SUMMARY

• 7+ years of diverse experience as Data Analyst across multiple organizations.
• Experience with mapping and validating various EDI files such as 834, 820, 835, 837, etc.
• Strong knowledge of software development methodologies including the agile methodology, Waterfall, and RAD Methodology.
• Knowledge and experience working with FACETS and FACETS claims processing.
• Skilled in bug reporting and tracking using ALM (Quality Center), IMB Clear quest and JIRA.
• Experience in developing, trouble shooting and customizing test scripts usingQuick Test ProfessionalQTP/HP UFTforFunctionalandRegression Testing.
• Experienced in using management tools such as HP ALM, JIRA - Zephyr combination, CA Agile Central (Rally) for writing the test cases, test data, executing the test cases, tracking, logging and reporting defects as well as developing Test Analysis Report (TAR).
• Performed backend database testing by writing SQL and PL/SQL scripts to verify data integrity.
• Tested the HIPAA EDI transactions 834, 837/835, 276/277, 270/271 according to the requirement test scenarios.
• Assist with managingFACETS of project life cycle, including design, development, testing, and deployment.
• Good working knowledge of HL7 standards and implementation.
• Worked with Microsoft SQL Server. Thorough knowledge and understanding of Dimensional Data Modeling, Star schema, Snow-Flake schema, creation of Fact and Dimension Tables, OLAP, OLTP and other Data-Warehousing concepts.
• Solid understanding ofMembership, Claims Processing, Benefit/Eligibility, COB, Authorization /Referrals,and have experience inHIPAAstandards and correspondingEDItransactions.
• Hands on experience with solid understanding of Business Requirement gathering, Business Process flow, Business Process Modeling and database/data warehouse experience.
• Excellent communication and organizational skills with the ability to adapt to a new environment.
• Experience in facilitating meetings with clients to discuss and sign-off on the document.
• Good experience in Back-End Testing using SQL queries on Oracle, MS SQL Server to validate the consistency of data.
• Expertise in Unit testing, Integration testing, Regression testing, System testing, User Acceptance testing, and Implementation testing.
• Extensive working experience in Functionality, System, Integration, Front-End, GUI, Back-End, Recovery Testing, Compatibility Testing, Usability Testing, Regression, Tracking Bug Reports using Bug tracking Tools like Quality Center.
• Experience in usage of defect tracking tools Quality Center/ALM, Clear Quest, Rally, JIRA for logging the defects, generation of reports and analyzes the reports.
• Used Agile-testing methodology for achieving deadlines in UAT.
• Performed planning and development of Test Plans, Test Strategies, Test Cases and Test Scenario to meet product’s business requirement
• Good knowledge of SQL and experience at conducting backend testing.
• Expertise in Testing of Client/Server and Web based applications.
• Experience in Functional Testing, System Integration Testing, Back End Testing, GUI Testing, configuration Testing, User Acceptance Testing.
• Tested web applications in Agile, waterfall development processes.
• Strong experience in Front-end Testing and Database (back-end) Testing, GUI testing black box testing, white box testing, gray box and User acceptance testing.
• Possess strong problem-solving skills with the ability to adapt to a new environment and meet deadlines.
• Motivated self-starter with exceptional team building, leadership, and interpersonal skills. Good team player with the ability to work in time sensitive environments.
• Experience in creating and maintaining the Requirements definition documents that included Business requirements and Functional requirements.
• Solid experience in creating and validating TCS letters through various FACETS Applications (Utilization Management, Claim Processing and Customer Service Applications) in the QAE1 environment.

TECHNICAL SKILLS

Operating Systems: Windows

Languages: Java, SQL, HTML, XML

Testing Tools: Selenium, SOAP UI

Bug Reporting Tools: Bugzilla, JIRA, HP ALM/ Quality Center

Project Methodologies: Agile Scrum, Waterfall

Database: MS SQL server

ETL Tools: MS SQL server integration Services

PROFESSIONAL EXPERIENCE

Confidential, Dayton, OH

Sr. Data Analyst

Responsibilities:

• Involved in Planning, Defining and Designing database using Erwin on business requirement and provided documentation.
• Installed SQL Server 2008 R2 and Management tools using SQL Server Setup Program.
• Created SSIS packages to extract data from OLTP to OLAP systems and scheduled Jobs to call the packages and Stored Procedures.
• Applied various data transformations like Slowly Changing Dimension, Aggregate, Sort, Multicasting, Conditional Split, Derived column.
• Developed SSIS packages for ETLto migrate data from different sources including insurance groups etc to the data Involved in FACETS configuration, Customization, reporting, analysis and enhancement and worked on membership, claim module, Batch Processing, Pricing Module.
• Coordinated with the developers and IT architects to design the interface of the new system according to the X12 (270, 276, 278, 834, 835, 837 (I,P,D) and 820) standards.
• Performed end to end analysis, design,testing, implementation, and support for enhancements of complex systems utilizing Waterfall SDLC.
• Detailed Analysis of the HIPAA 4010, 5010 along with the 6020 version of the834and820Companion guides.
• Created the logic for flat files and 837I, 837D, 837P according to business requirements and documented in FRD.
• Supported all healthcare workflows through HL7.
• Performed manual testing, including validation/smoke testing ofHL7 interface messages on each new build before delivering to the quality assurance team.
• Perform the system testing to see whether FACETS is passing the data thru Application Enablement to Provider Portal or Member Portal as per need or not.
• Validated that the 270/271 generated is in accordance with the 5010 implementation guide.
• Wrote T-SQL queries, Stored Procedures and used them to build packages.
• Handled slowly changing dimensions to maintain the history of the data.
• Followed HL7 standards to match the International Standard. Documented the Functional Specifications Document using Standards of HL7.
• Involved in FACETS configuration, Customization, reporting, analysis and enhancement and also worked on membership, claim module, Batch Processing, Pricing Module.
• Have done analysis on HL7 that establishes criteria for representing and communicating data associated with health care.
• Coordinated the efforts to implement appropriate HL7 changes on an ongoing basis.
• Analyzed the change detection process on FACETS database tables to capture the daily changes done by Users through Online FACETS Application.
• Responsible for optimizing all indexes, SQL queries, stored procedures to improve the quality of software.
• Designed, reviewed, and created primary objects such as views, indexes based on logical design models, user requirements and physical constraints.
• Designed, Developed and Deployed reports in MS SQL Server environment using SSRS-2008 R2.
• Generated Sub-Reports, Drill down reports, Drill through reports and Parameterized reports using SSRS.
• Created reports to retrieve data using Stored Procedures that accept parameters.
• Used SQL Server profiler for auditing and analyzing the events which occurred during a particular time horizon and stored in script.
• Planned a complete backup on the database and restored database from disaster recovery.

Confidential, Seattle, WA

Data Analyst

Responsibilities:

• Assisted the project manager in the creation of the project charter & vision document during the inception phase of the project.
• UsedInformaticaPower Center to extract, transform and load data from various source systems to staging and target Data warehouse.
• Tuned the performance of mappings by followingInformaticabest practices and applied several methods to get best performance by decreasing the run time of workflow.
• Imported Source/Target Tables from the respective databases and created reusable transformations (Joiner, Routers, Lookups, Rank, Filter, Expression, and Aggregator) in a Mapplet and created new mappings using Designer module of Informatica.
• Developed Test Cases for Testing the Facets Model.
• Analyzed business Processes, Subscribers - group - plan - county structure, current processes, Facets configurations and FACETS backend processes.
• Coordinated with the developers and IT architects to design the interface of the new system according to the X12 (270, 276, 278, 834, 837 (I,P,D) and 820) standards.
• Performed daily tasks including backup and restore by using SQL Server 2008 R2 tools like SQL Server Management Studio, SQL Server Profiler, SQL Server Agent, and Database Engine Tuning Advisor.
• Worked with Facets, e-Billing and EDI HIPAA Claims (837/835/834) processing
• Develop, design & implement department plan to operationalize new FACETS integrated processing system, to include but not limited to, workflow, management oversight and performance analysis.
• Translated business requirements into functional specifications and documented the work processes and information flows of the organization.
• Extensive use of OLAP Function as well as complex joins to extract data for reporting purposes.
• Designed the overall ETL solution including analyzing data, preparation of high level, detailed design documents, test plans and deployment strategy.
• Implemented ETL process to load and extract data.
• Written Test Cases for ETL to compare Source and Target database systems.
• Created ETL execution scripts for automating jobs.
• Created test cases and test procedures for various stages of the ETL process including source to extract, source to staging and staging to target using SQL, Quality Center 10.00 and TOAD for Oracle 10g.
• Administration of HL7 Interfaces (XML/CCD, Demographics, Appointments, Orders and Results, Billing, HIE) in various environments.
• Worked in all phases of SDLC in Waterfall and Agile environments with business stakeholders, platform leads, and test leads to define scope, gather user stories and requirements.
• HL7 v3 interface engineering to process ambulatory and acute EMR HL7 messages.
• Implemented HL7 interfaces to process EMR messages of medical POC (Point of Care) devices.
• Created views to make data available on need to know basis.
• Created queries to fetch data from different tables, using derived tables, Sub queries, as well as Correlated queries on SQL Server platform.
• Performed numerous SQL queries that were highly tuned using concepts like Explain, Stats and CAST.
• Used SAS to import and export data from and into SQL Server platform.
• Used UML Diagrams to graphically capture system functionalities.
• Periodically Designed Conceptual, Logical and Physical Models to effectively improve Business processes.
• Modified various data sources, writing complex new queries based on business needs.
• Maintained departmental reports on daily basis and managed performance issues.

