SUMMARY:

• Currently working as Programmer/Sr. Data Analyst wif Nearly 8+ Years’ experience in IT and software projects in web/windows application environment wif various relational database systems. Involved in various projects like Reporting, Integration, Migration/Conversion and Configuration from legacy application.
• Worked extensively in Business Analysis (Enterprise Analysis, Requirements Elicitation, Requirements Analysis & Documentation, Communications, Solution Assessment and Validation).
• Expertise in Data Analysis/Business Analysis/Data Modeling and BI reporting.
• Experience wif healthcare system, Medicaid and wif prime focus on claims adjudication, provider, eligibility and prior authorization.
• Expertise in using Informatica Power center / Power Mart for data extraction, transformation and loading (ETL) from desperate data sources like oracle, SQL server, flat files, MS Access, JMS and XML files and load teh data into different targets.
• Adequate knowledge in Health Administration - Claims processing (auto adjudication), COB, EOB/Drafts, Claims pricing and testing, HIPAA, enrollment, EDI, Medicare, Medicaid, CDHP (consumer driven health plans)
• Extensive experience in Data Analysis and ETL Techniques for loading high volumes of data and smooth structural flow of teh data.
• Good knowledge of Health Insurance Plans (Medicare Part A, B, C and D), managed care concepts (Medicaid and Medicare) and experienced in determining teh membership eligibility, billing experience wifin life and disability in health plans wif thorough understanding of CPT coding, CMS-1500 claim forms and reimbursement forms.
• Experienced in data warehouses and data marts for business intelligence reporting and data mining along wif developing and documenting process flows for business processes.
• Extensive experience in Strategic development of a Confidential and in Performing Data Analysis and Data Mapping from a Operational Data Store to a Enterprise Confidential
• Extensive work wif various Rational tools like Requisite Pro- Requirement gathering/maintenance, Use Case document maintenance, Clear Case- version control and Clear Quest/Test Director for bug tracking, Rational Rose for Use case diagrams, Sequence diagrams and activity diagrams.
• Efficient in MS Project/MS Excel for planning/status reporting/writing test scenarios.
• Experience wif HIPAA/EDI UB-82, UB-92 and HCFA 1500 claims, and HEDI information.
• Vast experience in FACETs,Facets Data Model and Facets Tables

TECHNICAL SKILLS:

Operating System: Windows 95/98, NT, 2000, XP, Vista, UNIX, DOS

Languages: SQL, HTML, SAS, XML

Databases: Oracle, MS SQL server, MS Access

Tools: MS Office, MS Project, TOAD, MS Visio, Rational Rose, Rational Requisite Pro, Clear quest, Clear case.

Business Tools: Rational Suite (Requisite Pro, Rose, Clear Quest, Clear Case), MS Visio, MS Project, MS Access, MS Office Suite, Visual ParadigmReporting Tools: Doors Erwin Data Modeller, Business Object (Crystal Reports),Cognos,informatica

Business Skills: Business Definition Requirements, Business Process Analysis, Gap Analysis, Use Case Modelling & Analysis, Business Environment and Market Research Analysis.

Methodologies: RUP, OOAD, UML & Business/Data Modeling

Packages: MS Office Suite, Dream Weaver, Adobe Photoshop.

PROFESSIONAL EXPERIENCE:

Confidential, St Petersburg, FL

Sr Data Analyst

Responsibilities:

• Used teh Agile methodology to build teh different phases of Software development life cycle.(SDLC)
• Created Data Stage jobs to extract, transform and load data into data warehouses from various sources like relational databases, application systems, temp tables, flat files etc.
• Worked extensively in running SQL queries in Toad for Oracle and Toad for Data Analyst
• Extensive working experience in FACETs,Facets Data Model and Facets Tables
• Created source table definitions in teh DataStage Repository by studying teh data sources.
• Completed teh documentation of Claims Scenario’s for teh source system
• Analyzed teh existing claims process and specific business rule logic will be applied in teh requirement model.
• Provided data modeling support for numerous strategic application development projects.
• Responsible for Data Extraction, Data Compilation, Data Analysis, Data Manipulation and Data Validation using SQL queries in a MS SQL Server 2005 environment
• Worked on data modelling and produced data mapping and data definition documentation
• Responsible for creating test scenarios, scripting test cases using testing tool and defect management for Policy Management Systems, Payables/Receivables and Claims processing.
• Worked wif EDI team, developers and production support team at various stages of teh project.
• Helped wif Data Mapping between teh data mart and teh Source Systems.
• Developed teh ETL Informatica Mappings for importing data from ODS into subsequent data marts.
• Prepared test Data sets and performed data testing using teh PL/SQL scripts. Also used MS excel for data mining, data cleansing, data mapping, data dictionary and data analysis.
• Reviewed EDI 837 claims and flagged HIPPA non-compliant claims received from teh Payer side
• Responsible for Data Extraction, Data Compilation, Data Analysis, Data Manipulation and Data Validation using SQL queries in a MS SQL Server 2005 environment
• Created SAS programs that are used for data validation, statistical report generation and program validation and automated teh Edit Check programs using Macros
• Prepared test Data sets and performed data testing using teh PL/SQL scripts. Also used MS excel for data mining, data cleansing, data mapping, data dictionary and data analysis.
• Used Data warehousing for Data Profiling to examine teh data available in an existing database.
• Analyzed teh QNXT (claims engine) data and discussed wif teh Business team regarding teh Requirement.
• Used Microsoft Visio for Business Process Modelling and Data flow diagrams.
• Involved in Managing Data modelling project from Logical design and implementation of Sybase Database
• Extensively used TOAD to write and execute SQL queries to extract teh data from teh database.
• Used Informatica to extract and transform data from various DB2 database to teh data
• Coordinated wif onsite and offshore teams for better understanding of client needs and provided quality deliverables.
• Manually generated reconciliation reports using MS Excel and Access.
• Design and streamlined process to facilitate annual reconciliation of plan sponsors.
• Developed, reviewed, understood and validated Testing scenarios/scripts.
• Defect Tracking wif Clear Quest, Configuration Management wif Clear Case.

Environment: Data Mapping Windows, Oracle, PL/SQL scripts, MS Excel and Access.MS Office (Word, Excel, Power Point), Crystal Reports

Confidential, Phoenix, AZ

Data Analyst

Responsibilities:

• Gathering, blueprinting and analyzing requirements using Requisite Pro and Requisite Web
• Extensively used Agile Methodology in teh process of teh project management based on SDLC.
• Extensive experience in running SQL queries in Toad for Data Analyst.
• Involved in Managing Data modeling project from Logical design and implementation of Sybase Database
• Performed extensive data modelling to differentiate between teh OLTP and Confidential data models
• Mapped high-level to-be designs using Business Process Modeling Notation (BPMN) on MS Visio.
• Extensively involved in data modeling
• Sound experience in Facets,Facet Data Model and Tables
• Data mapping, logical data modeling, created class diagrams and ER diagrams and used SQL queries to filter data wifin teh Oracle database
• Gathered and documented Business Requirements, created Functional specifications and translated them into Software Requirement Specifications.
• Conducted analysis of HIPAA compliance and took part in discussions for designing teh healthcare transactions to be HIPAA 5010 compliant.
• Designed conceptual and logical data models of Confidential and tables.
• Using Shared Containers and creating reusable components for local and shared use in teh ETL process.
• Prepared Logical Data Models that contains set of Entity Relationship Diagrams and Data Flow Diagrams and supporting documents and descriptions of teh Relationships between teh data elements to analyze and document teh Business Data Requirements.
• Prepared test Data sets and performed data testing using teh PL/SQL scripts. Also used MS excel for data mining, data cleansing, data mapping, data dictionary and data analysis.
• Designed and developed project document templates based on SDLC methodology
• Established RUP (Rational Unified Process) methodology and provided assistance in developing Use cases and project plans.
• Analyze business requirements and segregated them into Use Case Diagrams, Activity Diagrams, Sequence Diagrams, and OOD using Borland Together according to UML methodology thus defining teh Data Process Models.
• Documented Requirements for Management Reporting out of Clear Quest using Crystal Reports.
• Facilitated Change Control Board and Governance Board meetings and acted as a liaison between parties impacted by teh change requests.
• Provided training on new features wifin CQ and prepared training materials like Quick Reference Guides and Job aids.

