SUMMARY

• 9 years of experience working as a Business Systems Analyst in Healthcare and Shipping domain.
• Solid understanding of SDLC processes including requirements gathering, analysis and design, development tools and technologies, release and version control, contemporary testing methodologies and deployment management.
• Experience working with various industry standards: Waterfall, Rational Unified Process (RUP), SCRUM and AGILE Methodology.
• In - depth understanding of Project Management Practices and Principles including Time Management, Budget Management, Resource Management, Risk and Change Management.
• Experience in conducting GAP analysis, Impact analysis, SWOT analysis, Cost Benefit analysis and ROI analysis.
• Excellent analytical skills in understanding the business process functionality and translating them to Business Requirements Documents (BRD), Functional Requirements Documents (FRD), Technical Requirements Document (TRD) and System Requirements Specifications (SRS).
• Hands-on experience with process modeling using Unified Modeling Language (UML) including use case, sequence, activity, class and deployment diagrams.
• Experienced in facilitating and conducting JAD sessions, requirement workshops, focus group and user stories.
• Knowledge in RDBMS & Data warehousing, experience in design, development, testing, implementation and support of enterprise data warehouse.
• Experience in implementation of HIPAA 4010 and HIPAA 5010 changes in the existing claim processing integrated system.
• Extensive experience in Members and Claims processing including billing, Medicare/Medicaid billing and claims management.
• Proficient in ICD-9-CM and ICD -10-CM coding and claims processing.
• In-depth experience in working with Provider Data Management.
• Prepared Business Process Models that includes modeling of all the activities of the business from the conceptual to procedural level using Swim Lanes and Value Stream Mapping tools (VSM).
• Experienced in performing Business Process Reengineering to check the compatibility of the existing system infrastructure with the new business requirements by using AS-IS, TO-BE BPM’s diagrams.
• Strong knowledge of HL7, HIE (Health Insurance Exchange), EMR/EHR, Health Care Reform and Patient Protection and Affordable Care Act (PPACA).
• Extensive knowledge of Healthcare Insurance including Medicaid, Medicaid Information Technology Architecture, Medicare (Part A, B, C, D), Procedural and Diagnostic codes and Medicaid Management Information Systems (MMIS).
• Experienced with the IBM Rational tools suite like ReqPro, ClearQuest and Rational Rose.
• Experience working with Health Insurance Portability and Accountability Act (HIPAA) transaction and code set rules such as EDI healthcare transactions like 837, 835, 834, 820, 271, 275, 276, 277, 278, 997 and 999.
• Proficient in developing UAT plans, UAT cases, UAT scripts and executing UAT’s.
• Proficient in writing queries/ SQL/ MS Access to assist in UAT, data validations and data analysis.
• Good Knowledge of Test Plan, Test Scripts and Test Cases for Functional, System, Integration, and Regression Testing based on the Design Document and User Requirement Document for the Functional, Security, and Performance Testing.
• Extensive experience in using ALM tools (SharePoint 2010, SharePoint 2013, and Rational Suite).

TECHNICAL SKILLS

Business Analysis: Requirements engineering, business process modeling and improvement, gap analysis, cause and effect analysis, decision trees, data flow diagrams, data modeling, wire frames, Mockups.

Methodologies: AGILE (RUP, SCRUM, Iterative), Waterfall.

Data Analysis: Data Cleansing, Data Mapping, Data Transformations, Source Systems Analysis, Reporting Analysis, Regression Analysis.

Rational Suite: Rational Rose, RequisitePro, Clear Quest.

Business Tools: MS Excel, MS Word, MS Project, MS Access, MS Visio, MS PowerPoint, MS Outlook.

Programming: XML, SQL and UML

Web Technologies: PHP, JSP, HTML/DHTML, XML

Databases: MS SQL Server, Oracle 8i/9i/10g, MS Access, Toad 11.6

Test Tools: HPQC, Mercury Quality Control.

Healthcare knowledge: HL7, HIE, EMR, PPACA, ICD9, ICD10, HIPAA4010 & 5010, Claims Process, Providers.

PROFESSIONAL EXPERIENCE

Confidential | Chattanooga, TN

Systems Analyst

Responsibilities:

• Organized and facilitated meetings with the business, managers and development team and conducted the requirements workshop for creating and defining the Business Requirements Document (BRD) and Functional Requirements Document (FRD) on Caliber Author.
• Involved in GAP and feasibility analysis for the design and architecture of the application.
• Owned, updated and maintained an Access Tool (mapping tool) to capture the flow of data from legacy to all other databases.
• Served as a Project Manager for a team to work on the mapping requirements, updates, inserts, etc.
• Prepared presentations for the end users and provided walk-throughs of the entire process flow.
• Worked extensively with the creation of both canned and ad hoc reports on a daily, weekly and monthly basis and delivering the reports to the business.
• Used both canned and ad hoc SQL statements to generate the high volume of reports requested.
• Documented reporting processes and procedures.
• Created and maintained comprehensive workflows for the production and distribution of assigned reports.
• Established and maintained timelines for reports and projects.
• Identified and completed report enhancements and fixes.
• Assisted and supported with completion of special projects as requested by various internal departments.
• Took responsibility for and led new initiatives including ways for increasing work efficiency and level of effort assessment.
• Identified problems, planned and executed a resolution to improve processes in place.
• Managing team work load while meeting time constraints and expectations.
• Developed and implemented mapping procedures and guidelines for the team.
• Worked in developing and maintaining Reporting Mart solely for the purpose of report creation and delivery.
• Used Linux Server and Cognos in order to generate the reports.
• Formulated procedures for data extraction, transformation and integration of healthcare provider data.
• Conducted assessment to ensure data quality and completeness with validation techniques.
• Participated in critical review and revision of existing systems for updates and enhancements.
• Established and executed best practices based on methodology in the transition from the “as-is” to the “to-be”.
• Supported technical teams for development and execution of supplemental analytical tools and methods.

