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Veena - Business Analyst

[email protected]

Location: South Windsor, Connecticut, USA

Relocation: Local / Remote

Visa: GC

Veena Business Analyst +15178935038 [email protected] South Windsor, CT Local / Remote GC PROFESSIONAL SUMMARY: Over 7 years of experience as a Business Analyst in identifying business needs and determining solutions to business problems for complex software projects in Health care, P&C insurance (Auto, personal, commercial) domain. Exposure to creation of Business Requirement Documents (BRDs), Functional Specification Documents (FSDs), Use Case Documents, Acceptance Criteria Documents (ACDs), Business Rules Spreadsheets (BRS) and Requirements Traceability Matrix (RTMs). Experienced in all phases of the Software Development Life Cycle (SDLC) Waterfall methodology, Agile methodology (Scrum), Rapid Application Development (RAD) including Requirement Planning and Management, Requirements Elicitation and Requirements Analysis. Experienced in conduct interviews, brain storming sessions, group interviews, prototyping, focus group sessions and JAD sessions in order to gather requirements. Worked on various types of health insurance programs such as Medicaid, Medicare, PPO (Preferred Provider Organization), HMO (Health Maintenance Organization) and the healthcare standard Health Level Seven (HL7). Experienced working with EHR (Electronic Health Record) and EMR (Electronic Medical Record) team for data requirement. Excellent knowledge of HIPAA standards, EDI (Electronic data interchange), Implementation of HIPAA code sets, coding and HL7. Experienced in the hospital services and business sectors of Medicare and Medicaid for inpatients, outpatients, billing methodology and computer technology administration of Medicaid (MMIS). Worked on health care sector claims management, HIPAA regulations and 270,271,834, 835,837P EDI transactions specially. Medical Claims experience in Process Documentation, Analysis and Implementation in 835, 837IPD, 834, 270/271, 276/277, 999/TA1 (X12 Standards) processes of Medical Claims Industry from the Provider/Payer side. Experience with various Facets modules such as Provider, Subscriber/Member, Claims, Plan/ Product. Extensive knowledge of P&C insurance policies, policy life cycle, claims life cycle, Billing life cycle, Rating system and subrogation. Extensive knowledge of Auto insurance integrations, insurance quote applications, Homeowner insurance. Extensive knowledge of commercial insurance LOB s, Business owner s policy (BOP), BOP integrations and general liability insurance. Experience working with Guidewire for Claims, Billing and policy management. Strong Experience in using different requirement management and testing tools including Confluence, JIRA, Azure DevOps, Jama. Experience in conducting Gap Analysis, Risk Analysis and documentation of Use Cases and User Stories. Excellent knowledge of the AS-IS and TO-BE business processes and experience in converting these requirements into technical specifications. Experienced on User Acceptance Testing (UAT), SWOT analysis, Risk Analysis and mitigation plan and ROI analysis Proficient in creating UML diagrams, Context, Use Case, Sequence and Activity diagrams using MS Visio. Advanced proficiency in Microsoft, particularly Word, Excel, PowerPoint, and MS Project and expertise in Analyzing and Summarization of data using Excel. Strong experience in Application Design (Prototyping, Screen Mock-ups), wireframes and UI design. Proficient in evaluating SQL queries for data extraction, manipulation, analysis, and validation. Experience in Analyzing statistical reports on the company's web traffic using MS Excel and generated business reports, visualizations using Tableau. Interacted extensively with customers and UI designers to determine ways to improve the UI feel and the user experiences. Documented the gathered business requirements into detailed Business Requirement Documents. Experience in extracting UI based information by querying the Oracle database using SQL queries. Experience in maintaining the Requirement Traceability Matrix (RTM) table to track all the requirements in BRD. Good knowledge of identifying various test scenarios. Holds strong ability to handle multiple tasks and prioritize. Knowledge on System testing while performed on the entire system in the context of a Functional Requirement Specification (FRS) and System Requirement Specification (SRS). Strong understanding in Test Planning, Test Preparation, Test Execution, Issue Resolution and Report Generation to assure that all aspects of a Project follow the Business Requirements. Hands on experience in User Acceptance Testing (UAT) to ensure all the User Requirements were met by the application. Skills and Tools SDLC Methodologies: Agile-Scrum, Waterfall, Water-Scrum Fall, Kanban Business Skills: Project Management, Requirements Elicitation, Stakeholder Management, Strategic Planning, Business Process Mapping, Conflict Management, Scheduling, Risk Management, Impact Analysis, Liaising Business Modelling tools: MS Visio, Balsamiq Mock-ups, Lucid Chart Project Management Tools: JIRA, MS Project, MS SharePoint, Confluence, JAMA, Azure DevOps BI and Reporting Tools: Tableau, MS Office Suite (Excel, Word, PowerPoint), Power BI Databases and ETL Tools: Informatica PowerCenter, MS Access, Oracle, My SQL Languages: SQL PROFESSIONAL EXPERIENCE: Medical Mutual, Cleveland, OH May 2020 - Present