SUMMARY

• Over 8+ years of professional experience as a Business Analyst in the Health Care domain.
• Extensive experience in analyzing and requirements gathering and writing system functional specifications including use cases.
• Strong knowledge on the Systems Development Life Cycle (SDLC), Rational Unified Process Methodology (RUP), RAD, SWOT, and CRM.
• Strong skills in creating UML Diagrams and Data Models including Use Case Diagrams, Activity Diagrams, Deployment Diagrams, Data Flow Diagrams (DFD) and Entity - Relationship diagrams using Rational Rose and MS Visio.
• Experience in Clinical Data Management and Clinical Trial Management.
• Strong knowledge of Project management skills includes time estimation, task identification, and scope management.
• Proficient in designing Data Models (logical and physical) for Oracle, DB2 and SQL Server databases.
• Knowledge in the ETL (Extract, Transform and Load) of data into a data ware house/date mart and Business Intelligence (BI) tools like Business Objects Modules (Reporter, Supervisor, Designer, and Web Intelligence).
• Organized Joint Application developments (JAD), Joint Application Requirements sessions (JAR), Interviews and Requirement Elicitation sessions.
• Experience in preparing Systems Proposal Reports and performing GAP analysis.
• Experience and skills in creating design models and Extensive use of UML/RUP for modeling views using tools like Microsoft Visio.
• Understanding of BEA WebLogic Portal to simplify the production and management of custom-fit portals, allowing a shared services environment to roll out changes with minimal complexity and effort.
• Hands-on experience on EDI transactions such as 270, 271,276, 277, 278, 834, 835, 837 (P, I, D) for Health Care Industry.
• Hands-on experience using FACETS 4.3, FACETS 4.5, DB2, Oracle Packages, Stored Procedures and Database Triggers, Forms 9i, Reports 9i, PL/SQL, SQL.
• Performing variety of Data Analysis for 270/271, 276/277, ITS - 837P, 837I for BX Home and BX Host HIPAA X12/XML Transactions
• Familiar with HIPAA EDI transactions such as 835, 837 (P, D, I) 276, 277, 278 etc
• Conducted requirement analysis techniques such as Business Process Automation, Business Process Improvement, and Business Process re-engineering.
• Motivated self-starter with exceptional team building, leadership, and verba skills.
• Possess strong technical skills and business knowledge coupled with product knowledge in Oracle E- Business Suite.
• In depth knowledge Rational Unified Process (RUP) methodology, Use Cases, Software Development Life Cycle (SDLC) processes, Object Oriented Analysis and Design (OOA/D).
• Competent in Creating Unified Modeling Language (UML) diagrams such as Use Case Diagrams, Activity Diagrams, Class Diagrams and Sequence Diagrams.
• Extensive experience in developing Use Cases, creating Screen Mockups, conducting Gap Analysis and Impact Analysis, SWOT analysis, Cost Benefit Analysis, Risk Analysis.

TECHNICAL SKILLS

• Unified Modeling Language (UML)
• Rational UnifiedProcess (RUP)
• Agile
• Waterfall
• Rational Rose
• Rational Requisite Pro
• DOORS
• ClearQuest
• Microsoft Windows
• XP
• Vista
• SQL
• PL/SQL
• HTML
• XML
• C#
• Asp.Net
• SQLServer
• Oracle
• Toad
• Oracle Apps
• MS Access
• MS-Office
• MS Outlook
• MS Power-point
• MS Visio
• MS Project
• SDLC
• Test Director
• BMPN
• Balsamic
• Axure
• TFS

PROFESSIONAL EXPERIENCE

Confidential, Marlton NJ

Business System Analyst

Responsibilities:

• Met with client groups to determine requirements and goals. Utilized Rational Unified Process (RUP) to configure and develop process, standards, and procedures and create a Business requirement Document.
• Created new database objects like Tables, Procedures, Functions, Indexes and Views using T-SQL in Development and Production environment for SQL Server 2000.
• Involved in with data migration (ETL development), document data manipulation processes and scripts.
• Responsible for preparing Software Requirement Specification (SRS) and documenting them.
• Created Process Work flows, Functional Specifications documents and documented system requirements.
• Performed all necessary programming, testing and documentation for COBOL, DB2 batch programs and sub-routines.
• Extensive involved in Conducting Market Research, Feasibility Studies, Data Analyses, System Analyses, Gap Analyses, and Risks Analyses.
• Responsible for maintaining database of Medicare D inquiries.
• Develop detailed unit test plans and scripts and conducted rigorous testing per requirements and assisted in data mapping.
• Provide implementation assessment, strategy, and mentoring services for Rational Rose, UML and RUP.
• Interacted with various cross-functional teams on building business use cases, and understanding expenses and revenue stream.
• Worked with Quality Control Teams to develop Test Plan and Test Cases.
• Interaction with the developers to report and correct bugs.
• Developed Test Plans and Test Cases according to Business Requirements.
• Use HL7 implementation methodology to create specifications, assist with unit testing, and perform integrated testing for messaging between the state Departments of Health and the location office
• Conducted JAD sessions with extensive involvement from Business, Development, Testing teams, Architects, SME’s (Subject Matter Experts) and Managers of various Business Units
• Analysis of new Business Requirements and preparation of the Functional Design Specifications
• Interacted with clients like SPF Securities to finalize their website look and contents.
• Utilize HL7 implementation methodology to develop Electronic Laboratory Reporting interfaces

Confidential, Trenton, NJ

Business Analyst

Responsibilities:

• Worked as a liaison among stakeholders and IT to elicit and analyze various project requirements.
• Gathered requirements from claim adjudicators, nurses, and documentation specialist to translate the business details into functional specification documents that represent the different type of processes.
• As scrum master involved in Scum Sprint planning sessions, Backlog grooming, Spring Retrospectives, daily scrum meetings, User Stories and burn down charts
• Conduct JAD sessions with high profile decision makers, SMEs, IT team to ensure usability and validation of the new technological platforms
• Created Unified Modeling Language (UML) diagrams like case diagrams and Activity Diagrams using Visio
• Developed test plans, test scripts, use cases for testing of workflow automation tool with business users and IT development staff.
• Prepared training materials and conducted trainings for users highlighting clinical documentation guidelines
• Responsible for creating test scenarios, scripting test cases using testing tool and defect management for Policy Management Systems, Payables/Receivables and Claims processing.
• Involved with all the phases of Software Development Life Cycle (SDLC) methodologies throughout the project life cycle.
• Queried database using SQL for backend testing
• Used Rational clear quest for defect management

Confidential, Louisville, KY

Business Systems Analyst

Responsibilities:

• Interacted with business heads to finalize the Business Requirements for the application.
• Performed the requirement analysis and documented the requirements using Rational Requisite Pro.
• Used the requirement attributes (priority, effort, and risk) as the basis for negotiating the inclusion of the requirement, to manage the scope of the system efficiently.
• Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Medicaid Claims. Worked on EDI transactions: 270, 271, 834, 835, and 837 (P.I.D) to identify key data set elements for designated record set. Interacted with Claims, Payments and Enrollment hence analyzing and documenting related business processes.
• Identified/documented data sources and transformation rules required populating and maintaining data warehouse content.
• Represent Operations Team as Client Liaison for Medicare PartD Plan.
• Provided clear and concise documentation regarding requirements management plans, Functional Requirements, supplemental Requirements, Test Plans and Test Cases.
• Implemented Data Modeling standards, including element-naming conventions.
• Used SDLC (System Development Life Cycle) methodologies like the RUP and the waterfall.
• Understand the As Is system and develop the To Be system concept and also prepare the System Process Maps.
• Designed new Business Intelligence (BI) system using Oracle Discoverer 10g to provide reporting under Oracle Applications.
• Conversion of data from different database environments, while performing Back End Testing.
• Developed extensive experience in eligibility and benefits calculation for state, federal and local services such as Medicare and Medicaid.
• Performed Requirement Gathering & Analysis by actively soliciting, analyzing and negotiating customer requirements and prepared the requirements specification document for the application using MS Word.
• Developed criteria for IVR and online interface preauthorization process for providers.
• Checked Business Readiness and determined activities of flow.
• Worked extensively with the QA team for designing Test Plan and Test Cases for the User Acceptance Testing.
• Developed & executed several Optimized queries in SQL on this data.
• Wrote Procedure Manuals and was responsible for continuity preparedness.

