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Senior Business System Analyst Resume

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Tampa, FL

SUMMARY

  • Over 8 years of professional experience as a Business Analysis wif hands on experience in Requirement Gathering & Analysis and complete understanding of Project Cycle Management (SDLC) in Healthcare/Insurance domain.
  • Expertise in Waterfall and Scrum Agile methodologies, business process redesign, interacting wif business, understanding user requirements and articulating them into User Requirements Specifications.
  • Extensive experience leading and facilitating Joint application development (JAD) sessions among stakeholders, SME’s and technical team to gather high level requirements, creating project plans, schedules and managing changes.
  • Excellent Business writing skills in creating Business requirement document (BRD), Use case specifications, Functional specifications and System requirements specifications (SRS), Requirement traceability matrix (RTM) and Change request documents.
  • Expertise in designing business models, Use cases, Activity diagrams, Process flow diagrams and Unified modeling language (UML) using MS Visio and Rational rose.
  • Excellent knowledge of User acceptance testing (UAT), Smoke testing, Regression testing Performance testing and Functional testing.
  • Expertise in MS Project, Excel, Word, PowerPoint, Visio, clear quest, HPQC, JIRA, MS SharePoint and requisite - pro.
  • Experience writing SQL queries in Oracle, MySQL server databases.
  • Strong knowledge of Data Modeling, Data Warehousing and Data Mapping.
  • Strong knowledge of OLTP/OLAP System, E-R modeling and schemas like Star schema and Snowflake schema used in relational, dimensional and multidimensional data modeling.
  • Strong knowledge of HL7, HIX (Health Insurance Exchange), EMR/EHR, Plan Management, eligibility and enrollment process application.
  • Knowledge of Explanation of Benefits (EOB) and Explanation of Payments (EOP).
  • Extensive knowledge of Healthcare Insurance, Medicaid Information Technology (MITA), Medicare (Part A, B, C, D), Procedural and Diagnostic codes, Claims process and Medicaid management information systems (MMIS).
  • Experienced in provider and payer systems, including Electronic medical records (EMR) and revenue including Medicare and Medicaid projects.
  • Experience working wif HIPAA ANSI X12 4010A 270/271, 276/277, 834, 835, 837 for institutional, professional and commercial claims, and up-gradation of ANSI 4010 to ANSI 5010.
  • Excellent understanding of ICD 9, ICD 10, HCPCS and CPT.
  • Managed complex business initiatives to balance requirements for functionality, efficiency and quality.
  • Strong project management skills and breaking down complex issues identify solutions and communicate these to teh development and management teams.

TECHNICAL SKILLS

ff Packages: MS Office, MS Visio, MS Project

MS Office Tools: MS Word, Outlook, Excel, Access, and PowerPoint, MS SharePoint

Tools: Share point, Rally, Clear case, Clear Quest, Rational Rose, Requisite Pro, HP Quality Center, Java Script, SQL, HTML Desktop, OLTP/OLAP, ETL Process, E-R Model.

Database: Oracle 10g-11g, MySQL, MS Access.

Operating Systems: Linux, HP UNIX, Windows and MAC.

Methodologies: Agile, SCRUM, Rational Unified Process (RUP), Waterfall Model.

Business Documentation Skills: BRD, FRD, User Stories, Use Case Specifications, Functional and Non-functional Specification, System Requirement Specification, UML Diagrams Use case, Class and Sequence, Traceability Matrix, Project Estimate, System and Acceptance, Test Plan Review.

PROFESSIONAL EXPERIENCE:

Confidential, Tampa, FL

Senior Business System Analyst

Responsibilities:

  • Worked as client dedicated Business Analyst, responsible for gathering requirements from client ( Confidential Inc.) and documented Business requirement document (BRD).
  • Facilitated JAD sessions wif both internal and client teams to get a better understanding of On & OFF Exchange business processes.
  • Conducted sessions wif development and technical teams to document solution/functional requirements.
  • Attended Daily scrum calls, Sprint planning and review sessions in order to achieve efficient work progress.
  • Developed and maintained Market movement matrix, reporting members/policies.
  • Generated ad-hoc SQL queries to fetch data from main Database to develop and analyze reports of migrating members.
  • Designed and developed Activity Diagrams, Sequence Diagrams, Use Cases and other Process Flow Models using Visio.
  • Worked as production and testing support, performing daily testing validation of 834 files to analyze and understand teh impacts of migration.
  • Actively interacted wif other corporate departments, including executive, legal and recon and regulatory.
  • Participated in developing test plan, test scripts, and test scenarios and designed user documentation.
  • Managed change requests from business users and web developers and conducted sessions to resolve conflicts.

