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Senior Business Analyst Resume

NJ

SUMMARY:

  • Over 7 years of diversified experience in Business Analysis, Implementation and developing schematics of web based and client server applications with knowledge of the Software Development Life Cycle.
  • Strong Subject Matter understanding of HealthCare, Retail Banking, and Insurance sectors
  • Excellent organizational, planning, project and time management skills with ability to work under critical circumstances and ability to effectively communicate Business Requirements to Technical Teams.
  • Extensive Experience in gathering requirements using Traditional (Functional Requirements Specification (FRS) and System Requirements Specification (SRS) documents and Use Case Methodology with strong experience in writing Functional Use Cases.
  • Experience in modeling business requirements using UML (Use Case Diagrams, Activity Diagrams, Business Process Flow diagrams).
  • Strong domain expertise in handling Insurance/Claims processing - Medicare / Medicaid - Acute Care and Long Term Care - Claims Processing, Provider/Member Services, Provider Enrollment, Contracts, Reporting. Finance - Investment Processing Business, Banking - special focus in Loan Processing, Cash Management, Asset Management, Financial Reporting.
  • Working knowledge of Revenue Cycle Management (RCM) for Claims processing, Claims payments, Revenue generation, Claims Processing, Claims Adjudication process, Claims Billing/ Coding, ICD-9/ICD 10 coding procedures, Claims pricing methodology such as DRG, Fee for Service, Percent of Billed, Provider Fee Schedules and Capitation.
  • Understanding of business process flows, and ability To effectively write “As is” vs ‘To Be” business cases and documents.
  • Proven ability to bridge business goals and technology to provide productive solutions.
  • Effective communication skills for mediating between Management Teams, IT Groups, Business Groups and Clients with particular focus on specifications, requirements and documentation.
  • Exceptional analytical, problem solving, strategic planning and decision-making skills.
  • Strong team building, conflict management, time management and meeting management skills.

Skills/Expertise

Health Care IT Skills: MMIS- Medicaid Management Information System, Eligibility/Aid Codes, Federal reporting (CMS), Payer Systems, HIPAA 4010, 5010, Electronic Health Records, Electronic Medical Records, ICD9, ICD 10, HCPCS, EDI transactions – 270-271, 278, 820, 837I, 837P, 835, X12, Facets, Spec builder, HL7, Medical Billing, Claims Processing/Adjudication, CMS Reporting, Affordable Care Act (ACA), HEDIS Measures, Code Tables, Meaningful Use for Electronic Health Records

Business Analysis Tools/ Processes: JAD Sessions, Functional Requirements, Interviewing, Use Cases, User Stories, Mock ups, Wire Frames, Prototyping, Questionnaires, Elicitation, SDLC, Technical documentation, System analysis, Training Material Development and Delivery, Operations Analysis, Process Flow diagramming, Data Flow Diagramming, Data mapping, Audit, Compliance and Controls Analysis, Data Modeling, Business process improvement, Business Cases, Root Cause analysis, Fish bone analysis, Change management, SIPOC, Data mining, UAT execution. Six- Sigma Lean processes, IIBA processes.

Methodologies: Waterfall, Agile Methodology, SCRUM, Rational Unified Process (RUP), UML 2.

Databases / Tools / Standards: Oracle, SQL Server, and MS Access, Data Warehousing, OLAP, OLTP, ETL, Business Intelligence, Data Analytics.

Software Quality Assurance: Unit, System, Integration, Migration, Security, Smoke, Ad-hoc, Functional, Regression, UAT, Manual and Automation.

Other Technical Tools: SAP Business Objects, Crystal Reports, Webi, Data Services, and Dashboard Designer. IBM DOORS, IBM Clear Quest, HP Quality Center, CICS(Mainframe)

Productivity Tools: Microsoft Word, Excel, Visio, Project. Webex, Goto Meeting, Project Server, Share point, Microsoft Team Foundation Server (TFS), Pivotal Tracker.

Languages: SQL, PL/SQL, .Net, Visual Studio, JCL.

Professional Experience:

Confidential

Senior Business Analyst Consultant

Responsibilities with the client:

