PROFESSIONAL SUMMARY:

• 10.5 years of experience as a Business Analyst in Pharmaceutical,Healthcare, Mobile and Retail with strong understanding of Business Process Flows, Case Tools, and Business Analysis with strong knowledge in front - end architecture within Infrastructure and Application management to transform and accelerate business initiatives.
• Experienced in gathering user requirements, analyzing and preparing Project Deliverables such as Business Requirement Document (BRD) and Functional Requirement Document (FSD).
• Demonstrated ability to work actively in different phases of Software Development Life Cycle (SDLC) using agile methodologies (SCRUM) and Waterfall methodologies in multi-tier web-based architecture.
• Profound understanding of insurance policies like HMO and PPO and proven experience with HIPPA X12 EDI transaction codes such as health care benefits, status, 834(Benefit enrolment), 835(Payment/remittance advice), 837(Health care claim).
• Experience and strong understanding of HIPPA ICD- 9 & ICD-10, Claims Processing, Coordination-of-Benefits, Medical Management Information System (MMIS), Adjudication, Memberships, SNAP, TANF and FACETS.
• Strong experience in credit on the condition that it shall be returned on payment of the debt within a certain period. Involved in (LOS) Loan origination System originating a loan vary by loan type, various kinds of loan risk and regulator, lender policy and other factors.
• Expert at interacting with stakeholders, Subject Matter Experts (SMEs) and end-users to understand, analyze, communicate and validate requirements using Joint Application Design (JAD), Joint Application Review (JAR) sessions.
• Comprehensive understanding of the Organizational Framework that help to map the AS-IS and TO-BE model using the GAP Analysis.
• Demonstrated ability to handle Project Scope Change efficiently, and acted as an understanding and accommodating liaison between business and functional teams.
• Skilled in Object Oriented Analysis and Design with experience in creating Use Cases, Class Diagrams, Unified Modeling Language (UML) Diagrams like Activity Diagrams, State Diagrams, Sequence Diagrams, using MS Visio and Rational Rose.
• Experienced with ETL tools to Data Cleansing, Data profiling, Data Mapping, Data Validation and conversion rules & applications.
• Determining Task Dependencies, Identifying Milestones & Monitoring Critical Paths using Resource Plans (Schedule & Allocations), Network Diagrams and Entity Relationship Diagrams (ERD).
• Tracing requirements through Requirements Traceability Matrix (RTM) throughout the development process.
• Experienced in creating Work Breakdown Structures (WBS), Project Schedules and Project Timelines.
• Perform extensive SWOT analysis, Risk analysis, and Cost/Benefit analysis .
• Designed&implemented data ware housing/business intelligence (DW/BI) architectures based on dimensional star schema principles.
• Designed Work flows and communicated the trade-off decisions on product features based on technology and budget constraints and requirement.
• Strong hands on experience in creating functional requirements documents with end to end migrations or implementations of large scale data systems.
• Extensively working experience on the full life cycle implementation of Procure to Pay cycle (P2P) and Order to Cash cycle (O2C).
• Experience in data security concepts such as access management, vulnerability & patch management.
• Extensive experience in conducting Market Research, Data Analyses, Data Mapping, Risk Identification, Risk Assessment, and Risk management.
• Proficient in utilizing project management tools like MS Project and Clarity.
• Monitored and presented Confidential Planning, reviews, daily stand-up, daily scrum meetings, and weekly status reports, end of Confidential demos, user story, epics,backlogs, and feature list.
• Experience in User Acceptance Testing (UAT),Functionality Testing, Database Testing, Regression testing.
• Excellent written, verbal communication and presentation skills and have proven experience working independently and in a team.

