SUMMARY

• Over 8+ years of work experience as a Business System Analyst with in - depth knowledge in Banking, Health care and Insurance domain in the field of Information Technology.
• Experienced in Software Development Life Cycle (SDLC) methodologies like Waterfall Model, Agile Scrum methodology and Rational Unified Process (RUP).
• Proven excellence in analyzing business processes, eliciting requirements, defining business needs, and translating to business and technical specifications documents.
• Experienced in performing Gap Analysis, SWOT Analysis, Feasibility analysis, Business Impact Analysis and Risk analysis.
• Skilled in translating business requirements and user expectations into detailed specifications employing designing techniques like OOAD and Unified Modeling Language (UML).
• Sound proficiency in analyzing and creating, Use Case diagrams, Sequence diagrams, Activity diagrams, Data flow diagrams, Business flow diagrams using MS Visio.
• Very well versed with Data Warehousing concepts, data governance requirements, CRM data and Master Data Management (MDM)
• Hands on experience with IBM Rational tools like Requisite Pro and Rational Rose for managing requirements and analyzing Use Case development.
• Skilled in data and process modeling techniques (e.g., data analysis using data flow diagrams, Logical Data Structures (LDS) model and Entity Relationship (ER) model.
• Recurrently conducted Joint Application Development (JAD) sessions with end-users, SMEs’ and development team for project meetings, walkthroughs and customer interviews.
• Knowledge of health care services regulatory environment including HIPAA, Medicaid/Medicare and EDI.
• Knowledge of ICD 9/ICD 10 and various HIPAA 4010/5010 formats.
• Adept in conducting User Acceptance Testing and verifying performance, reliability and fault tolerance issues. Also familiar with testing tools to design and develop test plans and test scripts.
• Experience writing SQL queries and optimizing SQL queries. (inner and outer joins)
• Good understanding of BABOK and working towards Business Analyst Certification through IIBA.

TECHNICAL SKILLS

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

Business Modeling Tools: Rational Rose, MS Visio, iRise, Dream weaver

Requirement Management Tools: DOORS, Rational Requisite Pro, Clarity PPM

Content Management System: SharePoint, Clarity PPM

Operating Systems: Windows 9x/NT/ME/2000/XP/Vista/7, Unix

Database Skills: ORACLE 9i/10g/11g/12c, SQL Server 2012/2014, MySql, Toad, Squirrel, MS Access, DB2

ETL Tools: INFORMATICA 8.X/7.X, Datastage 9.1

Programming/Web: SQL, PL/SQL, JavaScript, Java, XML, HTML, DHTML, JavaScript, CSS

Testing Tools: HP Quality Center/ ALM, JIRA (Defect Tracking)

Project Management Tools: MS Project, Clarity PPM, Portfolio Vitals, PMO Playbook

Other Tools: MS Office Suite - Word, Excel, PowerPoint, Access, MS Outlook express

PROFESSIONAL EXPERIENCE

Confidential, Philadelphia, PA

Sr. Business Systems Analyst

Responsibilities:

• Acted as a liaison between the business SMEs, technical teams such as Data warehousing team called Informatics team, Development and Testing teams and Project stakeholders
• Acted as a liaison between the upstream and downstream data teams.
• Conducted JAD sessions with SME and project stakeholders for requirement gathering.
• Creatively optimized techniques for requirements gathering like Elicitation session, JAD session, Brainstorming sessions, Stakeholder Interviews and One on one interview.
• Created extensive Business processes and Data flows using Visio.
• Maintained Business requirements and via feedback emails using Clarity PPM shared tool, to satisfy the needs of all impacted and/or participating functional areas and baselined them.
• Worked with stakeholders and project team to prioritize the collected requirements.
• Baseline a business workflow document to ensure an accurate understanding of the steps needed to complete the process.
• Conducted GAP analysis and captured open items and issues throughout the project life cycle.
• Created artifacts like High Level Vision and Scope (HLVS), Requirements Traceability Matrix (RTM), Requirements Management Plan (RMP), Business Requirement Document (BRD), Infrastructure Requirements Document (IRD) and Functional Specification Document (FSD).
• Facilitated User Acceptance Testing (UAT) and reported the results to the Business Stakeholders.
• Maintaining proper communication with the developers so that they addressed the modifications and requirements and also monitored these revisions.
• Creating as-is and to-be process models, specifications, and process flow diagrams.
• Worked conjointly with the project managers to efficiently scope and deliver the project goals.

