SUMMARY

• 8+ years of experience as a Business Analyst/Data Analyst with solid understanding of Business Requirements Gathering, Data Analysis and Business Analysis.
• Diverse experience in Healthcare and Insurance Domain.
• Organized many Joint Application Developments (JAD) sessions, scrum meetings, walkthroughs, Interviews, Workshops and Rapid Application Development (RAD) sessions with end - user/clients/stake holders and the IT group
• In depth knowledge of Health Insurance Portability and Accountability Act (HIPAA), MMIS, ICD codes and MITA business areas
• An astute professional with enhanced functional experience in system and Business analysis in Health care, with FACETS and extensive interaction with client.
• Experience in Healthcare Application Facets in different modules like Claims, Memebrship, Provider and Billing.
• Worked on the conversion of existing legacy system to the FACETS
• Well experienced with SQL and database querying including FACET database.
• Excellent documentation, communication, and interpersonal skills
• Good Experience in Business Analysis methodologies and Iterative Software Development Life Cycle (SDLC) using Rational Unified Process (RUP).
• Experience in soliciting client requirements through interviews, workshops, and existing systems documentation and procedures.
• Experience in tracking, tracing and managing requirements using Requisite Pro.
• Proficient in creating UML Diagrams including Use Cases Diagrams, Activity Diagrams, Sequence Diagrams using Rational Rose and MS Visio.
• Experience in reviewing Test Procedures, defining Test cases, reviewing and maintaining Test scripts, analyzing bugs, interaction with team members in fixing errors, automated testing and User Acceptance Testing (UAT).
• Experience in project management tools like MS-Project for status reporting and planning.
• Involved in post implementation training and support end users
• Able to master new concepts and applications within a timeframe and Capable of rising up to mounting challenges.

TECHNICAL SKILLS

Operating Systems: Windows XP, and MS DOS.

Languages: C, SQL, PL/SQL, and HTML, UML

Databases: MS Access, SQL Server.

MS-Suite: MS-Word, MS Excel, MS outlook, MS Power-point, MS SharePoint

Testing Tools: Rational Req-Pro, HP Test Director, WinRunner, Load Runner

Methodologies: Rational Unified Process, Agile, Waterfall.

Design Tools: Microsoft Visio, Rational Rose.

Team Skills: Coordinating, Facilitating, Project Tracking and Reporting.

PROFESSIONAL EXPERIENCE

Confidential, Columbia, Maryland

Business System Analyst

Responsibilities:

• Responsible for every new release to validate that the new enhancements have not caused any issues when compared to existing functionality Defect tracking and management, analyze & document defect trend across Releases.
• Communicating and Coordinating between Client, Development (Onsite) and Offshore (Testing) teams.
• Involved in requirement gathering sessions on various programs for deployment of IBM’s Netezza tool. The tool will help in achieving the SLA times for different frequencies.
• Worked on Different versions of Facets like 4.41,4.471 and 5.01.
• Experience as a Facets Systems Analyst in mapping business requirements, designing customized solutions with strong analytical skills and ability to analyze business practices and define optimal procedures.
• Documenting requirements and creating functional design documents, process flow and design flow diagrams. Defined Functional Test Cases, documented, Executed test script in Facets system.
• Experience in analyzing the current world stored procedures in Oracle language and transforming them in to the future state’s business requirements.
• Training the development and testing team on Healthcare domain and Facets.
• Analyzing the various problems the business was facing and coming up with reports with possible solutions.
• Reviewed requirement documents for accuracy, clarity, and requirement testability.
• Running standard reports using Sequel server management Studio 2008 to monitor the growth of production databases on a day to day basis.
• Worked with the development team in order to improve the existing processes like API, and downstream applications like OCA, CXP etc for quarterly releases.
• Analyzing the historical data of RHI and coming up with recommendations in order to meet the SLA timing for different frequencies.
• Maintain the environmental log with all server names and owners, with their description of use.
• Closely interacted with developers, DBA and IT for space capacity management project in order to reclaim any space available from servers for future projects.
• Analyzed impact of changes to BCBSMN processing because of migration to ICD-10 for end to end testing.
• Identified major changes to the systems during JAD Sessions related to ICD-10 Migration like portal changes, new panel for references, prior authorization version changes.
• Data profiling and data validation for Netezza migration. Analyzed the data for inaccuracies and created reports for the management.
• Worked on documenting the data transfer requirements for moving data from Netezza to DB2
• Worked on different master databases like Teradata, SQL and Netezza.
• Participated in the user acceptance testing (UAT) for Netezza migration project.

Environment: Microsoft Word, PowerPoint, Excel, Outlook, Project, Visio, Windows, Rational requisite pro, SSMS 2008, SQL, Teradata, Netezza

Confidential, Jacksonville, Florida

Business System Analyst

Responsibilities:

• Involved in requirement gathering using Rational Requisite Pro, which included interviews, brainstorming and meetings with stakeholders, and SMEs.
• Gathered Requirements from various Business Areas like EM&B, Actuarial, product and Marketing
• Worked as a liaison between business users and developers to submit requirements and changes, clarify questions and issues.
• Using SDLC and Microsoft project planned scope, cost requirements and risk analysis of web application development team in Visual studio 2010 and SQL Server 2005.
• Created As is and To be process flows.
• Identified the process flaws in the current system and recommended business process in the new system after analyzing and documenting AS-IS Flow.
• Created To be flows based on input from various teams. .
• Prepared Business Requirement Document and managed requirements using Rational Requisite pro
• Worked with business to identify requirements for the design and development of enhancements to their facets application, interfaces to third party systems, and enhancements to and break fix their health plan systems.
• Completing requirements and design documentation liaising with IT Technical staff to complete development.
• Followed a structured approach to organize requirements into logical groupings of essential business process, business rules, information needs and insured that critical requirements are not missed.
• Conducted walkthroughs with the end users and stakeholders to gather the modification requests from the user to upgrade or change the business specifications for the product.
• Monitored Change Requests and documented them using a change log.
• Closely interacted with designers and software developers to understand application functionality and navigational flow and keep them updated about Business user’s sentiments.
• Developed use cases with input from SME’S.
• Used MS Share point for sharing documents, calendars and other data between users in different locations.

