SUMMARY

• Analytical, enthusiastic and innovative Business Analyst with over 7 years of extensive, practical experience in Health Care Domain.
• Extensive knowledge of Software Development Life Cycle (SDLC) methodologies like Agile, Waterfall, RUP and having through understanding of various phases like Requirements, Analysis/Design, Development and Testing.
• Expertise in EDI and HIPAA Testing Privacy with multiple transactions exposure such as Inbound Claims 837 - Institutional, 837-Professional, 837-Dental, 835-Claim Payment/Remittance Advise, 270/271-Eligibility Benefit Inquiry/Response, 276/277-Claim Status Inquiry/Response Transactions.
• Adept at creating and transforming business requirements into functional requirements and designing business models using UML diagrams - Context, Use Case, Sequence, Activity diagrams in Enterprise Architect, MS Visio and Rational Rose.
• Exceptional problem solving and sound decision making capabilities, recognized by alternative solutions, and confident, accurate, decision-making coupled with excellent communication and interpersonal skills.
• Experienced in facilitating Joint Application Development (JAD) sessions and conducting walkthroughs, surveys, and questionnaires, interviews, brainstorming sessions with end-users, clients, stakeholders and development team.
• Proficient in designing business models using UML diagrams- Use Cases, Sequence Diagrams, Activity Diagrams, Class Diagrams, Data Flow Diagram in MS Visio and Rational Rose.
• Strong experience in conducting User Acceptance Testing (UAT) and documentation of test cases. Familiar in designing and developing manual and automation test cases and test scripts using HPQC and Test Director.
• Well experienced in different management scenarios like change control, Quality Assurance, Defect Tracking, System integration and scheduling.
• Excellent track record for meeting deadlines and submitting deliverables on time.
• Experience in writing Test Plans, executing Test Cases and handling Change Management
• Excellent Team Player, self-starter with excellent Problem Solving and Sound Decision Making capabilities along with ability to provide attention to details and prioritize tasks.
• Good knowledge of MS Office especially MS Project, Visio, Excel, Power Point, Word etc.

TECHNICAL SKILLS

Project Methodologies: Rational Unified Process (RUP)s, Agile, Waterfall

Design Tools: Dreamweaver, Balsamiq, Snagit

Business Modeling tools: Microsoft Visio, Microsoft Project, Rational RoseEnterprise Architect

Requirement analysis tools: Rational Requisite Pro, Caliber RM

Defect Tracking Tools: Rational Clear Quest, Test Director, Rational Clear Case

Testing tools: Mercury Test Director, QTP, HPQC

Operating Systems: Windows 9.x/NT/2000/XP/7,UNIX, Mac OS, Linux

Databases: SQL server, MS Access

Programming Languages: C, C++, HTML

Microsoft office tools: Microsoft Project, Microsoft Visio, Microsoft Office, Microsoft Front Page, Microsoft SharePoint, Ms Outlook.

PROFESSIONAL EXPERIENCE

Confidential - Mechanicsburg, PA

Sr. Business Analyst

Responsibilities:

• Responsible for gaining a good understanding of user needs and accurately representing them in a well-documented software functional specifications document.
• Gathered business requirements, interacted with the business users, designers and developers, project manager and QA team to get a better understanding of the business processes.
• Interacted with the “End-Users” by interviewing them, by preparing appropriate questionnaire to better understand end-user needs and the business process.
• Followed a structured approach to organize requirements into logical groupings such as requirements for customer, client, group, member, eligibility, prescriber, pharmacy, COB, and Reporting that critical requirements are not missed.
• Involved in creating business process documentation. Identified use cases from the requirements.
• Created UML diagrams including use case diagrams, activity diagrams, sequence diagrams, and collaboration diagrams using MS-Visio.
• For project management purpose worked on Microsoft project, able to update Microsoft share point portal with the updated project documentation.
• Analyzed and optimized the process, prepared business requirement document and managed requirements using Rational Requisite Pro.
• Worked with project teams in preparing Software Requirement Specifications (SRS), Software Design Documents (SDD), and User Interface Design.
• Facilitated JAD sessions with business and technical units to fine tune, prioritize and detail requirements and use cases.
• Worked on the Waterfall Software Development Methodology.
• Managed change of the requirements and associated requirements to other requirements for traceability.
• Involved in risk-management process whereby identified critical areas of business risk and modified the business process to reduce the same.
• Involved in drawing data flow diagrams and process flow diagrams using Enterprise Architect for the Claim Adjudication module.
• Identified business rules, built a rule based application that automates fine-grained, variable decisions used for claim adjudication.
• Involved in data mapping of EDI transactions, creating work flow and activity and use case diagrams. Created validation documentations for the claim process.
• Writing Data Mapping Documents, Data Transformation Rules and maintaining Data Dictionary, Data Migration and Interface Requirements Documents.
• Updated Microsoft Share Point portal with the updated project Documentation.