Environment: Scrum and Waterfall Methodologies, Quality Center, MS Visio, MS Excel, UNIX & SQL Database Server, Web gateway tool, Macros requirement template, EDI notepad, Win.scp.

Confidential, Neptune, NJ

Lead Business Analyst

Responsibilities:

  • Involved in defining scope of teh project along wif vision statement using Agile and Waterfall Methodologies.
  • Worked as a primary liaison between teh business, SME’s and teh technical areas throughout teh project cycle.
  • Performed Gap Analysis to check teh compatibility of teh existing system infrastructure wif teh new business requirements.
  • Facilitated JAD sessions wif stakeholders and SMEs to gather requirements, create teh Business Requirement Document (BRD) and teh Functional Requirement Document (FRD).
  • Attended Daily scrum calls, Sprint planning and review sessions in order to achieve efficient work progress.
  • Conducted one-on-one sessions wif business users to gather data warehouse requirements.
  • Developed normalized Logical and Physical database models as well as worked on use cases diagrams for Data mapping and Data marts.
  • Wrote teh requirements for ETL mapping.
  • Organized and conducted meetings, briefings, demonstrations, and JAD sessions.
  • Worked wif Database Administrators, Business Analysts and Content Developers to conduct design reviews and validate teh developed models.
  • Created data models and data flow diagrams for teh to-be process.
  • Working wif developer, mainframe and backend system support team to understand existing and future implementations.
  • Involved in identifying Functional and Non-Functional requirements and created teh functional system design document (FSD).
  • Conducted User Acceptance Testing (UAT) and verified performance, reliability and fault tolerance issues.
  • Generated ad-hoc SQL queries using joins, database connections and transformation rules to fetch data from legacy DB2 and SQL Server database systems
  • Interacted wif teh developers and defined teh needs to update teh design of teh Graphical User Interface.
  • Actively interacted wif other corporate departments, including executive, legal and information services.

Environment: Scrum and Waterfall Methodologies, Rally software, Quality Center, MS Visio, MS Excel, OMS Oracle, UNIX & SQL Database Server, Rational Rose.

Confidential, Stony Brook, NY

Sr. Business Analyst

Responsibilities:

  • Followed waterfall and agile methodologies.
  • Involved in all phases of SDLC from requirement gathering, designing, and development/testing.
  • Facilitated JAD sessions wif stakeholders and SMEs to get a better understanding of HIX business processes.
  • Interacted wif client and teh Technical Team for requirement gathering and translation of Business Requirement to Technical specifications.
  • Gathered requirements to document teh Business requirement document (BRD), Functional requirement document (FRD) and also created business processes, business flows.
  • Designed and developed Activity Diagrams, Sequence Diagrams, Use Cases and other Process Flow Models using Visio and Rational Rose.
  • Execute business process maps for Affordable Care Act system implementation.
  • Managed teh Change management process to document change controls, justifications for teh changes, impact analysis and approvals.
  • Developed, maintained and published project plan & scheduled project deliverables using Clarity resource database as well as MS Project.
  • Extensively involved in teh modeling and development of Reporting Data Warehousing System.
  • Research, Review and update clients and Independent Verification and Validation edits for approval.
  • Formulate Test strategies, Test plans and test data and execute test scripts.
  • Create User Manualsfor teh HIX System for Training and Communications Team Design notices.
  • Maintain accurate documentation in all internal systems and their integration pointsand define technical solutions.
  • Environment: Scrum and Waterfall Methodologies, Rally software, Quality Center, MS Visio, MS Excel, OMS Oracle, SQL, Java, Oracle, Load Runner, MS Project, MS Office, Rational Requisite Pro, Rational Rose, Clear Quest.

Confidential, Philadelphia, PA

Business System Analyst

Responsibilities:

  • Involved in defining scope of teh project along wif vision statement using Agile and Waterfall Methodologies.
  • Performed teh GAP analysis, to understand teh gap between teh 4010 and 5010 conversions.
  • Worked as a primary liaison between teh business line, operations, and teh technical areas throughout teh project cycle.
  • Created Business requirement document (BRD), Functional requirement document (FRD), User stories and Product backlog.
  • Attended daily scrum meetings and sprint planning sessions to determine documentation requirements and deadlines.
  • Responsible for doing teh gap analysis for teh interfacing system.
  • Involved in 835,837 files validations at Claim level, Line level, Service level and Transaction level
  • Coordinated updates wif client's staff and implement efficiencies in documentation maintenance.
  • Worked wif ANSI X12 5010 as well as 4010 including medical transactions such as 837 (medical claims), 835 (medical claim payments), 270/271(enquiry and response) and 820 (enrollment.)
  • Extracted and maintainedSASdata sets from teh raw data created by teh data management group.
  • FacilitatedICD9-ICD10conversion requirement gathering session and created high level Business Required Document.
  • Extensively used SQL queries and procedures for data validation in both source system and target system.
  • Involved inforward mappingfromICD 9toICD 10andbackward mappingfromICD 10-ICD 9throughGEM.
  • Created Use Cases diagrams, Data Flow diagramsandUser Interface design diagrams.
  • Participated in developing test plan, test scripts, and test scenarios and designed user documentation.
  • ConductedUser Acceptance Testing (UAT)and verified performance, reliability and fault tolerance issues Participated in weekly status meetings to present status and incorporate any digressions from teh original scope.
  • Analyzed teh“As is”and“To be”system documents to show teh current and proposed functionalities of teh system using MS Visio.

Environment: Scrum and Waterfall Methodologies, Rally software, HPQC, MS Visio, MS Excel, OMS Oracle, UNIX & SQL Database Server, Rational Rose, JIRA.

Confidential, Oklahoma City, OK

Business Systems Analyst

Responsibilities:

  • Used SDLC (System Development Life Cycle) methodologies like teh Agile and Waterfall.
  • Gathered requirements from stakeholders for provider management and member management.
  • Developed teh stakeholder list and created stakeholder assessment matrix to prioritize them.
  • Conducted Risk analysis and developed mitigation plans.
  • Developed Gap Assessment and Impact Analysis Roadmap, Implementation Advanced Planning Document (IAPD) and developed teh action steps to fill teh gaps for teh HIPAA compliance.
  • Facilitated JAD sessions for Requirement Validation wif Dept. Of Health & Human Services (DHHS) to gather requirements for teh newMMIS.
  • Conducted interviews sessions wif SME’s and different divisions of state dept.
  • Gathered all documents divided into different areas Policies, state plans, Manuals, Business Process, Systems and Interface.
  • Developed documentation processes and supported project groups wif creation Visio diagrams, spreadsheets, and other documentation.
  • Performed detailed analysis for teh following functional areas that is going to be impacted by ICD-10 codes.
  • Used detailed knowledge of teh application features and functionality to assess teh scope of thebusinessneeds throughout teh analysis and completion of enhancement specification.
  • Conducted Business Process (As Is/To Be) sessions wif various department directors and staff to ensure teh Testing Plan and Test Approach would meet teh identified Business Requirements, and teh Training Program covered all identified new and changed processes.
  • Proposed strategies to implement HIPAA 4010 in teh newMMISsystem and eventually move to HIPAA 5010.
  • Facilitate HIPAA integration and applied ANSI ASC X12 standards for 837 (I, P, D), 270/271, 276/277, 278, and 835 and 837 transactions.
  • Created and maintain requirement traceability matrix (RTM).
  • Analyzed different data crosswalks, complicated logic and lookups required by different fields for teh source to target transformations.
  • Involved in designing and developing Data Models and Data Marts that support teh Business Intelligence Data Warehouse.
  • Analyzed EDI X12 data elements captured by teh existing system to validate it against teh data elements required for new system.
  • Worked wif legacy team in developing BRD for multiple system change requests and participated in system testing.

Environment: Scrum and Waterfall Methodologies, Rally software, JIRA, MS Visio, MS Excel, OMS Oracle, UNIX & SQL Database Server, Rational Rose

Confidential, NJ

Business Analyst

Responsibilities:

  • Involved in planning of development work using Agile Software Development.
  • GatheredBusinessrequirements from teh stakeholders, SME’s and documented teh requirements in theBRD.
  • Developed FRD (Functional requirement Document) for data architecture and communicated wif teh SME’s.
  • Designed Mapping document, which is a guideline to ETL Coding.
  • Created artifacts such as Use Cases, Activity Diagrams, Swim lanes Diagrams and Sequence Diagrams using UML/Visio.
  • Created Use case and Activity diagrams using MS Visio to give web developers a better idea of teh application design.
  • Managed change requests from business users and web developers and conducted JAD sessions to resolve conflicts between keys users and web developers.
  • Created several stored procedures for data profiling purposes to get a good understanding of duplications and anomalies already exist in teh source databases.
  • Created roles and file groups to authorize customers to access certain resources of database.
  • Generated reports weekly and monthly to an online management interface using SRS.
  • Created UAT testing status reports to present to upper management.

Environment: Scrum and Waterfall Methodologies, Rally software, JIRA, MS Visio, MS Excel, Oracle database, UNIX & SQL Database Server, Rational Rose.

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