SUMMARY

• Business Analyst with 8+ years of industry experience in identifying business needs, and determining solutions to business problems for complex software projects. Extensive knowledge of Agile methodology, RUP and UML modeling and handling various Health care transactions.
• Experienced working in a complex and geographically dispersed team environments with strong communication and interaction skills.
• In - depth knowledge and a practical experience of using Waterfall, Agile, Scrums, Rational Unified Process, Business Process Reengineering, Unified Modeling Language, System Requirements Specification and Functional Requirements Specification, Rapid Application Development, and MS Visio.
• Experience with full Software Development Life Cycle (SDLC) and project life cycle including Feasibility Analysis, Requirements Planning and Management, Application Design and Development, Testing, Implementation and Post-Implementation Validation, and Solution Assessment.
• Highly skilled in transforming the needs of business users and stakeholders to the functional/technical requirements. Served as a critical resource and liaison between subject matter experts (SME) and technologists throughout the project life cycle.
• Experienced in Business writing skills and Technical writing skills in developing Business Case, Scope Document, Business Requirements Document (BRD), Functional Requirements Document (FRD), Non Functional Requirements Documents (NFRD), Use Case Scenarios, Test Plans, Test Cases, AS-IS and TO-BE workflows.
• Excellent knowledge of Health Insurance Portability & Accountability Act (HIPAA) standards, Electronic Data Interchange (EDI), and Implementation and knowledge of HIPAA code sets, ICD-9, ICD-10 coding, and HL7.
• Worked with ANSIX12 5010 and ANSIX12 4010 including the standards for medical EDI transactions like 837, 835, 270, 271, 276, 277, 820, and 834.
• Conducted Joint Application Development (JAD) sessions with stakeholders and business partners to resolve open issues.
• Worked with the project team to determine appropriate test plans, deployment plans and supported the product launch.
• Prioritized work requests from project team.
• Worked successfully with on-site and off-shore teams.
• Exceptional Problem Solving and Sound Decision Making capabilities, along with the ability to resolve difficult situations.

TECHNICAL SKILLS

Operating System: Windows 98/2000/XP/Vista/7, UNIX, Solaris, Mac OS X

Languages: SQL, JAVA, HTML, XML, JSON

Database: MS-Access, Oracle, MySQL

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

UML Diagrams: Use Case, Activity, Sequence, Business Process Flow, Class, Object, Data flow

Development Tools: Rational Products including RUP, Rational Rose, ReqPro, FrontPage, Visio, Visual Studio, Eclipse, iRise, Snagit, FACETS 4.8/5, JIRA, BMC Remedy 7.5, AscentialDatastage 7.1/7.5, Oracle Weblogic Server 8.1/10.3, AltovaMapForce

Testing tools: Win Runner, Test Director, Load Runner, Quick Test pro

Modeling tools: MS Visio, Rational Rose

Document Repositories: MS Sharepoint, Apache Subversion

MS Office Suite: MS Word, MS Excel, MS PowerPoint, MS Project, MS Outlook

EDI: EDI, EDIFACT, X12 and EDI Health Care Codes

PROFESSIONAL EXPERIENCE

Confidential, MN

Business Analyst

Responsibilities:

• The project followed company’s own hybrid methodology, Requirements and Solution Analysis (RSA), primarily based on Agile approach.
• Perform collaborative interactions between business partners and IT teams.
• Elicitation and documentation of requirements to meet business needs - Business Requirement Documents.
• Effort estimation for requirements gathering and design documentation
• To provide constant support during the design, development and testing of the project.
• To facilitate data mapping to meet the business needs and support Solution Architects.
• Analyze and document the completion of end-to-end business process to meet the business needs.
• Track the acquisition of external claims data and perform necessary reach out activities to the external sources.
• Used Microsoft SharePoint to manage the documents and have version control.
• Used Microsoft Visio to develop data flow diagrams for the business process.
• Responsible to present complete requirements to the business and acquire approvals from all required stakeholders.
• To make sure all the requirements are met and the design and development efforts adhere to the documented requirements in order to meet the business needs.
• Mapped the new ICD 10 implementations for EDI 834 and 820.
• Worked with EDI 834, 837 and 820 files for verifying compliance with 3rd party vendors, consumers and clients as agreed upon.
• Use of FACETS for 834 and 820.
• Performed Data Modelling, Data Profiling.
• Worked on Medicare and Medicaid for EDI 834, 835, 837 and 820 files.
• Worked on all the parts of Medicare and Medicaid for Benefit enrollment, Claim processing for the consumers and providers.
• Worked with different databases to run SQL queries and ETL for extracting, transforming and loading data into a single database for performing BI operations using Cognos BI.
• Ran complex queries to fetch data from various tables for checking data integrity and normalization.
• Used JIRA as a project management tool and change tracking tool for managing defects and issues and also the progress of each phase of the project along with critical paths, blockers, etc.
• Used Version One for managing project user stories and integrating project status, change request status with JIRA
• Used Version One to mark user stories in different status and also assign to team members depending on their availability.
• Used Version One to create project planning with project manager.

