SUMMARY

• 7+ years of diversified experience as a Business System Analyst & A Scrum Master Health Care and Bank/Finance domain with in - depth knowledge in Expert in all phases of Requirement Management, including gathering, analyzing, tracking requirements.
• Worked closely with project managers, SMEs, and staff to understand and brief the requirements and specifications for new applications along with re-engineering the existing applications.
• In-depth knowledge of Software Development Life Cycle process which includes Waterfall and Spiral methodologies and expertise in Rational Unified Process methodology (RUP), Agile, and Six Sigma methodologies.
• Expertise in requirement gathering using various techniques such as JAD sessions, walk-throughs, and grooming sessions.
• Experience in testing Business Intelligence reports generated by various BI Tools like Cognos and Business Objects.
• Experience designing and developing SQL statements and queries for Oracle, Sybase and SQL Server 2000 database.
• Experience in writing SQL queries and optimizing the queries in Sybase, Oracle and SQL Server 2000.
• Responsible for EDI strategies (EDI 835, 837, … 278) enabling Health Care Providers and Insurance Careers to communicate effectively.
• Used ETL tool for Extraction, Transformation and Loading the data into the target database.
• Advanced the data analysis and reporting skills using Tableau
• Extensive knowledge of Object Oriented Analysis and Design (OOAD) using UML and Rational Unified Process (RUP).
• Experience in writing use cases and creating detailed use case documents.
• Expertise in working on Change Requests and Enhancements through constant prioritization.
• Experience administering a production MFT software application with industry best practices on IBM Sterling B2B Integrator and Sterling File gateway on Windows
• Conducted data analysis using SQL and Excel to create reports in Tableau.
• Experiences in end to end testing of Facets Billing, Claim Processing and Subscriber/Member module
• Experienced in writing and preparing business requirements documents (BRDs), system requirements specifications (SRS), system design specification (SDS), functional specifications, defining project plan and change requests.
• Excellent knowledge in validating and testing of Client/Server and Web-Based Applications in various environments.
• Extensively used Global Scape server, IBM Sterling solution, FileZilla, Putty, FTP Schedulers, PGP etc.
• Extensive experience in customization and configuration of FACETS,
• Worked on Claims, Customer services, Members, Billing-Enrolment interfaces and extensions for FACETS as a part of a FACETS implementation team.
• Experience with health care Systems: Facets, Medicare Part A, B, C, D, Medicaid systems
• Assisted with JAD sessions, Gap analysis, and prioritized requirements using interviews, document analysis, and requirements workshops.
• Strong understanding of test plans, test cases, test scripts and defects tracking/reporting.
• Experienced in various Healthcare areas like Enrollment, Benefits, Claims, Medicare, and implementation of HIPAA key EDI (ANSI X12) transactions.
• Thorough understanding and hands-on working experience with standards for medical transactions like 820 (premium payments), 834 (enrollment), 835 (medical claims payments), 837 (medical claims), 270 (eligibility inquiry), 271 (eligibility response), 276 (claim status), and 277 (claim status response).

TECHNICAL SKILLS

Methodologies: Waterfall Methodology, Agile Methodology, RUP Rational Unified Process

Version Control: Rational Clear case, Visual Source Safe

Change Management: Rational Requisite Pro, Clear Quest, Test Director

Testing Tools: Rational Enterprise Suite, Test director, Win Runner

RDBMS and Databases: MS Access, SQL server, Oracle 9i, Sybase

Operating Systems: Windows Family, Familiar with UNIX and LINUX

Office Tools: MS Office, Word, Excel, PowerPoint, Visio, Outlook.

OLAP Tools: Tableau, SAP BO, SSAS, Business Objects, Crystal Reports 9.

ETL Tools: SSIS, Informatica, Power Center 6.0/7.1/8.1.1 , Power Mart 6.0

PROFESSIONAL EXPERIENCE

Confidential - St. Louis, MO

Business Systems Analyst

Responsibilities:

• Work closely with stakeholders to gather business and functional requirements.
• Prioritize requirements throughout multiple builds as per feature priority.
• Write Use Cases to cover multiple business scenarios, while incorporating proper flows were needed.
• Member of Core Business Applications and Integration, reviews business requirements and creates system technical specification documentation, including system flows, use cases for one or more complex applications or modules independently or with the team of system analysts.
• Provided user requirements analysis. Documented requirements using various tools, including Requisite Pro as directed.
• Use of Sterling Integrator Map Editor for both: gets a flat file layout and after data extraction translate input to EDI
• Developed SQL queries to perform the back-end testing on Microsoft SQL server.
• Experience in coding using SQL, PL/SQL, SQL plus, stored procedures, functions, triggers, packages and UNIX shell scripting
• Install, configure and manage new upgrades on the MFT application servers.
• Develop and document procedures for managed file transfer systems - initialization, disaster recovery, engagement.
• Worked on the Sterling interface for order capture, payment processing, order processing and fulfillment of orders.
• Created ETL documentation such as EDI X12 837 (P,I), 834 and 835 Data Mapping, Transformation logic to Main Frame Layout, Updating Meta data documents for new Platform.
• Enhanced the Medicaid encounter (837) and enrollment (834) companion guides, enhanced requirements, co- authored test plan, and developed test data via SQL and manual editing (ETL)
• Performed validation of X-12 270, 271, 835 and 837 Professional and Institutional format files according to EDIFECS engine.
• Used IBM Sterling File Gateway is an application for transferring files.
• Created 834 X12 formats using EDIFECS Specbuilder
• Perform Analysis, Design, Development and Implementation of X12 EDI maps by using Ramp Manager Application (an EDIFECS Program).
• Reviewed the data model and reporting requirements for Cognos Reports with the Data warehouse/ETL and Reporting team.
• Optimizing and tuning the Redshift environment, enabling queries to perform up to 100x faster for Tableau and SAS Visual Analytics.
• Reviewed all MFT documentation and processes.
• Performed Data Analysis using visualization tools such as Tableau, Spotfire, and SharePoint to provide insights into the data.
• Streamlined Claims (837 EDI X12) Migration project by gathering functional specifications in EDIFECS.
• Executed EDIFECS validations for verifying the bill and claim file structure.
• Used Spec Builder to check SNIP levels of X12 files for various EDI transactions
• Create Gap Analysis Document to determine ‘As-is’ and ‘To-be’ Business process for Medicare Health Risk Assessment Survey.
• Extensively used ReqPro for requirements. Documented all the changes in the initial templates.
• Include Business rules in System Use case document to identify claims, membership, Billing etc.
• Possesses and applies a broad range of expertise of principles, practices and procedures of business functions to the completion of complex assignments.
• Implements changes to horizontal integrated software solutions and build new solutions.
• Worked on FACETS Data tables and created audit reports using queries. Manually loaded data in FACETS and have good knowledge of FACETS business rules.
• Analyzed the mainframe reports for member/eligibility/claims and mapped the fields with FACETS batch jobs and report.
• Development and implementation experience in EDI ANSI X12, HIPAA, EDIFACT, Sterling’s Gentran Server on UNIX, Gentran Integration Suite (GIS), Sterling Integrator (SI), Sterling File Gateway & Mercator applications.
• Performed Defect Tracking and Change Control Procedures using Rational Clear Quest and Configuration Management and Version Control using Rational Clear Case.
• Lead process flow mapping work group of current and future state for encounter and RAPS data capture and submission to Medicare and Medicaid.
• Hands-on knowledge of integrating various systems within an organization (CRM, ERP, PIM) by utilizing APIs , ETL , and Managed File Transfer (MFT) best practices.
• Responsible for Root Cause Analysis for claims, encounters still outstanding, identified various trends in data or processing issues, and routed to the appropriate team for resolution.
• Responsible for working with the State to review and modify process flows to increase productivity and effectively utilize FACETS features not provided by the legacy systems.
• Maintains and develops documentation as part of defect resolution and change management
• Performs peer review of design documentation
• Analyzed the mainframe reports for member/eligibility/claims and mapped the fields with FACETS batch jobs and reports.
• Implement & integrate FTPs Protocol with Sterling Integrator & Sterling File Gateway
• Created and Redesigned new, existing reporting solution using IBM Cognos Frame Work Manager and IBM Cognos Report Studio to improve the performance of the reports.
• Generated clear business, technical, operational and user requirements using Rational Requisite Pro and System Design Specifications.
• Gathered requirements with different teams to meet the goal of MFT Initiative
• Gathered requirements and utilized user stories in Mobile Marketing, Mobile website development, and content
• Constantly interacted with various teams ensure clear understanding of requirements updates for mobile applications.
• Created specification document highlighting the major differences and similarities across IOS, Android, and Windows mobile platforms
• Researched ideas to identify the most sought-after functionalities for mobile application.

Environment: Agile Scrum-Waterfall, HIPAA, HP ALM, Teradata, MS SharePoint, MS Visio, MS Project, MS SQL Server, HTML, XML, SOAP UI, Tableau, MS Office, UAT, Windows.