Confidential, Harrisburg, PA

Business Analyst

Responsibilities:

• Developed Test Cases for manual and automated testing of an application.
• Gathering the requirements and analyzing the requirements.
• Conducted Functional, Integration and Regression testing.
• Involved in testing web testing with automated tool SOAPUI.
• Analyzed HIPAA 5010 standards for 837P transactions, related to providers, payers, subscribers and other related entities.
• Worked on 834 and 835 projects, including syntax and business rules for X12 HIPAA 4010 and5010 validation for loops, segments, elements, qualifiers and code sets.
• Worked with providers and Medicare or Medicaid entities to validate EDI transaction sets or Internet portals. This includes HIPAA 4010; 837, 835, 270/271, and others.
• Also worked on 837 and 835 projects, including syntax and business rules for X12 HIPAA 4010 and 5010 validation for loops, segments, elements, qualifiers and code sets.
• UAT testing for HIPAA 4010 and 5010 projects including legacy testing and HIPAA requirements and compliance mandates.
• Performed back-end testing procedures using SQL statements
• Recorded scripts in QTP to perform Functionality testing.
• Using VB scripting in the expert view did enhancements to the scripts.
• Created different types of checkpoints (Standard, Text, Text Area, Bitmap, and Database) and checked for properties of fields with respect to requirements.
• Imported/Exported Excel sheets with Parameterized values into/from QTP.
• Managed property values for objects in the Object Repository.
• Developed automation test scripts for performing regression testing on the application using Quick Test Pro
• Perform Backend testing by extensively using complex SQL queries to verify the integrity of the database.
• Performing GAP analysis for the existing systems and processes.
• Conducted Back-End Testing and Regression Testing using various phases of the application.
• Completed several HIPAA 4010 and 5010 Projects, included Medicaid and Commercial entities. Projects include claims and enrollment testing as well as NPI and medical coding and ICD-9 EDI testing.
• Validated triggers using Toad for Oracle.
• Involved in exporting data from the database to flat files using Toad for Oracle.
• Identified, analyzed and documented defects, error and inconsistencies in the application using Quality Center.
• Created and maintained Test Matrix and Requirement Traceability Matrix and performed GAP Analysis.

Confidential, Charlotte, NC

Business Analyst

Responsibilities:

• Prepared the Business requirement Document (BRD) and functional requirement document (FRD) for the SecureTrack web portal.
• Provide support and assisted technical analyst team with preparing Technical Design Document (TDD).
• Analysis and Design transaction sets, and modification of these transaction sets to ensure HIPAA compliance.
• Gap analysis between HIPAA 4010 and 5010. Prepare a PDF document of claims issue and challenges by comparing HIPAA 4010 and 5010 implementation guideline.
• Define project scope, to identify the business flows and determine whether any current or proposed systems are impacted by the new development efforts.
• Created workflow diagrams, UML diagrams, process models, activity diagrams, use cases, E-R diagrams for incorporating business process modeling & design changes in the order creation/ management system.
• Assisted with UAT such as producing test plans and test cases, conduct user testing. Design and execute test plans, tracking defects and getting them resolved to ensure that business requirements and functional specifications are tested and fulfilled.
• Provide mapping document of HIPAA P, I & D, 278 and 835 transactions and 837P, I & D, 278 and 835transactions.
• Prepare the document for Claims Editing & Resubmission and verify the backend process to resubmit the claim by transferring correct X12 files.
• Perform X12 test with the help of Spec Builder tool and make sure the system passes correct X12 data file.
• Planned, coordinated, and monitored project levels for performance and activities to ensure project completion using Work Breakdown Structure in MS Project.