Profiling

Name

Ankita Giri

Experience

Total Years : 9 + Years

Designation

Senior Business Analyst

Contact number

804-***-****

Skills

Business Analysis, Agile / Scrum, Healthcare Domain(HIE), Insurance(P&C), Finance(Home loans), Business Requirements gathering, Documenting BRD, FRD, Change request documents, Status reports, meeting minutes, Meeting Agenda, Risk/issue management, Use Case Modeling, ITIL, Business Process Modeling, Business Rules, Process Design, Creating and documenting high level and detailed design documents i.e. context dig., data flow dig, sequence dig., system documentation, user manuals etc.

Core Capabilities

Business Analysis, Extensive knowledge and working experience in Medicaid Enterprise, ACA Act, HIPPA, HIE, EMR, EHR, ICD9/10, Health Insurance, EDI 835/834/837, Claims Processing, Adjudication, Payer, Providers

Any Other Comments (Adaptability, flexibility and attitude towards work, communication skills etc..)

In-Depth Insurance domain knowledge, expert in agile and waterfall project management methodologies, expert in business analysis and planning, knowledge on IT service lifecycles, Ability to manage / Lead small to complex project deliverables, Ability to quickly master new concepts and technologies, Detail oriented and conflict resolution skills

Enriching experience of client facing roles for 6 + years, Excellent communication skills, Can adapt to new environment easily, have a positive attitude towards the challenges, good Team leadership skills.

Current Work Visa Status

Green Card

SUMMARY

Experienced Senior Business Analyst offering 9+ years of success leading all phases of diverse technology projects; degree in Bachelor of Engineering.

Business strategist; plan and manage multimillion-dollar projects aligning business goals with technology solutions to drive process improvements, competitive advantage and bottom-line gains.

Excellent communicator; leverage technical, business and financial acumen to communicate effectively with client executives and their respective teams.

In-Depth Healthcare and Insurance domain knowledge; brings 5+ years or experience working with Healthcare domain and 4+ years of experience with Finance Services

Expert in agile and waterfall project management methodologies. Able to manage large project teams and known for high-quality deliverables that meet or exceed timeline and budgetary targets.

Expert in business analysis and planning. Managed requirements received and gathered from multiple stakeholders, performed requirements validation and solution assessment.

Knowledge on IT service lifecycles having knowledge in various phases Service Strategy, Service Design, Service Transition, Service Operation and Continuous Improvement.

MANAGEMENT SKILLS

9 + Years of rich customer facing IT experience with most recent role as Senior Business Analyst for Xerox.

More than 9+ years of enriching experience as Business Analyst for leading industries like Xerox, Humana, PNC Bank.

Exceptional ability to maintain and build client relationships, frequent travel meeting one on one with clients, able to comfortably converse with all facets in the clients organization.

Acted as a liaison between product owners and development team.

Excellent verbal and written skills, especially with regards to presenting findings to both technical and non-technical audiences

Thorough Understanding of Software Development Life Cycle (SDLC), lead in various phases like Requirements, Analysis/Design, Development and Testing.

Experienced with all the phases of SDLC throughout the project life cycle in Waterfall and Agile methodology.

Proficient in gathering requirements and developing Business and Functional Requirement Documents (BRD and FRD).

Experienced in facilitating Joint and Rapid Application Development (JAD and RAD) Sessions, workshops and requirement elicitation sessions. Organizing project meetings, reviews, walkthroughs, and customer interviews.

Experience with Responsive Web Design and Mobile Applications development. Created functional and nonfunctional specification for web based applications (Web Services, API requirements), documented Interface Control Document (WSDL/XML/SOAP/DTD)

Good experience in documenting existing process, analyzing business requirements, working with requirements traceability matrix and re-engineering business processes.

Proficient in creating Use Case diagrams, Class diagrams, State Transition Diagrams and Activity Diagrams using UML methodology in MS Visio.

Experience in performing end-to-end User Acceptance Testing (UAT).

Suggested & implemented processes within the project along with Business Process Management & Modeling using BPMN & Six Sigma – DMAIC & RACI Matrix.

Experience with Data Warehouse (DWH) system including OLTP/OLAP concepts, Concepts around Facts & Dimensional tables and how reporting tools work in DWH environment.

Experienced in development and design of reports and dashboards for supporting the business analysis in a corporate wide reporting using Business Objects XI 3.1 and Tableau.

