Objective

• To take a challenging role on business operations as Business Analyst and give an efficient and effective solution that would help the organization to achieve the best solution in business, which would increase its productivity in market.

SUMMARY

• 5+ years of experience as a Business Analyst.
• Excellent communication skills, writing skills as well as presentation skills. Experience working with business users as well as senior management.
• Solid understanding of all phases of Software Development Life Cycle (SDLC) methodology (such as requirement, analysis, design, data modeling, business process modeling, implementation and deployment).
• Extensive experience in conducting Joint Application Development (JAD) sessions for project definition involving analyzing requirements, creating prototypes, user interface, database schema and system design.
• Extensive experience in gathering Business/Functional user requirements, creating Use Cases as per user requirements, developing/designing diagrams such as Activity, Class, and or Sequence diagrams, and in addition to creating Business Requirements Document (BRD).
• Exceptional problem solving and sound decision making capabilities.
• Capable of managing multiple projects simultaneously.
• In - depth knowledge of Rational Unified Process (RUP); risk engineering, data modeling and mapping, and design using UML (Unified Modeling Language), Rational Rose and Visio.
• Excellent knowledge of HIPAA (Health Insurance Portability and Accountability Act) transaction codes such as 270/271 (inquire/response health care benefits), 276/277 (claim status), 470 (benefit codes), 834 (benefit enrollment), 835 (payment or remittance advice), and 837 (health care claim).
• Well versed with HIPAA, Facets, claim adjustments, claim processing from point of entry to finalizing, claim review, identifying claims processing problems, their source and providing corresponding solutions.
• Analysis done to determine if the system abides by the HIPAA regulations.
• Broad knowledge of Test plans, Test cases and test scripts from the Requirements Document.
• Experience in writing queries/scripts for data analysis ad QA report testing.
• Conducted successful projects with the help of teams to achieve deadlines timely and proficiently.
• Experience in User Acceptance Testing, Smoke Testing, Regression Testing Performance Testing and Functional Testing.
• Experience in conducting SWOT Analysis, Cost Benefit and ROI Analysis.
• In-depth experience in financial analysis, financial modeling, Research, Accounting, and good knowledge of Assets, Liabilities, Equities, Fixed Income and Taxation.
• Created Requirements Traceability Matrix to keep the stakeholders informed of the progress of the project.
• Strong expertise in Health Insurance Claim process, Medicare and Medicaid projects and knowledgeable in CMS guidelines.
• Belief in teamwork, dedication, and professional ethics within the working environment.
• A good understanding on database and have experience writing SQL queries for access and manipulate database.
• Organized, goal-oriented, self-starter, and ability to master new technologies; manage multiple tasks while following through from start to completion.
• Flexibility in adaption to a wide range of work environments.
• Extensive experience in working in a Customer - oriented environment.
• Ability to inculcate new relevant skills with ease in a time sensitive frame.
• Experience in writing Use cases and Functional Requirement Document.
• Knowledge of ISO, Six Sigma and CMM standards.

TECHNICAL SKILLS

Databases: MS SQL, MS Access, Oracle

Languages: SQL, Visual Basic

Methodologies: SDLC, RUP, UML, CMM

Test Management Tools: Test Director, Quality Center, JIRA, Track, Mantis

Operating Systems: Windows 95/98/2000/XP/Vista/NT

Project Management: MS Office Suite (Word, Powerpoint, Excel), MS Project

Change Management: Rational ClearQuest

Business Modeling Tools: MS Visio, Rational Rose

PROFESSIONAL EXPERIENCE

Confidential, New York, NY

SR Business Analyst

Responsibilities:

• Helps in conducting Gap Analysis (GAP), User Acceptance Testing (UAT), and System Integration testing (SIT) and SWOT analysis.
• Performed GAP Analysis for HIPAA 4010 and 5010 transactions.
• Involved in implementation of HIPAA EDI Transactions (835,837)
• Facilitated Electronic Data Interchange.
• Used EDI tools to verify mapping to X12 format.
• Analyze HIPAA EDI transactions in X12 responses and of 270/271, 837 and 835 and looked for defects.
• Do data analysis for various version changes of EDI messages on different sub-systems.
• Providing the required test data for the developers in order to fix the defects.
• Participating in the planning, development, coordination and presentation of specific testing needs as appropriate to the quality assurance needs of the end user.
• Assisting business users in defining UAT test cases and plans; Established and maintained test cases and test data in Quality Center.
• Coordinated with the QA Team for testing activities across multiple systems and managed Conversion test execution.
• Assisting in writing efficient and effective Test Plans, Test Strategy, System testing, End-to-End Testing and User Acceptance testing.
• Participating in QA team meeting and bug tracking meetings.

Environment: User Acceptance Testing (UAT), Rational Clear Quest, MS Access, Windows, Rational Test Manager, and MS Office.

Sr Business Analyst

Responsibilities:

• Organizing and managing meetings between clients, conductJADsessions involving subject matter experts, development teams and analysts.
• Meeting with business users and definingfunctional and non-functional business requirements.
• Perform an in-depth analysis of the system’s organizational structure, services and processes.
• Created Project management plans forPMOto manage deliverables using MS Project along with writingUse Cases,BRD’s,SRD’s andHLD’s.
• Assisted Solution teams and IT architects to draft theAID’s with various documentations and diagrams.
• Created Use Case Diagram, Activity Diagram, State Diagram and Interaction Diagrams using MS Visio.
• Created UI mockups and demo presented to Business approval teams.
• Led multiple presentations using Microsoft Power Point for business and the support team.
• Worked onstatus reportingon a daily, weekly and Fortnightly basis to keep the executive management up to date on the progress of the projects.
• Lead daily team huddle for the entire period of the project tohelp PMO to track the internal statuses(from IT perspective.)
• Worked actively withTSO(Test support office) teams for monitoring the test phases and activities and reported them to PMO and Exec leadership.

Environment: UML, Microsoft Project, Microsoft Visio, Microsoft PPT, Rational Tools (ReqPro)

Confidential, Philadelphia, PA

Business Analyst

Responsibilities:

• Conducted detailed and consolidated Business research through brainstorming sessions with end users and stakeholders to identify the system and business requirements and proposed enhancements for the existing process.
• Gained information through the use of SAS CRM by manipulating and presenting relevant data; ensured that programs implemented across channels are effective and timely and that they target the right customers with the right offers.
• Drafted business requirement specifications document that would enable the architects to come up with a design model for the project.
• Captured all HIPAA related EDI data in the back end repository and supported integrated EDI batch processing.
• Integrated the module with the existing systems through the use of HL7 Interface Engine and created a messaging standard to ensure easier packaging and communication of messages between systems.
• Conducted RCM to oversee all end-to-end management from patient access to claims processing and ensured reduction in costs and increase in collections enabling for financial success.
• Used the HL7 interface engine to be used in Medicaid managed care programs and helped work with inpatients, outpatients and disabled patients.
• Complied with HIPAA 5010 to oversee the ICD - 10 encryptions and ensured for proper Medicaid Architecture.
• Gathered the logic and test objectives from the QA team to in corporate test plans, cases and protocols into the testing phase.
• Extensively used Business Process Management (BPM) to satisfy all customer needs and to ensure timely deliver and quality of the proposed application.
• Supported in the extensive testing process of the system and business processes through integration testing. Attained user approval and confidence through User Acceptance Testing (UAT).
• Verified the end application and up gradation of the existing processes with the functional specifications of the proposed project.

Environment: Windows2000, MS Visio, Rational Requisite Pro, RUP, RCM, MS-Project, MS Office, UML, SQL reports & queries.