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Business System Analyst/quality Assurance Tester/data Analyst Resume

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Dublin, OH

SUMMARY

  • 8+ year’s expertise in Business Analysis, Quality Assurance and Testing with hands on experience in Healthcare and Insurance Sectors.
  • Extensive experience with Medicare/Medicaid processing as well as the Claims/Billing.
  • Strong knowledge of the Software Development Life Cycle methodologies (phases and gates) like Agile and Waterfall models
  • Test Data Generation for Quality Assurance using various testing tools like EDISIM or EDIFECS, conducting JAD (Joint Application Design) sessions.
  • Knowledge of using automation tools - Win Runner, QTP, Load Runner, Quality Center and Test Director.
  • Good working knowledge of Claims processing, Excellent knowledge of HIPAA standards, EDI (Electronic data interchange) Transaction Set EDI X12 837, 270/271, 276/277, 278, 301, 322, 835, Implementation and Knowledge of HIPAA code sets, ICD-9, ICD-10 coding and HL7.
  • Experience with HIPAA 4010 and 5010 EDI healthcare transactions and transition of ICD 9 to ICD 10 codes.
  • Responsible for EDI strategies enabling Health Care Providers and Insurance Careers to communicate effectively.
  • Broad knowledge of Medicare, Medicaid, PPO, HMO, POS, diagnostic codes and claims process.
  • Well versed with HIPAA, STAR CHIP claim adjustments, claim processing from point of entry to finalizing, claim review, identifying claims processing problems, their source and providing corresponding solutions.
  • Experience with Iterative Software Development Life Cycle Process as per Rational Unified Process (RUP), involved in inception, elaboration, construction & transition phases using rational tools like Requisite Pro, Clear Case, Clear Quest during various phases of RUP.
  • Extensive experience in Business Requirements gathering and writing skills with expertise in developing and documenting Business Requirement document (BRD), Functional Requirement Document (FRD),Software Requirement Specification (SRS) across the deliverables of a project.
  • Effectively used Rational Requisite Pro to organize, track and change requirements of the system.
  • Expertise of UML in visualizing and documenting the artifacts using Use Cases, Use Case Diagrams, Activity diagrams, Class diagrams, Data Flow Diagrams, Business Flow Diagrams, Sequence Diagrams using MS Visio
  • Facilitated User Acceptance Testing (UAT) with the stakeholders and the business users as well as trained users to use the system configured.
  • Analytical, methodical and resourceful approach to problem solving, identifying root causes and corrective actions to meet short and long-term business, financial and system requirements
  • Excellent verbal/written communication skills and strong analytical abilities and can perform well both independently and as a team player
  • Consultant with proven record of over 6 years of experience in Business Analysis, Business Process Modeling, System Analysis, Requirements management using SDLC methodology, UML Modeling, Prototype design, project team management in healthcare, pharmaceutical and other domains
  • Experience in understanding and supporting both the Business and Technical teams in all Phases of Software Development Life Cycle (SDLC) by using different Methodologies like Iterative, waterfall, agile-scrum and Rational Unified Process (RUP)
  • Emphasis on requirements gathering from business stakeholders by using methods like Elicitation, conducting Interviews with users as well as Subject Matter Experts (SMEs) by asking detailed functionality aspect of business process, Requirement workshops, organizing Joint Application Development (JAD) sessions and carefully updating the information to create a Business Requirements Document (BRD).
  • Extensive experience in gathering business and functional requirements, feasibility studies, risk analysis, Gap impact analysis, creating narrative Use Cases and UML diagrams- Class diagrams, Use Case diagrams, Activity diagrams, Data flow diagrams using UML Tools like MS Visio and Rational Rose.
  • Expertise in the areas of writing Scope documents, Request for Proposal (RFP), BRD, Functional Requirements Document (FRD), incorporating use cases in creating System Requirements.
  • Employed LESat the analyst work level to aid in step enforcement for laboratory test method execution.
  • Experience in Object Oriented Design Technologies and maintain traceability of Requirements using Requirements Traceability Matrix (RTM).
  • Working with QA and testing teams in close co-ordination in developing Test Plans, building Test Conditions and Test cases, creating test data, analyzing bugs, Interacting with development team to fix the errors; Facilitated User Acceptance Testing (UAT) with client representatives.
  • Strong exposure to automated testing tools like Quick Test Professional (QTP), Rational Test Manager, Quality Center, Rational Clear Quest for Software Quality Management Purpose
  • Good working knowledge of Microsoft Office Suite including - Word, PowerPoint, Excel, Access, MS Visio, Rational Rose, Rational Requisite Pro
  • Experience in creating wireframes and mockups. Good understanding of web development process and developing prototypes of web pages using Balsamic mockups
  • Experienced of Data Warehouse Environment including Data Analysis, Data Modeling, Data Mapping, Data Integration and Data Migration using ETL tool- Informatica; Designed and Implemented Ad-hoc SQL queries to extract data from different databases for timely reporting, Data Analysis and Validation

