SUMMARY

• Facilitator between Business Systems and Information Technology with over 7 years of extensive experience in the field of Business Analysis, System Analysis and Project Management.
• Experience in gathering business and application requirements, Business Processes, Identifying risks, Impact analysis, UML modeling, Sequence and Activity Diagrams using Rational Rose and Microsoft Visio.
• Experience in writing Business Requirements Documents (BRD), Functional Requirement Documents (FRD), System Requirement Specifications (SRS), and Non - Functional Requirement Documents (NFRD).
• Several years of experience and advance knowledge of the Systems Development Life Cycle (SDLC), Waterfall, Agile, Spiral, Rapid Application Development (RAD), Extreme Programming (XP), Rational Unified Process (RUP).
• Experienced in interacting with business users and executives to identify their needs and authoring Use Case Diagrams, Activity Diagrams and Sequence Diagrams using UML modeling.
• Active role in eliciting requirements from users by utilizing methods like Interviews, Requirement workshops, Joint Application Development (JAD) and Participatory Design.
• Efficient and proven track record with handling Change Requests by the Clients.
• Proficient in working with project management tools like MS Project for status reporting and planning.
• Well versed with Medicaid Management Information Systems (MMIS), National Provider Identification (NPI) and familiar with Patient Protection and Affordable Care Act (PPACA).
• Experienced in various MS Windows platforms, OS, Office Suite, etc.
• Excellent knowledge of Health Insurance Portability and Accountability Act (HIPAA) transaction, code set rules such as EDI 837, 835, 834, 270, 271, 276, 277.
• Extensive knowledge of Medical Management Information Systems (MMIS), Medicaid, Medicare, Procedural and Diagnostic codes and Claims Process.
• Strong knowledge of Health Insurance Portability & Accountability Act (HIPAA) standards, Electronic Data Interchange (EDI), Implementation and knowledge of HIPAA code sets, ICD-9, ICD-10 coding, HL7, HMO, PPO.
• Good knowledge of Health Insurance Plans (Medicare Part A, B, C and D), managed care concepts (Medicaid and Medicare) and experienced in determining the membership eligibility, billing experience within life and disability in health plans. Experience with Business Process Management.
• Capable of writing SQL queries for the retrieval and management of data
• Experience in working with Microsoft Office Suite (Word, Excel, Power Point, Access, Visio, and Project) for documentation, analysis and presentation.
• Strong knowledge of Business Process Modeling, Business Intelligence and Business Architecture.
• Experienced in writing Test Plans and executing Test Cases

PROFESSIONAL EXPERIENCE

Confidential, Bismarck, ND

Sr. Business System Analyst

Responsibilities:

• As a System Analyst, I acted as a primary liaison between Business & the development team throughout all phases of SDLC.
• Assisted in data modeling, data mapping and produced the data definition documentation.
• Engaged in different phases of SDLC of the project executing RUP methodology of iterative software development from Inception to Transition phase.
• Developed a Requirements Traceability Matrix recording the requirements through each stage of requirements gathering process.
• Analyzed and translated business requirements into system specifications utilizing UML and RUP methodology.
• Extracted the business requirements from the stakeholders keeping in mind their need for the application and documenting them.
• Conducted one on one and group interviews to understand Business Requirement and subsequent documentation.
• Involved user interface design by providing detailed functional requirements.
• Used Business Requirements to write Functional Specification documents.
• Conducted JAD Sessions to develop an architectural solution to ensure that the application meets business requirements to resolve any open issues, and manage change requests.
• Created Use Cases, Activity Diagrams, State Chart Diagrams, Sequence Diagrams, and Collaboration Diagrams thus defining the Data Process Model and Business Process Model using MS Visio and Business Process Model tools.
• Ensured that all artifacts are in compliance with corporate SDLC policies and CMS guidelines.
• Developed customized SQL reports and queries for management decision-making and operational management.
• Worked on documents for version controlling, to maintain up to date changes in the documents.
• Assisted in authoring test plans, test cases for various test scenarios and helped testing team to better understand the test scripts.

Environment: - RSA, MS Office Word/Excel/PowerPoint/Outlook, MS Project, MS Visio, Windows, XP/Win 7, SharePoint, Power Designer.

Confidential, Detroit, MI

Sr. Business System Analyst

Responsibilities:

• Conducted brainstorming and JAD sessions with stakeholders and end-users for requirement analysis and documented the same.
• Documented business requirements, and communicated these requirements to the development team for the design and implementation of business solutions.
• Created EDI documents for EDI maps to generate requirement documents, and logical design documents for EDI transactions and code sets.
• Used UML during requirements gathering and created Use Case Models and Use Case Diagrams for the purpose of stakeholders in the project to help them understand the workflow of the system associated with the requirements.
• Worked on HIPAA ANSI X-12 EDI 837 transaction and version 5010 of this transaction.
• Performed GAP and Impact Analysis for ICD 10 changes.
• Developed, implemented and executed test methodologies and plans to ensure software product quality as per the Rational Unified Process (RUP) methodology. Test some of the Extensions in Facets application manually.
• Analyzed, coordinated, documented and managed project processes and procedures and its changes throughout the software development lifecycle.
• Involved in creating sample mappings for the conversion of EDI X12 transactions code sets version and translation of ICD 9 codes into ICD 10 codes.
• Performed Requirements Analysis and traceability using Quality Center and MS Word.
• Involved in writing test plans, defining test cases, test scenarios and data sets; analyzed bugs and interacted with development team in fixing the errors.
• Established questionnaires required for implementing and upgrading ICD-9 diagnosis codes to ICD-10 codes.
• Worked with Subject Matter Experts (SME), project team members (business and technical), to define technology application for the business and system requirements. Also worked with the QA Team Lead to develop QA standards and ensured compliance with all regulatory requirements.
• Developed several MS Excel spreadsheets and applications to automate manual calculations and optimize reporting structure.
• Participated in Logical design and ETL processes development discussion.
• Also involved in analysis for the conversion of ICD-9 to ICD-10 and also worked with the Data management team for data mapping and data analysis.
• Created Gantt charts and project charters, and followed the Software Development Life Cycle (SDLC) methodology to complete projects on time and within budget.

