Vaibhavi Khot

Email Id: acgbyn@r.postjobfree.com

Contact: 325-***-****

Professional Summary

Sr. Business Systems Analyst with 10 years of experience specializing in Healthcare Industry and E Commerce.

Excellent Knowledge of Agile Backlog Grooming, Release Management & Sprint Planning, Estimation Velocity

and Change Management.

Experience in creating Project Charter, Project Plan, and Project Schedule and Status reports, while keeping

schedule, cost and resources at balance.

Experience in Requirement gathering & Management in individual as well as group settings; Skillfully documented

Business Requirements, Use Case Specification, Functional and Non Functional specification, UML diagrams including

Use Case diagram, Activity diagram, Class diagram, Sequence diagram, Data Flow diagram (DFD), Entity Relationship

diagram (ERD), Requirement Traceability Matrix (RTM), Change Version Control, Training and User Manuals;

Workflow Diagrams, Business Process Analysis &Re engineering, Testing Lifecycle, GAP analysis, risk analysis,

cost benefit analysis

Extensive knowledge and experience of n tier architecture, web controls, Mockup Diagrams, web services

implementations in a SOA environment; SEO, Page Indexing, Sitemaps and Robot.txt files

Experience in scheduled and ad hoc report generation using MS Excel, SSIS, PowerPivot, ROLAP & MOLAP

cubes and other relational data sources using SQL.

Knowledge of Health Insurance Portability and Accountability Act (HIPAA) standards, Electronic Data

Interchange (EDI) and implementation of ASC X12N code sets 4010A/5010, ICD 9, ICD 10 and HL7.

Experience with standards for medical transactions like 820 (enrollment), 834 (premium payments), 835 (medical claims

payments), 837 (medical claims), 270 (eligibility inquiry), 271 (eligibility response), 276 (claim status), and 277 (claim

status response).

Experience in White Box, Black Box, Unit, Functional, Integration, Back End and System Level Load and Stress

Testing.

Experience in Data Analysis, Data Warehousing; writing DDL & DML SQL queries (T SQL & PL SQL) especially

stored procedures, joins, triggers and views.

A team player with experience in handling remote teams esp. managing schedules and meeting agenda.

Technical Skills & Tools:

Business Skills: Business Process Analysis & Design, Gap Analysis, Impact Analysis, JAD/JRP Sessions Requirement

Gathering, Change Management and Use Case Modeling, User Stories

Methodologies: Agile (Test Driven Development & SCRUM), RUP, Prototyping and Waterfall

Languages: T SQL, C#, JAVA, HTML and XML

Tools: Clear Quest, Clear Case, MS Visio, Rational Requisite Pro, HP Quality Center, TFS, Microsoft Team

Manager, JIRA, JIRA Agile( Green Hopper), DNN, Moodle, MS Office Suite (Word, Excel, Power Point, Outlook), MS

SharePoint, MS Visio, MS Project, and MS FrontPage

Vaibhavi Khot

Email Id: acgbyn@r.postjobfree.com

Contact: 325-***-****

Data Tools: DB2, MS SQL Server, Oracle, Teradata, SSMS, Toad, Crystal Reports, PowerPivot, MicroStrategy,

ERWin, BIDS

PROFESSIONAL EXPERIENCE

Senior Business Analyst March 2013 –August 2014

UST Global/ Emdeon

Atlanta, Georgia.

Emdeon is a leading provider of revenue and payment cycle solutions with connections to payers, providers and vendors.

The project was to deliver a data mining solution for Payment Integrity based on EDI Claims data fully integrated into an

OLAP cube.

Responsibilities:

Participated in Backlog Grooming sessions, identified obstacles, planned releases and managed sprints, also created

a Business Requirement Document for management.

Created and Managed User Stories in Epics, Themes and Sprints; also calculated velocity and Story points in

TFS. (I was also part of the team that assessed and analyzed TFS, HP Agile Manager and Green Hopper as

Agile ALM tool)

Conducted interviews with the SME and gathered information about Health care Enrolment, Billing and Claims

processing leading to creation of user stories, test cases in epics and themes.

Analyzed HIPAA 5010 related to 837,835, 834; creating Data warehouse model schemas for faster data processing;

also performed Normalization De Normalization at various occasions.