Environment: My Eclipse, Java, IBM Web sphere, Microsoft Share Point, Dream Viewer, Rational Requisite pro, Enterprise Architect.

Confidential, Louisville, KY

Sr. Business Analyst

Responsibilities:

• Basic Responsibilities involved the analyzing end user requirements and communicating and modeling them to the development team.
• Took critical part in formulation of the Project Plan and Scope to lay out the Project Definition, Budget and various factors affecting the project and the actors.
• Initiated JAD sessions with End Users through one on one and group interviews to better understand the user requirements.
• Created extensive use case, activity, sequence diagrams of the required system to enable clear project idea and goals.
• Created System Specification Document using RUP Methodology, Requirement Specification Documents, Use Case Models, and Work Flows.
• Involved in creating 837(I, D, P), 835, 277-U, 270/271, 276/277, 278 and 834 transactions processing flow.
• Detail knowledge and experience working on HIPAA.
• Change and Traceability Matrix was maintained throughout the project to keep track of changing user requirements and alterations made by the team.
• Met with technical/development team on weekly basis to determine the project structures such as Privacy protection, communication, and security and explain them the various changes made to the system that needs to be tested before implementation
• Helped the testing team in making up the test strategies and test plans to be used in the testing process
• Created Use Case scenarios and interfaces using UML methodology.

Environment: Rational Unified Process (RUP), MS Project, SQL, Rational Requisite Pro, Rational Rose, Clear Quest, Microsoft Visio, Windows 2000/XP, Mercury Test-Director.

Confidential, Windsor, CT

Business Analyst

Responsibilities:

• Worked on EDI transactions: 270, 271, 834, 835, and 837 (P.I.D) to identify key data set elements for designated record set. Interacted with Claims, Payments and Enrollment hence analyzing and documenting related business processes.
• Prepared product backlog working with Product Owners and other SMEs’
• Prioritized user stories and assigned to different iterations.
• Facilitated daily stand ups and managed task board with user stories and tasks
• Experienced in using EHR technology to submit clinical quality and other measurement.
• Prepared and tracked burn down charts and velocity charts for timely delivery of projects.
• Functioned as the primary liaison between the business line, operations, and the technical areas throughout the project cycle.
• Utilized corporation developed Agile SDLC methodology. Used Scrum Work Pro and Microsoft Office software to perform required job functions.
• Involved in creating FRD, use case and UML diagrams to communicate the intended system functionality and execution to developers.
• Establish documentation for agile methodology for implementation with a very water-fall-centric development team.
• Managing personnel allocation and SDLC process for systems projects enhancements
• Use Cases and other Process Flow Models were designed using Visio and Rational Rose
• Facilitated brainstorming sessions and coordination meetings for requirement gathering
• Conducted workflow analysis and GAP analysis to understand the shortcomings of the existing process and evaluated the benefits of the new system
• Experience in Health Care Industry with exposure to Electronic Medical and Health Records (EHR)
• Followed the UML methodology to Create Business Process Diagrams including Use Cases Diagrams, Activity Diagram (Swim Lane Diagram) for AS-IS and TO-BE process.
• Managed and allocated resources using MS Project to keep up with the project deadlines.
• Worked with development team to come up with class diagrams and logical flow diagrams.
• Created and managed project templates, use case templates, requirement types and traceability matrix in Requisite Pro.
• Identified and developed Use Cases from the requirements.
• Transformed the requirements into Functional Requirements for the purposes of preparing the Functional Requirement Document (FRD).
• Assisted development team in preparing wireframes for validating designs by the stakeholders.
• Employed Rational Clear Quest for effective Change Management (Scope Creep) and bug tracking during the testing lifecycle.
• Involved in Black Box Testing and User Acceptance Testing (UAT) by preparing logical test cases.

