SUMMARY

• Having 8+ years of experience as a Senior Data Analyst and working with the technical staff to implement business requirements into the software application in Healthcare and Health Insurance Industry.
• Strong knowledge of Software Development Life Cycle (SDLC - Feasibility Requirements Analysis, Design, Construction, Testing, Implementation, Support) and Rational Unified Process (RUP) and UML methodology.
• Experience in the Development, Implementation of Database, BI Analytics and Data Profiling, Data Extraction, Data Transformation, Data Loading, Data Visualization using Tableau, SSRS technologies.
• Excellent knowledge of Health Insurance Portability & Accountability Act (HIPAA) standards, Medicaid and Medicare regulations, Health Care Reform (HCR), Electronic Medical Record (EMR) and Electronic Health Record (EHR) and Medicaid Management Information Systems (MMIS).
• Proficient in design and development of various dashboards, reports utilizingTableau Visualizationslikebar graphs,scatter plots,pie-charts,geographic visualizationand other making use ofactions,otherlocal and global filtersaccording to the end user requirement.
• Extensive experience in Strategic development of a Data Warehouse and in Performing Data Analysis and Data Mapping from an Operational Data Store to an Enterprise Data Warehouse (EDW).
• Extensive hands-on and HealthCare management experience in a variety of projects involving the customization, design, development, implementation, and testing of automated systems to support the Medical Management Information System (MMIS) as well as day-to-day business operations.
• Expert in Agile/SCRUM methodologies, specifically rapid prototyping and in CMS XLC (expedited Life Cycle) Agile currently used at DHS.
• Knowledge on Hadoop ecosystem components like: Pig, Hive, Sqoop, Flume, Oozie, Cloudera Manager, Flume.
• Experience in deploying Hadoop cluster on public and private cloud environments like: Amazon AWS, Rackspace and Open stack.
• Working knowledge of Amazon Web Services (AWS) and Cloud Data Management.
• Hand on Cloud computing using Microsoft Azure with various BI Technologies.
• Experience in deployed Hadoop cluster on public and private cloud environments like: Amazon AWS, Rackspace and Open stack.
• Experience working with HIPAA ANSI X12 4010A 270/271, 276/277, 834, 835, 837 for institutional, professional, dental and commercial claims, and up-gradation of ANSI 4010 to ANSI 5010.
• Knowledge on HL7 standards (v 2.5 through 2.7), HIPAA (Health information portability and accountability act), ICD-10 - International Statistical Classification of Diseases and Related Health Problems.
• Experienced in Facets Implementation, involved end to end testing of Facets Billing, Claim Processing and Subscriber/Member module.
• Experience in designing and developing Data Warehouse applications using ETL and Business Intelligence tools like Informatica Power Center, DataStage, Mainframes SAS, SSAS, SSIS, SSRS, OLTP, OLAP, IBM DB2 Business Objects.
• Experience in designing and developing SQL statements and queries for Oracle Sybase and SQL Server 2000 database.
• Experience with TriZettoFacetsSystem Implementation Claims and Benefits configuration set-up testing, Inbound/Outbound Interfaces and Extensions, Load and extraction programs involving HIPAA 837 and proprietary format files and Report’s development.
• Expertise inTeradata,Oracle,SQL Server,Informatica, SSIS, SSRS, SSAS, UNIX,Toad,Microsoft Office Suite.
• Experience in configuration of claims adjudication systems Facets and QNXT.
• Posses' strong knowledge ofdatabase managementin writing complexSQLqueries,Stored procedures,database tuning, query optimizationandresolving key performance issues.
• Worked on different EDI healthcare transactions like 837-Institutional, 837-Professional, 837-Dental, 835-Claim Payment/Remittance Advise, 270/271-Eligibility Benefit Inquiry/Response, 276/277-Claim Status Inquiry/Response Transactions.
• Working knowledge in the ETL (Extract, Transform and Load) of data into a data warehouse/date mart and Business Intelligence (BI) tools like Business Objects Modules (Reporter, Supervisor, Designer, and Web Intelligence).
• Knowledge of healthcare standard Health Level Seven (HL7).
• Excellent Knowledge in Electronic Medical Record (EMR) / Electronic Health Records (EHR) modules and process flow and also Good Knowledge of various HL7 EMR systems.
• Proficient in developing and executing Test Plans, SQL and PL/SQL queries, performing functional, usability testing and ensuring that the software meets the system requirements.
• Expertise in Logical Modeling, Physical Modeling, Dimensional Modeling, Star and Snow-Flake schema.
• Experience in conducting Joint Application Development (JAD) sessions with end-users, expert team, development and QA team for project meetings, walkthroughs and customer interviews.
• Collaborate with multiple business and technical stakeholders to identify, propose, and deliver new and enhanced designs and process changes that align with business strategies and priorities.

