SUMMARY

• Over 6+ years of extensive experience as a Business Analyst/Business System Analyst, in Healthcare, Operations/Supply Chain, and Insurance using IT Business Analytics, Modeling expertise, and SDLC.
• Experience in HIPAA 4010 and 5010 EDI healthcare transactions like 837, 835, 834, 820, 270, 271, 276, 277, and 278 along with ICD - 9/10.
• Experience working in domain like Healthcare and IT.
• Knowledge of Relational Database Management System (RDBMS).
• Analyzed and tracked revisions across Engineering Bill of Materials (BOMs), configured Engineering change order (ECO) and Engineering change request (ECR) in Engineering Central application suite.
• Executed SQL Statements to extract Data from Tables to verify the output Data of the reports.
• Excellent skills in gathering business requirements, facilitating Joint Application Development (JAD) sessions, developing Use Cases, creating Business Requirements Document (BRD), Functional Specifications Document (FSD) and Software Requirement Specifications (SRS).
• Strong understanding of the principles of Normalization, Data warehousing, Data Mart, Fact Tables, Star Schema and Snowflakes Schema methodologies.
• Experienced in RAD, RUP, Agile, Waterfall development methodologies, object-oriented programming (Java, HTML, JavaScript, C++, JSP, Servlets), procedural programming (C), SQL and OOAD principles.
• Good knowledge of Business Analysis methodologies and Iterative Software Development Lifecycle using RUP. Thorough knowledge of implementing RUP in all four phases of a project.
• Developed Use Cases/diagrams, Data Flow Diagrams (DFDs), Conceptual Model, Behavioral diagrams for order processing, billing & payment systems.
• Skilled in determining system requirements and specifications from complex application development projects of Automotive supplier, Healthcare payer and provider.
• Involved in integration of Engineering Central application suite with a parts repository system of an Automotive supplier.
• Interacted and coordinated between End-Users, SMEs, development and QA team and suggesting key enhancements and changes to the business architecture.
• Experience in conducting Joint Application Development (JAD) sessions and Joint Application Requirement (JAR) sessions with Project sponsors and Development team.
• Strong experience in conducting Unit Testing, Integration Testing, System Testing, User Acceptance Testing (UAT) and documentation of test cases. Expertise in designing and developing test plans.
• Ability to organize, document and track changes and defects using the Rational Clear Quest and archive change request in Clear Case.
• Assisted QA’s and end user to understand functionality and technical requirements.
• Worked closely with project stakeholders and SME’s to understand the requirements and specifications for new application development.
• Experienced in all phases of SDLC including requirement gathering, change control and management, analysis, design, implementation and testing.
• Skilled in creating Use Cases, Business Context diagrams, Work Flow Diagrams, Activity diagram, class diagram.
• Extensive working experience on preparing Business requirement documents and functional requirement documents.
• Expertise in interacting with the client and the IT Department and thus acted as a facilitator between the client and the IT Department and resolved conflicts and thus possesses excellent co-ordination, negotiation and interpersonal skills.

TECHNICAL SKILLS

Business/Modeling Tools: MS Project, MS Visio, MS Excel, MS Word, MS PowerPoint, Rational Rose

Testing Tools: MatrixOne PLM Version 10.5, Quality Center (QC), Quick Test Professional (QTP), Load Runner, Rational Test Manager, Rational Clear Quest

Database Management: Oracle 11g, 12c, MS SQL, PL/SQL

Scripting Languages: HTML, XML, CSS, C, Java, PHP

ETL/ Data warehousing Tool: Informatica Power Center, Business Objects

Cloud and Virtualization: Windows Azure, VMware Horizon View Client

Development Tools & Technologies: SDLC (Agile, Waterfall), Rational Unified Process (RUP), Joint Application Development (JAD) sessions, Object Oriented Analysis and Design (OOAD), RAD, Prototyping, Business Modeling, Data Modeling, Change Control Process, Oracle Developer, Visual Studio, Eclipse, JUnit, Wamp Server, Komodo Edit, Team Collaboration (GoToMeeting,WebEx), MS Office Suite.

Synergistic Competencies: Project Planning, IT Service Management, Excellent collaboration and teamwork, Excellent analytical and problem solving skills, Ability to learn new concepts and apply them to solutions, Strong written and verbal communication skills.

