Professional Summary:
Result oriented Senior Business Analyst with more than 8 years of industry experience in SDLC with proven track record of implementing enterprise wide software development projects for increasing usability, performance, efficiency and traceability of business processes to deliver enhanced results.

• Strong knowledge of Software Development Life Cycle (SDLC); SDLC Models – Waterfall, Prototyping, and Methodologies – Agile (SCRUM), Rational Unified Process (RUP).
• Worked closely with Project Stakeholders, Subject Matter Experts (SMEs), and Business Users to understand the requirements and specifications for new applications as well as projects with re-engineering of existing applications.
• Extensive experience in writing Vision & Scope Document, Business Requirement Document (BRD), Functional Requirement Document (FRD), Use Cases, maintaining Requirement Traceability Matrix (RTM).
• Proficient in developing Use Case Diagrams/Models, Workflow Maps, and Activity diagrams based on UML using Rational Rose and MS Visio.
• Extensive experience in producing Wireframes for UI extensive projects and specifying Usability requirements.
• Used elicitation techniques such as interviews, questionnaires, brainstorming sessions, JAD sessions, observation, and document analysis for requirement gathering.
• Solid understanding of Gap Analysis and converting requirements in to test plans.
• Experienced in performing Business Process Analysis and creating AS-IS and TO-BE Business Process Models (BPM’s).
• Participated in Change Management Processes and performed Impact Analysis to ensure Changes/ New Requirements are aligned to the Scope and agreements of the project.
• Proficient in facilitating and performing User Acceptance Test (UAT) by working with internal and external Users / Customers and obtaining delivery approval for the project.
• Knowledge of Medicare (Part A, B, C, D), Medicaid, and Commercial Insurances.
• Knowledge of HIPAA ANSI X12 4010/5010 formats including EDI transactions (270/271, 276/ 277, 837/835, 834, 997) and codes (NPI, ICD9/ICD10 NDC, DRG, CPT, NCPDP).
• Good knowledge of Claims Adjudication Processes. Have profound knowledge in various domains such as Healthcare, Insurance, Trading and Finance.
• Excellent written and oral communication skills with the ability to communicate appropriately in business and technical situations at all levels.
• Involved in Quality Assurance (QA- Manual Testing and Automation Testing); Experienced in reviewing test procedures, defining Test cases, reviewing and maintaining test scripts, analyzing bugs, interaction with team members in fixing errors.
• Adept problem solving skills and learning new technologies.
• Expertise in creating Ad Hoc Reports using Business Objects and Crystal Reports tools.

Technical Skills

Waterfall, Prototyping, Agile (SCRUM), RUP

Business Modeling Tools:

MS Visio and Rational Rose

Wireframing Tool:

Balsamiq, iRise

Requirement Management Tools:

Rational Requisite Pro, DOORS

Content Management System:

SharePoint 2010

Defect Tracking Tools:

JIRA, QC

Databases:

SQL Server - 2008, Oracle

ETL Tools:

Cognos

Desktop Tool:

MS Excel, MS Word, MS PowerPoint.

Reporting Tools:

SAP Business Objects, Crystal Reports

Automation testing:

QTP

Professional Experience:

May 2012 – Till Date

Project: Fresenius Integration Hub (FIH)

Role: Senior Business Analyst

Confidential,offers quality health care products and services designed exclusively to meet the changing health care needs of customers. They provide kidney dialysis services and renal care products, including treatment options for later stage Chronic Kidney Disease to Medicare patient with End Stage Renal Disease (ESRD).
This project called for integrating the Renal Care Group (RCG) clinics patient data in the Fresenius Integration Hub. This included upgrading the RCG ADT (Admission, Discharge and Transfer) HL7 messaging system to Fresenius ADT HL7 messaging system. As a part of this system migration and data integration, error reports were created to examine if the interface accurately transformed the messages.

Responsibilities:

• Worked with business representatives to understand requirements and priorities and ensure that software development work is appropriately aligned
• Involved in the meeting with Business Process Owners, Subject Matter Experts (SME) and Health Center users for Requirement gathering in Definition Stage using Rational Requisite Pro.
• Facilitated Requirements Sessions, as well as weekly client & team meetings.
• Performed Gap Analysis to identify the deficiencies of the current system and to identify the requirements for the change in the proposed system.
• Documented Transfer Specifications and Implementation Guide for ADT messaging.
• Organized system risks into high, medium and low impact to help business analyze the level of effort for remediation activities and ease resource allocation work.
• Participated in user meetings to understand requirements for the Data- Warehouse design.
• Created various Use Cases and workflow diagrams, using MS Visio..
• Maintained Traceability Matrix in Excel.
• Created Report Mockups and Sample Mapping documents for the Error Reporting.

Environment: RUP, MS Office, MS Visio, UML, Adobe Acrobat, MYSQL, Oracle, Windows 7, Cloverleaf.