Environment: Microsoft Office suites (Word, PowerPoint, Access, Excel, Outlook, Project, Visio), Windows, Rational requisite pro.

Confidential, Mississippi

Business System Analyst

Responsibilities:

• Actively worked on Business requirement gathering, analysis and Data analysis
• Created Business Rule Comparison (BRC) documents and Side-By-Side (SBS) comparison documents using 4010 / 5010 implementation guides for X12 transactions(i.e. 837 (I, P, D), 834, 835)
• Created BRCs of EDI inbound and outbound transactions and mapped the provided data
• Identified risks, problems, requirements and concerns of the Hospital in order to comply with ICD-10 changes by conducting interviews
• Collected the information related to ongoing application upgrade. Studied their impact on ICD-10 implementation and created awareness within departments
• Involved in providing education/training about the ICD-10 codes and 5010 standards, its requirements, complexity, and accuracy to Physicians and Nurses.
• Extensively involved in HIPAA 5010 User Acceptance Testing (UAT). Defined and maintained Test Cases for EDI transactions.
• I worked as an Analyst in Implementation of FACET 4.81.The Claim System was a web based application that the providers can use to manage patient information and file claims electronically. The scope of the project was the conversion of the 837 EDI format from 4010 X12 formats to the 5010 X12 format as per HIPAA compliance.
• Worked with business users to assess the impact of implementation of HIPAA 5010 on claims processing and EDI Transactions.
• Worked with multiple clearing houses to ensure smooth transition to 5010 standard for their day-to-day EDI X12 transactions.
• Manually read through the loops, segments and elements of individual test files from clearing houses using Notepad++ and compared them to Implementation Guide/ Companion Guide to ensure that they met 5010 standards. If errors were found on these, the same were communicated back to the clearing house and asked them to resubmit the file after making necessary changes.
• Work to set Facets data in Claims Processing, Members/Subscribers, Groups, Billing for different testing efforts.
• Used HP Quality Center for error reporting and communicating between developers, product support and test team members
• Worked on various subsystems within the MMIS including but not limited to Recipient Payer, EDI etc
• Used MS Share point for sharing documents, calendars and other data between users in different locations.
• Checked the functionality at implementation level using SQL and PL/SQL.

Environment: Microsoft Office suites (Word, PowerPoint, Access, Excel, Outlook, Project, Visio), Quality Center.

Confidential, Nashville, TN

Business Analyst

Responsibilities:

• Gathered Requirements from various Business Areas like Claims, Provider Relations, Enrollment, Finance and Benefits Administration for their updates to the Claim Processing Engine.
• Assisted the team in SDLC from initiation to testing.
• Developed Use Cases using MS Visio, and a detailed project plan with emphasis on deliverables.
• Developed and Implemented Test Strategies using the Test Director.
• Assisted QA team in testing phase by creating Test Plans and Test Cases documents.
• Checked the data flow through the front end to backend and used SQL queries to extract the data from the database.
• Developed the Requirements Traceability Matrix, prioritized and determined Impact of all applications.
• Identified all the applications and interviewed the application owners to recommend the process improvements.
• Defect Tracking and Bug Reporting was performed using Test Director.

Confidential, DE

Business Analyst

Responsibilities:

• Defined project scope, goals and deliverables that support business goals in collaboration with senior management and stakeholders.
• Analyzed complex business processes and documented AS-IS flow charts and developed To-Be Process flows and helped the team get a better understanding of the current and the To - Be business processes.
• Conducted JAD sessions with SMEs, business and technical units and documented business requirements
• Efficiently and effectively worked with offshore development team and provided some oversight on the design documents to make sure that no business requirement is left out.
• Coordinate and prioritize outstanding defects and enhancement/system requests based on business requirements, allowing sufficient time frame to ensure accuracy and consider deadlines.
• Created Business Process workflow models using industry standard tools like MS Visio and Project.
• Followed the UML based methods to create Sequence Diagrams, Collaboration Diagrams and Class Diagrams and Activity Diagrams.
• Developed the Requirement Traceability Matrix (RTM) for tracing the requirements throughout the project life cycle.
• Assisted the testing team in User Acceptance Testing and heavily involved during business validation and user sign-off.

Environment: Rational Requisite Pro, Rational Rose, UML, MS Visio, MS Project, Quality Center, MS Office, HTML.

Confidential

Business Analyst

Responsibilities:

• Worked in the operation & maintenance team to look after the proper functioning of the WLL & OBC (a digital switching system supporting the communication need in telephony, ISDN, mobile communication).
• Study of GSM network architecture, GSM interface, its functions as well as GSM services particularly Teleservices.
• Created Flow Charts, Use Cases, Sequence Diagrams, and Collaboration Diagrams thus defining the Data Process Model and Business Process Model.
• Compiled, verified, and transformed raw data into charts and corresponding graphs for seven metric areas using Traceability Matrix.
• Documented the data using HTML, Power point & Micro-Soft Word. Supported users with Word processing, spreadsheets, databases and presentation software. Created and developed presentations using PowerPoint and SWISH.

Environment: HTML, MS Office, Rational Rose, Swish.