PROFESSIONAL EXPERIENCE

Confidential, Dallas, TX

Business Analyst

Responsibilities:

• Conducted JAD sessions with all stakeholders including development team/technical team to drive out detailed business requirements for the Claim Processing system.
• Was involved in requirements gathering, identifying and preparing Use Cases, creating Traceability matrix and tagging it in the Rational Requisite Pro.
• Prepared the BRD (Business Requirement document), FRD (Functional requirement document) UCN (Use case narrative), for transaction sets 837, (Inbound-Professional, institutional, dental claims), 835 (Outbound transactions), 270/271 (Eligibility Request and Response), 277CA (Health Care Claim Acknowledgement) as per the requirements.
• Prepared the Process flows, Flowcharts and Information Value Chain for the Current state for all the transactions across all channels.
• Implemented Agile Methodology to process, standards and procedures.
• Created parsing methodology process for EDI files to convert data elements into Class objects and its properties.
• Documented risk analysis of the requirements to identify the key business risks areas for the project and prioritized the application development and testing.
• Implemented system functionality through UML artifacts such as use cases, process charts.
• Performed SQL queries by executing Procedures, triggers to perform backend testing.
• Assisted with Testing and Certification of EDI transactions as per HIPAA guidelines to help ensure transactions are compliant with standards, and requirements

Environment: Rational Unified Process (RUP), UML, MS Office Tools - MS Word, MS Excel, MS Visio, MS PowerPoint, MS Access dB, Oracle, SQL Navigator.

Confidential, Denver, CO

Business Analyst

Responsibilities:

• Worked on claim processing receipt and verification of the claim forms (837) and claims attachments (275), claim Enquiry and Response (276/ 277).
• Oversee the EDI process, working directly with trading partners to enhance the secure and HIPAA Compliant electronic flow of information.
• Involved in the procedural identification of erroneous claims utilizing the MCN and ICN number and the claim status code.
• Responsible for Claim Editing due to data entry error, enrollment adjustments
• Conducted Claim Validation and Verification Process together with FACETs Team in compliance with HIPAA guidelines.
• Conducted Brainstorming and Facilitated Joint Application Development (JAD) session.
• Prepared Business Requirement Documents, Functional Requirement Document, Non-functional Documents from the gathered requirements.
• Adopted AGILE methodology throughout the project.
• Maintained the Traceability Matrix to trace the identified business requirements against functional requirements to use case.
• Attended daily SCRUM and guided QA and Developer regarding the defects, technical specification Documents and Mapping documents.
• Involved in in drawing data flow diagrams and process flow diagram using MS Visio for claim adjudication module.
• Created UML based diagram: Use Case diagrams, Sequence Diagrams, and Activity diagrams using Rational Rose and MS-Visio.
• Participated in entering, tracking system defects using Rational Clear Quest.
• Involved in Configuration Management, Requirement Management and analysis.

Environment: Windows XP, SQL, Rational Clear Quest, Requisite Pro, Microsoft Visio, MS office tools, Java, Business Object reports.

Confidential, Bloomington, IL

Business Analyst

Responsibilities:

• Studied the inherent systems in detail, to have a clear understanding of the business processes and associated system workflow.
• Conducted Gap-impact analysis to understand business model and additional functionalities to be incorporated into the new application.
• Conducted JAD sessions for better understanding and refining of requirements in coordination with multiple teams; Clarified and prioritized requirements by conducting brainstorming sessions with the stakeholders and SMEs.
• Gathered detailed requirements from all users; documented various documents including the Business Requirements Document (BRD) using Rational Requisite Pro.\
• Participated in various architectural development sessions to provide technical teams with a better understanding of the requirements.
• Analyzed Requirements and created Use Cases, Use Case Diagrams, Activity Diagrams using MS Visio.
• Gathering business requirements and converting them into functional requirement specifications (FRS) and user requirement specifications using Rational Requisite Pro.
• Participated in Change control meetings recommending appropriate action after analysis of changing requirements.
• Assisted QA team by Reviewing test cases and clarifying requirements to ensure complete coverage of requirements.
• Provided project manager with regular status updates assisting the overall project management initiative.
• Performed requirement walkthroughs with the Dev. and QA teams with the aim to develop testing strategies and test plans such that test cases reflect user needs.
• Conducted UAT sessions to approval and provided training to end user to gain user confidence
• Utilized Agile Scrum to configure and develop processes, standards, and procedures and to perform System analysis and organizational review of existing QA processes.

Environment: MS Visio, MS Access, Rational Requisite Pro, MS Excel, MS Project, Quality Center.

Confidential, Syracuse, NY

Business Analyst

Responsibilities:

• Gathered business requirement through JAD sessions with SMEs and end users and in addition through document analysis, brainstorming, interviews and questionnaires.
• Created Use Cases, activity and sequence diagrams.
• Worked as an Interface between users and the technical teams involved in the application development for the better understanding of Business and IT processes.
• Provided knowledge and support to the development teams to understand HIPAA and EDI transactions and processes.
• Coordinated with QA team in creating Test Cases and conducted UAT to test the final application for usability, to verify all the user requirements were satisfied.
• Communicated with the developers and QA’s, and referred to HIPAA guidelines to ensure that the system complies with the HIPAA guidelines.
• Involved in writing Test Plan, Test Cases and test scenarios.
• Coordinated on work with claims and benefits configuration set-up involving Inbound/Outbound interfaces and ETL functions.
• Validated existing workflows written for Member eligibility verification, security access in the portal.