Client: Confidential,Chicago, IL

Apr 2011 –Apr 2012

Project: ET Migration (4010-5010)

Role: Senior Business Analyst

Project involved a regular optimization and standardizing of claims processes such as maintaining historical data, ad Hoc request/reports tracking and addressing the problems encountered by Providers, Vendors, Health plan groups etc. on timely manner. It was also intended to manage changes in the internal CAS (Claims Adjudication System) while transitioning from 4010 to 5010 transactions and to manage changes of codes from ICD9 to ICD10.

Responsibilities:

• Studied existing system requirements, environment, and operation by interacting with the Project and Business team members.
• Conducted interviews with the SME and gathered information about Health care Enrolment, Billing and Claims processing.
• Involved in creating and modeling the AS IS diagrams and TO BE business process flows.
• Performed a detailed GAP Analysis and documented scope.
• Documented the Business requirements, and communicated these requirements to the development team for the design and implementation of business solutions.
• Maintained ad hoc report requests for the clients as per requirements. Created SQL queries to fetch complex data from different tables in remote databases.
• Facilitated JAD sessions with business SMEs and analyzed the Functional Requirements and documented Use Cases, Process Maps and Wireframes & Prototypes.
• Conducted walkthrough of requirements to technical team and helped resolve outstanding issues.
• Managed Change Request Process and performed Impact Analysis for several changes.
• Exposure to EDI transaction (837,276, 277) quotes sets and validations and insurance claims.
• Exposure to HIPAA Compliance standards.
• Gathered requirements for impacted system and business areas for ICD-10 and their needs to embrace the changes.

Environment: Waterfall, SharePoint 2010, UML, HIPAA EDI, Windows XP, SQL server 2008, MS Visio, Balsamiq, DOORS, Windows Xp/7.

Client: Confidential,Chicago, IL

May 2010- Jan 2011

Project: Integrated Policy Management Portal

Role: Business Analyst

Confidential,is the world\'s leading international insurance and financial services organization, with operations in more than 100 countries and jurisdictions. Its member companies serve commercial, institutional and individual customers through the most extensive worldwide property-casualty and life insurance networks of any insurer. The IPMP project was to build a solution, which integrates All States four existing policy management systems including P&C, Workmen’s Compensation, Life and Annuity and extends their functionality for web-based access by the company’s countrywide network of independent producers.

Responsibilities:

• Performed Gap Analysis to check the compatibility of the existing systems infrastructure with the new business requirements.
• Accumulated system requirements from Workmen’s Compensation and Life and Annuity groups through surveys and interviews.
• Conducted JAD sessions with management, SME, vendors, users and other stakeholders for Business Requirements.
• Documented Functional Specifications using IBM Rational DOORS.
• Created Use Case Model, Activity Diagrams using UML in MS Visio.
• Created Use Case narratives and Use Case relationships and Traced them to Functional and Business specs.
• The user interface (UI) screens were mocked up in Microsoft Visio and reviewed with the end users prior to programming to solicit user acceptance.
• Involved in Performance Measurement to develop measurable indicators that can be systematically tracked to assess progress made in achieving predetermined goals.

Environment: Windows XP/2000, SQL Server, MS Office Suite, SharePoint, MS-Project, JIRA, Microsoft Dynamics CRM, XML.

Client: Confidential,Austin, TX

Nov 2009 – Apr 2010

Project: Misys Fast Services System (MFSS)

Role: Business Analyst

Confidential,a member of the Misys Group of Companies, develops and supports reliable, easy-to-use software and services of exceptional quality that enable physicians and caregivers to more easily manage the complexities of healthcare. Misys Fast Services System (MFSS) is a HIPAA compliant system designed for both real-time & batch environments, it caters to the needs of the various Misys systems such as Tiger, Vision, Payer path and third party clearing houses. MFSS is a set of web services that are connected to MISYS payer network; the system consolidates the process of creating and validating the HIPAA transactions in a centralized location. Some of the HIPAA transactions that are supported by MFSS are eligibility verification, claim status, claim submission and referral. The project also involved generation of certain Health Check reports for the system.

Responsibilities:

• Worked on Problem opportunity analysis, user interviews, gathered, analyzed and documented business requirements based on the analysis of HIPAA transaction processing workflow model.
• Gathered the requirements by customer interviews to define and document user requirements.
• Reviewed Project Charter Documents, Business Requirement Documents and RTM for tracing to Use-Case Specifications, System Requirements Specification and UI Functional specification documents.
• Designed and developed Use Cases, Activity Diagrams, using UML.
• Facilitated and managed sessions with committee of SMEs from various business areas including Payer network, payer path, Tiger.
• Clarified QA team issues and reviewed test plans and test scripts developed by QA team to make sure that all requirements will be covered in scripts and tested properly.
• Participated in the bug review meetings, updated requirements document as per business user feedback and change in functionality of the application.
• Worked on SCRUM for the Reporting requirements. Participated in daily standup meetings and owned daily milestones to gather and create reporting specifications.