Confidential - Jefferson City, MO

Business Systems Analyst

Responsibilities:

• Performed a project analysis on new projects, including requirements, personnel, and costs.
• Developed and maintained a work plan for system projects.
• Involved in the execution of the project life cycle, including requirements gathering, design, testing, implementation and documentation, as required.
• Portrayed strong visual modeling and business process modeling skills in Rational Unified Process (RUP) and Agile Modeling with tools like Rational Rose, MS Visio.
• Provided reports and other documentation on projects to client and internal staffs, as needed.
• Worked with team leaders and supervisors to ensure project and organizational deadlines are met.
• Coordinated updates with the client's staff and implement efficiencies in documentation maintenance.
• Organized and conducted extensive JAD sessions with users to identify and understand the requirements.
• Performed gap analysis for the interfacing system.
• Documented the Business Requirements Document (BRD) and the Functional Specification Document (FSD).
• Coordinated with the different teams distributed at different geographic locations for various releases.
• Identified Actors, Activities, Artifacts and Workflows and developed use case diagrams using Rational Rose.
• Prepared Use Cases, prepared use case diagrams (using Rational Rose) and followed Rational Unified Process at every stage of the process.
• Resolved/tracked production issues with Reports in Cognos and Mainframe.
• Facilitated requirements gathering activities, including meeting with users to discuss System Task Requests (STRs), Enhancements, and Project Assessment Quotations (PAQs) requirements.
• Documented issues and resolutions, and wrote specific requirements for system changes.

Environment: Agile Scrum-Waterfall, HIPAA, HP ALM, Teradata, MS SharePoint, MS Visio, MS Project, MS SQL Server, HTML, XML, SOAP UI, Tableau, MS Office, UAT, Windows.

Confidential - Jersey City, NJ

Business Systems Analyst

Responsibilities:

• Elicited business requirements through interviews, document analysis, design workshops, surveys, use cases, and workflow analysis.
• Utilized the Agile Scrum methodology to analyze the requirements to create stories
• Conducted daily SCRUM meetings during the Sprint Development as a part of Agile Methodology. Also captured and addressed concerns from IT to Product Management or Business Team, as needed Identified and implemented processes for developing and documenting detailed business requirements.
• Performed Requirements Gathering and Analysis, interacted with the SME (Subject Matter Experts), and ensured that contributors and all key stakeholders were motivated to complete assigned tasks.
• Performed in depth analysis of data & prepared weekly, biweekly and monthly reports by using MS Excel, MS Access and SQL.
• Performed System, Functional, Integration and User acceptance (UAT) testing
• Prepared Business Workflow models that covered business processes. Prepared Workflow diagrams to analyze “AS IS” and “TO BE” scenarios and designed a new process flows.
• Created use cases, User Interface documents and functional/requirements specification documents to document business needs.
• Used Tableau as a data visualization tool to communicate information clearly and efficiently via statistical graphics and to create executive dashboards, weekly/monthly reports on the status of key business measurements.
• Successfully performed all phases of the Solution Development Life Cycle to create new solutions in On Base
• Successfully created a Human Resources recruiting, onboarding and employee record solution in On Base, significantly increasing processing time over the previous method.
• Interface with department level and business unit management teams to understand business requirements of existing and prospective customers.
• Analyze current business processes and deliver well documented solution recommendations for efficiency gains within the department or business unit.
• Experience in developing mapping documents Use Cases, BRD (Business Requirement Document), FRD (Functional Requirement Document), UAT Test cases and test data.
• Teach end users to utilize the ECRM products within customer's business processes.
• Participate in project reviews and other actives within the Technical Services organization that allow all project team members to understand the requirements for a proposed solution.
• Performed Defect Tracking and Change Control Procedures using Rational Clear Quest and Configuration Management and Version Control using Rational Clear Case.
• Participated in preparing templates and guidelines to be used by the project team with detailed screen layouts with regards to various types of corporate actions.

Environment: Agile Scrum-Waterfall, HIPAA, HP ALM, Teradata, MS SharePoint, MS Visio, MS Project, MS SQL Server, HTML, XML, SOAP UI, Tableau, MS Office, UAT, Windows.

Confidential

Financial Analyst Intern

Responsibilities:

• Interacted with other Jr. Financial analysts to prepare data for financial statements and analyzed sales revenue, cost, expense and tax rates for all business units.
• Engaged in the preparation of the department monthly Financials, quarterly forecasts and annual budgets.
• Prepared customer reporting about the individual accounts.
• Assisted with year-end audit, including the preparation of schedules required by senior auditors.
• Consolidated and reconciled financial statements.
• Assisted in budgeting and forecasting by analyzing the existing framework and operations in IB (Investment banking).