Environment: - SQL Server, Agile, MS Project, MS Access, Microsoft Excel, Microsoft Word, Microsoft Power Point, Visio, Rational Clear Quest, Rational requisite pro.

Confidential, Holly Hill, FL ‎

Sr. Business Analyst

Responsibilities:

• Facilitated all aspects of the scrum framework, including sprint planning sessions, backlog grooming sessions, daily scrums, product demos, sprint reviews and sprint retrospectives.
• Supported and consulted product owner in developing, maintaining and grooming product backlog.
• As Scrum Master maintained the capacity plan, iteration board, sprint backlog, velocity charts and burn down charts
• Identified and removed impediments to the success of the sprint by working with every single team member.
• As Scrum Master communicated dependencies and potential risks to the completion of the sprints including resources, costs and systems.
• Conducted JAD sessions, workflow diagrams, UML diagrams, process models, activity diagrams, use cases, for incorporating design changes in the order creation/ management system.
• Actively participated on creating Migration strategy from existing PDE (Microsoft Access files) to Gold Data Repository.
• Clearly understood coding standards required for all Medicare Part D Users transactions involvingelectronic data interchange as provided by department of health and human services and incorporated at every stages of the project wherever found necessary.
• Prepared the Business Requirement Document (BRD) and Functional Requirement Document (FRD) for the enhancement of the existing services.
• Analysis and Design of existing transaction sets, and modification of these transaction sets to ensure HIPAA compliance.
• Did Data Analysis, created Data Mapping and data interface documents and kept the documents updated with changes in requirements and functional specifications.
• Worked on developing the business requirements and use cases for Facets batch processes; automating the billing entity and commission process.
• Coordinated the upgrade of Transaction Sets 837P, 835 to HIPAA compliance.
• Worked on the EDI 834-file load to Facets through MMS (Membership Maintenance sub-system).
• Did gap analysis for HIPAA P and 835 transactions and HIPAA P and 835 transactions.
• Involved in impact analysis of HIPAA and 837P transaction sets on different systems.

Environment: - Rally, Agile, Microsoft Office, HTML, Microsoft Visio, Share Point, Mega, XML schema, J2EE, UML, Quality Center

Confidential, Wilmington, DE

Business Analyst

Responsibilities:

• Gathered business requirements based on interactions with the process owners and stakeholders.
• Involved in examining, processing, calculating and pay claims insuring fillings, documentation and reports.
• Involved in processing applications, recording changes to policies, processing reinstatements and handling required reports.
• Facilitated brainstorming sessions with the SME from underwriting, finance, customer service, and fulfillment departments so as to capture self-service portal requirements.
• Engaged with Business teams to understand the reporting needs and work with development team to document business requirements into Functional Required Document (FRD) which was utilized by development team for constructing business application.
• Created current and future state business workflow process using UML diagrams, Conducted walkthroughs with the stakeholders to gather the modification requests from the user to upgrade or change the business specifications for the product.
• Involved in Bug-Review meetings with software developers, QAs, and managers proposed solutions to existing bugs. Coordinating closely with QA team to ensure all quality checks are being followed rigorously.
• Acted as a lead to coordinate testing, ensured that Test Cases (UAT, system, performance, and regression) were executed and testing results were documented properly.

Environment: - HP Quality Center, Agile, MS office Suite (Word, Power Point, Access, Excel, Outlook), MS Project, MS Visio, SQL2005.

Confidential, Tampa, FL

Business System Analyst

Responsibilities:

• Conducted user interviews at both in-house and client locations, gathering and analyzing requirements using Requisite Pro and Requisite Web
• Extensively used Agile Methodology in the process of the project management based on SDLC.
• Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams, Object Oriented Design (OOD) using UML
• Gathered and documented Business Requirements, created Functional specifications and translated them into Software Requirement Specifications.
• Performed Gap analysis by identifying existing technologies, documenting the enhancements to meet the end state requirements
• Developed test cases and test scripts and assisted Quality Assurance activities, with system integration testing and user acceptance testing (UAT), developing and maintaining quality procedures and ensuring that appropriate documentation is in place
• Responsible for identifying and documenting business rules and creating detailed Use Cases
• Participated in the process of internal and external auditing activities and developed timelines for project delivery, and managed projects and resources to successful completion.
• Reviewed all Test Requirement Documents. Conducted system, integration andUATtesting.
• Involved in data dictionary management, Extraction Transformation and Loading (ETL) of data from various sources. Participated in ETL requirements process during data transition from source systems to target systems.
• Involved in Data Analysis & Mapping to track all data elements used in the application from the user interface through different interfaces to the target databases in which they are stored.
• Developed Tables, Views, Stored Procedures and Triggers using SQL Scripting
• Established Inner Join, Outer Join and created Indexes whenever necessary
• Writing Complex SQL queries and optimizing SQL Queries
• Responsible to meet the information demands of our business users by delivering timely, accurate, meaningful and standardized data and reporting
• Participated in creating logical and physical data models, their enhancement. Based on the data models, worked with business architect, to create the software solution models.
• Helped in creating of Data-Mapping best practices document including visual processes and trained team members on Data Mapping process and tools.

Environment: - SQL Server, Agile, MS Project, MS Access, Microsoft Excel, Microsoft Word, Microsoft Power Point, Visio, Rational Clear Quest, Rational requisite pro.