Environment:SQL Server 2000, Windows, Crystal Reports,UML, MS Office, MS Visio

Client: Confidential,Bangalore, INDIA

Jun 2007 – Aug 2009

Project: Customer Relationship Management System (CRMS)

Role: Business Analyst

Confidential,is one the leading health insurance providers in India. The project was about individuals seeking health insurance. The goal of the CRMS Project is to increase the use of the current Web platforms by expanding its capabilities to provide more services including FAQ. With the success of this project, the business intended to see a significant reduction in the calls handled by technical support personnel, thus leading to both short and long-term cost savings.

Responsibilities:

• Acted as a liaison between the Business and Technical teams to deliver requirements deliverables – beginning with assisting Senior Business Analyst.
• Involved in all four phases of the requirements development including Elicitation, Analysis, Specification and Quality Validation.
• Conducted GAP analysis and Impact Analysis to identify customer channel usage trends and interactions focusing on likelihood to buy product recommendations and reduce customer attrition.
• Conducted Joint Application Development (JAD) sessions with SMEs from Market Research Group, Hospital Survey Group and Web Management Stem to gather Business and Functional requirements including Use Cases and UML Models for the CRMS project.
• Involved in finding and documenting requirements where the new data capture solution would be compatible with existing Customer Interface Control Systems (CICS).
• Developed Screen Mock-ups / Prototypes to provide demonstration to the Business teams.
• Supported Design and Development activities, by providing walkthroughs and feedback.
• Ensured that the clients adhere to the Change Management Notification (CMN) process.
• Responsible for managing the Change Request Log and RTM.
• Extensively involved in writing and executing Test Cases and User Acceptance Testing (UAT).
• Assisted in developing end user training material and training sessions.

Environment: RUP, Microsoft Office, Visio, Microsoft Project, SQL server, UML.

Client: Confidential,Hyderabad, INDIA

Jun 2006 – May 2007

Project: Revenue Cycle Management Application (RCMA)

Role: Business Analyst

Confidential,is a global healthcare service provider for healthcare clients in US. Project was to develop a tool to measure the performance of the BPO project and teams and bill the client accordingly. Functionality of RCMA (Revenue Cycle Management Application) included analyzing the data from client. Other functionalities included tracing the claims status based on status codes and sending back to client for corrections or write off’s. RCMA was to be designed to reverse interface the client Practice management system to reduce the manual efforts.

Responsibilities:

• Acted as primary liaison between the client departments and the Information systems IT department to perform analysis, review, and estimation of client requests.
• Performed Gap Analysis to check the compatibility of the existing system infrastructure with the new business requirements. Followed solely RUP methodologies during the course of the project.
• Accumulated system requirements from various departments through surveys and interviews.
• Involved in prioritizing the defects and writing Business Requirements to resolve them.
• Conducted JAD sessions with management, SME, vendors, users and other stakeholders for open and pending issues. Planned and defined system requirements to Wire Frames with Use Case, Use Case Scenario and Use Case Narrative and UML (Unified Modeling Language).
• Created Use Case Diagrams, Activity Diagrams, Sequence Diagrams and ER Diagrams in MS Visio.
• Responsible for creating test scenarios, scripting Test Cases using testing tool and defect management.

Environment: MS Word, MS Access, Waterfall, UML, HTML, SQL Server 2000, MS Visio, iRise, Share Point.

Client: Confidential,Hyderabad, INDIA

Jun 2004 – May 2006

Project: CPS Upgrade

Role: Business Analyst

Confidential,is one of the largest insurance companies in its class with approximately 3500 insurance contractor agents. The project requirement was to develop a system to integrate and upgrade the CPS (Claims Processing Service) and other disparate systems on a common environment for their Life Insurance division. Project involved in assimilating its isolated systems into a synchronized system, providing remote access through a web interface and maintaining the infrastructure required for these systems.

Responsibilities:

• Researched and assessed client systems and business processes.
• Explored all aspects of the Claim Processing lifecycle, starting from identifying a claim to its closure.
• Worked intensively on various phases in the project lifecycle to design the system in such a way that the high risk claims could be easily identified and monitored.
• Participated in preparing basis for Project Requirement documentation.
• Involved in walkthroughs with business team, architects and developers to refine the requirements.
• Implemented Traceability Matrix and User Requirement Specification Document (URS) to verify the functionality.
• Streamlined clerical work processes and mapped to the automated system.
• Involved with the Software Quality Assurance (SQA) Team to develop Test.

Environment:Microsoft Office Suite, Microsoft Visio, Unix, Windows NT/XP, Oracle