Environment: Agile, XML, MS Word, MS Excel, MS PowerPoint, MS Visio, Oracle, SQL, Rational Requisite

Confidential, Pittsburgh, PA

Business Systems Analyst

Responsibilities:

• Provided key input in working with users in indentifying and defining system and project requirements.
• Translated the business needs into functional requirements, and communicated the same to the business users, to baseline the initial high-level requirements.
• Involved in conducting JAD sessions with the entire team to come up with the possible solutions for the business problems.
• Worked with the software architects / developers to ensure that the applications conform to customer requirements.
• Functioned as the primary liaison between the business line, operations, and the technical areas throughout the project cycle.
• Partnered with the technical areas in the research and resolution of system and process problems.
• Played a key role in the planning, testing, and implementation of system enhancements and conversions.
• Conducted impact analysis for the requested change by business users/stakeholders to control change in the requirements.
• Assisted the QA team to write the test plan and test cases.
• Data mapping, logical data modeling, created class diagrams and ER diagrams and used SQL queries to filter data within the Oracle database
• Provided inputs in the strategic development of detailed project plans, work assignments, and target dates.
• Designed and developed use cases, activity diagrams, and sequence diagrams, using MS VISIO.

Environment: Windows, Oracle 9, SQL, Microsoft Office suite, Microsoft Visio, Clear Quest, Rational Unified Process (RUP), ClearCase, UML.

Confidential, Atlanta, GA

Business Analyst

Responsibilities:

• Gathered business requirements by driving user-group meetings and working with various global, cross-functional and virtual teams
• Managed the team of consultants responsible for developing on-demand Medicaid Management System reports.
• Responsible for business system analysis of customizing the BPS Risk Management product with involvement through the whole SDLC
• Developed medical claims business workflows andworked extensively on adjudication systems
• Managed the transition to new development standards, procedures and processes including the introduction of UML,, Clear Case and Clear Quest as well as the Mercury Test Suite
• Responsible for working on the document mandating that all covered health care providers and health care plans as described in the document begin using a single, assigned National Provider Identifier
• Responsible for developing Front end edits for claimsadjudication
• Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams, OOAD using UML and Business Process Modeling.
• Responsible for understanding current processes and tools in relation to ITIL and experience in reviewing and analyzing documentation.
• Responsible for maintaining and administering Share point and update the document repository
• Experience in working in the Application development in Agile environment
• Responsible for pulling and validating the data from SQLservers and validating the data
• Responsible for Defining, Implementing and operating a SharePoint governance model providing structure for site rollouts and content management
• Experienced in working with technical Writing teams and ensure the delivery of a high quality software application
• Experience in Facilitating organizational change strategy development and objective setting with a cross-functional group ofBusiness/Statestakeholders

Environment: Windows 2000/XP, Microsoft Office SharePoint, RUP methodologies, Scrum, Rational Requisite Pro, MS Office, SQL Server, MS Project, MS FrontPage 2003, MS Access, EDI, Documentum 2.0., UML

Confidential

Business Analyst

Responsibilities:

• Analyzed and optimized the existing business processes using the conceptual modeling methods and documented the business process through DFD (Data Flow Diagram) narratives.
• Documented user and technical interface design documents to specify data files, control files, trigger files, receiving and sending systems.
• Analyzed and translated business requirements into system specifications utilizing UML and Waterfall methodology.
• Build a knowledge base to understand the electronic submission process and clarify any questions users have on guidance document.
• Gathered reporting requirement from end user to generate report
• Recommended changes for system design, methods, procedures, policies and workflows affecting regulatory submissions in compliance with government compliant processes
• Data validation, analysis and generating accurate reports for different testing of pharmaceutical drugs.
• Trained business end for new functionality of application
• Created Use case diagrams, activity diagrams and class diagrams using UML for designer and developer to describe whole scenarios using MS-Visio.

Environment: MS Access, MS Excel, MS Word, Requisite Pro, MS Project, MS Visio, VCM, Outlook

Confidential

Business Analyst

Responsibilities:

• Proper planning and clear statements of requirement was documented during the requirement gathering phases by face to face meetings and JAD sessions.
• Circulated the business requirements document to the stake holders and get their sign off.
• Responsible for continuous process improvement and for identifying and maintaining a clear and measurable development process that is deployable using waterfall.
• Conducted walkthroughs for High level requirement to discuss data, technology and application integration. Documented business process workflows for user’s review.
• Documenting High and Detail level requirements, Test plans, Test cases, Test summary reports, determine test needs, test environment, test data, Installation, Troubleshooting.

Environment: MS Office Tools, Java, HTML, MS Access.