SUMMARY

• Over 8+years of experience as a Business Analyst and UAT coordinator with frontline leadership role in System Development Life Cycle (SDLC).
• Demonstrated ability to work efficiently in different phases of Software Development Life Cycle (SDLC) such as Agile methodologies (SCRUM) and Waterfall methodologies in multi tier web based architecture.
• Facilitated and attended Scrum ceremonies (grooming, sprint planning, retrospectives, daily stand - ups).
• Thorough understanding of Agile software development methodologies, values, and procedures.
• Experienced in authoring various documents such as Software Requirement Specifications (SRS), Business Requirement Document (BRD), Use Case Specifications, Functional Specifications (FSD), Systems Design Specification (SDS), Requirement Traceability Matrix (RTM) and testing documents.
• Adept at coordinating with stakeholders, Subject Matter Experts (SMEs) and End Users to understand, analyze, communicate and validate requirements through User interviews, Joint Application Design (JAD), Joint Application Review (JAR) sessions.
• Experienced in conducting different requirement gathering techniques like Brainstorming, JAD sessions, Focus Analysis, Reverse Engineering, Survey, Document Analysis, Interview, Prototyping and Observation.
• Proficient in requirement analysis and creating Use Cases, Sequence Diagrams, Activity Diagrams, Class Diagrams using Object Oriented Analysis and Design (OOAD).
• Excellent knowledge of Medicaid, Medicare (Part A, B, C, D), Procedural and Diagnostic codes and Claims Process.
• Involved in reviewing test procedures, defining test cases, reviewing and maintaining test scripts, analyzing bugs and User Acceptance Testing (UAT).
• Dedicated, results-oriented and motivated team player with excellent communication, analytical, leadership, interpersonal and problem solving skills.
• Experienced in conducting different requirement gathering techniques like Brainstorming, JAD sessions, Focus Analysis, Reverse Engineering, Survey, Document Analysis, Interview, Prototyping and Observation.
• Strong knowledge of HL7 Standards, HIX, EHR - Electronic Health Records, EMR - Electronic Medical Records, CMS regulations, Meaningful Use Compliances, Health Care Reform, EMTALA, PPO, POS and HMO.
• Well versed with clinical workflows and EHR/EMR systems like AllScripts, EClinicalWorks, EPIC Clarity
• Strong experience on working with EPIC Clarity Data Model
• Experienced in Membership, Billing and Claims Payment Processing in relation to HIPAA 4010A/, EDI codes 834, 837,835, 270/271, 276/277 and 820, and ICD-9/ICD-10.
• Excellent knowledge of Medicaid Management Information Systems (MMIS)
• Proficient in Trizetto Facets implementation 5.01.
• Proficient in requirement analysis and creating Use Cases, Sequence Diagrams, Activity Diagrams, Class Diagrams using Object Oriented Analysis and Design (OOAD).
• Adept experience working with ETL (Extract, Transform and Load) of data into a data warehouse/data mart and Business Intelligence (BI) tools.
• Extensively used DDL and DML Commands in SQL for back end testing on Oracle and SQl databases.

TECHNICAL SKILLS

Business Modeling Tools: Rational Rose, MS Visio, MS Office Suite, Rational Suite

Methodologies: Agile, RUP, Waterfall, Spiral, Iterative, UML, Six Sigma, CMM

Requirement Management Tools: Rational Suite ( requisite Pro, Clear case, Clear Quest, Rose), Caliber RM, Optimal Trace 5.1, Rally, HP Quality Center

Applications: MS Office (Word, Excel, PowerPoint, InfoPath, OneNote, Publisher, Outlook) MS Project 2000, PowerBuilder, Intuit QuickBooks, Business objects, Crystal Reports, ACT Sales Database

Languages: UML 2.0, HTML,XM

LOperating System: Windows NT/98/200/2003, Windows XP, UNIX.