Business Analyst Responsibilities: Gathered requirements and developed Process Model towards understanding the stakeholder's business priorities to effectively identify business problems, assess proposed solutions, and represent the needs of stakeholders. Requirements analysis and document them according to corporate standards and procedures and prioritize them for assigned areas. Facilitated Joint Application Development (JAD) sessions, as well as conducted interviews with appropriate business/technical stakeholders. Worked with development/technical team members to ensure that the defined business requirements are met. Worked in Agile methodology of system development. Identified and conducted stakeholder analysis to gather Business Requirements, interact with stakeholders, gather requirements and assign priorities to each of them. Involved in Claims Processing, Enrollment (834), Group and Individual Member billings Conducted UAT (User Acceptance Testing) with End Users for final Sign-off on the project. Involved in testing Claims payment and implementation, HIPPA compliance ANSI X12-837 EDI Transaction Code 837-claims encounter, 834- Benefit Enrollment, 835 - Claim Payment. Coordinated activities and evaluated performance of project team and reports performance. Conducted meetings to allow different stakeholders to communicate their perspectives with each other. Prepared Business Requirement Specification Document (BRD) and converted into Functional requirement specifications document (FRD). Responsible for checking member eligibility, provider enrollment, member enrollment for Medicaid and Medicare claims. Responsible for Bug free delivery of Sales and Service Oriented applications. Supported new business requirements by extending the functionality of the core Facets system using the Facets extensibility architecture feature. Extensively worked with FACETS Implementation, FACETS Billing, Claim Processing and Subscriber/Member module. Develop the detailed business requirements based on the High-Level requirements and information gathered from multiple business partners. Conducted and participated in walkthroughs of requirements and Use cases with business and IT team members. Designed Use case Diagrams, Workflow diagrams, Activity diagrams for most of Use Cases identified using UML/Visio. Highly involved in Gap Analysis to identify the deficiencies of the current system and to identify the requirements for the change in the proposed system. Played major role to create the Business Requirement Documentation (BRDs), using MS Word and MS Visio that provided appropriate scope of work for technical team to develop prototype and overall system. Identified the schema to persist the mapping of new system to existing system codes. Reviewed test cases and test plan for UAT testing. Metro mile, SFO, CA January 2019 April 2020 Business Analyst Responsibilities: Worked on Waterfall methodology and created a Business Requirements Document and System Requirements Specification Document. Prepared BRD, FRD, and used HP Quality Center to manage, analyze, and convert business requirements into functional specifications. Conducted Joint Application Development (JAD) sessions with IT groups and identified the Key Changes and participated in Stakeholder Management to communicate effectively with them. Maintained and kept track of stakeholder's requests for enhancements and changes using Azure DevOps. Converted Business specifications into Business and Functional Specifications. Lead system requirements definition, design, testing, training and implementation support. Worked as a UAT Testing Lead and coordinated with SMEs in defining, designing, conducting and evaluating results. Wrote complex SQL queries to extract and validate the data from the Facets database. Worked with key business stakeholders to understand the Tableau Report requirements and then create Visual Design of the Reports as well as conducted detailed multiple stakeholder walkthroughs on each Tableau report developed. Created Tableau reports for healthcare modules such as Enrolment, Claims, Operation and Finance in Tableau Desktop that were published to the internal team for review and further data analysis and customization using filters and actions. Conducted in-depth design and development session with developers and testers to explain the requirements and clarify functional questions regarding system development and testing, including supporting an offshore team involved with development activities. Worked as Tableau production support and made sure the Tableau dashboards are up and running. Assisted the Project Manager with project administrative tasks, such as work plan administration, time tracking, and project schedule maintenance. Various versions of the documents generated during the project were maintained and managed using Jama and performed defect tracking using Jama. Used MS Office extensively (Word, Excel, PowerPoint) for analysis, presentation, and documentation throughout the project. Prepared monthly Status Reports for Enhancement Requests to the project team that was used inefficient tracking and monitoring of open issues of the project. Designed and developed Use Case Diagrams, Activity Diagrams, Sequence Diagrams, and Collaboration Diagrams using Lucid Charts. Erie insurance, erie, PA May 2017 December 2018 Business Analyst Responsibilities Gathered the high-level business needs from the directors and prepared the High-level Business