TECHNICAL SKILLS:

Software Models/ Methodologies: Waterfall, Agile (SCRUM), RUP

Operation Research Techniques: GAP Analysis, SWOT Analysis, Risk Analysis, ROI

Cloud computing: Salesforce

Business & Project Modeling Tools: MS Visio, MS Project and UML

Requirement Management Tools: Rational Requisite Pro, JIRA

Content Management: SharePoint, AEM

Scrum and QA Utilities: JIRA, Rally

Operating Systems: Windows NT/XP/2000/2003, Mac OS

Databases: SQL Server 2008, MS Access, Oracle

Reporting Tools: SAP Business Objects, SSRS, Crystal Reports

Testing Tools: HP Quality Center, Rational Enterprise Suite, Test Directory

Productivity Tools: MS Word, MS Excel, MS PowerPoint

Domain Knowledge: Pharmaceutical, Healthcare, Retail and Mobile

Technologies: Java, J2EE, .Net

Change Management Tools: JIRA

Wireframing Tools: Axure, iDesign Studio, Skagit, MS Visio

PROFESSIONAL EXPERIENCE:

Confidential, Houston, TX

Business Analyst

Responsibilities:

• Responsible for transition of development from blended agile to 100% Scrum.
• Trained multiple teams in Agile methodology, Scrum Framework and JIRA tool.
• Collaborated with stakeholders and team in initiating/leading Scrum Ceremonies.
• Responsible for On-site/Off-shore coordination through daily meetings.
• Worked on Business requirement analysis and data analysis.
• Involved in backlog grooming and reprioritization.
• Involved in extensive functional testing and CRON testing.
• Responsible for daily automation/manual test report analysis.
• Worked with EDW team and third party process partner to provide Daily Metrics report.
• Wrote business rules/retention rules on database side.
• Responsible for Copy Approval and WAST cycles.
• Acted as Websecure admin.
• Responsible for Adobe Developer/Production accounts.
• Responsible for Post-Prod functional testing.
• Worked with Copy Approval Team and Development team in analyzing ICADs, FCADs and Final Samples.
• Worked with QA team in UI testing of the application against Copy Approval changes.
• Worked with WAST (Security testing) team and Development team in analyzing WAST reports.
• Worked with Compliance on reviewing and updating ITMS documentation.
• Worked on presenting concept reviews to LMRC (Legal,Medical,Regulatory anc Compliance) teams before release.
• Responsible for handling third party vendor contracts and meetings.
• Set up daily stand up, retrospectives, Confidential reviews or Confidential planning sessions.
• Analysed production tickets in Remedy Ticketing System and served as a point of contact between Development team and GSK response center.
• Responsible for providing training material, FAQs and speaking points to GSK Response Center.
• Responsible for
• Worked closely with the product owner, scrum master and technical project lead to meet the project goals.
• Understood the business logic, user requirements and test-objectives to develop User Stories and Acceptance Criteria.
• Responsible for entering and updating Issues (Epics, Stories, and Tasks) onto JIRA Agile application.
• Involved in requirement gathering sessions with and Product Owner and Business Owner.
• Maintained requirements and entered bugs in JIRA for tracking and testing purposes.
• Worked on Mock up for each story cards to give visual effects using Axure and Skagit.
• Worked with the development team during the Design, Build and Test phase of system projects to clarify business requirements as required.
• Co-ordinated User Acceptance Testing activities with Business Owner. nteracted with the SME's, Business User & Teams to get understanding of Business Processes.

Environment: JIRA, Agile-Scrum, AWS, MS Office Suite, Skagit, Axure, Star UML,MS Visio, MySQL, SQL Developer,Windows 10, JAVA 1.6, React/Redux, Selenium,Adobe esign, J2 Global efax, Selenium, HPQC-ALM, Quality Manager, MS SharePoint,, SOAP/REST Web services, SOAP UI, Postman.

Confidential, Suwanee, GA

Business System Analyst

Responsibilites:

• Understood the business logic, user requirements and test-objectives to develop Use Case Scenarios, test plans, test cases.
• Involved in requirement gathering sessions with and Product Owner and Architect for building Data warehouse as part of ODS (Operational Data Store) project.
• Worked on Business requirement analysis and data analysis.
• Worked with Facets Team for HIPAA Claims Validation and Verification Process (Pre-Adjudication) and assisted in version upgrade and impact analysis on data warehouse tables.
• Assisted in EDI transactions of medical claims (837) /underwriting for support and point of reference for the providers in business issues.
• Wrote business rules on database side. Also Worked on Data modeling as part of building databases using Database Diagrams in SQL Server management studio.
• Extensive use of FACETS backend tables and front end application system for data validation purposes.
• Maintained daily ad-hoc (SSRS) reporting.
• Produced X12 transaction sets 835 and 837, complete gap analysis 4010 - 5010 against the document application 5010 enhancements ensuring the upgraded application included the required changes and additions for 5010 compliance.
• Involved in the upgrading process of 4010 transactions to 5010 by conducting impact analysis and risk assessment and worked on the mitigation plan to avoid the risks.
• Performed extensive Gap Analysis in order to understand and to identify AS-IS processes of claims transactions of standard and TO-BE processes of 5010 standard.
• Conducted Claims and HIPAA Compliance Training in order to run the test cases.
• Interacted with the SME's, Business User & Teams to get understanding of Business Processes.
• Conducted Joint Application Development (JAD) sessions/ workshops for project definition, requirement analysis and user interface.
• Worked on creating & drafting conceptual models using UML for Use cases, Class Diagrams, and a number of interaction diagrams.
• Worked closely with the product owner, scrum master and technical project lead to meet the project goals.
• Set up retrospectives, Confidential reviews or Confidential planning sessions.
• Conducted walk-through sessions on user stories with the product owner.
• Assisted in entering and updating Issues (Epics, Stories, and Tasks) onto JIRA Agile application
• Maintained requirements and entered bugs in JIRA for tracking and testing purposes.
• Worked on Mock up for each story cards to give visual effects using Axure and Skagit.
• Worked with the development team during the Design, Build and Test phase of system projects to clarify business requirements as required.
• Co-ordinated User Acceptance Testing activities with customer

Environment: Rational Rose, Requisite Pro, Agile-Scrum, MS Office Suite, Skagit, Axure, Star UML,MS Visio,Windows 7, SQL, Facets 4.81, Teradata, ETL, Informatica, SQL Server, SSRS, Unix IEE, HPQC-ALM, Quality Manager, MS SharePoint, Java, PLSQL, SOAP/REST Web services and SOAP UI.

Confidential, Ontario, CA

Business Analyst

Responsibilities:

• Worked on Facets Claims Software System, to convert data from their legacy system (LRSP) and add custom applications to satisfy in-house requirements.
• Involved concurrently in enhancement of HIPAA X12 4010 transaction to HIPAA X12 5010 and ICD 9-CM (Clinical modification) to ICD 10-CM/PCS (Clinical modification/procedure coding system)
• Expertise in Claims, Subscriber/Member, Plan/Product, Claims, Enrollment, Provider, Commissions and Billing Modules of Facets.
• Analyzed client business requirements and translated those into pricing rate sheets in NetworX.
• Create Access queries utilizing NetworX and Facets Data tables
• Worked with Accumulators, Deductibles, Coordination of Benefits, and Overrides of the Claim Line detail and used them for testing various claims scenarios in Facets.
• Proposed FACETS claims adjudication procedures, standards and editing guidelines.
• Worked closely with developers and a variety of end users to ensure technical compatibility and user satisfaction.
• Worked on analysis of FACETS claims processing system and gathered requirements to comply with HIPAA 5010 requirements.
• Wrote system requirements for APTC Subsidy Billing and Family Accumulators for on and off exchange members.
• Creation of new service definitions and unique pricing requirements
• Conduct JAD sessions to gather and document requirements that enhance a wide range of functionalities including claims processing, eligibility and enrollment, provider networks, and electronic data interchange for our Facets core application.
• Gap Analysis of client requirements, generated workflow process, flow charts and relevant artifacts.
• Designed Use Cases using UML and managed the entire functional requirements life cycle using RUP.
• Developed flow diagrams for Business process of the company, UI Wireframes and Mockups using Microsoft Visio
• Used General Equivalence Mapping to convert ICD 9 to ICD 10. Involved in both forward mapping and backward mapping.
• Used GEM for forward and backward mapping to convert ICD 9 codes to ICD 10 codes and vice versa.
• Worked as a liaison between the business and technical side to convey the business needs to the system architects.
• Used SQL Queries in Oracle to pull out data from the databases for the data validation and routine report generation.
• Created ETL mapping document for users.
• Used JIRA to enter and and verify the closed bugs.
• Worked on claims, Claim adjudication Membership, Eligibility, Accumulators,
• The process included importing claims into Facets that had been adjudicated and setting them in a "PAY" status so that a payment cycle could be run to create checks on Facets.
• Involved in writing and implementation of the test plan, and various test cases.
• Initiated, proposed and implemented critical analytical and technical turnkey solutions extensively increasing the quantitative and qualitative value of the application.
• Provided overall project management to multiple projects successfully completing them on-schedule and on-budget.
• Extensive backend testing using SQL queries, generating the reports to ensure the data integrity and validate the business rules.
• Participated in solving Billing issues from the FACETS Problem Log for Trizetto and Billing Entities.
• Analysis and Design of the Trizetto FACETS Data Model to ensure optimal system performance and tuning.

