PROFESSIONAL SUMMARY

• With 7+ years of extensive IT experience in all aspects of Business Analysis, Business Modeling, Requirements gathering, Technical Documentation and all phases of Software Development Life Cycle (SDLC) and a firm
• Understanding of OLTP, OLAP, Data Modeling Experience using Star Schema and Snowflake Schema models, ‘SQL and code and hands on experience in using CASE tools in gathering, analyzing and documenting all business requirements.
• Extensive experience in gathering, managing and documenting business requirements, communicate TEMPeffectively with Project Managers, SME's, Technical Leads and Business Users.
• Comprehensive noledge of SDLC methodologies including AGILE methodologies and traditional methodologies like WATERFALL.
• Adept at creating and transforming business requirements into system requirements/business rules and designing business models using UML diagrams - Context, Use Case, Sequence and Activity diagrams in MS Visio, Rational Rose and Lucid Charts.
• Exposed to Medicare and Medicaid domains of teh healthcare systems and industry for inpatients, outpatients, Reimbursement Methodology and Medicaid Management Information System MMIS.
• Knowledge and Experience on Membership, Billing, Claims Payment Processing in relation to HIPAA, EDI 4010, 5010 X12, ICD-9 ICD-10, codes 834, … and 270, 271.
• Strong noledge and understanding of ICD-9/ICD-10 and implement FacetsClaims Processing system.
• Expert in business process engineering including analysis, design, development, testing and implementation of innovative software applications, Data Warehousing Systems, Data Marts as well as re-engineering existing applications.
• Proficient in conducting GAP Analysis, SWOT Analysis and coordinating Impact Analysis.
• Experience in writing TEMPeffective Test Cases and Requirement Traceability Matrix (RTM) to ensure adequate software testing.
• Strong Knowledge and experience of EDI transactions, HIPAA, ASC X12 Transaction sets: 834 (Benefit Enrolment and Maintenance), 835 (Claim Payment/Advice, 837 (Claims and Encounters), 820 (Payroll Deducted and Other Group Premium Payment for Insurance Products) 270/271 (Explanation of Benefits (EOB) /Response to EOB), 276/277 (Claim Status/Claim Status Response).
• Extensive noledge and working experience with SQL Server, Oracle SQL scripts.
• Extensive experience working with ETL tools such as Informatica Power Center 9.0/10.0 and varied source systems-Salesforce, Relational Systems and Flat Files.
• Exposure and noledge to Data Warehousing Reporting tools such as MicroStrategy, Business Objects (X1 version R1/R2) using Desktop Intelligence.
• Experience working with on-shore, offshore, on-site and off-site individuals and teams.
• Strong understanding of Software Testing Techniques especially those performed or supervised by Analysts including Black Box Testing, Regression Testing and UAT.
• Excellent communication, analytical, interpersonal and presentation skills and expert in managing multiple projects simultaneously.
• Experience working with Production support teams for resolutions to daily batch applications.

PROFESSIONAL EXPERIENCE:

Confidential, Wilmington, MA

Business/Systems Analyst

Roles and Responsibilities:

• Develop business process models for projects and demonstrations using business process model notation and enterprise architecture models for teh MDM systems.
• Worked extensively with developing business rules enabling teh business users and data stewards with accessing teh MDM system with other applications such as SAP, Salesforce and Decision Centre Reporting Systems.
• Analyzed and Validated teh existing documents and upgraded teh documentation to reflect all teh processes to acquire acquisitions.
• Performed GAP analysis of teh versions of teh Informatic MDM in QA verses Prod.
• Worked with Business users in upgrading attributes to MDM systems and teh impact analysis of teh same in teh underlying base objects Oracle database.
• Coordinated with teh offshore development team via Agile team meetings for all progress and communicated with teh stakeholders.
• Creating documentation such as BRDs and FSDs (Business and Functional design specs) with elaborate Use Cases and process flows.
• As scrum master communicated dependencies and potential risk to teh completion of teh sprints including resources, costs and systems.
• Created data mappings to transform teh data according to business rules.
• Prepared various diagrams by using MS Visio.
• Worked closely with QA and Developers to clarify/understand functionality, resolve issues and provided feedback to nail down teh bugs.
• Conducted project related Presentations periodically to teh management and end users during various phases of Software Development Life Cycle SDLC.
• Communicated across teams to propose integrations of teh MDM systems with SAP and Salesforce and estimated timelines using MS Project Gantt Chart.
• Wrote user acceptance testing (UAT) scripts and led testing/ quality assurance teams.
• Facilitated all Aspects of scrum framework, including product backlog, release backlog, sprint planning session, daily scrum meeting, sprint reviews and sprint retrospectives.
• Possess high-level understanding of JIRA admin activities like creation of user, sprints, epic, bulk upload, confluence content creation and data movement across screens etc.
• Worked extensively on Gap analysis, Root Cause Analysis and Impact analysis of issues to requirements to meet teh gap and redesign of teh user interface.
• Involved in mentoring specific projects in application of teh new SDLC based on teh Agile Unified Process, especially from teh project management, requirements and architecture perspectives.
• Worked on many Change Requests, Action Items, Process Flow Diagrams (UML), Pain Points, and Use Cases.
• Primary liaison between teh development team and teh business owner to understand and implement teh amendment and modification required through change request or work request.

Environment: Oracle, Informatica MDM (Master Data Management) ETL Tool, Informatica Data Directory (IDD), SalesForce, SAP, JIRA, Confluence, MS Visio, MS Project, MS Excel.

Confidential, Boston, MA

Sr. Business Analyst

Roles and Responsibilities:

• Worked with teh Business users to understand teh existing model built in Access database by conducting a series of informal and formal discussions to understand core aspects of business including purpose, process, target customers, sources, operational processes and policies.
• Involved in Requirement gathering by interacting with teh business users through interviews, prototyping and conducting elaborate observations of teh existing Access database and understanding teh disadvantages teh users were listing.
• Worked on all teh documentation process including Project vision Document, Requirement Management Plan, Business Requirement Document, Requirement traceability matrix (RTM), Functional requirement specification (FRS)/ Functional Specification Document (FSD) and System requirement specification (SRS)/ System Requirement Document (SRD).
• As part of teh BRD and FRD documents ETL design solutions and development process were proposed to achieve processing all teh vendor data received as flat files, part of which involved developing staging tables, ODS tables, DIM and FACT tables using inhouse ETL Informatica tool.
• Responsible for creating teh RTM document that included teh ETL design, development end to end for delivery for teh International Commercial Warehouse within specified timelines.
• Leading teh development team by creating/reviewing high level technical design documents and maintaining teh progress of teh project in MS Project by creating Grant Charts.
• Responsible for all migration, FTP user access, SFTP process, Production Support activities and working across teams to provide status of progress of projects
• Responsible for documenting teh process of integrating teh International DWH with Oracle Hyperion using inbuilt event driven/file driven trigger logic mechanisms to extract source data.
• Implemented teh SDLC for teh developing life cycle and followed teh standards process in teh application.
• Followed Standard Operating and Compliance Procedures that are SOX compliant.
• Managed off shore teams for Production Support to ensure successful nightly batch cycle runs daily.
• Responsible for all FRD for Salesforce application, Data warehouse requirements and on-going enhancements to teh US-Commercial warehouse.
• Worked closely with teh Informatica admin team on Data Warehouse Production support by interacting with Technical leads and Project Leads.
• Designed/Developed data warehouse level Audits/Controls documentations for reconciling between source and target systems and to satisfy SAS standards.
• Worked closely with teh DBA team for identifying /determining storage requirements and addressing data retention strategy protocols
• Collaborated with teh PMO team and implemented data warehousing projects progress in both Agile and Waterfall implementation methodologies which also included exposure to JIRA tool /Issue monitoring systems and maintaining documentation in Confluence Project collaboration platforms.
• Responsible for creating Use Case documentations, Test Case Scenario documentation, Visio diagrams, Physical and Conceptual diagrams to represent teh STAR schema model.
• Coordinated teh UAT (User Acceptance Testing) with teh business users and stake holders to validate teh generated reports from MicroStrategy Reporting tool.
• Worked across teams such as teh QA teams and Production Support team for all maintenance work for teh ICDW.
• Experience working with CRM systems like Veeva for Data Mapping and Data Profiling requirements for specific business users.