Confidential, BOSTON, MA

DATA ANALYST

Responsibilities:

• Worked on the Data Warehouse team analyzing data files that had to be compiled from disparate non-production sources and readied them for production. Tasks included: comparing data to requirements documentation, creation of data layouts and data dictionary.
• Coordinates HIEmaintenance events with application owners and partner systems; executes maintenance routines in the system
• Developed various T-SQL objects such as Functions, Tables, Views, Triggers, Indexes, Constraints, Stored Procedures and Queries to be used in the project.
• Optimized the performance of queries with modification in T-SQL queries, creating sub queries, establishing joins and creating indexes wherever necessary.
• Lead client discussions relating to theFacetsconfiguration of a standard Medicare Advantage plan.
• Supported new business requirements by extending the functionality of the core Facets system using the Facets extensibility architecture feature.
• Involved in Facets Implementation, including end to end testing of Facets Billing, Claim Processing and Subscriber/Member module.
• Receives reviews and enters data and source documents into Medicaid billing system
• Participated as member of a project team performing various lifecycle tasks for an intranet application with SQL Server 2012 database. Developed logical and physical database models and data dictionary documentation.
• Created Stored Procedure and Views, Indexes, SQL joins and Sub queries
• Worked with integration services for transferring and reviewing data from different sources like (Flat file, Excel, CSV)
• Responsible for acquisition of Medicaid data from MDW (Medicaid Data warehouse)
• Generated Daily, Weekly, Monthly reports for the analysis of managers and end users by using SQL Server Reporting Services.
• Co-ordinate with different application team to develop and standardize enterprise wide data model, created dimensional data model using Agile Methodology, Designed and developed dimension tables, fact tables, conformed fact and dimension tables.
• Analyzed the member eligibility, plans includingMedicaid/Medicare, refill, pricing and drug edits.
• Participate in weekly data analyst meeting and submit weekly data governance status
• Examined existing XML with TIBCO Resources to solve any existing issues or provide new direction
• Data profiling and Data quality checks along with integration rules determination and documentation.
• Experience withdata mining,data cleansing,data modeling,data manipulation,record matching,table linking,table structures,importing and exporting.
• Created ETL documentation such as EDI X12 837(P,I), 834 and 835 Data Mapping, Transformation logic for Main Frame Layout, Updating Meta data documents for new Platform.
• Extracted raw data from an Oracle database and usedSSIS to read it and run statistical analysis usingSSIS.
• Normalization to 3NF/de-normalization techniques for optimum performance in relational and dimensional database environments.
• Wrote Test Plans, Test Scenarios, Test Cases and the Test Matrix.
• Participated in the tasks of data migration from legacy to new database system
• Responsible for creating and modifying the PL/SQL procedures, functions according to the business requirement.
• Re-engineered and captured EDI transactions with legacy systems Enrollment -834, Eligibility Transaction (270/271), Claims (837), Claim Status Request and Response (276/277), Remittance (835) .
• Created SQL Server Reports, handling sub-reports and writing queries to perform drill down, drill-through operations in SSRS.
• Used shell commands to create serialized C# class files from XML based schemas Involved in performing the unit testing, Regression and User Acceptance Testing.

