SUMMARY

• Over 10 years of experience in Business Analysis using both iterative software development life cycle principles, and classic waterfall to agile methodologies in the Healthcare industry.
• Adept in interacting and coordinating between end - users, expert teams, development and QA teams and drawing key changes to the business architecture.
• Able to discover the appropriate resources in the organization, extract information, develop alternatives and obtain level of effort estimates from impacted work groups.
• Worked with users to gather, analyze, model and subsequently apply various tools to capture, link, trace, and manage requirements changes.
• Results-driven, self-directed technology systems professional offering experience and success in the planning and execution, operational efficiencies, and working in multi-year, multi-million dollar enterprise projects.
• Recognized as a change agent, with documented ability to take initiative and provide for positive program results using best practices and project management disciplines.

AREAS OF EXPERTISE

• Requirements Development
• Traceability Matrix
• Testing Methodology
• Change Management
• Software Development Lifecycle
• Cross-Functional Team Management
• Process Re-Engineering
• Risk and Issues Management
• Gap Analysis & Content Management

PROFESSIONAL EXPERIENCE

Confidential, Owings Mills, Maryland

Senior Business Analyst

Responsibilities:

• Working extensively with ACA Escalated Case Resolution team and developed processes to efficiently handle the incoming case volumes from MD, DC and VA exchanges. Developed Escalated Issue tracker in SharePoint to capture and track all the escalated cases coming from MD, DC and VA exchanges.
• Trained CSRs on new processes for instance I trained a group of dedicated CSRs to handle 1095B inquiries coming in via phone and Lobby services. Worked with third party vendor Confidential in setting up the process for generating 1095B forms and then trained dedicated CSRs to work on Confidential One Source Application to generate a copy of the duplicate 1095B tax form. As a BA/QA, I was involved in end to end testing in this project.
• Working on Facets and Pega Customer Service application for addressing enrollment, eligibility, claims processing issues. Working with Confidential for the generation and distribution of 1095B tax forms.
• Created TIN Solicitation forms as a part of 1095B project to request SSN from the members in year 2015. Worked extensively on all the TIN Solicitations throughout the year. Also worked on providing solution for storage of iTIN in Facets.
• Documented business and technical requirements for developing Consumer Direct Customer Service Resource Management Dashboard.
• Documented Standard Operating Procedure Documents (SOPs), BRDs, PRDs, Job Aids, Service Alerts and Training Manuals.
• Developed FAQs and detailed workflows to address different inbound Call scenarios.
• Worked on Facets and Pega Customer Service Application to address the issues coming in to Service team.
• Annually reviewed and updated SOPs to ensure processes are current in Compliance 360 system. It is an auditing tool that acts as a SOP clearinghouse.
• Participated in Stake holder discussions during initiation phase and assisted in preparing the preliminary scope statement.
• Facilitated face to face, teleconference and web-conference meetings for requirement gathering and discussions.
• Documented Request for Proposal (RFP) detailing the business needs for the perspective vendors who would provide customer support services. Also participated in the selection of the vendors process.
• Extensively working on MS Visio to create cross functional “As-Is and “To-Be” process flows.
• Created issue templates in SharePoint to capture and track the cases sent in by the three different customer service vendors.

Confidential, NYC, New York

Business Analyst

Responsibilities:

• Gatheredrequirements from theSubject Matter Expertsand documented the business requirements in theBRS and system requirements in SRS.
• Identified gaps in the business process and did extensive data mapping of EDI and paper claims for Executive Dashboard Reporting project.
• Designed Emdeon - QNXT EFT/Check Payment Current state and Future state Process Flows using Visio for EFT Compliance project.
• Created Vitech workflows for Pension Application Process and Employer Inquiry Process in MS Visio and updated the Vitech specs.
• Gathered and documented business and system requirements for moving V3 tickets from old application ITSM to a new application Microsoft Visual Studio/TFS.
• Acted as liaison between functional business units and application team managers to assist in defining objectives, requirements, functions, and priorities of applicable business system related projects.
• Worked closely with the development team to clarify/understand functionality and ensure that the developers clearly understood the business requirements that the system was designed to fulfill.
• Developed and managed work plans, acted as the key client contact, handled scheduling, resource planning and allocation matters, ran status meetings and compiled various reports on the progress of the project.
• Evaluated all the information gathered from multiple sources, reconciled conflicts, decomposed high-level information into details, abstracted up from low-level information to a more general understanding, distinguished user requests from the underlying true needs and distinguished solution ideas from requirements.
• Coordinated and attended meetings to review the requirement specifications with the Quality Assurance Manager and other team members.
• Also attended New York City NOREX IT Roundtable conferences.