The user interface (UI) screens for SharePoint Web Parts & User controls were mocked up in Microsoft Visio and

reviewed with the end users prior to programming to solicit User Acceptance.

Worked with end users to define business design solutions (e.g. new workflows, systems, programs, and reports) as

well as created integration requirements for system coupling.

Created Mockups for SSRS based data and Sample Data Mapping documents for ETL process.

Created SharePoint workflow diagrams describing how to use the new system.

Participated and conducted daily standup meetings and owned daily milestones to gather and create reporting

specifications.

Created UAT plans and several other types of test cases for each project to ensure that the system runs smoothly after

the proposed enhancements.

Coordinated between business line, operations and the technical team throughout the project.

Gathered requirements for impacted system and business areas for ICD 10 and their needs to embrace the changes.

Created T SQL statements, stored procedures to query the custom claims OLAP database.

Provided Full Text Search requirements and catalogs for advanced search.

Vaibhavi Khot

Email Id: acgbyn@r.postjobfree.com

Contact: 325-***-****

Environment: Agile, TFS,MS Office 2007, MS Project, Rational Requisite Pro, MS Visio 2010, MS SQL Server,

Oracle, Business Intelligence tool (MS Share Point), Android Apps, JAVA,

Business Analyst November 2012 to February 2013

East Coast Pharmacy

Titusville, FL

East Coast Pharmacy is a fastest growing pharmacy chain and part of nationwide health mart pharmacies, subsidiary of

McKesson with its base in state of Florida. It’s a provider to over 25000 health maintenance organizations (HMOs), preferred

provider organizations (PPOs), commercial health insurances, Medicare Part D and State Medicaid patients. The project was

to develop Pharmacy Benefit Management System, Health Insurance Claims Adjudication and Web Application.

Responsibilities:

Gathered all the required functional requirements

Coordinated and conducted several JAD sessions with SMEs, stakeholders, design/development teams and users.

Prepared Business Requirement Documents (BRDs), Technical Requirement Documents (TRDs) and Case Studies to

evaluate business needs for Pharmacy chain.

Custom solutions were created and tested to resolve operational issues.

Designed and developed Use Cases, Activity Diagrams, and Sequence Diagrams using UML in Visio to map the

claims adjudication workflow, and POS integration.

Created and maintained the Requirement Traceability Matrix (RTM) between the requirements and design

documents and test plans.

Conducted various meetings and interacted with the SMEs, and developers to discuss Enhancement and

Modification Request issues.

Assisted in developing User Interface (UI) designs and prototypes using Fireworks for web application development.

Assisted in User Acceptance Test (UAT).

Environment: Windows, MS Visio, Requisite Pro, Bugzilla, UML, SQL, MS Office, .Net, J2EE, HIPPA, EDI.

Business Analyst September 2011 to October 2012

ConnectiCare

Farmington, CT

ConnectiCare, health plans serves more than 240,000 individuals in Connecticut and Western Massachusetts. ConnectiCare

offers full range of health insurance products on both a fully insured and self funded basis including. To develop application

for online insurance services for members, providers and agents. The system would provide online enrollment eligibility,

selection of health plan, provider enrollment processing, tools for agents, claims management, etc.

Vaibhavi Khot

Email Id: acgbyn@r.postjobfree.com

Contact: 325-***-****

Responsibilities:

Gathered all the functional and nonfunctional requirements.

Coordinated Interviews and conducted JAD sessions with management, SME, vendors, users and other stakeholders

to gather functional requirements.

Documented requirements and communicated with development team for design and implementation of business

solutions.

Participated in Gap analysis between stakeholders and user’s needs and proposed solutions.

Worked with Project Manager and Project lead on detailing Business Requirement Document.

Maintained Requirement Traceability Matrix.

Managed Change Request documents and defect tracking.

Planned and defined system requirements to wire Frames with Use Case, Use Case Narrative, Activity Diagrams and

Use Case Model using UML (Unified Modeling Language).

Incorporated stakeholder feedback throughout project lifecycle to ensure project quality and customer satisfaction.

Each phase of software development life cycle created using agile methodology.

Analyzed HIPAA administrative standards to incorporate in health plan products.

