SUMMARY

• Over 7 years of extensive experience as a Business analyst in business requirement gathering and analysis, object oriented design and modeling, Agile and traditional methodologies.
• Proven skills in Business Analysis, Planning, Process Management, Change Management
• Software Development & Implementation Management in diverse business & technical environments, with demonstrated leadership abilities and excellent communication skills.
• Experienced in HIPAA compliance, Electronic Data Interchange ( Confidential ) and implementation of HIPAA code sets, ICD - 9, ICD-10.
• Thorough understanding and hands-on working experience with standards of Confidential /X12- 270/271 & 276/277, 834, 835, 837
• Excellent knowledge of health care industry and claims management.
• Experience with QNXT 3.4, QNXT 4.6, Facets 4.71, Inbound & Outbound interfaces, Confidential configuration, and data mapping using ANSI X12 4010 and 5010.
• Extensive experience and Proficiency in user requirements gathering, Use Case design and analysis, Use Case specifications, Scenarios
• Business processes, Work flow diagrams, process flows and technical documentation, following RUP methodology, using UML, MS Visio, MS Office Suite.
• Expertise in Business Process Reengineering Initiatives, Continuous Improvement Initiatives, conducting Joint application development (JAD) sessions as a Facilitator to gather requirements from a group.
• Expertise in maintaining the Requirements Traceability Matrix (RTM) across the Deliverables of a project.
• Proficient in Documenting the objectives, constraints and scope of the system.
• Strong skills in Presentations to all levels of users on the solutions designed.
• In depth understanding of Software Development Life Cycle (SDLC) Methodologies.
• Proficiency in preparing Vision Document and User Interface Specification to define system boundary for the project.
• Expert in interfacing between the users of the systems and the development team.
• Expertise in using MS Office Products suite, Visio and rational suite.
• Exceptional ability to research, analyze and translate technical information to end-users at all levels.
• Excellent Communication, interpersonal and multi-tasking skills, strong team player, resourceful, result driven and self- motivated.

TECHNICAL SKILLS

• SQL
• HTML
• Windows NT/95/98/XP/vista/7
• MS-Dos
• MS Office 2000/2003/2007/2010
• Word
• Excel
• PowerPoint
• Adobe Acrobat
• Rational Rose
• Microsoft Visio
• Microsoft Project
• SQL Server
• MS Access
• Rational Unified Process (RUP)
• Use Cases

PROFESSIONAL EXPERIENCE

Confidential, Irving, TX

Business Analyst

Responsibilities:

• Interviewed SMEs and Stakeholders to get a better understanding of client business processes and gather Business requirements.
• Conducted controlled brainstorming sessions with project focus groups for collecting high level business requirements.
• Conducted several Requirement Gathering Sessions for gaining detailed requirements and finalizing Business Requirement Document (BRD).
• Involved in data mapping, field mapping of the data elements responsible for the BRD.
• Performed GAP analysis of business rules, business and system process flows
• Participated in the application scrum meetings and the sessions
• Requirement gathering, Business Process flow development, and Business Analysis
• Created and maintained a project schedule using MS Project showing all target dates for deliverables.
• Worked with the project manager for planning and organizing the project activities, and in communicating with other business center mangers and stakeholders of the project.

Environment: Oracle, MS Project, MS Access, Lotus Notes, MS office 2010, Sql Loader.

Confidential, San Antonio, TX

Business Analyst

Responsibilities:

• Performed as a high-visibility business relationship management liaison, working with internal and external business owners / customers (e.g. including website stakeholders).
• Able to manage significant workload while maintaining good balance of priorities/issues and sense of urgency.
• Conducted interview sessions with primary care staff and JRP sessions with health informaticians (physicians), stakeholders and subject matter experts to identify the needs of the integrated system.
• Designed the primary templates of the flow of the new system with HIPAA rules using MS-Office and Visio.
• Checked and converted all the legacy system into the standards of HIPPA which included National standards for Confidential, Unique health identifiers, Security standards, privacy and confidentiality.
• Developed documents to design the data to be accepted in HIPAA Compliant 10A1), National Standard Format (NSF) other proprietary formats and to be converted into the required format by the provider/clearing houses/Insurance agencies.
• Enforced change management process and captured all changes as new revisions of system documentation.
• Conducted GAP analysis in comparison to the proposed system to enhance the functionality of the system, which had to fulfill the 3 formats.
• Wrote test cases with all required information for further analysis.
• Created reports using MS-Word such as Error Summary Report, Submissions Report, and Payers Responses Report. These were used for further claim version reports for the providers.