Confidential, Newark, NJ

Business System Analyst

Responsibilities:

• Documented and created Business & Technical Requirement Documents, Use-Cases, and Process Flows and Requirements Traceability Matrix spreadsheets for various projects in BPI team.
• Involved in extensive business process mapping for Inbound and Outbound 834 SHOP and Individual Electronic Enrollment Process for Day 0 and Day 1 Health Care Reform.
• Successfully resolved various SSCR’s on claim processing system.
• Analyzed, documented and maintained Test Results and Test Logs.
• Participated in Process Mapping working sessions with different domain leads and Architects of NMS and MembersEdge systems to get the related information.
• Designed the Requirements Traceability Matrix (RTM) to trace the relationship between business and functional requirements.
• Developed Desk Level Procedures for customer service staff to give them an overview of the new sales portal screens.
• Involved in Gap Analysis for the Initial Payment Binder process.
• Worked extensively in Agile and Waterfall environment
• Involved in creating test plans, test cases and coordinated in UAT leveraging Clear Quest.
• Worked towards resolving various defects and updating status reports for weekly business and technical meetings.
• Identified risk and project impact and performed risk assessment and mitigation. Created Contingency plans for the Payment Binder Process.
• Schedule weekly meetings with Business & Various tech group to discuss issues and concerns.
• Extensively worked on MS Visio to complete Cross Functional process flows with different swim lanes.

Confidential, Windsor, CT

Business Systems Analyst

Responsibilities:

• Documented and created Business & Technical Requirement Documents, Use-Cases, and Call Flows, Wireframes, and Requirements Traceability Matrix spreadsheets.
• Supported UAT testing and did production checkouts related to EDI 270/271 and ICD9/10 conversion projects.
• Executed and read various XML coded 270/271 transactions.
• Worked with different QA teams to help design test scenarios, test plans and test cases for User Acceptance Testing UAT and System Integration Testing SIT.
• Successfully resolved various SSCR’s on claim processing system for EDI 270/271 transactions.
• Involved in unit and functional testing;Webservices and XML with tool called'soapUI'.
• Analyzed, documented and maintained Test Results and Test Logs.
• Participated in Defect review meeting and go/no meetings and Responsible in providing regular test reports to the management.
• Created Data mapping documents for both medical as well as dental groups which involved multiple backend systems.
• Developed training curriculum for customer service staff to give them an overview of new web portal system in their respective line of business.
• Worked extensively in Agile and Waterfall environment
• Involved in creating test plans, test cases and coordinated in UAT leveraging Clear Quest.
• Worked towards resolving various defects and updating status reports for weekly business and technical meetings.

Confidential, Jacksonville, FL

Business Analyst

Responsibilities:

• GatheredBusiness Requirements from theSubject Matter Expertsand documented the requirements in theBRS. Utilized data flow diagrams, use case diagrams and process flow diagrams to represent information provided by the Business Owners. Also, worked towards getting sign offs from business.
• Participated in Stake holder discussions during initiation phase and assisted in preparing the preliminary scope statement.
• Facilitated face to face, teleconference and web-conference meetings for requirement gathering and discussions.
• Worked on change requests for Oracle based application called Guidewell
• Supported eCommerce Business Websites functional and operational change requests.
• Identified the content and asset types for product web applications in a Content Management System (CMS).
• Performed business analysis to define project requirements, scope, and business case.
• Organized and documented Use Cases, Business Rules and Functional Requirements for all system functionalities and ensured that critical requirements are not missed.
• Created user interface (UI) design for various web applications.
• Designed the Requirements Traceability Matrix (RTM) to trace the relationship between business and functional requirements.
• Reviewed Test Plans for all phases and updated/fixed requirements and specifications as defects came through from Quality Center.
• Identified risk and project impact and performed risk assessment and mitigation.
• Worked closely with Architects and System owners for Architectural reviews for Reporting, Balance and Control as well as Error Handling system/process designs.
• Prepared and presented power point presentations to upper management about the new system and added functionalities.

Confidential, Oakland, CA

Business System Analyst

Responsibilities:

• Documented and created Business & Technical Requirement Documents, Use-Cases, and Call Flows, Wireframes, Scope Tracking and Requirements Traceability Matrix spreadsheets.
• Worked with different LOB & SQA teams to help design test scenarios, test plans and test cases for User Acceptance Testing and System Integration Testing.
• Planned and defined system requirements to create Use Cases, Data Flow Diagrams using MS Visio and wireframes for User Interface (UI).
• Analyzed and gathered Level of Effort (LOE) estimates for various projects with technical requirements to schedule the timely solution for CRM, claim adjudication, enrollment and billing application releases.
• Developed training curriculum for customer service staff to give them an overview of new CRM system in their respective line of business.
• Worked towards resolving various defects and updating status reports for weekly business and technical meetings.
• Worked as an Interface between the users and the different teams involved in the application development for the better understanding of the business and IT processes.