SUMMARY

• Sr. Business Analyst with 6 years of extensive experience in the Insurance and Healthcare industry with ability to understand and translate business, clinical and financial inputs into actionable plans to complete legislated healthcare remediation projects.
• Experience includes Requirements Gathering, business analysis, Business Process Flow, Use Case modeling, System Development Methodologies, Business Process Modeling and experience in HIPAA 4010 and 5010 and EDI healthcare transactions like 837, 835, 834, 270, and 271.
• Experience working in Healthcare and banking domains.
• Interacted and coordinated between end - users, expert team, development and QA team and suggested key enhancements and changes to the business rules.
• Extensive experience using ICD-9-CM diagnosis and procedure code sets and terminology
• Extensive experience using ICD-10-CM and ICD-10-PCS diagnosis and procedure code sets and terminology
• Proficient in all phases of Software Development Life Cycle (SDLC) achieving milestone using Agile, Rational Unified Process (RUP) and waterfall model.
• Hands on experience in gathering requirements from business owners, developers and project stakeholders and write both high-level and detailed-level requirements
• Skilled in creating Use Cases, Entity Relationship diagrams, Work Flow Diagrams, Activity diagrams.
• Extensive experience in preparing Business & Functional requirement documents.
• Experience in conducting Joint Application Development (JAD) sessions with Project sponsors and Development team.
• Strong experience in creating Test Cases and conducting User Acceptance Testing (UAT. Expertise in designing and developing test plans.
• Extensive expertise in documenting, tracking changes, defects management, change control using Quality Center, Rational Clear Quest and Clear Case
• Strong expertise in Client Relationship Management, worked as a liaison between businesses, technical and non technical departments within IT organizations.
• Played a dynamic role in the IT team as a Business Analyst on several projects on enrollment, claims, finance, provider admin, and group admin business areas in healthcare domain
• Excellent communication, presentation, client interaction and problem solving skills.

TECHNICAL SKILLS

Languages: Java, SQL, dot net

Databases: Oracle, MS, SQL Server, Excel, Access

Tools: Rational Suite, MS Visio, Quality Center, MS Project, Clarity, Caliber RM, JIRA

Defect Tracking Tools: Test Director, Rational Clear Quest, Win runner, Load runner

Web Development/Tools: HTML, XML, Java Script, Perl Scripting, Dreamweaver

Content Management Tools: Vignette, SharePoint, IBM ECM, Open text

PROFESSIONAL EXPERIENCE

Confidential - Houston, TX

Sr. Business Analyst

Responsibilities:

• Proficient in discussing and defining project, Gap Analysis with the clients from both a business and technical perspective
• Gathered requirements from claims business area, prepared process flows and diagrams for the project.
• Performed gap analysis for HIPAA 4010/4010A - 5010 conversion - Involved in the documentation of HIPAA 5010 changes to EDI 837 transaction.
• Performed gap analysis of ICD 9 to ICD 10 conversion for procedure and diagnosis codes in accordance with the HIPAA compliant.
• Wrote functional requirements and non-functional requirements based upon the approved business
• Requirements by following UML processes and standard procedures for developing use cases, use case diagrams and other supporting documentation
• Responsible for addressing, diagnosing and resolving issues that arise on a day to day basis for the team.
• Effectively elaborated the current process and gave a clear picture of the proposed process for the projects in the organization and aggressively worked towards timely completion of high priority tasks.
• Led the change control process for changes submitted for the BRD after the document was submitted to IT department.
• Worked with IT team to resolve issues and clarify business requirements from the business owners.
• Documented the UAT plan for the project and worked with the UAT Team to ensure every acceptance criteria for the requirements has been included in the UAT task plan.
• Maintained the traceability matrix to uniquely trace the identified business requirements of general design to testing as proof that requirements requested have been developed into a solution and tested.
• Tracked all the defects with QA team and worked on resolving the defects.
• Led the team during Unit Testing, System Testing, Volume testing, Integration Testing and User Acceptance testing.

Environment: Rational Rose, Requisite-Pro, SQL Server, MS Project, MS Visio, MS Word, MS Excel, Quality CentreASP.Net, VB Script.