PROFESSIONAL EXPERIENCE

Confidential, New York, NY

Sr. Business Systems Analyst

Responsibilities:

• Worked on more than 25 Different reports simultaneously under Explorys Project.
• Coordinated and Interacted with stakeholders to get a better understanding of clientbusinessprocesses and gathered requirements.
• Created Use Cases, Workflows, and Screen Shots for the Application.
• Worked on AGILE Environment with daily scrum meetings, grooming sessions, planning and sprint cycles.
• Groomed stories effectively using OneNote as an effective tool and gathered business requirements through discussions and brainstorming sessions and conducted specification reviews and walkthroughs with the designers, developers and stakeholders.
• Co-ordinated JAD sessions with Multiple Stakeholders (Customer Marketing, Security, Fraud, Sales and UX), SME’s and the End Users for feasibility studies and to discuss the functionality of the flows.
• Experience creating Mock ups based on the discussion with Business and provided the same to UX and Development team.
• Responsible for Prioritization of Stories in Version One for every Sprint.
• Co-ordinated the Triage Meetings and got the defects fixed based on priority.
• Documented the final flow of each features and presented it to End users (Sales and Marketing team) for their usage
• Actively participated and initiatedSprint Planningmeetings in order to plan the functionalities which were supposed to be implemented for the sprint.
• Helped Product Owner in creating and developingProject Charters.
• Facilitated meetings, workshops, for in depth ofbusinessdiscussions and to extractbusiness requirements.
• Responsible for running SQL reports for ARRA Meaningful Use Stage 1 & 2
• Report writing from all Health Information Systems including Allscripts Electronic Medical Records system and Data
• Extensively involved in requirement gathering and design meeting withBusiness/Lead users to understand requirement for configuring / test system workflows.
• Conducted sign off meetings with IT teams to lock down the requirements.
• Used Microsoft SharePoint Connector and Confluence for accessing and sharing project data.
• Facilitated meetings, workshops, for in depth ofbusinessdiscussions and to extractbusiness requirements.
• Built Excel formatted tracking sheets for the project and its 25+ applications.
• Performed Data Mapping and confirmed validations with the SME's.
• Created and executed SQL queries in SQL analyzer to view and update data in tables.
• Helped QA team in testing Sprint stories and in completing the testing.
• Conducted reviews with QA team for Test Scenarios, Test plans, Test cases and analyzed Test results and involved in Defect management using ALM (Quality Center - QC) and made sure those defects are efficiently closed.
• Co-ordinated to get the Automation scripts which are scheduled to run every day to perform Regression Testing for different versions of application.
• Involved in each Sprint Regression testing where different functionality was tested after every Sprint elevation.
• Hands on experience on Mobile Apps application and involved in testing the mobile message applications to check the message transfer for security features via SMS and Email.

Confidential, Wallingford, CT

Sr. Business Systems Analyst

Responsibilities:

• Worked for operating support group involved in multiple projects for the claims and compliance department.
• Worked on EDI 270/271,276/277, 835 &837 for the claims department and interacted with Affinity’s compliance, special investigation department & PA state DOH(Department of health)
• Extensively used SQL queries to fetch data from different claim & membership table(CLCL CLAIM,CDML CL LINE,MEME MEMBER,SBSB SUBSC)
• Interacted with affinity’s Medical management, Customer service & Intake team (provider authorization)
• Designed screen mockup/layout after taking input from customer service, intake team.
• Designed the look & feel of the CDRS front end (auth grid search screen)
• Validated HCPCS & CPT codes in Facets, worked with configuration analyst for configuring missing CPT & HCPCS codes in Facet
• Developed mapping documents based on Clearing House’s specs & CAQH core operating rules
• Mapped clearing house provided service codes to Facet by developing crosswalk tables
• Worked with plan data model in Facet front end (2X) & backend (CMC PLDS PLAN DESC, CSPI CS PLAN, CMC SETR TIER)
• Documented claims extraction process using Visio and worked with provider relation & membership department
• Performed Root Cause Analysis for errors found in facet for membership and claims status
• Conducted offshore testing with cognizant team in Chennai India
• Facilitated issue resolution and created RFC’s presenting in CAB (change advisory board) meetings
• Performed UAT, modified requirement to improve functionality based on user input
• Conducted reviews with QA team for Test Scenarios, Test plans, Test cases and analyzed Test results and involved in Defect management using ALM (Quality Center - QC) and made sure those defects are efficiently closed.