Confidential, Phoenix AZ

DATA ANALYST

Responsibilities:

• Analyzed the source data coming from Legacy system, Oracle, DB2, SQL server and flat files. Worked with Data Warehouse team in developing Dimensional Data Model.
• Worked on solving the errors of EDI 834 load to Facets through MMS. Created keyword files to have member data bulk loaded into the FACETS system through the MMS batch
• Built apythonclass where the objects were batch jobs depending on their severity.
• Worked withdatainvestigation, discovery and mapping tools to scan every singledatarecord from many sources.
• Optimized the performance of SSIS packages by filtering data at source level, using fast load options and tuning embedded SQL queries.
• Worked extensively on EDI transactions 837 and 835 Involved in writing test cases for different LOB’s (ITS, FEP and Regular) for SIT, Parallel and UAT.
• Set Claim processing data for different FACETS Module.
• Analyzing Medicare, Medicaid healthcare programs and performs data transformations, data manipulations, data validations using SQL, Access, VLOOKUP, and Index Matches for dealing with data inconsistencies and maintain data systems with accurate data.
• Converted syntax of diverse queries from Oracle to MS SQL Server in order to reach the business requirements
• Accomplished the data mapping documentations for database updates
• Experienced in full life cycle MDM development including data analysis, database design, data mapping and data load in batch.
• The data was integrated with the Medicaid data after extensive analysis.
• Involved in DataAnalysis, Data Cleansing, Requirements gathering, Business Analysis, Entity Relationship diagrams (ERD), Architectural design docs, Functional and Technical design docs, and Process Flow diagrams
• Handled and maintained model versioning using Erwin.
• Created entity / process association matrices, entity-relationship diagrams, functional decomposition diagrams and data flow diagrams.
• Analyzing the reference of data which is extract from source table and transform to the target table by using the SQL query.
• Experiences in Designing, modeling, and creating database and Normalizing or de-normalizing data according to business requirements and Creating Star and snowflake schemas.
• Designed Enterprise reports using SQL Server Reporting Services (SSRS)
• Did Transformation and data cleansing activities use various Control flow and data flow tasks in SSIS packages during data migration
• Created and managed Event Handlers, Package Configurations, Logging, System and User-defined Variables for SSIS Packages.
• Analyzed the FACETS Requirements and conducted gap analysis.
• Responsible for Medicaid Claims Resolution/Reimbursement for peach state health plan using MMIS.
• Used SSIS and T-SQL stored procedures to transfer data from OLTP databases to staging area and finally transfer into data marts and performed action in XML.
• Participated in Complete Formal Design process from initial specifications and requirement. Involved in creating technical design documentation.
• Worked with data compliance teams, Data governance team to maintain data models, Metadata, Data Dictionaries.
• Analyzed results and EDI ANSI X12 file mapping and reported on standard analysis spreadsheet. Reviewed EDI companion guides for all payers to ensure compliance, edit integrity and maintain up-to-date list of payer contacts. Acted as a liaison between client and payer/intermediary.
• Tested SOAP request and response in XML format using SOAP UI.
• Extracted data from a data source and performed ad-hoc queries.
• Extracted data from existing data stores, Developing and executing departmental reports for performance and response purposes by using SQL Server procedures, packages, functions, database triggers
• Created numerous views with complex SQL statements to retrieve data from the Tables.
• Devising a planned approach to maintain the month long segmentation process.
• Extensively used ERWIN to design Logical/Physical Data Models, forward/reverse engineering, publishing data model to acrobat files and Data Cleansing.
• Validated the positions and the characters after the data gets translated through TIBCO.
• Analyze test cases and defects being loaded in HP ALM by QA teams to ensure the link entities and accuracy of data.
• Involved in designing, development and testing of Interfaces to communicate with third party data.
• Prepared technical design/specifications for data Extraction, Transformation and Loading.