Confidential - Indianapolis, IN

Sr. Business Analyst

Responsibilities:

• Interfaced withbusinessusers to prepare and updateBusinessProcess Requirements for the new release ofHealthcaretools.
• Utilized RUP to configure and develop process, standards and procedures.
• Create and execute project work plans and revise as appropriate to meet changing needs and requirements.
• Monitored all the HIPAA transactions through the gateway. Used ICD9 for diagnosis and procedure codes.
• Conducted GAP analysis of the different reports that are being presented to clients to accommodate their requirements.
• Tracked and maintained Stakeholder requested enhancements and changes using Requirement Traceability Matrix (RTM).
• PreparedBusinessprocess models; used Visio to create use case diagrams.
• Used SQL query management tools to write basic queries to support processing and analysis, such as queries to determine results for management reporting.
• Designed Test Plans and Test Cases for User Acceptance testing (UAT) with the help of QA teams.
• Used Rational Clear Quest for defects and bug testing.
• Administered and coordinated User Acceptance Testing and obtain final system acceptance sign-off with the help of Program Manager.

Environment: Rational Clear Quest, Rational Test Manager, J2EE, SQL Server, MS Visio

Confidential - Des Moines, IA

Business Analyst

Responsibilities:

• Conducted Joint Application Development (JAD) sessions for communicating and managing expectations.
• Experienced in working with Cross Functional Groups and reporting needs of client.
• Facilitated the Customer in defining the high-level Functional Requirements and needs.
• Responsible for Gathering Requirements based on the client requirements and specifications
• Initiated in the meeting withBusinessprocess owners, SME (subject matter experts) and Marketing Team for Requirements gathering In Definition Stage.
• Interacting with other teams through walkthroughs, teleconferences, meetings, etc. to resolve various issues.
• Used Rational Requisite Pro for gathering requirements and traceability.
• ManageBusinessas well as System requirements to perform requirements analysis along with the creation of Use Case Scenarios.
• Created BRD and FRD to document all scenarios and requirements for the new application and process.
• Modeling of thebusinessand application using Unified Modeling Language (UML)
• Developed BPMN, wireframe and User Interface (UI) to create exact scenarios of new functional application.
• Developed webpage for user registration for loan origination process.
• Prepared logical data model in the form ofBusinessContext diagram to include various entities and attributes in order to facilitate the design of Data model in the form of ER Diagrams.
• Used Rational rose to create use cases, activity, class diagrams and workflow process diagrams.
• Gathered the Requirements, developed Process Model and detailedBusinessPolicies and modified thebusinessrequirement document.
• Involved inBusinessProcess Mapping and Master Data Management
• Performed Data Analysis and Data validation by writing SQL queries.
• Created test plans and test scripts and interacted with QA team for execute the plan.
• Facilitated withbusinessusers for User Acceptance Testing (UAT).
• Interacted with the developers to report and track bugs using Rational clear quest.
• Trained the users for new process and applications.

Environment: UNIX, Windows, MS Visio, SharePoint, JAD, J2EE, WBSD, UML, RUP methodology

Confidential - Houston, TX

Jr. Business Analyst

Responsibilities:

• Identified, researched, Investigated, Analyzed and Documented thebusinessprocess.
• Conducted interviews, meetings and JAD sessions during the process of Requirement Gathering. Planned and documented procedures for data processing and prepared data flow diagrams for the application.
• Interacted with client, Subject Matter Experts and the Technical Team for requirement gathering, and translation ofBusinessRequirement to Technical specifications.
• Analyzed and translatedbusinessrequirements into system specifications utilizing UML and Waterfall methodology
• Experienced with MS Access to store testing data and retrieved data from MS Access data base for reporting needs.
• Gathered requirement for CMS (Content Management System) using Vignette Content Mgmt. (VCM) tool to create, manage and publish content of drugs to web application.
• Conducted walkthrough session withbusinessend users, stakeholders, Subject Matter Expert (SME), project Manager etc. to discuss and resolve various issues.
• Extensively worked on Data Analysis of different testing of tablet such as Disintegration, Hardness, Friability and Dimensional analysis etc.
• Gathered reporting requirement from end user to generate report using Cognos.
• Created process flow using MS-Visio for technical team to describe whole scenarios.
• Data validation, analysis and generating accurate reports for different testing of pharmaceutical drugs.
• Other responsibilities include assisting in Analysis, Validation and Cleanup efforts, producing reconciliation reports to prove results for financial reporting and providing reliable information to management.
• Created and maintained RTM for tracking requirements with test cases and confirming the testability of all the requirements
• Conducted Regression Testing, Build Verification Testing, and Incremental Integration Testing with developers and QA to ensure the requirements as perbusinessend users.
• Facilitated User Accepting Testing (UAT) with end client representative.