Confidential, Richmond, VA

Business Analyst

Responsibilities:

• Successfully implemented Password Management Pro Tool within a stringent time frame.
• Involved with testing of Password Management Pro Tool and documenting procedures for Administrators
• Actively involved in different phases of manual software testing which included understanding project requirements, execution, test result analysis and bug reporting for the application
• Acted as a Liaison between various technical, functional teams and stakeholders
• Prepared Test Scenarios, Test Conditions, Test cases and Automation Scripts in Quality Center
• Generated flow diagrams for various processes and functionalities used in Cash Management Module
• Prepared technical specifications for the development of Informatica mappings to load data into various target tables and defining ETL standards
• Designed test plan and test cases to test Informatica mappings
• Developed and validated the test packages ofbusiness process like sales order, credit management, billing and pricing
• Created standard guidelines for User Interface Testing
• Performed manual testing for the reports.
• Involved in testing the new functionalities based on test cases and coordinated with the development team in fixing the identified bugs and defects

Environment: MS Visio, MS Project Plan, Microsoft Office, HP Quality Center, Informatica Power Center, Agile, MS Excel, Visio, SQL server 2008, Facets 5.01, outlook, share point

Confidential, New York, NY

Business Analyst

Responsibilities:

• Conducted requirement gathering sessions with the purpose of creating and defining theBusiness Requirement Document (BRD) and the Functional Requirement Document (FRD) using Rational Requisite Pro.
• Conducted JAD sessions to allow different stakeholders to communicate their perspectives with each other, resolve any issues and come to an agreement quickly.
• Incorporated HIPAA standards, EDI (Electronic data interchange), Implementation and Knowledge of HIPAA code sets, ICD-9, ICD-10 coding.
• Responsible for the UAT testing of the ICD 9 to ICD 10 Diagnostic and Procedure codes while reviewing the information to ensure accuracy.
• Developed (UAT) User Acceptance Testing plan to guide a select group of key end-users in testing the user interface and functionality of the application.
• Also developed Requirements Traceability Matrix (RTM) mapping UAT plan and BRD.
• Conducted Smoke Testing of the new ICD-10 UAT region and recorded all the testing results in RTM.
• Developed UAT Test Cases to cover overall quality assurance testing.
• Compared and validated 5010 system test results with 4010 results for the same test scenarios.
• Developed Functional Testing Approach for ICD-10 Remediation and included in UAT Plan.
• Clarified QA team issues and reviewed test plans and test scripts developed by development team and QA team to make sure all requirements have been covered in scripts and tested properly.
• Checked files in Electronic Data Interchange (EDI) transaction support tool and reporting tool and modified the files based upon the errors and also checked them if they were loaded successfully in CIS.
• Performed System testing, Regression testing and UAT for several claim types and test scenarios.

Confidential

Business Analyst

Responsibilities:

• Worked with client, project managers and business users to gather and elicit detailed business requirements
• Created use-case models, business process flows and activity diagrams using UML
• Produced & maintained Requirements Traceability Matrix
• Closely worked with project managers to manage the project scope, identify & engage appropriate resources to support the systems development efforts
• Played a significant role in co-coordinating with various teams, demonstrated excellent communication skills
• Performed coding/programming tasks in java, oracle and documented technical artifacts
• Developed test plans and participated in code testing to ensure workability, completeness and quality
• Developed the service layer test cases

Confidential

Business Analyst

Responsibilities:

• Closely interacted with Clinical Research & Development Management and Leadership teams, regarding sensitive handling of confidential information and comprehensive attention to accuracy and quality.
• Participated in functional requirement gathering and design review meetings which resulted in the creation of Views based on responsibilities in Siebel 8, as well as creating i-Help applets within the application.
• Documented specifications for CTMS business processes, including report design in Siebel Analytics to meet organizational needs, serving also as a CTMS Administrator, super-user and technical support.
• Researched, analyzed and presented best practices in a Clinical Trials Study environment to determine the best overall solution to leverage metrics with the support of CTMS-Siebel 8.
• Developed, wrote and published training materials, user manuals and process flow maps as well as e-learning systems for the CTMS Siebel 8.0 System.
• Tested, executed, and reviewed User Acceptance Test (UAT) scripts.
• Responsible for ensuring end users continue to update and maintain the system on a daily basis and identified and implemented new areas to utilize the system to increase efficiencies.