Evaluate Medicare requirements and benefits in Medicare Health Plans for member enrollment and management

(EDI transaction 270/271).

Worked with QA team for mapping documents, creation of Test Plan, Test Scenarios and Test Cases for unit, system

and system integration testing.

Developed and manages creation of User Manual documentation to communicate features and benefits.

Environment: Agile, UML, Rational Requisite Pro, Visio, MS Project, MS Office

Business Analyst January 2010 to August 2011

Ameri Group

Virginia Beach, VA

Ameri Group offer innovative health insurance coverage and a full range of health and wellness plans for groups and

individuals. Ameri group offers health care services through three government programs that target different segments of the

country's low income population: Medicaid, the Children's Health Insurance Program (CHIP) and Medicare. In this project I

have been involved in attaining Level 1 compliance. Performed initial impact analysis to testing and validation efforts and

have delivered some critical artifacts including BRD, mapping document and companion guide based on TR3 documents.

Responsibilities:

Created process flows for HIPAA EDI transactions such as 270, 271, 276, 277 and 820.

Played an active and lead role in gathering, analyzing, and writing business requirements.

Involved in Requirement Scoping and analysis of high priority requirements for implementation.

Vaibhavi Khot

Email Id: acgbyn@r.postjobfree.com

Contact: 325-***-****

Designed the business requirement collection approach based on the business need and requirement priority.

Conducted end user surveys and interviews to come up all the relevant fields and information required.

Conducted JAD workshops to achieve consensus on critical and sensitive issues and members privacy requirements.

Consulted with legal SMEs to ensure compliance with state medical privacy laws.

Actively involved in the creation of comprehensive resource center through collection, documentation and extensive

editing of relevant medical literature.

Used UML to perform Use Case analysis to capture the dynamic aspect of the application.

Developed UI document with UI designs and mock ups through wireframes. Utilized Story boards and screen

mock ups to obtain client feedback and approval. Suggested changes when the user interface was confusing or

needed rewording.

Authored Companion Guide to support all the information needed to process HIPAA transactions with Ameri

Group.

Prepared user acceptance criterion and testing strategy that will be utilized by QA team to validate the addressed

functionality of all critical requirements.

Developed and maintained Test Matrix and Traceability Matrix. Utilized Quality Center to plan and execute tests,

track defects and create change alerts. Conducted User Acceptance Testing (UAT).

Environment: HIPAA ANSI X12, Rational Rose, Rational Requisite Pro, Microsoft Visio, SAS, Java, MS word, MS

Excel, MS outlook, MS Access, EDI, Oracle, MS SQL Server

Systems Analyst Aug 2008 – Dec 2009

Footlocker, Chicago, IL

FL.NET DFS is a web based, three tiered merchandising and inventory management system developed with .NET

technology. The system allows a store to manage the workflow required from creating sales orders to getting them approved,

making requests to the warehouse and updating the inventory, to finally making a delivery order. It also allows the company

to configure and make dynamic changes to their business rules.

Responsibilities:

Interacted with business heads to finalize the Business Requirements for the application

Implemented SCRUM for Project planning and estimation

Adept in creating Agenda for Sprint Planning and Review Meetings

Created User Stories to create Product Backlogs and conducted backlog grooming to maintain priority, rank and

complexity of each story

Developed a Use Case Model using MS Visio and developed a detailed project plan with emphasis on deliverables.

Successfully conducted JAD sessions, which helped synchronize the different stakeholders on their objectives and

helped the developers to have a clear cut picture of the project.

Performed Use Case testing to support QA team in adjusting to agile environment.

Managed various tests, stored test information, reviewed and analyzed test results.

Vaibhavi Khot

Email Id: acgbyn@r.postjobfree.com

Contact: 325-***-****

Conducted presentations of the Q/A test results with analysis to the stakeholders and users and documented

modifications and requirements.

Environment: MS SQL Server, Agile, Scrum, SQL, MS Visio, MS Office, UML, Windows XP, HP Quality Center,

Rally

Jr. Business Analyst August 2007 to June 2008

Unicare Insurance

Chicago, IL

Unicare is a national organization dedicated to the delivery of quality health care plans and products to its customers. This

project was aimed at developing a lightweight internal Work Flow Management system to automate business processes based

on preset business rules and conditions. The system is primarily aimed at handling Medicare/Medicaid insurance claims and

process exceptions based on HCFA 1500 and CMS 1500.