Environment: MS Visio, MS Office Suite, HTML, UML, SDLC, MS Access, MS SQL, Oracle, SQL Server, TOAD, MS OneNote 2010, Teradata, Informatics, Web Forms, Clarity PPM, SharePoint, Portfolio Vitals, PMO Playbook

Confidential

Sr. Business Data Analyst

Responsibilities:

• Fulfilled the role of a Sr. BSA and a Data steward by managing Requirements for various inbound and outbound data file in Data Warehouse environment using SQL as a primary tool for data analysis.
• Acted as a liaison between Wholesale Lines of Business and Non-wholesale (including Retail) lines of Business and technical (Development and Validation) organization.
• Acted as a liaison between the On-boarding teams and downstream consumer applications.
• Conducted JAD sessions with downstream consumers and lines of businesses to understand, analyze and document business requirements.
• Conducted and created reports from Data Validation, Reference Data Analysis, Data Profiling and Master Data Management (Data Glossary).
• Reviewed PL/SQL procedures and worked with the developers for any modifications.
• Conducted extensive Data Analysis to be able to make data-driven decisions, backed with data facts.
• Used MS SQL to design complex queries in order to generate put together data field elements that were part of business requirements.
• Used BI tool Tableau to visually analyze data and create reports. Also, assisted in creating concise and actionable dashboards that are not only analytical tools, but were also be intuitive to use and visually appealing.
• Extensively involved in creating Data linage, data mapping, data profiling, data governance standards, data integrity standards and data definitions.
• Conducted Data Validation for Referential Data in SQL Server
• Gathered and defined business requirements for reference data from downstream Lines of Businesses.
• Created business and functional requirements for SQL Server Reporting Services (SSRS) reports and worked closely with the developers to ensure logic in SSRS Report builder
• Created Data Prototype that included specific size of data from the database reflecting different data field elements’ values. Data Sample would then be compared with Source Application Systems i.e. System of Records (SOR) to test the accuracy of data field elements values
• Generated Reports using SSRS, Pivot Tables and Pivot Charts, VLook Up to show the attributes that are currently being solved through an IT build
• Designed and developed Use Case Diagrams, Activity Diagrams, Sequence Diagrams by using MS Visio
• Created and provided training, resolve questions, assess user needs, and recommended changes to the Confidential Line of Businesses and downstream application consumers.
• Created pages and lists on SharePoint using SharePoint designer access, to demonstrate the logic used to build org structures for each Lines of Businesses.
• Assisted the team members in writing the Test Cases and executed the Test Plans for the User Acceptance Testing in HP Quality Center

Environment: MS Visio, MS Office Suite, HTML, XML, Test Director, VB, Tableau Desktop 6.1,Client Server, UML, SDLC, Test Director, MS Project, MS Access, MS SQL, Oracle, TOAD, Teradata, Informatics, Websphere, PL/SQL, ASP.NET, ADO.NET, Web Forms, IIS 6.0, MS Visual Studio.NET, Toad, Essbase

Confidential, Woodlawn, MD

Sr. Business Analyst/ Quality Analyst

Responsibilities:

• Analyzed Use cases provided by the SSA and utilized them as a source to gather requirements and created Detailed Systems Specification (DSS) document to include these requirements, to solve the business needs for the Confidential ’s Disability Determination Services offices nationwide.
• Persistently worked with the SMEs to understand the business process.
• Created User Interface Specification (UIS) document which included wireframes of the screens and navigation paths and integrations.
• Assisted the project manager with release planning and sizing. Conducted sessions with the Development and Validation leads for scoping and re-scoping the requirements in Req-Pro for every release.
• Facilitated the JAD sessions to communicate with the SMEs and stakeholder and allowing them to share their perspective and issues.
• Worked closely and on daily basis with the Validation and Development teams for workflows like providing them assistance with requirements interpretation, defects and enhancements releases schedule, defects sizing and other production needs.
• Worked extensively on XML and Metadata definitions within the XML. Conducted testing those XMLs in the database environments and conducted root cause analysis to track back the issues
• Worked directly with the clients to understand the requirements and providing the solution to the issues clients were facing.
• Acted as a liaison between the Business Team and Technical team to get them quickly on an agreement.
• Assisted testing team for successful completion of Integration Testing, Smoke Testing, Regression Testing and Requirements Testing.
• Authored templates related specifications (requirements) in Req Pro and validated in the multi-channel communications and document automation tool Thunderhead 5.0/5.1, that SSA uses for its correspondence with the applicants.

Environment: MS VISIO 2007/2010, MS Office suite, MS Project Management, Microsoft SharePoint, HTML, CSS, Rational Requisite Pro, Thunderhead 5.0/5.1, XML, HTML, Oracle, MS Office suite, SQL, SQuirrel, DB2, Windows 2007/2008

Confidential, Windsor, CT

Business Analyst/Quality Analyst

Responsibilities:

• Elicited requirements from Subject Matter Experts and documented them as per the needs and requirements of the project. Prepared BRDs and FRDs for the enhancement of the existing services.
• Created Statement of Work (SOW) document for various capabilities in the Initial Requirements Gathering Phase.
• Managed all the requirements in Requisite Pro, making requirements available to all team members.
• Built benefit plans for all lines of business and conducted unit systems integration and regression testing of those plans.
• Part of Business Process Reengineering Support Team of 6 personnel that leveraged Lean Six Sigma, Change Management and other Continuous Process Improvement methodologies to improve Claim Processing Cycle.
• Work closely with Underwriting and other internal departments to coordinate medical and dental responses to RFPs.
• Performed research and trouble-shooting for claims transactions or software issues for CMS Change Requests and Medicare Secondary Payer (MSP) claim adjudication processes.
• Validated data at the Backend to ensure that all the Claims related data has been loaded as per the Standards.
• Good knowledge of medical billing codes such as ICD-9, Revenue, HCPCS and CPT codes that are used on the UB04 and CMS1500 claim forms and various systems and applications for claims adjudication. Assist and troubleshoot daily medical billing/contract issues on a more technical level.
• Monitor daily processing of medical billing data on a daily basis to proactively identify potential client service issues related to Managed care, Medicare, Medicaid, Tricare and Workers Compensation contracts/claims.
• Trained customers on how to build benefit plans and use the claims modules of the claims processing software program.
• Conducted JAD sessions with business units and stakeholders to define project scope, to identify the business flows and determine whether any current or proposed systems are impacted by the new development efforts
• Created workflow diagrams, UML diagrams, process models, activity diagrams, use cases, swim lanes, for incorporating design changes in the order creation/ management system.
• Developed complex SQL queries using joins, sub queries to test data tables against the source and target and to validate data and verifying referential integrity.
• Coordinated the upgrade of Transaction Sets 837P, 835 and 834 to HIPAA compliance, Support CIGNA's ability to intake both 4010 and 5010 compliant claim transactions.
• Used MS SharePoint as a central repository for all Project documentation and the communication of Project information.

Environment: HIPAA., MS Office Suite (Excel, Word, PowerPoint), Window XP/7, MS Visio, UML, JAD, Requisite Pro, SharePoint 2010, CA Clarity, UAT, Agile, Lotus Notes

Confidential

Business Analyst/ Systems Analyst

Responsibilities:

• Gather requirements (from key stakeholders) and created Business Requirements Documents, Functional Requirements Specification document, including use cases. Prototype screen elements to help development team understand requirements.
• Facilitate JAD sessions with project stakeholders, subject matter experts and development and QA teams.
• Coordinate with onshore and off-shore development team.
• Created Use Case diagrams and UML diagrams using MS Visio.
• Experience working on Medco Medicare Prescription Plan® Claims processes from Admin/Provider/Payer side.
• Involved in the development of processes and systems to support HIPAA 5010, ASCA compliance, Medicaid Management Information System (MMIS) and administrative procedures.
• Followed Scrum development process using Agile methodology.
• Experience in 834/835, 270/271, 276/277, & 997 processes of medical claims/underwriting for support and point of reference for the vendor in business issues.
• Provided support during the integration and UAT.
• Worked closely with database architect and data analyst in providing assistance related to the requirements.
• Involved in writing Data Mapping Documents for the system and involved in documenting the ETL process and writing SQL Queries for the retrieval of the data.

