PROFESSIONAL SUMMARY:

• Business Analyst with over 7 years of relevant experience in Information Technology with focus on Business Analysis, Business Modeling, Requirement Gathering, Gap Analysis, Technical Documentation and Software Validation, along with successful, progressive experience in all phases of the iterative Software Development Life Cycle (SDLC).
• Excellent experience in the domains of Healthcare and Insurance.
• Full understanding of the SDLC: requirement analysis and business specification, development, enhancement, quality assurance, testing including developing Test Cases and Test Scripts using automated testing tools and implementation
• Good experience in HIPAA laws and Guidelines related to electronic data transfer system and health Insurances business, (Fundamentals of health Insurances, Insurance operations, Insurance Contracts, Loss Exposure and Risk Management).
• Experience in HIPAA standards transactions and data migration from 4010 to 5010.
• Good knowledge in Analysis of Bug Severity, Bug Tracking system and Bug Reporting.
• Experience in creating Work Breakdown Structures (WBS), Project Schedules and Project Time - lines.
• Extensive experience in using tools such as Rational Requisite Pro, Rational Requirements Composer for Gathering and putting the requirements.
• Strong experience in project management tools like MS-Project for status reporting and project planning.
• Experience with claims processing.
• Experience in customer / client interaction, deep understanding of business systems functionality and technicality.
• Experience in maintaining Test Matrix and Traceability Matrix
• Good experience in performing GAP Analysis and recommended the remediation of the issue findings
• Experience in working with QA teams during all phases of testing and actively involved with UAT.
• Highly analytical in developing the methods and measures to meet requirements and solve any issues that arise during the project.
• Excellent in dealing with external vendors, clients and offshore teams.
• Wide-ranging experience in using methodologies such as UML (Unified Modeling Language), Agile, RUP (Rational Unified Process) & Waterfall using rational tools and Microsoft Suite.
• Solid business and presentation skills and can perform well both independently and in a team. Expert at handling multiple projects simultaneously.
• Demonstrated initiative, drive, and ability to manage multiple priorities throughout academic and professional term.

TECHNICAL SKILLS:

Project Methodologies: Rational Unified Process, OOAD, UML, SDLC.

UML Modeling Tools: Rational Rose, Microsoft Visio, Visual Paradigm.

Project & Requirement Management Tools: Rational Requisite PRO, Microsoft Project, Traceability Matrix.

RDBMS: MS SQL Server, Oracle, MS Access

Languages: C, C++, Visual Basics 6.0 and SQL.

Scripting Languages: HTML, Java Script

Defect Management Tools: Test Director, Rational Clear Quest PRO

Documentation Tools: MS Office, MS Visio Pro.

Concepts: Programming, Networking, Data-warehousing, Business Intelligence.

Operating Systems: Windows 7, Vista, XP, 2003, 2000, 98, 95, MS DOS, Unix.

PROFESSIONAL EXPERIENCE:

Confidential, Erie, PA

Business Analyst.

Responsibilities:

• Handled the development of business requirement documents (BRD) resulting from JAD sessions.
• Reviewed scope on project artifacts such as Process Flow Documents (PFD), Entity Relationship Diagrams (ERD), workflow diagram, test plans and policy and procedure manuals.
• Responsible for preparing the Software Requirement Specifications (SRS) document, creation of Process Work Flows and Functional Specifications.
• Extensively used data flow diagrams for modeling the business processes and their interrelations, with respect to data flows.
• Developed system specifications as needed to support reporting, policy and claims systems.
• Analyzed business needs/requirements, incorporating regulatory changes, ratings, re-engineering processes.
• Provided up-to-the-minute market/sales/claims data for decision-making.
• Used the guidelines and artifacts of the Rational Unified Process (RUP) to release multiple iterations of the deliverable over the span of the project lifecycle; Setup milestones at transition from one phase to another.
• Conducted architecture review board at such milestones.
• Used rational rose to document Use Cases according to latest UML standards.
• Extensive use of Rational Requisite Pro for reviewing and analyzing requirement.
• Created test plans and executed them. Recorded the results of such tests in test description and results document.
• Conducted regular meetings with developers and clients.
• Responsible for implementation of Rational Clear Case for defect and open issues tracking tool.
• Developed User Acceptance Test Cases and completed User Acceptance Testing.
• Created transition plan to help the organization transition the system from developing state to production state.
• Ensured quality of system changes through the development and execution of system test plans, built, and executed test plans.
• Communicated directly with Clients to understand their business needs and to resolve business issues.

Environment: RUP, Rational Requisite Pro, Rational Clear Case, Rational Clear Quest, Rational Test Manager.

Confidential, Colorado Springs, CO

Business Analyst.

Responsibilities:

• Participated in gathering User Requirements, developing functional and technical specifications and creating Project Definition and Scope (PDS) document.
• Analyzed, Documented and managed all Project Requirements with RUP Methodologies.
• Partnered with the Project Manager, Project Sponsors and Business users to scope out the project objectives and determine impact and timeline of various deliverables.
• Worked on developing requirements through active co-ordination and JAD sessions and developed use case scenarios and diagrams.
• Gathered and analyzed Reporting requirements and formulated Business Rules for Net Premiums, Investment Income and other financial parameters for the Property & Casualty Personal Line Business as part of the Data Warehouse Initiative with Business Objects as the front end reporting tool.
• Defined Acceptance Criteria and collaborated with the team to define staggered defect criticality levels.
• Actively worked with the Business Users in the UAT phase by helping them build test scenarios and resolving any anomalies in the results of the reporting elements.
• Recommended a reporting solution in the Oracle Data Warehouse that would minimize the impact on the system from evolving business needs.
• Documented Business processes and data flow using Process Flow and Data Flow diagrams in Microsoft Visio.
• Facilitated sessions and meeting with project team, developers, analysts, and support team. Interacted extensively with the client to successfully and swiftly identify and resolve problems, and integrate system enhancements.
• Created management decision support models and reports (SQL Queries) that derived information from the system to help make funding decisions.
• Developed test cases and coordinated system testing (beta and regression testing) with working group committee.
• Prepared reports and presentations for weekly management meeting to update PM on project deliverables, progression and timelines.