Environment: Oracle, SQL Server, Informatica ETL tool, CRM Systems, Agile and Waterfall Methodologies, JIRA, Confluence, ER Diagrams Concepts, UAT, Production Support and Maintenance, MS Visio, MS Word, MS Excel.

Confidential, Boston, MA

Business Analyst

Roles and Responsibilities:

• Worked on developing BRD and FRD for teh Customer Segmentation Cutover Process, part of which involves teh description of all associated ETL code, update of associated SQL views in teh DataMart tables.
• Worked on teh SLA (Service Level Agreement) Development Project-For all Data Warehouse subject areas below teh DW operations team is responsible to send a notice to teh distribution lists if teh data delivery expectations are not met and this required detailed requirement documentation after discussions with teh business users.
• Coordinated with teh stakeholders and project key personnel to gather functional and non-functional requirements during JAD sessions.
• Created BRD, FRD/FSD and SSD for implementation of functional areas for teh Model Execution Process Project which involved many updates and enhancements proposed by teh business which need to be validated at teh DW phase, teh QA phase and finally teh Reporting phase for teh scheduled reports to be delivered to teh business team.
• Delivered business requirement documents, functional specification documents, Use Cases, test plans, and requirement traceability matrices.
• Understood teh product to be built, gathered requirement and created BRD/FRD documents.
• Part of multiple implementation plans involving DW implementations, BI team implementations.
• Participated in an Agile BI/DW team setting, as a Core team member, participated in teh daily scrum meetings for reporting updates on onsite work as well as teh offshore development team.
• Participated on-call support to teh Data Warehouse nightly batch monitoring.
• Worked on Production Support issues such as validation of SQL query, data-type mismatches, checking for database connectively, and Stored Procedure connectivity, dropping indexes in independent session and re-creating them in different sessions.
• Worked with multiple source systems DB2, SQL Server, Oracle databases.
• Developed mappings by implementing teh High-Level Design Document, was involved in discussions in preparing teh Low-Level Design Document and analysed corporate business processes to develop customized solutions.
• Testing was done extensively with comprehensive test cases and scenarios to validate teh data in teh DW tables and documented all teh test cases with teh QA team.
• Extensively worked with SQL for testing with teh users in generating reports.
• Working with travel operational management groups to monitor, trend and report on operational metrics such as timeliness, workload, and staff trending, customer satisfaction, and other key measures to facilitate performance excellence.
• Ensured teh accuracy and consistency of teh data during teh data loading process.
• Developed Use case, Functional, Object diagrams using Rational Rose.
• Was involved in managing teh Daily Stand-up meetings and ensured that quality standards were enforced as per teh build-release schedule.
• Developed a detailed test plan and test cases to cover all teh requirements.
• Used rational Rose to create UML diagrams such as use case, activity, sequence, class and component diagrams.
• Developed Flowchart and process diagram using Microsoft Visio.
• Analysed data architecture, documented and delivered data mapping, performed risk analysis.
• Frequently communicated with developers to resolve technical issues.
• Preparing Database documents of thebusinessfunctions for teh development team to use teh mapped data sources from multiple tables for development.
• Doing impact analysis of certainbusinessfunctions which would effect otherbusinessfunctions and make teh teams understand teh impact for further development.

Environment: Oracle, SQL Server, Informatica ETL tool, Agile Methodologies, UML diagrams, SQL, UAT, MS Visio, MS Word, MS Excel, Rational Rose.