Environment: MS Office 2003, MS Project, UML, Rational RequisitePro 2002.05, MS Visio 2003, Rational Rose Data Modeler 7.0, Rational ClearQuest, SQL Server 2005, MS Visual Studio 2005, MS Share Point 3.0, EDI, XML, WinRunner.

Confidential, Central Falls, RI

Business Analyst

Responsibilities:

• Involved in defining the whole project life cycle, following RUP methodology.
• Developed a vision plan that defined the primary goals and objectives of the project.
• Analyze business requirements and segregated them into high level and low level.
• Use Cases, Activity diagrams/Actor Lists and Robustness Diagram using MS Visio according to UML methodology thus defining the Data Process Models.
• Created Mock-up forms in MS Access for better visualization and understanding of the software solution.
• Responsible for participating in the review of change management, release contents and schedule.
• Assisted Project Manager in developing design and specification, according to the requirement and information gathered during JAD sessions and other forms of information gathering method.
• Analyzed and prioritized user and business requirements as system requirements that must be included while developing the software.
• Assisted in defining the initial common terminology to be used throughout the project lifecycle.
• Examined progress and wrote completion reports which were submitted to project management on a weekly basis.
• Worked with MS project for Time allocation and Resource management
• Created different Traceability views to maintain the Traceability of the requirements with the help of MS Excel.
• Created Use cases and activity diagrams to extract business process flows and workflows involved in the project using MS Word, UML and Microsoft Visio.
• Extensively involved in running manual tests on the applications.
• Identified and classified Manual and Automated test cases by isolating the repetitive actions.
• Involved in manual testing to check images, broken links, buttons etc on the web pages.

Environment: Microsoft Windows XP, Documentum, Zachman frame work, Oracle, MS Word, MS Excel, Case wise Modeller.

Confidential, Sacramento, CA

Junior Business Analyst

Responsibilities:

• Interacted closely with the Business Users along with the administration and management to gather business requirements and analyze the functionalities to be incorporated into the system
• Worked on HIPAA 5010 transaction requirements and analysed and tested HIPAA ANSI X12 formats including 270/271, 276/277, 834, 835, 837, 997, and NSF formats for interfaces and images to third part vendor applications.
• Analyzed processes in medical coding and transition from ICD 9 - ICD 10.
• Attended demo sessions to understand existing system functionalities.
• Arranged interviews with all the stakeholders to review and understand the gathered business requirements
• Coordinated with system architects and developers to convert business requirements into system requirements.
• Conducted meetings to document Change Requests for new requirements.
• Analyzed business requirements and segregated them into Use Cases.
• Created Use case diagrams and documented detail use case.
• Maintained various versions of the documents generated during the project using Rational Clear Case.
• Was responsible for creating and updating project schedule and managing resources and timeline using MS Project.
• Participated in UAT along with the development & testing teams.
• Gathered requirements from collection, claims, Billing, and insurance appeal departments.
• Working with the business and various technology departments, and acting as a liaison between the underwriters and application developers to provide production support for the National Pricing Solution web based application.
• Interacting with National Pricing Staff (Underwriting, Actuarial & Sales/AM) on daily basis with regards to how the NPS application functions, troubleshooting incidents/issues for Users and completing defect and enhancement requests on daily basis.
• Participating in UAT and test cases documentation.

Environment: Microsoft Word, Project, Excel, PowerPoint, Ms Visio.