Confidential, MN

Project Business Systems Analyst

Responsibilities:

• Elicit and analyze various kinds of requirements-business requirements document and process flows.
• To gather requirements and develop detailed documentation related to systems requirements and conceptual solutions.
• To work with application developers to support applications and customer requests.
• Created Data Flow Diagram, ER diagram for database modeling and web-page mockups using MS Visio for acceptance from analysts, surveyors and customers.
• Used MS SharePoint for Project Management tasks like baseline, change request, project plan, resource assignment and other project related activities.
• Worked on improving the new website functionality for the business including the non-functional requirements.
• Wrote detailed description of user needs, program functions, and steps required to develop or modify computer programs.
• Develop Logical and Physical data models that capture current state/future state data elements and data flows using Erwin.
• Created User stories and project planning and management with Version One.
• To generate the new EDI 820 reports for the Finance department giving a detailed breakdown of all payments made by CMS at the Program level and at the subscriber level.
• Updates to existing riders to add/reduce benefits for eligible group health insurance plans.
• To develop mapping documents for incoming EDI 834 files from the Exchange and analyze the differences between the current 834 process and the future 834 enrollment process.
• Performed GAP analysis for ICD 9 to ICD 10 upgrade.
• Implemented ICD 10 standards for all existing EDI 834 and 820 code sets.
• Mapped the new ICD 10 implementations for EDI 834 and 820.
• Use of FACETS for 834 and 820.
• Documented business and technical processes, work-flow with requirements within the context of technical specifications and diagrams.
• To analyze the existing Broker Commission System and automate the new Broker Administrative fee for brokers obtaining Individual and Group Businesses.
• To analyze the existing 820 reports and modify them based on the changes resulting from FFE.
• To analyze current business processes and systems to provide business process improvement ideas
• Worked with IT and business project teams to understand reporting and data warehousing requirements and propose solutions.
• QA testing in lower environment, User Acceptance testing(UAT).
• Working with development team for testing before release.
• Used Test director, Quick Test pro for testing different scenarios.
• Utilized knowledge of relational database concepts, and client-server concepts to help upgrade the systems and data conversion for newer systems.
• Data mapping with XML and JSON formats for ease of use by clients for data consumption.
• Reverse Data mapping with XML and JSON formats for producing data for supporting multiple data formats.
• Created WIKI pages, articles for describing and explaining process flows.
• Created BO for ER models and mapped them backed to the UI for users, health care payments.
• BO Object Mapping with XML and JSON payloads.
• EDI standard code mapping with XML format from clients.

Confidential, Chicago, IL

Sr. Business Analyst

Responsibilities:

• Gathered requirements and prepared Charter, Business Requirement Documents (BRD), System Requirement Specification (SRS) by interviewing Business Users/SME's.
• Used RequisitePro for writing/analyzing project vision, goals, specifications and requirements.
• Conduced Joint Application Development (JAD) sessions and walk in interview with the business users to gather requirements.
• Created Use Case diagrams and Activity diagrams to depict the interaction between the various actors and the system in Microsoft Visio for the Business Use Case and System Use Case.
• Analyzed HIPAA 5010 related to EDI 837, 835, 270, and 271 transactions and performed gap analysis between the 4010 and 5010.
• Responsible for GAP analysis of ICD9-ICD10.
• Documented the Business Process Flows, Business Use Cases, System Use Case, Business Rules and Use Case Realization following the Rational Unified Process (RUP) methodology.
• Tagged and traced the created artifacts (Business Use Cases, System Use Case, Business Rules and Use Case Realization) in RequisitePro, making requirements available to all team members.
• Maintained Requirements Traceability Matrix in Rational RequisitePro and used ClearQuest to manage change requests and track defects.
• Created documents like the Business Glossary to facilitate the other teams in understanding client business in RequisitePro.
• Used Microsoft SharePoint to manage the documents and have version control.
• Analyzed the business requirement as per the HIPAA rules and regulations.
• Adhered data transition of the payment and remittance advice as per the EDI standard 835.
• Worked on different EDI scenarios for batch processing.
• Ensured day-to-day- EDI transmission, reject tracking and reconciliation.
• Used FACETS for EDI 837, 835, 270, and 271 transactions and mappings.
• Created maintenance reports and spread sheets for analysis purposes using Microsoft Excel.
• Created WIKI pages, articles and links for describing and explaining process flows.
• Created BO for the UI response for users and health care eligibility response.
• Data mapping with XML and JSON formats for ease of use by clients for data consumption.
• Reverse Data mapping with XML and JSON formats for producing data for supporting multiple data formats.
• BO Object Mapping with XML and JSON payloads.
• EDI standard code mapping with XML format from clients.
• Integration testing, production environment setup, User Acceptance testing(UAT).
• Testing with business and development team before release and verifying all BRD criteria are satisfied.
• Production Support and monitoring before, during and after release.