  • Worked with Informatics Product Managers in conceptualizing the Web Based Code Table Manager Web Interface.
  • Conducted JAD sessions and Kaizen sessions with Stakeholders to understand business requirements.
  • Created Product Requirements Document (PRD) for the conceptualized product.
  • Worked with Product Managers and other stakeholders in defining the sprint planning process.
  • Planned Sprits and releases with Project Managers, developers and testing resources to collect Level of Efforts (LOE’s) for Requirements.
  • Conducted Analysis of project requirements and prioritized backlog items with Product Managers.
  • Analyzed Clinical, Patient Reported and External data for developing functional requirements.
  • Navigated complex data structures and retrieved data to resolve issues on projects.
  • Used existing quality/measurement frameworks such as NQF/HEDIS for efficient delivery using high performing healthcare systems.
  • Used Team Foundation Server (TFS) to document Product Backlog items and acceptance criteria for each BackLog Item in the Sprints.
  • Worked with Visual User Experience Designers to mock up wireframes for the Web Interface of the product.
  • Conducted testing on the Enhanced Provider Directory Application by running test scripts and conducting validation of the data.
  • Participated in the Daily Scrums with Team Members and managed defects and open issues on a daily basis.
  • Analyzed defects and assigned to appropriate teams members for resolution
  • Conducted System Analysis on Database tables to view gaps in requirements
  • Interacted with Developers and ETL teams for Product Design and Architecture Planning

Confidential

Senior Business Analyst

Responsibilities with the client:

  • Gather, define and document highly complex business requirements.
  • Facilitate JAD/Elicitation sessions with business users, business analysts and technical teams.
  • Created Business Requirements Document (BRD) when requested by Department of healthcare services (DHCS).
  • Participated in the creation of the 10-day and 20-day estimates for projects requested by DHCS.
  • Subject Matter Expert on the CMS64 Accounting system used by the Accounting division for DHCS (Department of Healthcare Services).
  • and Payables for monthly closing and balancing.
  • Performed Gap analysis for various projects by using Mainframe Legacy Systems to lookup Aid Codes for Medi-Cal patient eligibility.
  • Worked as Lead Analyst on State Level Registry Project (SLR) which allowed all eligible practitioners and hospitals in California to receive substantial financial incentives to adopt, implement or upgrade to CMS certified Electronic Health Record systems (EHR).
  • Worked on various HIPPA compliance projects such as ICD9- to ICD10 conversion and Healthcare Claims/Encounters 837 Standard Transaction Increase Line Limits Project.
  • Develop work flows that demonstrate current and proposed business requirements
  • Document organizational policies and procedures in the context of system requirements
  • Work with technical staff to conduct root cause analysis for complex system analysis and issue.
  • Work on problem statements and OIL’s in conjunction with SDN’s associated to the projects.
  • Prioritize and track Project Schedule in MS Project for multiple project assignments, deadline and milestones.
  • Create estimates for SDN projects using resource matrix and coordinate resource allocations with the team and project managers.
  • Ensure testing results correspond to the business user’s expectations.
  • Identify project risks and coordinate mitigation plans with the project team and EPMO.
  • Performed Gap Analysis for new functionality requirements, as well as prioritized them based on actual business needs so as to align them with the product release roadmap.
  • Provide user support, including training, help and instructions.
  • Work on releases with the EPMO release management team to execute implementation plans for SDN’s.
  • Created implementation plans (IMP documents) and Education and training documents (ETP) deliverables for various assigned projects.
  • Performed User Acceptance Testing (UAT) sessions, and supervised the development of User Manuals for customers.
  • Mentor junior business analysts on methodologies, policies and processes.

Confidential

Senior Business Analyst (Contractor)

Responsibilities with the client:

  • Conducted JAD sessions with End User Community and the IT Group ensuring that the software addressed all business needs. Conducted many informal Sessions to develop an architectural solution that the application meets the business requirements, resolve open issues, and change requests.
  • Full life cycle initiating, planning, executing, monitoring and closure for internal data gathering, software development, design & analysis initiatives.
  • Facilitate meeting discussions between business users, business analysts and technical analysts.
  • Document organizational policies and procedures in the context of system requirements
  • Work with technical staff and business users to problem-solve and identify workable solutions.
  • Ensuring the Requirements gathered are verified and confirmed by the Business and the Subject Matter Experts, by conducting Inspection Sessions and Obtaining Approval's and Sign Off's from Designated Stakeholders.
  • Develop work flows that demonstrate current and proposed business requirements
  • Create and executed test cases, test scripts, data sets and user procedures.
  • Ensure testing results correspond to the business user’s expectations.
  • Work with team leads, technical staff and key users to identify, track and manage project issues as they arise.
  • Provide user support, including training, help and instructions.
  • Maintain effective relationships with system users, stakeholders, and other outside entities (i.e. vendors) within own area of responsibility.
  • Design, distribute and facilitate the execution of test plans.
  • Knowledge of Enterprise Analysis, Requirements planning & Management, Requirement elicitation, Requirements communication, Requirements Analysis & documentation and solution Assessment & validation.
  • Performed User Acceptance Testing (UAT) sessions, and supervised the development of User Manuals for customers. Confidentia

ConfidentialBusiness Analyst (Contractor)

Responsibilities with the Client:

  • Involved in project planning and coordination using Microsoft project.
  • Creating business process flows, use cases, information modelling, data mapping and gathering business requirements.
  • Conducting JAD Sessions as a Facil

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