Environment: Waterfall/Agile Scrum, SDLC, UML, Test Director, Quality Center, MS Office Suite (Microsoft Word, Microsoft PowerPoint, Microsoft Excel), MS Project, MS Visio, MS SQL Server, Oracle, SQL, Visual Basic, MS Access Informatica, SharePoint, Linux Server, Cognos, Caliber Author.

Confidential | Princeton, NJ

Technical Business Analyst

Responsibilities:

• Worked with conversion specialists on the data conversion project to implement the project's data conversion methodology.
• Worked closely with IT, legal specialists, policy, and accounting groups, as appropriate.
• Understood conversion issues as well as practical issues faced in the implementation of the system.
• Data conversion activities, including data reconciliation, document management, data mapping, data cleansing, quality control and validation.
• Specific duties and responsibilities will include the following:
• Gathered all the business requirements and organized and pre-screened the accuracy of data, detecting errors and inconsistencies.
• Involved in the design of Data-warehouse and converted the data from various sources to oracle tables.
• Identified and resolved conversion issues with specific involvement in resolving data accuracy and quality concerns.
• Identified and entered data from various sources, and dealt appropriately with confidential and sensitive data.
• Reconciled data elements for including documents, dates, addresses, status, correspondence and accounting, and work on data mapping and cleansing to new system.
• Insured good quality control for the data conversion process.
• Converted data from multiple sources and run validation test on converted data.
• Worked with Oracle ERP systems and implementations.
• Experienced with data analysis, leading data mapping efforts within an enterprise environment.
• Developed Data Conversion Design Documents.
• Facilitated data conversion workshops.

Environment: Waterfall Methodology, Windows XP, Java, XML, Java Script, Oracle, UML, Quality Center, Show Case, SQL Query, MS Office Excel, Word, PowerPoint, MS Project, MS Visio, MS Project, MS SQL Server, Informatica, SharePoint.

Confidential | Newark, NJ

Business Systems Analyst

Responsibilities:

• Organized and facilitated meetings with the management and development team and conducted the requirements workshop for creating and defining the Business Requirements Document (BRD), Technical Requirements Document (TRD) and System Requirements Specification (SRS) using Requisite Pro.
• Supported tactical and strategic goals of the IT Production Support Team. Ensured compliance with structured Project Delivery Process.
• Conducted JAD sessions to allow different stakeholders to communicate their perspectives with each other, resolve any issues and come to an agreement quickly.
• Involved in GAP and feasibility analysis for the design and architecture of the new application.
• Created workflow diagrams and UML diagrams (use case diagram, activity diagram, sequence diagram) using MS Visio for various stakeholders.
• Created high-level Use Cases from Business Requirements.
• Prepared the report spec and created mapping to develop and generate the reports.
• Prepared Request for Proposal (RFP) documents and vendor evaluation by interviewing and simultaneous comparison of all vendors.
• Involved in Requirement Scoping and analyzing high priority requirement for implementation.
• Conducted functional requirement reviews and walkthroughs with the designers, developers, and stakeholders.
• Involved in validation for the recent changes in EDI transaction sets and ICD 10.
• Implementation of HIPAA 4010 and HIPAA 5010 changes in the existing claim processing integrated system.
• Conducted testing for labs with HL7 standards and coordinated with QA team to test the complete application as per requirements.
• Involved with the quality assurance team to develop and design test plan and test cases, tested all the features of the EMR after every upgrade of Meditech and reviewed the implementation of the changes made in the systems as per the formats and compliance for EDI usage.
• Conducted Triage calls to monitor defects using Mercury Quality Center to ensure that testing effort is synchronized with the development team.
• Responsible for Data modeling and Mapping through data analysis to extract data elements from various OLTP’s using ETL technique (Informatica Power Center 8.1) and utilized Business Intelligence Tool (Cognos) for report generation.
• Prepared Static Prototype (Wireframes) using MS Visio and Mockup Screens, and assisted UI/UX team in creating Dynamic HTML Prototypes.
• Extensively worked with SharePoint 2010 for document management and accessibility.
• Conducted workshops to understand requirements for Data Warehouse design.