Confidential, Strongsville, OH

Business Analyst

Responsibilities:

• Writing the detailed user needs, gathered requirements during inception phase, documented and delivered functional specification documents, and assisted architecture analysis and design using UML and Rational tools.
• Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams, and OOD (Object Oriented Design) using UML and Visio.
• Identified, researched, investigated, analyzed, defined and documented business process and Use Case scenarios.
• Conduct workflow, process diagram and GAP analysis to derive requirements for existing systems enhancements.
• Worked on insurance data related to Medicare, Medicaid, and Insurance claims.
• Accepted inbound transactions from multiple sources using FACETS.
• Used FACETS for mapping back different EDI standard codes like 834, 835, 837, 270, 271 and 820.
• Helped manage risk analysis and mitigation plans, status reports, and client presentations; prepared business process models, defined milestone deliverables, and established critical success factors.
• Functioned as the primary liaison between the business line, operations, and the technical areas throughout the project cycle.
• Formulating the systems of project to parallel the business strategies.
• Analyzed research on operational procedures and methods and recommended changes for improvement - with an emphasis on automation and efficiency.
• Wrote SQL queries in MS Access for data manipulations.
• Assist with user testing of systems, developing and maintaining quality procedures, and ensuring that appropriate documentation is in place.
• Develop the test plan, test conditions and test cases to be used in testing based on business requirements, technical specifications and/or product knowledge.
• Used Test Director with QA team for testing.
• Interfaced with SME’s to prepare BPR documents for ongoing projects.
• Created WIKI pages, articles for describing and explaining process flows.
• Created BO for the UI response for users and health care eligibility response.
• Mapped BO with the ER data models and verified the mapping with the FRD.
• Data mapping with XML and JSON formats for ease of use by clients for data consumption.
• Reverse Data mapping with XML and JSON formats for producing data for supporting multiple data formats.
• BO Object Mapping with XML and JSON payloads.
• Production and acceptance environment support.

Confidential, Virginia Beach, VA

Business Analyst

Responsibilities:

• Incorporated and implemented all the HIPAA standards, Electronic Data Interchange (EDI), transaction syntax like ICD-9, ICD-10 coding.
• Involved in upgrading HIPAA X12 4010 to HIPAA X12 5010 transactions.
• Gathered user requirements and business requirements from business/user group and documented User, Business, Functional, and Technical requirements specifications using MS Word and MS Visio that provided appropriate scope of work for technical team to develop prototype and overall system.
• Identifies Actors, Activities, Artifacts, and Workflows and developed use case diagrams using MS Visio.
• Implemented Rational Unified Process (RUP) as the software development methodology.
• Performed GAP analysis and came up with alternative options which could be preferred to better serve its members and customers.
• Wrote test cases and test plans for the related and assigned scripts according to the test strategies defined in the project and testing team guidelines.
• Developed process flow diagrams and created Script Files containing the test cases. These would later help the testing team to properly comprehend the scope and extent of testing required.
• Performed UAT testing and took business sign off as necessary for release.
• Drafted the Physical Data Mapping document for the data flow from Facets to the data warehouse.
• Accepted inbound transactions from multiple sources using FACETS.
• Tracked and maintained Stakeholder requested enhancements and changes using Requirement Traceability Matrix (RTM).
• Designed and implemented SQL queries for the retrieval and management of data.
• Reviewed development plans, quality assurance test plans, and user documentation to ensure correct interpretation of original specifications.
• Developed Business case and assessed the ROI
• Created BO for the UI response for users and health care eligibility response.
• Data mapping with XML and JSON formats for ease of use by clients for data consumption.
• Reverse Data mapping with XML and JSON formats for producing data for supporting multiple data formats.
• BO Object Mapping with XML and JSON payloads.
• Mapped BO with the ER data models and verified the mapping with the FRD.