Environment: RUP, MS-Visio, Test Director, UNIX, Windows XP, Java, HTML, and Oracle.

Confidential, Nashville, TN

Business Analyst.

Responsibilities:

• Gathered requirements for the different products and did the gap analysis for the products.
• Constantly interacted with the Product Director at Emdeon for the enhancements and discussion on the changes.
• Interacted with one of their important Client, provider Yale for the usability and current challenges that are faced from usability point of view.
• Documented all the changes for the enhancements and recommended changes.
• Involved in enhancements of HIPAA 4010 to HIPAA 5010 eligibility and verification transactions, involved in Automation of Secondary claims.
• Worked on the Institutional and Professional Claims, Design of the real time transaction.
• Created screen mockups and wireframes for prototype for the front-end application of the different products.
• Analyzed the current state and recommended changes for the future state of the products.
• Created Test Cases, Test Strategy, and Test Plan and interacted on constant basis with the testing team.
• Documented the Screen inventory of the products and analyzed the best go forward approach for the products.
• Worked on RPT 10 reports, Provider Claim Status reports which Emdeon had lots of concern from the clients as lots of paper is being utilized and it was getting expensive for the providers.
• Analyzed and recommended changes for the password reset, which is going to be implemented in the future, currently clients have to call the Emdeon Help desk for password reset and there is no online facility.
• Documented the current state of the Denial Manager, which gives clients the Electronic Remittance Notice (ERA) and also created Visio Diagrams for the application.
• Involved in working on the EDI Transactions 835, 837 and Request Response, 270, 271 HIPAA upgrade from 4010A to 5010.
• Created the mapping documents for the membership enrollment.
• Conducted result analysis and interacted with developers to resolve bugs.
• Participated in the project meetings.

Environment: Rational Clearquest, MS Word, HIPAA, Excel, PowerPoint, Toad, .Net, Visio, Quality Centre, Oracle.

Confidential, NJ

Business Analyst.

Responsibilities:

• Involved in Gathering and documenting the business requirements from user groups and vendors.
• Worked with Project Manager and business users to gather, analyze and document the functional requirements for the project.
• Responsible for Healthcare Claims Processing (837/835/834), Resource Management & Utilization Management.
• Worked on EDI tools like 837,835,270,271,276 and 277.
• Involved in HIPAA Validation of Healthcare Claims.
• Thoroughly involved in Claims for Billing and Payment.
• Responsible for 834 Claims for Benefits Enrollment.
• Worked on Balancing and Claim Overpayment Recovery.
• Managed requirements and communicating with user groups and team members using MS-Visio.
• Utilized UML diagrams such as activity and use case diagram to document the requirements and ensured creation of high level business requirements documentation.
• Used Ultra Edit to capture Errors in the EDI file.
• Involved in Regression Testing.
• Developed Test Plans, Test Cases to test the Screens and workflows for Quality Assurance.
• Involved in Meetings and walkthroughs on daily basis to ensure the delivery of quality Product.
• Participated in meetings to make sure that application is responding as per the business logic.
• Met with the developers and technical content writers on a daily basis to update the test documents.
• Follow up with developers on defects status on a regular basis.
• Extracted the business requirements (BRS) from the end users keeping in mind their need for the application, and documenting it for the developers.
• Involved in Integrating system functionality for multiple components for achieving the ability to send and receive currency/ cash via various EFT (electronic funds transfer) systems.
• Designed and developed all Use Cases and UML models using Microsoft Visio.
• Implemented the entire Rational Unified Process (RUP) methodology of application development with its various workflows, artifacts and activities.
• Designed and developed project document templates based on SDLC methodology.
• Designed and implemented basic SQL queries for QA testing and report / data validation.
• Maintained and kept track of stakeholder’s requests for enhancements and changes using Unified Change Management tool (UCM) such as Rational ClearQuest.
• Played a key role in the planning, testing, and implementation of system enhancements and conversions using ClearCase.
• Partnered with the technical areas in the research and resolution of system and User Acceptance Testing (UAT).

Environment: MS Office, MS Access, Rational ClearQuest, MS Visio, Rational Rose, Test Director.

Confidential

Business Analyst

Responsibilities:

• Acted as a liaison between the technical and management group.
• Conducted user interviews, gathered requirements, analyzed and documented business requirements.
• Used MS Project to develop Gantt chart and used them to develop project schedule, allocate resources and make cost estimates.
• Prioritized the requirements gathered from business users, domain experts through interviews and JAD sessions.
• Identified the deliverables at the end of the inception and elaboration phase of the Rational Unified Process (RUP) life cycle in terms of business modeling and requirements analysis.
• Used MS Visio to create Business use case diagrams.
• Involved in translating the business requirements to technical requirements for development team.
• Performed Feasibility, Adaptability and Risk Analysis to identify the business critical and high-risk areas of the application.
• Used Test Director to store, schedule, execute and track test cases and reporting.
• Prepared detailed reports of the Bugs, Pass-Fail report, Comparison Chart.
• Assisted in User Acceptance Testing.
• Interacted with the developers to report and correct bugs.

Environment: Rational Suite, MS project, SQL, Oracle, Test Director, MS Office, Windows 2000/NT.