TECHNICAL SKILLS

Business / Modeling Tools: MS Project, MS Visio, MS Excel, MS Word, MS PowerPoint, Rational Rose

Requirements Management Tools: Rational Requisite Pro

Databases: SQL Server, Sybase, MS Access, Oracle

SDLC Methodologies: Rational Unified Process (RUP), Agile Scrum, Waterfall, Iterative

Operating Systems: Windows 95/98/2k/NT/XP/Vista/Window 7

Web Technologies: Java, JSP, VB Script, VB 6.0

Testing Tools: Quality Center (QC), Quick Test Professional (QTP), Load Runner, Rational Test Manager, Rational Clear Quest

PROFESSIONAL EXPERIENCE

Confidential, Dublin, OH

Business System Analyst/Quality Assurance Tester/Data Analyst

Responsibilities:

  • Organized and facilitated JAD sessions with programs’ solution owners, stakeholders, and SMEs conducting high and low-level requirements
  • Documented requirements in the form of user stories
  • Created Activity and Swim Lane Diagrams to help the developers comprehend the workflow from end-to-end
  • Designed and developed interactive, detailed and dynamic prototypes in Axure 7.0 simulating to-be application
  • Reviewed and approved test plans, and cases for regression testing
  • Developed pseudo code, and Source to Destination table for ETL in order to help them understand the logic that goes behind integration with destination tables
  • Generated integration test cases, and conducted integration testing verifying program and billing activations and terminations in destination tables
  • Performed smoke, functional, regression, ad hoc, and integration testing; and raised defects upon encountering
  • Conducted pre-deployment workshops with solution owners helping them learn the application
  • Demonstrated the application to stakeholders in Show n Tell sessions
  • Maintained Production Defects Tracker, and Decision Log and kept it up to date on Confluence
  • Worked on MDM in researching, and analyzing data before import process and shared the duplicates, and discrepancies with the solution owners seeking learnt decision on how to handle the same
  • Provided historical data import exclusion and inclusion lists to Tech Lead before each release
  • Employed Data Mining in monitoring billings on a frequent basis before each invoicing
  • Extensively used SQL scripts/queries for data verification and Validation at the backend.
  • Provided maintenance support to business post release
  • Actively involved in the entire Software Development Life Cycle Agile Process

Environment: JIRA, Confluence, MS Visio, MS Office, UML, Windows 7, SQL Server Management Studio 2008 R2, WinSQL Professional, Issue Tracker, Axure 7.0

Confidential, Alpharetta, GA

Sr. Business System Analyst/EDI Analyst

Responsibilities:

  • Gathered requirements for creating new templates from doctors and nurses through interviews.
  • Organized and facilitated meetings with the management and development team and conducted the requirement gathering sessions with the purpose of creating and defining the Business and Functional Requirement Document (BR/FR) using Requisite Pro.
  • Used Meditech 5.6 Electronic Medical Records to create templates and documents for EMR.
  • Co-ordinate with off shore development team and resolved all the EMR related queries.
  • 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 doing data mapping and validation for the recent changes in EDI transaction sets and ICD 10.
  • Created high-level Use Cases from Business Requirements and created UML diagrams like use case diagram and activity diagram using MS Visio for various stakeholders.
  • 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.
  • 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.
  • Designing test scripts for testing of Claims in Development, Integration and production environment.
  • Designed and developed reports for data in the data warehouse using BO.
  • Facilitated the configuration of the Middle Layer using JAVA.
  • Monitored defect tracking using Mercury Quality Center to ensure that testing effort is progressing with the development team.
  • Responsible for Data modeling and Mapping and creating model documentation through data analysis by extracting data elements from various data marts using Informatica Power Center 8.1
  • Worked on MDM for removing duplicates, standardizing data, and incorporating rules to eliminate incorrect data from entering the system in order to create an authoritative source of master data.
  • Involved in GUI Design sessions with Usability Team; Browser compatibility and navigation were tested manually.
  • Tested the final application for usability testing to verify whether all user requirements were catered to, by the application.

Environment: Rational Rose and Requisite Pro, MS Visio, MS Office, MS Project, UML, XML, Windows XP, NT/2000, HTML, DB2, SQL Server 2000, JAVA, J2EE, HL7, MDM, EDIFECS, Mercury Quality Center, Informatica Power Center 8.1

Confidential, Philadelphia, PA

Sr. Business System Analyst

Responsibilities:

  • Involved in preparing the project scope and objectives.
  • Prepared business requirements documents by conducting client group interviews, focused groups, workshops and online surveys.
  • Prepared and maintained the Requirement Traceability Matrix (RTM) to record the business, functional and non-functional requirement.
  • Prepared business requirement document (BRD) and functional requirement document (FRD) to provide details of each business and functional requirement, development and implementation plan of these requirements, timelines, owners, etc.
  • Prepared the efforts and cost estimation of the project and worked towards obtaining approvals from all the stakeholders.
  • Participated in prioritize the requirements to better manage the project.
  • Performed comparative analysis and gap analysis to meet HIPAA standards.
  • Ensured that the CPT codes requirements are thoroughly understood by all the stakeholders to in corporate appropriate changes in the recording system.
  • Prepared use case diagrams and description documentation based on the analysis, and obtained approvals from the clients.
  • Prepared activity diagrams and sequence diagrams on MS Visio to better understand the flow of activities along with the timelines of each actor.
  • Used Rapid Application Development (RAD) model to in corporate all required features as per the HIPAA guidelines in the patient’s ID.
  • Conducted workshops, and acted as an Agile Coach in order to teach the team of the Agile SCRUM methodology.
  • Actively involved in the entire Software Development Life Cycle Agile/SCRUM Process.
  • Helped in the development of the Web Services using JAVA.
  • Coordinated with project stakeholders to track the progress of the project, update status and lead review meeting to ensure that schedules and deliverables are met.
  • Worked on the Data warehouse and MDM for producing the analytical data and updated to the SharePoint.
  • Coordinated and controlled change request for the clients by conducting impact and cost analysis, prioritizing and mitigating changes.
  • Prepared change request form to provide details of the changes requests, and obtained approvals from the appropriate stakeholders.
  • Prepared test plan and test cases.
  • Supported the testing team during the testing stage by conducting user acceptance testing (UAT)

Environment: Rational Rose and Requisite Pro, MS Visio, MS Office, MS Project, UML, XML, JAVA, Windows XP, NT/2000, HTML, RAD, Issue Tracker, Windows XP

Confidential, Virginia Beach, VA

Business System Analyst

Responsibilities:

  • Was involved in the planning of the RUP iterations anddocumenting of theartifacts throughout the various phases of thedevelopment process.
  • Compiled the Vision Document and composed detailed Use Case Specification Documents in Rational Requisite Pro.
  • Used UML to perform Use-Case analysis to capture the dynamic aspect of the application.
  • Interacted with stakeholders and gathered requirements as per thebusinessneeds.
  • Identified AS-IS processes of claims transactions of4010/4010A standard and TO-BE processes (ICD-10-CM and ICD-10-PCS compliance requirements) of 5010 standard using the gap analysis.
  • Tested the claims processing and Adjudication (EDI 837I, 837P, 837D& EDI 835).
  • Ensured the accuracy andconsistency of the dataduring the data loading process.
  • While working with various members at the management levelto understand thebusinessprocess and decision models, was also involved in Compilingthe Vision Documentand composingdetailed Use Case Specification Documents in Rational Requisite Pro.
  • Aided the formation of the Application Layer using JAVA.
  • Was involved in managing the Daily Standup meetings and also ensured that quality standards were enforced as per the build-release schedule.
  • Conducted GAP analysis byunderstanding the AS-IS system and the TO-BE system requirements by having discussions with the SME's.
  • Worked on MDM for removing duplicates, and including rules to disregard incorrect data from entering the system in order to create an authoritative source of master data.
  • DocumentedRequirement Traceability Matrix inRequisite Profor traceability of requirements through test cases.
  • Worked with QA Team and SME to create data mappings for the back office systems in ETL/Data warehouse.
  • Worked on the SharePoint platform to update the status of the project.
  • Developed Test Plan and Test cases based on the Use cases and Functional specifications and also performed manual testing of the functionality of the application by inserting varying data on different test runs.
  • Developed Flowchart and process diagram using Microsoft Visio.
  • Was in regularcontact withBusinesspartners on the status of issues, action plans and timeframefor resolution throughout the development cycle.
  • Contributed in reviewing and editing of the test scripts.

Environment: Rational Requisite Pro, UML, Microsoft Office (Project, Publisher, Excel, Word, PowerPoint and Visio), PHP, SQL, Issue Tracker, MDM, JAVA, Hyperion BI Applications, SDLC, Oracle 10g and VPN Client

Confidential, Swedesboro, NJ

Business System Analyst

Responsibilities:

  • Analyzed the existing explanation of benefits and understood its shortcomings.
  • Arranged JAD sessions with the employees to understand their needs.
  • Conducted detailed walkthrough of Business requirement and functional requirement.
  • Developed Project Plan around RAD (Rapid Application Development) and gap analysis.
  • Chalked out the scope, timeframe, risk analysis, cost and maintenance procedure.
  • Managed the entire functional requirements life cycle using Agile Scrum methodology; used SharePoint to share and maintain the document versions.
  • Researched and established the points of improvement in the software and the possible implementation of security standards.
  • Formulated High level designs for new process
  • Collaborated with the Middle Layer Developers in the construction of MT Layer using JAVA.
  • Microsoft Visio was used to create various documents such as Use Cases and Activity Diagrams.
  • Used Microsoft project to develop the project plan.
  • Provided analytical support in design development and implementation for Informatica.
  • Extensively used SQL scripts/queries for data verification and Validation at the backend.
  • Played the key role in planning, developing, implementing and User accepted testing and maintenance.

Environment: Rational Rose and Requisite Pro, MS Visio, MS Office, MS Project, UML, XML, Windows XP, NT/2000, HTML, DB2, SQL Server 2000, JAVA, J2EE, HL7, Agile Methodology, RAD, Informatica, MS Visio, MS Office, Windows 2000/XP

Confidential, Bloomington, IL

Business System Analyst

Responsibilities:

  • Studied the inherent systems in detail, to have a clear understanding of the business processes and associated system workflow.
  • Conducted Gap-impact analysis to understand business model and additional functionalities to be incorporated into the new application.
  • Conducted JAD sessions for better understanding and refining of requirements in coordination with multiple teams; Clarified and prioritized requirements by conducting brainstorming sessions with the stakeholders and SMEs.
  • Gathered detailed requirements from all users; documented various documents including the Business Requirements Document (BRD) using Rational Requisite Pro.
  • Identified all use case components including basic, alternate and exception flows, and created Use Case Specifications documents.
  • Tested the claims submission EDI X12 837 Transaction set, worked in processing EDI X12 270, 271, 276, 277 Transaction set.
  • Utilized Agile Scrum to configure and develop processes, standards, and procedures and to perform System analysis and organizational review of existing QA processes.
  • Worked with technical architects in modeling Web Services for Service Oriented Architecture (SOA) to integrate various regional and national healthcare services.
  • Participated in various architectural development sessions to provide technical teams with a better understanding of the requirements.
  • Analyzed Requirements and created Use Cases, Use Case Diagrams, Activity Diagrams using MS Visio.
  • Gathering business requirements and converting them into functional requirement specifications (FRS) and user requirement specifications using Rational Requisite Pro.
  • Participated in Change control meetings recommending appropriate action after analysis of changing requirements.
  • Used Teradata loading utilities (BTEQ, Fastload, and Multi Load) to extract data from external sources and transform and load into data warehouse.
  • Extensively used SQL scripts/queries for data verification at the backend.
  • Conducted multiple interviews to clarify requirements in order to identify use cases and document Use Case Specifications.
  • Assisted QA team by Reviewing test cases and clarifying requirements to ensure complete coverage of requirements.
  • Provided project manager with regular status updates assisting the overall project management initiative.
  • Performed requirement walkthroughs with the Dev. and QA teams with the aim to develop testing strategies and test plans such that test cases reflect user needs.
  • Conducted UAT sessions to approval and provided training to end user to gain user confidence.

Environment: MS Visio, MS Access, Rational Requisite Pro, SQL, MS Excel, MS Project, Quality Center, SharePoint

Confidential

Jr. Business System Analyst

Responsibilities:

  • Analyzed and optimized the existing business processes using the conceptual modeling methods and documented the business process through DFD (Data Flow Diagram) narratives.
  • Conducted JAD sessions with key business users to make them understand the project scope and deliverables and to check the feasibility of the project.
  • Documented user and technical interface design documents to specify data files, control files, trigger files, receiving and sending systems.
  • Analyzed and translated business requirements into system specifications utilizing UML and Waterfall methodology.
  • Manage all the requirements and maintained traceability matrix using Rational Requisite Pro.
  • Conducted walkthrough session with business end users, stakeholders, Subject Matter Expert (SME), project Manager etc. to discuss and resolve various issues.
  • Extensively worked on Data Analysis of different tests for tablets such as Disintegration, Hardness, Friability and Dimensional analysis etc.
  • Directed the users to follow specific steps to ensure the rigidity of the test method and the process' end results using LES.
  • Engaged in quality control and quality assurance applications using ELN systems.
  • Used Vignette Content Management to create, manage and publish the Pharmaceutical drugs testing result to the web application.
  • Created Use case diagrams, activity diagrams and class diagrams using UML for designer and developer to describe whole scenarios using MS-Visio.
  • Build a knowledge base to understand the electronic submission process and clarify any questions users have on guidance document.
  • Mapped code letters, payments, and status to back-office database.
  • Gathered reporting requirement from end user to generate report using Cognos
  • Recommended changes for system design, methods, procedures, policies and workflows affecting regulatory submissions in compliance with government compliant processes and XML format
  • Data validation, analysis and generating accurate reports for different testing of pharmaceutical drugs.
  • Analyzed UAT Test scripts and scenarios for functional testing of new development, reports and issues resolution and created training material for users and QA group.
  • Trained business end for new functionality of application.

Environment: LES system, ELN system, MS Access, MS Excel, MS Word, Cognos, Requisite Pro, MS Project, MS Visio, VCM, Outlook

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