Responsibilities:

Analyzed current business process flow by understanding preset business rules and conditions

Conducted formal interviews, live meetings with business users and subject matter experts (SME's).

Documented, organized and tracked the requirements.

Designed and developed Use cases, Activity diagrams, and Sequence diagrams using UML.

Developed Business process flow diagrams, Data Flow Diagrams (DFD's), Activity Diagram for data modeling

Created web page mock ups on MS Visio using Data Fields from HCFA 1500 and CMS 1500.

Defined project milestones, schedules, and monitored progress using MS Project and updated plans as required.

Analyzed, organized, and updated database using SQL.

Involved in back end testing to verify data integrity using SQL.

Analyzed and tested data interface needs with external systems.

Developed Test plans, Test conditions, and Test cases to be used in testing based on business requirements and

technical specifications.

Assisted with user testing of systems and maintained quality procedures and ensured appropriate documentation in

its place.

Maintained Requirement Traceability Matrix (RTM) and utilized Clear Quest for change requests and defect

tracking.

Environment: UML, MS Word, Rational Requisite Pro, Rational Rose, Rational Clear Quest, Quality Center, SQL,

MS Visio

Systems Analyst June 2005 – March 2007

Sipra Laboratories, Gurgaon, India.

Vaibhavi Khot

Email Id: acgbyn@r.postjobfree.com

Contact: 325-***-****

SIPRA is the preferred destination for the research needs and drug development services .The project was to design a Drug

Management System that computerized the various details on a drug and includes details like the Researches, Trial Phase,

Therapy area, Disease Area, Country, Region, etc. The main benefit of this system was to ensure fast and easy accessibility

to the drug and research databases.

Responsibilities:

Created Data Migration Plan for migration of data from various sources.

Conducted Q&A sessions with the SME’s, to analyze and document the requirements

Functioned as the primary liaison between the business line and the technical areas

Organized meetings via WebEx, Lotus Notes and face to face, documented action items and minutes; presented

summarizations to the peers and communicated with clients, regarding issues, using Lotus Notes.

Created Business Requirement Documents and Functional Requirement Documents.

Conducted status update meetings weekly, to review the progress of the project.

Performed rigorous data modeling involving creation of a normalized relational ER model and creating SQL scripts.

Coordinated in developing test scenarios, test cases and implemented test plan with QA team

Analyzed business requirements and segregated them into high level and detailed Use Cases.

Created Activity and Sequence Diagrams using Rational Rose & MS Visio.

Frequently updated the requirement and defect status as per the current status of testing.

Environment: Rational Rose, RUP, MS Visio, Crystal Reports, MS office, Requisite Pro, Windows XP, .NET, Oracle

EDUCATION

Master of Business Administration from Tarleton State University, Stephenville, Texas.

Bachelors of Computer Science from Nagpur University, India.

Jr. System Analyst (Intern) June 2004 – March 2005

Altisource, Pune, India

Altisource provides services to some of the most respected organizations in their industries, including one of the nation’s

largest sub prime servicers, government agencies and many lenders, servicers, investors, mortgage bankers, credit

unions, financial services companies and hedge funds across the country. The project was to develop an automated web

based system for the mortgage services for the Agencies. The system generates reports of individuals based on the data

provided by the various agencies. The system also maintains a record of any information obtained to and individual’s

report and updates the database.

Responsibilities

Vaibhavi Khot

Email Id: acgbyn@r.postjobfree.com

Contact: 325-***-****

Primarily involved in gathering requirements for the GUI (Graphical User Interface) screens and designing the

•

same.

Participated in arranged JAD sessions with business users for requirements gathering.

•

Participated in preparation of workflow diagrams and presented to developers.

•

• Participated in preparation of use cases and designed use case diagram, class diagrams and sequence diagrams using

Rational Rose.

• Participated in preparation of Software Requirements Specification (SRS) taking functional requirements

specification as a base.

• Participated in preparation of non functional requirements.

Environment: MS Word, MS Excel, SQL, MS Visio, Windows XP

REFERENCES AVAILABLE UPON REQUEST

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