Environment: Rational Requisite Pro, HTML, Java Script, Rational Rose, UML, SQL 2005/2008, PL/SQL, MS Office Suite, MS Project, MS SharePoint, Windows 2005/2007, Crystal Reports, MS Visio 2007/2010.

Confidential, Deerfield, IL

Business Analyst/ Quality analyst

Responsibilities:

• Assisted Sr. Business Analyst in developing business models.
• Gathered requirements and analyzed them to convert into functional requirements.
• Conducted JAD sessions to elicit business and system requirements.
• Conducted Gap analysis and documented inconsistencies between the product enhancements.
• Created use cases to demonstrate business requirements to IT development team.
• Designed workflow model, prototype model, Collaboration and Sequence Diagrams, Context and Data flow Diagrams and UI Specs.
• Strong knowledge of HIPAA 4010A rules to store the transactions. Monitored all the HIPAA transactions through the gateway.
• Tested the system and applications for compliance with the HIPAA, HL7 and EDI.
• Verified the privacy issues and compliance with the HIPAA Security and Privacy Act.
• Created class diagrams and participated in formal requirements review sessions.
• Analyzed requirements to ensure that the established acceptance criteria for requirements are met.
• Developed test scenarios and participated in system, regression and user acceptance testing.
• Managed requirements and identified inconsistencies with project plans and work products.
• Developed the project using web based technology. Worked to provide billing system enhancements.
• Worked with the front end team while storing the patient’s information into the database using Facets software.
• Worked with Facets software for maintaining data about the enrolment, billing and health care claims management and to store, send, receive HIPPA transactions and facilitate the administration of HIPAA privacy rights.
• Interacted with the SME’s to gather information about the health care enrolment, billing and health care claims processing and checked if they are processed correctly or not.
• Experience of working with EDI transactions such as 837, 270, 271, 276 and 835 transactions.
• Monitored all the HIPAA transactions through the gateway.
• Worked closely with technical team to ensure testability of requirements.
• Examined, analyzed and modeled Test plans Use Case Model cases & Test procedures based on RUP methodology.
• Used Rational Rose to visually determine the proper structure, key elements and optimal design for database.

Environment: HTML, XML, MS Visio, MS Excel, MS SQL, Rational Requisite Pro, UML, Rational Unified Process, SQL.

Confidential, Pleasanton, CA

Jr. Business Analyst/ Quality Analyst

Responsibilities:

• Conducted user interviews, gathered Requirements, analyzed the Requirements and managed change requirements by implementing change management methodology
• Documented and delivered Functional Specification Document to the project team.
• Understand and articulate business requirements from user interviews and then convert requirements into technical specifications.
• Identified and documented issues, risk and gaps, their descriptions, their impact and provided recommendation and alternatives to develop the application to meet the user requirements
• Worked in a team to develop use cases for their newly added application layout. I understood all the business processes related to newly added layout and designed use cases that helped Application developers to build application.
• Interacting with the developers on resolving the reported bugs and various technical issues
• Involved in UAT to confirm that the system under test meets the user needs and provides confidence in its use
• Reports were the main driver for cross-functional team meetings that were held twice a day to direct priorities and resources
• Performed verification tests to make sure the data integrity
• Used excel to perform pivot table to make sure the data was easily presented and actionable for the executive team
• Worked cross functionally with developers, QA and project managers to make sure each the data could address their needs

Environment: Rational Test Manager, Data Stage, Rational Requisite Pro, Rational Clear Case, Clear Quest, Rose, SQL Server, UNIX, Oracle 8i, PL/SQL, MS Word, MS PowerPoint, MS Access, MS Visio, MS Excel.