase deliverable and documented the results in Test Reports.

Environment: SQL, HP Quality Center, Share Point, MS Office, UML, Rational Rose, Windows, MS Visio, MS Project.

Confidential, Paramus, NJ

Sr. Business Analyst

Responsibilities:

• Gathered Business Requirements. Interacted with the Users, Designers and Developers, and the Project Manager to get a better understanding of the Business Processes.
• Collected, documented and managed business requirements, functional requirements and non-functional requirements using MS Word.
• Facilitated meetings with the technical team and client team to analyze the current process and gather requirements for the proposed process.
• Presented several documents and Use Cases for multiple transactions and worked with ANSI X12 5010 and ANSI X12 4010 including the standards for medical transactions like 837I, 837P, 835, 276, 277, 270, 271(both inbound and outbound) transactions.
• Analyze EDI - X12 data elements captured by the existing system to validate it against the data elements required for new system.
• Responsible for the HIPAA 4010/5010 compliance lifecycle from gap analysis, mapping, implementation and testing process of Medicaid Claims in the new MMIS system.
• Responsible for mapping documents, test plan, test scenarios, test cases for unit, system and system integration testing.
• Developed UAT test cases associated with the functional requirements.
• Used the Rational Unified Process (RUP) to build the different phases of Software development life cycle.
• Involved in GAP analysis around the identification of business rules, business and system process flows, user administration, requirements and assumptions.
• Worked closely with QA and Developers to clarify/understand functionality, resolve issues and provided feedback to nail down the bugs.
• Trained and acted as point of contact for new employees.

Environment: Rational Unified Process (RUP), SQL, MS Visio, MS Project, MS Office, UML, Windows, HP Quality Center.

Confidential, Piscataway, NJ

Business Analyst

Responsibilities:

• Involved in the analysis of HIPAA compliance and EDI transaction sets and actively participated in the designing of the EDI transactions using the new HIPAA 5010 version also including the use of ICD-10 codes
• Interacted with the project team to help define the Business and System Objectives, confirmation of scope, identify constraints and the measures of success for the system to be developed.
• Participated inJAD sessions, daily meetings, brainstorming sessions to solve the problems and enhance the workflow.
• Assisted in building a Business analysis process model using Rational Rose and Visio.
• Monitored change requests and documented requirements, integrating them withClear Case.
• Experienced in RUP software development cycle methodology with four consecutive phases - Inception, Elaboration, Construction and Transition.
• Participated in preparing Scope Document and identifying Business areas included in the project and areas not part of Project Scope.
• Ensured that the claims processing is strictly under the HIPAA compliance regulatory document to safe guard patient information.
• Part of the team assisting in documentation involved in this project such as RFP, proposal, evaluation criteria, proposal approval, design document, project plan, project scheduling, project report, release document.
• Prepared and presented monthly collection reports.
• Documenting workflow and results of analysis for the aging accounts.
• Clarified QA team issues and 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.
• Maintained Test Matrix with the test results obtained.
• Followed the UML based methods using Rational rose to create use cases, activity diagram, sequence diagram, collaboration diagram that include functional and non-functional specifications to hand off to development teams.

Environment: Agile/Scrum, Version One, UML, HP ALM, Rational Clear Quest, Windows, MS Office, HTML, Windows

Confidential, Plainfield, NJ

Business Analyst

Responsibilities:

• Perform validation on derived datasets and following the standard operating procedures during the validation process.
• Generated reports in HTML, PDF or RTF formats according to the client specifications.
• Conducted analysis and generated tables, listings and graphs using SAS.
• Created new analysis datasets from raw datasets for clinical trials.
• Extensively involved in creating safety and efficacy tables, listing and figures
• Performed Quality Checks on the existing table, listing and figures.
• Extensively used company standard macros for effective and efficient outputs for clinical trials. Created study specific macros for better performance
• Actively participated in monthly departmental meetings and providing the necessary inputs on how to improve the standards.
• Create and Maintain Requirements, Test Cases and Test Plans, Perform Agile development methodology on development process we are going through.
• Coordinate with BSA to analyze User requirements, Current operational procedures, functional specifications and User data processing.
• Run Batch eligibility query (BEQ) files; check Transaction Code (TC) and Transaction Reply Code (TRC) to make sure Member enrollment has been completed.
• Worked closely with Statisticians and Data managers to get requirements.
• Developed Traceability Matrix including BRD and FRD to track down different defects related to Member enrollment & eligibility, Claims adjudication, Clinical request from members.
• Developed and Maintained Requirements work plan and assessed the performance metrics of the team members.
• Created and Analyzed Business Requirement (BR) and Functional Requirement, Directed development team to developed Member login Web Portal (Intranet).
• Worked on Document Management, used Workflows to route documents from person to person so they can complete their document management tasks, such as Reviewing documents, approving their publication and managing their disposition.
• Modeled the ‘as-is’ process flow and the ‘to-be’ process flow and analyzed the gap and developed the action steps to fill the gaps.

Environment:MS Visio, MS SharePoint, TFS, MS Project, MS Visio, SQL, Oracle, SOA, HTML, Agile

Confidential, Franklin Lakes, NJ

Business Analyst

Responsibilities:

• Worked as a liaison between technology and the business clients to improve business processes and support critical business strategies.
• Gathered business requirements from SME’s and drafted business requirement document (BRD)
• Participated in JAD sessions for user interviews to gather requirements.
• Organized program leadership meetings for the top management to discuss these issues, risks and assign actions to specific work stream owners.
• Identified all necessary Business and System Use Cases from requirements and created UML diagrams using MS Visio.
• Maintained a continuous follow-up with the technical leads and stakeholder, generating periodic brief reports and validating the Requirement Documentation.
• Carried out a dynamic Gap analysis to determine the proficiency of the new process plan in comparison to the old one, as well as conformance to the requirements.
• Implemented an incremental maintenance process plan to enable user acceptance testing on the go.
• Actively involved in generating test cases for each phase deliverable and documented the results.
• Primarily responsible in managing deployment of each phase deliverable and successful fusion into the current running system.

Environment: MS Visio, MS Office, UML.