Environment: AGILE SCRUM Methodology, Facets, Windows XP, Java, XML, Java Script, Oracle, Rational Requisite Pro, UML, Load Runner, Quality Center, Show Case, SQL Query, HP ALM, Java, MS Project, MS Office, DB2, MS SQL Server, Informatica, SharePoint, Cognos.

Confidential | Rochester, MN

Business Analyst

Responsibilities:

• Defined, gathered, and analyzed business requirements.
• Gathered requirements for administrative transactions with implementation in compliance with Patient Protection and Affordable Care Act (ACA).
• Understood and articulated Business Requirements from SME interviews and workshops and translate requirements into Business Requirements Specifications (BRS).
• Developed Functional Requirements Document (FRD) and use case document.
• Coordinated with the development team and translated the requirements to develop the product to comply with expected standards.
• Supported tactical and strategic goals of the IT Production Support Team and ensured compliance with Project Delivery Process.
• Identified defects using Rational Requisite Pro and assigned it to the development team.
• Conducted testing for labs with HL7 standards.
• Facilitated the testing team to test the complete application as per requirements and reviewed test scenarios and test cases for functionalities.
• Extensively worked on Excel sheets update the running job statuses to the higher Executive management.
• Extensively worked with SharePoint tool for document management and accessibility.

Environment: SCRUM, Rational Test Manager, Rational Clear Quest, Windows, MS Office: Excel, Word, PowerPoint, MS Project, MS Visio, MS Access, .Net, UML, HTML, HL7, HIPAA EDI Transactions.

Confidential

Business Systems Analyst

Responsibilities:

• Interactions with the end users in order to generate the report required and to understand the business requirements relating to Medicaid program and Pharma.
• Worked on hospital information systems and electronic medical records.
• Performed the GAP analysis for the various loop segment elements.
• Worked with DBA and data architects on implementation of database changes.
• Documented and worked on analyze process flows.
• Analyzed data flow requirements and assisted in developing a scalable architecture for staging and loading data and translated business rules and functionality requirements.
• Analyzed business requirements and implemented technical solutions and assisted with local WAN, LAN, Server, desktop and other technologies.
• Worked with QA Team and SME’s to create data mappings for the back office systems.
• Developed test plans, test scenarios and test cases to be used in testing based on business and user requirements, technical specifications.
• Involved in the requirement gathering and analysis for implementing the data warehouse.
• Interpreted logical and physical data models with data modelers to determine common data definitions and establishing the referential integrity system.

Environment: AGILE, Rational Tools, MS Office, MS Visio, UML, SQL, Oracle, HTML, Windows, UNIX, Java, Informatica.

Confidential

Business Analyst

Responsibilities:

• Gathered business requirement, defined scope and analyzed data.Worked at different stages of the Software Development Life Cycle (SDLC) with business users, developers, and stakeholders.
• Interacted with clients to gather all requirements to formulate business specifications and translate those into application functionality.
• Involvement with the project from its inception phase to transition and production rollout phase.
• Facilitated and managed JAD sessions with committee of SME’s from various business areas.
• Documented and delivered Functional Specification Document (FSD) to the project team
• Held review meetings to monitor progress of the project as per schedule, and ensured timely completion and delivery of the project to the client.
• Conducted interviews with key business users to collect requirement and business process information.
• Documented Functional Requirements for business level components, user interface, and system security.
• Defined Core Business Rules and Core Business Validations for the entire application.
• Developed business process models in RUP to document existing and future business processes.
• Wrote Use Cases, Business Flows and Work Flows Diagrams for effective plans.
• Involved in benchmarking activities to identify best practices.
• Wrote queries and developed reports for various levels of management by using SQL and Excel.
• Provided reporting to management via Excel reports of workload and work completion on daily, weekly, and monthly bases.

Environment: RUP, Oracle EBS Supply Chain, Business Intelligenceand Analytics, MS Project, MS Office, Enterprise Architect, LoadRunner, MS SQL, Rational Requisite Pro.

Confidential

Business Analyst

Responsibilities:

• Worked with business representatives to understand requirements and priorities and ensured that software development work is appropriately aligned.
• Involved in the meeting with Business Process Owners, Subject Matter Experts (SME) and Health Center users for Requirement gathering in Definition Stage.
• Facilitated Requirements Sessions, as well as weekly client & team meetings.
• Conducted JAD sessions to understand the working system impact.
• Created work scenarios and work sessions to come up to the most economical scenario of change.
• Created layout and mockup of the change to be made in form of the report.
• Worked on Impact analysis for each of the systems and their sub entities for both inbound and outbound systems.
• Created various Business Requirement Documents (BRD) and Functional Requirement Specification (FRS) for the project.
• Created Requirement Action Plan for various project deliverable.
• Created various Use Cases and workflow diagrams, using MS Visio.
• Maintained Traceability Matrix in Excel.
• Created Report Mockups and Sample Mapping documents for the Error Reporting.
• Extensively worked with SharePoint tool for document management and accessibility.

Environment: Waterfall Methodology, MS Office (MS Word, MS Excel, MS PowerPoint), SWOT Analysis, GAP Analysis, UML, Enterprise Architect, SharePoint.