Confidential, Boston, MA

Business Analyst

Roles and Responsibilities:

• Interviewed SMEs and Stakeholders to get a better understanding of client business processes and gather business requirements.
• Created use case scenarios and documented work flow and business process using MS Visio.
• Gathered and documented business requirements for existing and future business systems.
• Analysed and tested various Common Eligibility Outbound Interface Process and other Inbound/ Outbound Facets interfaces.
• Acted as a liaison between business staff and technical staff to articulate needs, issues and concerns.
• Analysed current MMIS and EDI claims and documented teh requirements to implement new MMIS automated system.
• UsedFacetsAnalytics for fast and easy retrieval, display and grouping of information for performing queries and generating reports.
• Defined Functional Test Cases, documented and executed manually using quality centre.
• Analysed trading partner specifications and created EDI mapping guidelines.
• Responsible for Data Manipulation and Data Validation using SQL queries in a MS SQL Server.
• Helped with building ICD 9 to ICD 10 crosswalk map by grouping thousands of codes and ranges in Clinical, Benefits, Financial, Medical policy waves.
• Working within a growing environment of X12 4010/5010 HIPAA Transaction Processing 837 I, P, D, 835, 834, 820, 270, 271, 276, 277, 278, EDI, Privacy, Security, and Medicaid.
• Reviewed EDI companion guides for all payers to ensure compliance, edit integrity and maintain up-to-date list of payer contacts.
• Written test cases, test scenarios, and prepared test data to conduct teh manual testing of EDI files and teh mainframe screens.
• Involved in creation and execution of manual test cases in HP quality centre and automated Test Cases in QTP and analysed teh Test Results.
• Performed functional testing with teh development team as well as User Acceptance Testing and Regression Testing of teh application using Quality centre and JIRA for prioritizing defects and assigned it to teh developer to fix teh bugs.
• Worked with MS Office (MS Word, Outlook, Excel, PowerPoint, and Project) and MS Visio.
• Communicated and lead teh Business Analysis team to ensure process, definitions, metric designs, and metadata are used consistently, and that documentation is updated accurately and available for all team members.
• Lead cross-functional linked teams to address business or systems issues and resolved complex analyses.

Environment: Agile / SCRUM, MS Office Suite, MS Visio, MS access, SQL, Quality Centre, JIRA, Java Script, Project Management, QTP.

Confidential, Boston, MA

Business Analyst

Roles and Responsibilities:

• Worked extensively with developing business rules engine enabling teh business rules such as referral, prior authorization, eligibility, claims processing and billing essential.
• Manually loaded data inFACETSand has good noledge ofFacetsBusinessrules.
• Manage company's EDI catalogue for prospective EDI customers.
• Experience in ICD9-ICD10 conversion and expertise in forward and backward mapping using GHEM.
• Involved in HIPAA 5010 gap analysis of ANSI X12 4010 and ICD 10 initiatives.
• Developed understanding of various transactions involved in transition from HIPAA 4010 to HIPAA 5010 like eligibility, benefit, claim submission transactions inFacetstables.
• Analysed and validated requirement for HIPAA 5010 and gathered requirement for ICD10.
• Worked on EDI 270/271 (Claim Eligibility Inquiry), 276/277 (Claim Status Check), 837(Claim Submission), 835 (Claim Remittance) inFacetslifecycle.
• Developed mapping documents for ICD 9 to ICD 10 application.
• Performed UAT, regression testing on EDI 835 and 837 X12formats inFacets.
• Gathered teh Requirements for Medicare Systems as part of Patient Protection Affordable Care Act (ACA).
• Implement new services and programs via MMIS for teh Medicaid program by directly interfacing with teh customer and teh system engineers on a regular basis.
• Wrote user acceptance testing (UAT) scripts and led testing/ quality assurance for both HL7 ADT interface and teh application.
• Creating documentation such as BRDs and FSDs (Business and Functional design specs) with elaborate Use Cases and process flows.
• Worked on FACET claim processing system and gathered and documented functional requirements in teh Functional Requirements Document (FRD).
• Analyse and document Medicaid EDI transactions issues related to implementation of HIPAA 5010 and ensure these issues are documented and addressed in teh approach to teh HIPAA 5010 version.
• Prepared Business Requirements Documents, Functional Requirement Documents.
• Worked on analysis of FACETS claims processing system and gathered requirements to comply with HIPAA 5010 requirements.
• Conducted project related Presentations periodically to teh management and end users during various phases of Software Development Life Cycle SDLC.

Environment: FACET Claim Processing, HIPAA 5010, MMIS, EDI, GAP Analysis, ICD-9-ICD-10 Conversion, MS Office.