Name : Joseph Thomas

Phone : 813-***-****

Email : abmgzf@r.postjobfree.com

Summary

Results-driven, versatile Business Analyst with more than 8 years of healthcare experience and more than 14 years of overall experience in technology-based complex projects.

Experience in Data mining, Analysis and creating Data transformation requirements for different regulatory reports and Management Reports

Experience in Oracle PL SQL, SQL server and SQL DTS.

Experience in creating Management report and data analysis report.

Good Health care domain knowledge and experience in working on different modules within healthcare (Encounters, Claims, Enrollment, Healthcare Analytics and Regulatory compliance).

Engage in various project management responsibilities to ensure departmental goals are met.

Ability to work within deadlines and with multiple priorities; ability to adapt to changing priorities

Extensive experience in writing Business Requirement Document (BRD) and Functional Specification Document (FSD) and creating Business and Functional Use Cases.

Experience in 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.

Created Requirements Traceability Matrix to keep the stakeholders informed of the progress of the project.

Experience in working with ANSCI X12 HIPAA HealthCare Transactions: HealthCare Claim/Encounter (X12 837), Benefit Enrollment (X12 834), Claim status inquiry and response (X12 276 and 277), Functional Acknowledgement (X12 999)

Experience in SQL programming, Analysis & design (UML: Use case, Sequence and activity diagrams) and high proficiency in Microsoft excel.

Experience in User Acceptance Testing, Regression Testing Performance Testing and Functional Testing.

Experience working on reporting requirements and maintaining their data for analysis on MS Excel.

Experience in creating functional flow diagram using MS Visio.

Experience in using MS Office

Working experience with Dell Xcelys Claims Processing System and Healthcare Transaction Repository (HTR).

Excellent interpersonal skills, presentation and communication skills

EXPERIENCE HIGHLIGHTS

Aug 2010 – Till Date

Sr. Business System Analyst, Wellcare Healthplans Inc. contract through Cognizant Technologies

WellCare Health Plans Inc provides managed health care services for the government-sponsored healthcare programs focusing on Medicaid and Medicare. Headquartered in Tampa, Florida, WellCare offers a variety of health plans for families, children, and the aged as well as prescription drug plans.

Responsibilities:

Understand the real Business requirements; define the Scope and vision of the project.

Work with Project state holders, translate the Business requirements to Functional requirements so that the developers can understand and translate the developer questions to business questions that stake-holders can understand.

Translate the technical and architectural complexities and convey the same to project stakeholders.

Work with stakeholders to identify current business model, document their requirement and provide improvement suggestions.

Create business and functional use cases and flow diagrams

Conduct JAD sessions and Manage requirements.

Serve as a liaison and facilitator between Market, business and IT.

Provide support to developers, QA and UAT.

Created requirements and test cases for HIPAA X12 5010 Encounter for institutional and Professional Encounters.

Created mapping document for 837 5010 Prof and inst encounter and HTR.

June 2008 – July 2010

Business System Analyst, Wellpoint Inc, Camarillo, CA, contract through UST GLOBAL, CA, USA

Worked Wellpoint State sponsored Business Division which provides managed health care services for the government-sponsored healthcare programs focusing on Medicaid and Medicare.

Responsibilities:

Loading the claims into D950 system

Worked with the SSB Encounter Data Analysis Group (EDAG) team for validating and delivering the Encounter (HIPAA EDI 837) files to CA State Plans- LA Care, County Medical Service Program (CMSP) and Mainstream.

Report Encounter data submission status to WellPoint Management.

Analysis of 997 and error reports and Identify potential issues, Write requirements to resolve it and hence improve submission quality.

Associate with other departments and vendors like Pharmacy, WGS, Doral and VSP to resolve potential encounter issues.

Involve in Technical design walkthrough, UAT and implementation.

May 2006 – June 2008

System Analyst, Wellpoint SSB IT through UST GLOBAL, Trivandrum, India

SSB IT was a team for providing technical support for a Wellpoint State sponsored Business division located at USA. Worked as a system analyst with this team and my responsibilities includes

Lead service delivery team, assign task and monitor team’s assignments

Understand Functional specifications and prepare Technical design Document.

Coordinate with the team working at client location and make sure the quality of the deliverables.

Design, Code review and test plan preparation

Writing stored procedure, triggers, functions and packages based on the requirements

June 2004 – April 2006

System Analyst, Dimensions CyberTech India (P) Ltd, Trivandrum, India

Worked as a System Analyst and Sr. Software Engineer for Dimension Cyber tech and involved in design and development of following projects.

SWIFT Warehouse: A fully web based warehouse automation package focused on Optimized utilization of machinery, space and manpower.

BISAK : This is a fully Web based project developed for a school at Saudi Arabia for coordinating all their administrative activities under one roof.

Shipping Dimensions: Developed for a Shipping Cargo company at Dubai. This project includes all activities of shipping agent under one roof. This project includes Inventory Management, Accounts and Payroll.

Feb 2003 – June 2004

Module Lead Xylon Technologies (P) Ltd., Palarivattom, Cochin. India

Worked as a Developer and Module Lead of Distribution module which is a part of company’s ERP package AZURE. This module consists of sub modules sales, Purchase, Inventory, Exports Sales, VAN Sales and Point of Sales

June 2000 – Jan 2003

Senior Software Engineer, DataMate Infosolutions (P) Ltd. Cochin, India

Worked as a software engineer and Sr. Software engineer and involved in the development for following projects

Airline Billing: Developed for an Airline travel agency at Mauritius, The software provides complete solution of an Airline Travel agency.

Travel Agent Billing Software: This is an inventory package for an Airline Travel agency located at USA. This application helps the user to keep track of the tickets booked by the travel agent.

HotSoft: This software is developed for hotel groups, to coordinate all the activities under one roof. I developed the Food Costing module for the system.

Technical Skills Summary

Operating System: Microsoft Windows NT, 2000, 2005 & XP

Languages: VC, VB, .Net

Database: SQL Server, MS Access, Oracle, FoxPro

Web Servers: IIS

Tools: Edifecs Spec builder, TOAD for oracle, Pervasive Data junction, MS Visio, Crystal Reports, MS DTS.

EDUCATION, TRAINING & CERTIFICATIONS

Master of science in Information Technology

GNIIT from NIIT COCHIN. India

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