Needs. Work with production underwriters to review commercial property insurance renewal and new business opportunities to ensure proper risk identification, analysis and assessment and the development and growth of a profitable portfolio of business. Gathered requirements for the Guidewire Billing & Policy Center Integration Team by coordinating with SMEs from external systems and also with the Billing & Policy Center functional and configuration teams. Worked with Billing center, Customer Portfolio, Forms team to test the integration between these services. Aligned with the Guidewire Policy Center work stream and worked closely with Billing Center, Integration, Rating, Claim Center, Data Hub, and Agent Portland Forms streams. Performed Data Cleaning, Data Profiling, and Data Analysis and Data Mapping operations to bring more insights onto the raw data. Worked on a project, which dealt with the Production Stabilization and Defect Tracking of the newly migrated Guidewire Billing Center. Responsible for gathering requirements from users in operations group and performing data mapping for the application, confirm and vacillating the requirement at time of BA testing Elicited requirements for various Claims Integrations with Policy Center and Billing Center on activities like Policy and Billing Status retrieval, Checks Issued and Void Processes for Claims etc. Involved in testing the Quote & Purchase for both Auto and Home Property Insurance ratings of the customers. Performed Data mapping, logical data modelling, involved in creating class diagrams and ER diagrams and used SQL queries to filter data Worked on conducting User Acceptance Testing (UAT) and documenting test cases in both personal commercial line of property and casualty insurance Used JIRA for User Story requirements management throughout the Agile Sprints and development life cycle. Prepared requirements document for Commercial Auto, Inland Marine, Crime, Worker's Compensation, Umbrella, Business Owners Policy, Commercial Output Policy, and Commercial Property Package. Converted Business specifications into Business and Functional Specifications. Involved in generating Test cases for (P&C) property and casualty Insurances for Different Levels of Business Work closely with production underwriters to review commercial property insurance renewal and new business opportunities to ensure proper risk identification, analysis and assessment and the development and growth of a profitable portfolio of business. Blue Shield of California, CA July 2015 April 2017 Business Analyst Responsibilities: Elicited requirements from the SMEs and stakeholders to get clarifications on the business requirements to help System Testers to get a better grip on the project. Conducted numerous Joint Application Design (JAD) sessions and performed Gap analysis with the help of Business Workflow models and Workflow diagrams to analyze AS-IS and TO-BE scenarios. Performed risk analysis of the requirements to identify the key business risks areas for the project and prioritized the application development and testing. Assisted QA team with the understanding of requirements and bug issues. Attended JAD sessions for Requirement Validation to gather requirements for the new MMIS. Executed SQL scripts to pull the data from the existing database based on the business rules with the help of the DB and Testing Team. Extensively involved in the creation of the RTM document initially done in MS Excel, later moved to HP ALM to map the requirements with the test-cases and design elements. Responsible for writing Functional Requirement Specifications (FRS) and User Requirement Specification (URS). Acted as a Subject Matter Expert (SME) on many occasions to explain in brief to the business users about the internal systems. Facilitated JAD sessions with the management, developers and analysts from all the dependent systems/applications and backlog. Proficient in creation of source to target data mapping documents in a data warehouse environment and execute sql queries in a data warehouse environment. Experience managing requirements using JIRA and HP Quality Center. Review and approve test plans and participate in User Acceptance Testing. Also took lead in Customer Fulfillment Requirements. Performed testing for Medicare, Medicaid and X-Over claims for Medicaid Management Information System (MMIS). Analyze and document Medicaid EDI transactions issues related to implementation of HIPAA 5010 and ensure these issues are documented and addressed in the approach to the HIPAA 5010 version. Responsible for updating clients with provider information within MMIS on a weekly basis by running queries and exporting data in a defined file format. Translated 834 enrolment, 820 payments, and Group Setup EDI information onto technical mapping documents using State s HIPAA compliance X12 companion guide Generated reports to ensure that Medicaid policies, rules and business processes are consistent with the development. Monitored projects from initiation through transition and organized interdepartmental or cross-functional team activities and ensuring completion of projects on schedule. Coordinated project management while participating in project scoping, planning, issue, and risk management & improvement. Keywords: cprogramm quality analyst business analyst user interface business intelligence database information technology hewlett packard green card microsoft California Connecticut Ohio Pennsylvania