Environment: Agile SDLC, Clear Quest, Confidential Oracle, SQL, MS Office (Word, Excel, Power Point), Crystal Reports

Confidential, Trumbell CT

Data Analyst

Responsibilities:

• Involved in requirement gathering phase (Provider, Claim components and HIPAA)
• Utilized Rational Unified Process (RUP) to configure and develop process, standards and procedures.
• Met wif report users and stakeholders to understand teh problem domain, gathered customer requirements through surveys, interviews (group and one-on-one) along wif JAD sessions.
• Involved in understanding teh current business process, defining scope of teh project along wif position statement.
• Wrote BRD, FRD, use cases, test scenarios, test cases for testing teh functional requirement.
• Implemented automated COB processing of Medicare claims into Facets
• Constructed entity-relationship diagrams (ERDs) and data models using Erwin.
• Integrating systems of record into conformed dimensions and fact tables.
• Use of data transformation tools such as DTS, SSIS, Informatica or Data Stage.
• Using UNIX console commands to check database has been connected teh other functionalities.
• Wrote database interface specifications and documented in Data Manager data dictionary
• Worked on development of a information access strategy for teh client including integrated data and information requirements, Tools & Process recommendations.
• Create and maintain data model/architecture standards, including master data management (MDM)
• Maintain historical records of contracts and accounts, support internal/external audits on a yearly and quarterly basis for Pharma Sales Operations
• Performed Data Verification in Oracle database by writing SQL Queries using Toad.
• Worked on Data mapping, logical data modeling used SQL queries to filter data wifin teh Oracle database tables.
• Made sure that teh systems complied wif teh rules of HIPAA and CFR Part
• Documented teh dimensional models of ETL system.
• Led teh testing efforts of teh datamarts in development, coordinated moving/setting up of processes in dev/qa/production. Worked wif QA team and UAT team to go over teh various test scenarios for different types of loads in teh data marts.
• Used SQL to test various reports and ETL load jobs in development, QA and production environment

Environment: BRD, RUP, JADHIPPA, SSIS, Informatica ETL, data models UAT, SQL Queries

Confidential

Technical Analyst

Responsibilities:

• Reviewed teh requirements and performed analysis on existing system.
• Created several simple to complex queries involving self joins, correlated sub-queries, functions, cursors, dynamic T-SQL
• Written Stored Procedures to display teh data in front end application
• Utilized T-SQL on a daily basis in creating customs view for data and business analysis
• Tuned and optimized Queries by altering Database Design, analyzing different query options, and indexing strategies Optimize existing T-SQL code
• Analyzed Execution Plans to troubleshoot potential performance issues
• Utilize Dynamic T-SQL wifin functions, stored procedures, views, and tables
• Customized script utilizing expressions and VB scripting to enhance tasks in SSIS
• Created and maintained SSIS packages designed for replication of data
• Used teh SQL Server Profiler tool to monitor teh performance of SQL Server - particularly to analyze teh performance of teh stored procedures
• Design high availability solutions and implemented database mirroring and replication for teh data security
• Assist in Unit Testing on different scopes of Data Architecture

Environment: Windows NT / Windows XP, MS Office (Word, Excel, Power Point), SQL Server.