PROFESSIONAL EXPERIENCE

Confidential - Long Beach, CA

Sr. Data Analyst

Responsibilities:

• Involved in extensive Data validation by writing several complex SQL queries and involved in back-end testing and worked with data quality issues.
• Collaborated with PCE Systems a provider of Electronic Health Record (EHR), to ensure claims and health data accuracy for reporting purposes.
• Worked with the business product owners and Data Architects to understand new functionality of EMR.
• Extensively used Data stage Enterprise Edition (Parallel Extender) to develop various jobs to extract, cleanse and load the data and involved in migration from DS to versions.
• Work with SSIS to load individual table and work with SSRS to generate reports.
• Stayed focused onInnovation projectsand involved in creating scripts inpythonto connect and download files from team sites and uploading excel data to Teradata using python and presented onGitHubefficiency (upload, download, move, rename, remove files etc. And continuing learnings onAWSandMachine learningspecialization.
• Used Data stage Director to schedule, monitor, cleanup resources and run job with several invocation ID’s.
• Performed extensive task which include Data Quality Analysis, Data lineage and Data Standardization data structures, data base design, data warehouses, business intelligence/analytic tools, SQL, ETL tools, and data integration methods.
• Collaborated with QA Performance Team members and developing script using JMeter and running test in the Blaze Meter Cloud platform and sharing results.
• Involved in Performance Testing Tools like HP Load Runner, LoadUI Pro, JMeter, Blaze Meter and DevTest in Cloud, Azure, Amazon/AWS Cloud Environments.
• Prepare high level analysis reports with Excel and Tableau.
• Worked on data extraction through queries in SQL Server 2008, Excel, SAS, Tableau report or PDF.
• Assisted in monitoring ancillary data transactions and addressed problems with HL7 messages.
• Worked on Hospital billing application analyst with experiences in all aspects of Epic EMR billing system.
• Involved In building the Dimensions, cubes with star schema using SQL Server Analysis Services (SSAS).
• Used Facets Analytics for fast and easy retrieval, display and grouping of information for performing queries and generating reports.
• Involved in the different phases of Analytics using Python and Jupiter notebook.
• Created Tableau scorecards, dashboards using stack bars, bar graphs, scattered plots, geographical maps, heat maps, bullet charts, Gantt charts demonstrating key information for decision making.
• Worked with Facets, Facets are extended enterprise of TriZetto’s solution to assist payer organizations in staying ahead of trends in the employer benefits market.
• Worked with HIPAA compliant ANSI X12 837 formats for both professional claims and institutional claims.
• Worked with interfaced practice and EHR systems, uploaded reports directly to systems.
• Support and Maintenance for current HL7 users. Supported HL7 errors and messages provision.
• Having knowledge in using HL7 and XML in designing and documenting interface requirements.
• Worked closely with Development team on ETL process, data infrastructure, data modeling, business intelligence reporting and dashboards.
• Prepared dashboards using calculated fields, parameters, calculations, groups, sets and hierarchies in Tableau.
• Expertise in broad range of technologies, including business process tools such as Confidential Project, Primavera, Promodel, MS Excel, MS Access, MS Visio, technical assessment tools, Data Warehousing concepts and web design and development.
• Responsible for Data mapping testing by writing complex SQL Queries using WINSQL.
• Configured SSIS packages to in corporate slowly changing dimensions for tracking historical data.
• Expert in TSQL, creating and using Stored Procedures, Views, User Defined Functions, implementing Business Intelligence solutions using SQL Server.
• Used SharePoint web application platform for content management, document management file management, business intelligence and process integration.
• Extensively used SQL procedures in SAS for creating SAS datasets and generating reports using them when Teradata was offline for maintenance.
• Scheduled reports for daily, weekly, monthly reports for executives, Business analyst and customer representatives for various categories and regions based on business needs using SQL Server Reporting services (SSRS).
• Worked with Waterfall methodology during the beginning of the project then transitioned to agile methodology.

Confidential - Houston, TX

Data Analyst

Responsibilities:

• Involved in the development of test cases based on functional requirements for Institutional and Professional claims for EDI and HIPAA Transactions 837/835, 834, 276/277, 270/271 testing.
• Created EDI documents for EDI maps to generate requirement documents and Project Charter, and logical design documents for EDI transactions and code sets.
• Worked with DBAs to design and implement Conceptual data model, Physical Data Model, SSIS mappings and workflows to meet business requirements.
• Conducted testing to confirm that HL7 messages from each application conform to the appropriate HL7 interface specification.
• Carried Data visualization and analysis on Data sources provided using Qlik view and accessed reports generated through Qlik sense cloud.
• Worked exclusively on Reconcile Reports to match the data in both systems (In EPIC and Invision systems).
• Updated and manipulated content and files by using python scripts.
• Maintained and troubleshot daily HL7 error logs by manually editing HL7 records when required.
• Worked on complete Performance Testing by creating Virtual users and analyzing the reports in LoadRunner.
• Create User scripts and inserted Transactions and Think Time within the Virtual User Script to emulate heavy user load on the server.
• Understood logical data models and physical data models using ER-Studio and EMR Salesforce.
• Created and executed SQL queries to fetch data and compare expected results with those obtained.
• Create scripts using LoadRunner HTTP/HTML web services, Oracle & GUI protocols, and executed scripts using Virtual User.
• Experience in creating various views in Tableau (Tree maps, Heat Maps, Scatter plot).
• Wrote Test cases for Enterprise Data Warehousing (EDW) Tables and Data Mart Staging Tables.
• Worked in the core Facets modules such as Plan/Benefits, Membership, Provider, Claims, Billing, Customer Service and Utilization Management.
• Used Python to extract weekly information from XML files.
• Created demos in Tableau Desktop and published onto Tableau Server.
• Involved in deploying the Tableau Dashboards and worksheets in clustered environment.
• Documented a whole process of working with Tableau Desktop and evaluating Business Requirements.
• Involved in utilizing SSIS for ETL data modeling, data migration, and analysis
• Involved in designing Data Mart and Data Warehouse using Star and Snowflake Schemas.
• Experienced in full life cycle MDM development including data analysis, database design, data mapping and data load in batch.
• Conducted Functional Testing, Joint Functional Testing and UAT, documented and reported user feedbacks to management team.
• Used Informatica power center for (ETL) extraction, transformation and loading datafrom heterogeneous source systems.
• Involved in creating the executed Functionality and Regression Testing on IBM Curam web application.
• Backend testing of the DB by writing PL/SQL queries to test the integrity of the application.
• Used Quality Center/Test Director for requirement management, test planning, scheduling, executing test cases, managing and tracking defects.
• Involved in creating and maintained user stories in JIRA for better understanding of the requirements for the development team. Also use JIRA for bug tracking.
• Automation of test scripts was done using QTP for test re-usability of different online transaction modules.

Confidential - Austin, TX

Data Analyst

Responsibilities:

• Worked on development, implementation, administration and support of ETL processes for large-scale Data Warehouses using SSIS and DTS.
• Created Star schema dimension modeling for the data mart using Visio and created dimension and fact tables based on the business requirement.
• Migrated data from different sources (text-based files, Excel spreadsheets, and Access) to SQL Server databases using SQL Server Integration Services (SSIS).
• Participated in Facets Table data modeling; planning, designing, implementation of the data warehouse and conducted testing by developing complex SQL queries.
• Created Tableau scorecards, dashboards using stack bars, bar graphs, scattered plots, geographical maps, heat maps, bullet charts, Gantt charts demonstrating key information for decision making.
• Provided support throughout the EHR implementation life cycle post Go-Live support.
• Involved in ProcessingQNXT837 Healthcare Claims (Institutional and Professional) in PORTAL with valid TPI.
• Responsible for executing Epic workflow / flow sheet analysis, system setup and configuring Epic ambulatory and inpatient templates according to the specialty clinic patient order sets.
• Testing of Epic billing reports (hospital billing and insurance billing) for Epic billing output and interface accuracy.
• Utilized Agile/ SCRUM and PMI methodologies to monitor steer and develop project objectives.
• Responsible for executing User Interface Testing, System Testing, Data Quality Testing on the configuration design and prototypes.
• Informed provider when diagnostic studies are completed, prepare for review, and document in EMR.
• Served as a liaison between the internal and external business community (Claims, Billing, Membership,Capitation, Customer service, membership management, provider management, advanced Healthcare management, provider agreement management) and the project team.
• Conducted user interviews and documented business and functional requirements. Assisted quality assurance team to functional-test the new HL7 interfaces always keeping in mind HL7 and HIPAA guidelines, and coordinated user acceptance testing using derived test data.
• Highly provide hands-on Database, DataModeling, DataWarehousing, ETL expertise and mentoring.
• Involved in developing Enhanced Electronic claims processing screens and programs for online editing and Claim entry in CICS, working with a developer.
• Involved in mapping data from different EDI files onto database using different routing transformations.
• Involved in testing QNXT Member, Provider, Claims Processing, and Utilization Management, Contracts, and Benefits modules.
• Assisted JAD sessions to identify the business flows and determine whether any current or proposed systems are impacted by the EDI X12 Transaction, Code set and Identifier aspects of HIPAA.
• Execute timely completion of quarterly reviews and annualSOXaudits by cooperating with external auditors
• CreatedProcess Flowdiagrams, use case diagrams (UML) using MS-Visio.
• Managing overall testing process and project to production change management life cycle and participated in preparation of root cause analysis (RCA) documents.
• Preparing System Test Cases from functional and technical requirement and Use case documents and performing System Testing. Data mapping, logical data modeling, created class diagrams and ER diagrams and used SQL queries to filter data.
• Involved in creating business processes and modeling diagrams using Rational Unified Process (RUP).
• Extensive involved in Conducting Market Research, Feasibility Studies, Data Analyses, System Analyses, Gap Analyses, and Risks Analyses.
• Created Source to target data mapping documents identifying key data elements and prepared Data Flow Diagrams
• Highly involved in data reporting, exchange, and archival, data conversion functionalities, validation programs, keyword resources, related products, services, and information.