Environment: MS-Office, IBM DB2, MS-Visio, MS-Suite, SharePoint, Lotus Notes

Confidential, San Francisco CA

Business Analyst

Responsibilities:

• Involved in all phases of software development life cycle in agile methodology.
• Worked in the agile environment for the elicitation, representation of requirements and in change management.
• Assessed the flaws in the existing AS-IS system and made clear recommendations of Business process improvements and Business process reengineering (BPR) and incorporated them in the future to-be system design.
• Performed Gap Analysis on the same system in different locations.
• Wrote User requirements specification (URS) and Functional requirements specification (FRS) Documents as per the Business requirements and process flow.
• Helped to identify potential problems quickly, before they occur and interacted with customers providing product information, product use information, and technical assistance on web sites that are accessible 24 hours a day, 7 days a week.
• Developed UML Use Cases for the application using Rational Rose and prepared the detailed Work flow diagram based on the proposed enhancement for the system.
• Developed Process for Data Flow Diagrams (DFD) and Entity Relational (ER) models for the AS - IS and TO-BE systems.
• Actively involved in the UML based Class, Communication and activity Diagrams for certain modules of the application in collaboration with Design Team.
• Extensively interacted with both user group and development team in coming up with structured charts, Class and sequence diagrams.

Environment: Rational Requisite Pro, Rational Rose, Rational Clear Quest, Base Clear case, Java, crystal reports 6.0, Oracle, DB2, MS Project, MS Office Suite.

Confidential, Melbourne, FL

Business Analyst

Responsibilities:

• Identified and validated high potential business opportunities for stakeholders.
• Gathered business Requirements, analyze data/workflows. Defined the scope and progressed from problem Statement to well-documented Designs
• Utilized Rational Req Pro as a user to analyze the business requirements
• Developed Use Case diagrams with MS Visio and also created Business Flow Diagrams
• Activity/State diagrams, and Sequence diagrams, which enabled developers and other stakeholders to understand the business process
• Created business process workflow diagrams (Activity diagrams) in Rational Rose
• Worked through Software Development Life Cycle (SDLC) from Requirements, Analysis, Design, and Implementation through Testing.
• Worked as an Interface between the users and the different teams involved in the application development for the better understanding of the business and IT processes
• Conducted iterations and communicated results and milestone achievements to the stakeholders while keeping the developers closely updated on all documented refinements.
• Created and maintained a project schedule using MS Project showing all target dates for deliverables.
• Created and maintained complete development plans that included functional specifications, requirements engineering, Use Case modeling, risk assessment and mitigation, internal and external workflow.

Environment: Windows 98 / NT, UNIX, C++, HTML, XML, Rational Rose, Rational Requisite Pro, SQL, MS-Project, MS-Office.

Confidential, NY

Business Analyst

Responsibilities:

• Made major contribution in the implementation of EDW Incremental (pull and load) that constitutes different modules like claims, providers, pricing, members, and products for different source systems.
• Interacted with business users for better understanding of individual subject areas and modified specifications to reflect accurate user needs.
• Conducted JAD sessions with end user community ensuring that the software addressed all business needs.
• Implementation of 5 key aspects of HIPAA - Transactions, Identifiers, Codes, Privacy and Security, Non-Compliance issues and penalties.
• Involved in preparing the Methodology document for the HIPAA implementation.
• Understood the Technical specifications and developed functional design document for Extract Transformation and Loading process of EDW.
• Successfully merged legacy data in EDW.
• Addressed production, UAT issues, proper action was taken accordingly based on priority and requirement.
• Worked closely with the UI team to model the screens, which met user, defined requirements and also company standards.

Environment: Oracle 10g, RUP, MS office, MS Project