Environment: Rational Rose, NetworX, Agile-Scrum, MS Office Suite, MS Visio, Star UML, Axure,Windows 7, SQL, Facets, ETL, Informatica, SQL Server, SSRS, Unix, HPQC-ALM, MS SharePoint, Java, PLSQL, REST Web services and SOAP UI.

Confidential, Overland Park, KS

Business Analyst

Responsibilities:

• Performed AS-IS Study of the system and TO-BE Analysis, revision of Business Process Procedures to in corporate necessary changes.
• Successfully used Agile/Scrum Method for gathering requirements and facilitated user stories workshop. Documented User Stories and facilitated Story Point discussions to analyze the level of effort on project specifications.
• Conducted interviews with key users to collect requirement and business process information.
• Verified the functional aspect as per the Business Process and validated the interfaces with the other systems and data conversion from the legacy systems.
• Modeled the business process and documented it by creating Business Process Flows and Data Flows.
• Created the flow diagrams and use case diagrams using Visio activity,sequence and collobaration diagrams using Star UML.
• Created Software Requirement Specifications containing all solution requirements including functional, non-functional, data and report specs in co-ordination with the Business area and development team.
• Maintained policy lists business requirements, Software Requirement Specifications and created extensive traceability matrix in Rational Requisite Pro from requirements to use cases, use cases to business rules and business rules to exception messages.
• Maintained risks and issues register and escalated risks and issues as needed.
• Acted as a liaison between the IT group and the Management team. Worked with IT to debug and resolve all code issues.
• Assisted the creation of the UAT Test Strategy and Plan and conducted detailed walkthrough sessions with all stakeholders to communicate their responsibilities and effort requirements for UAT.
• Created test cases and executed test cases as part of the UAT team.
• Conducted interviews with Process Owners, Administrators and Functional Heads to gather audit-related information and facilitated meetings to explain the impacts and effects of compliance.
• Analyzed test data to detect significant findings and recommended corrective measures.
• Created tickets for all defects identified and coordinated with development team and business to get the defects resolved using JIRA.
• Involved in regular reports, feedback and communication with the management, coordinating the team members and maintaining the project log presentation, delivery and documentation of project.

Environment: IBM BPM, IBM Websphere Application server, Oracle, Requisite Pro, Agile-Scrum, MS Office Suite, Windows 7, SQL, JIRA, MS SharePoint, REST Web services and SOAP UI

Confidential, Atlanta, GA

Business Analyst

Responsibilities:

• Developed Software Requirement Specification (SRS) documents using Visio and MS Office (The requirements for this project are being subdivided into three separate Software Requirement Specification (SRS) documents, one for each release of the project).
• Coordinating all the testing activities between offshore and onsite as well as with development team.
• Review all Requirement specification docs, Functional design docs for completeness and testability.
• Assisting the team while Test Case execution.
• Strong coherence with SDLC process focusing on Waterfall methodologies.
• Analyzed, documented, and managed all project requirements and changes to requirements throughout the software development lifecycle.
• Conducted user interviews, attended JAD (Joint Application Development) sessions, created agendas and documented analysis in requirement gathering.
• Responsible for post development peer reviews and deployment of packages.
• Detailed repeatable end-to-end test cases for application, interviewed developers to gain detailed information on complex calculations and backend exception.

Environment: Microsoft Project 2010, Rational Clear case, SQL Server, HPQC, Office, MS Access, MS Visio, MS Office, Lotus Notes, PL/SQL, Gap Analysis.