Confidential - Los Angeles, CA

Data Analyst

Responsibilities:

• Responsible for writing Functional Requirement Specifications (FRS) and User Requirement Specification (URS).
• Understand the As Is system and develop the To Be system concept and prepare the System Process Maps.
• HIPAA EDI transactions such as 835, 837 (P, D, I) 276, 277, 278.
• Successfully conducted JAD sessions, which helped synchronize the different stakeholders on their objectives and helped the developers to have a clear-cut picture of the project.
• Conducted presentations of the Q/A test results with analysis to the stakeholders and users and documented modifications and requirements.
• Responsible for integrating with Facets. Designing test scripts for testing of Claims in Development, Integration and production environment.
• Documented a whole process of working with Tableau Desktop and evaluating Business Requirements.
• Worked closely with the ETL SSIS Developers to explain the complex DataTransformation using Logic.
• Was responsible for sales and marketing specializing in practice management, managed care systems, thin-client technology, Electronic Media Records EMR/HER and full integration tools.
• Involved in testing the HL7 File formats received from different Vendors & validated the parsing and Data Loader (BizTalk, SSIS Process) functioning using SQL Statements in the backend.
• Responsible for designing data model to create star schema model contains Fact tables and dimension tables.
• Expertise in Claims, Subscriber/Member, Plan/Product, Claims, Provider, Commissions and Billing Modules of Facets.
• Been a part of Architecture and modeling team and have used SOA (Service Oriented Architecture).
• Participated in all phases of the Facets Extended Enterprise (TM) administrative system implementation including the planning, designing/building/validation (DBV), testing, and Go-live support phases.
• Assigned tasks among development team monitored and tracked progress of project following Agile methodology.
• Involved in the Process Flow diagrams, Use Case Diagrams, Class Diagrams and Interaction Diagrams using Microsoft Visio and Rational Rose.
• Wrote Test Cases and performed User Acceptance Testing (UAT), documented the in-detail defects using the Defect Tracking report.
• Involved using ETL tool Informatica to populate the database,datatransformation from the old database to the new database using Oracle.
• Identified patientsthroughEMRwho were due for screenings and provided data extracts to better treat and assess them.
• Created Use cases, activity report, logical components and deployment views to extract business process flows and workflows involved in the project. Carried out defect tracking using Clear Quest
• Maintained proper communication with the developers ensuring that the modifications and requirements were addressed and monitored these revisions.
• Involved in compatibility testing with other software programs, hardware, Operating systems and network environments.

Confidential - Irvine, CA

Data Analyst

Responsibilities:

• Involved in developing the SQL queries and tables which replicated the ETL and compared the SQL results with the Informatica tables.
• Worked on HIPPA 5010 security and compliance, HL7.
• Created source table definitions in the DataStage Repository by studying the data sources.
• Worked on EDI transactions: 270, 271, 834, 835, and 837 (P.I.D) to identify keydataset elements for designated record set. Interacted with Claims, Payments and Enrollment hence analyzing and documenting related business processes.
• Performed the Gap Analysis to find the existing gap between the HIPAA 4010 to HIPAA 5010 EDI.
• Worked on solving the errors of EDI 834 load to Facets through MMS.
• Actively involved in testing new/upgraded features like new Visualizations, Forecasting, Data Blending, Parallelized Dashboard, Hyperlink Objects, Color-coded tabs etc. in Tableau 8 desktop/Server.
• Participated in the hash tables used for referential integrity and/or otherwise while transforming the data representing valid information.
• Involved in performing the GUI, Integration, white box, middle ware and web service testing.
• Enabled Proper selection of the hash table design parameters for faster table look-up.
• Wrote PL/SQL statement and stored procedures in Oracle for extracting as well as writing data.
• Worked with ETL teams and used Informatica Designer, Workflow Manager and Repository Manager to create source and target definition, design mappings, create repositories.
• Involved in preparing the documentation of Data Acquisition and Interface System Design.