Healthcare Domain Specific skills:

Strong knowledge of managed claims management process, Knowledge of Medicaid and Medicare Services. CMS, Health Assessment Systems, Hl7 Standards, HIPAA, Compliance issues, LOINC and SNOMED Mapping, HL7 Message Validation, IHE/XCA transactions, Electronic Health Records, Electronic Medical Records.

Extensive knowledge Health Level Seven (HL7) message experience including:

V2.x messages: ADT, OUL, ORU, MDM, QRY/DOC, VXU, VXQ/VXR/VXX, QBP/RSP.

V3 (ITI) request/response transactions for Cross Enterprise Document (XDS) sharing.

Extensive knowledge of the HIPAA 4010/5010 implementation guidelines, ICD-9 and ICD-10 code sets.

Knowledge of HIPAA compliance, HIPAA Insurance Regulations and Claims Processing in EDI X12 transaction sets, including 276/277 (claim status), 835(payment/remittance advice / explanation of benefits) and 837 (health care claims).

Experience with US and International hospital information systems (HIS), health information technology (HIT), health information exchange (HIE), electronic health records (EHR), and clinical interoperability and healthcare standards application and development.

HIE Interoperability & Product- XDS.b, XDS.i, XCA, XCPD, HL7 v2.x, HL7 v3.0, NwHIN, Direct Project, IHE Profiles, HITSP, all relevant coded vocabularies - LOINC, ICD-9/10, Snomed, CPT.

Consolidated CDA (CCDA) - MU Stage 2, Transitions of Care, CCDA R1.1 and R2

CCDA Interoperability support - all documents; Continuity of Care Document - HITSP C32 v2.1 - 2.5

Meaningful Use - CCD, Lab reporting - HL7 v2.5.1, Immunizations, public health, Cancer registries, NEDSS, Syndromic Surveillance.

TECHNICAL SKILLS

FUNCTIONAL

TECHNOLOGY

S/W development life cycle methodologies.

Analysis and understanding of Store Item File, Store Backroom, Store Management Tools, Time Management Systems, Integration Applications, International Integration Projects

Requirements gathering, Use cases, Business requirement (BRD), functional specifications (FRD), trend analysis, gap analysis, ITIL

Use Case Modeling, UML, Business Process modeling (BPMN), Process Design, and Swim Lanes, DMAIC Methodology, Six Sigma

Project Coordination, Risk/Issues, Dependencies Project management tools and techniques in Healthcare, Health Insurance domain

Business requirements definition, functional specifications and gap analysis.

Competent in Agile / Scrum Methodology

Overall Claim Processing life Cycle through the legacy systems

Implementing projects, end to end testing and user acceptance testing.

Languages - OLAP, OLTP, SQL, HTML, XML

Databases - DB2, Oracle, MS SQL Server

Operating systems – Windows (XP / 2007)

Packages – MS Office

Testing Tools – HP Quality Centre

Requirement Management Tools –MS Office 2010, Rally, IBM Rational Requisite Pro, Rally, Quick base, TFS

Methodologies: Agile, Waterfall

Browser: Internet explorer, Firefox, Google Chrome and Safari

Modeling & Designing Tool: MS Visio, Business Objects XI 3.1, Tableau.

Miscellaneous: Adobe Photoshop, Autocad, Revit, Google Sketchup

PROFESSIONAL EXPERIENCE

Xerox Richmond, VA

Sr. Business Analyst Dec’14 – Till date

Project Summary: Xerox’s HIE product supports US state government healthcare department to connect all participating state providers and across communities under one network, which ensures the availability of the patient medical history and treatment information to all providers, irrespective of the location, resulting in better treatment. This helps state healthcare department to comply with Meaningful Usage healthcare standards and Affordable Care Act. Worked on multiple projects related to up gradation of HIE product for various states.

Project 1– Establishing a Reverse Silver connection between Xerox-HIE and statewide HIN (State of Missouri): Worked on multiple projects related to up gradation of HIE product for various states. This particular initiative involved establishing a connection between X-HIE and Statewide Health Information Exchange as a part of phase development, This connection will facilitate the providers to send a request to Health Information Exchange based upon containing the necessary patient identifier and demographic data to match to a patient record and receive back a consolidated clinical data in a form of CCD.

Project 2–Adding CFR verbiage to CCDA-CCD’s (State of Kentucky)

Project 3– KHIE connectivity to KYIR (State of Kentucky)

Project 4– KHIE connectivity to KY-MDM System (State of Kentucky)

Project 5- DIRECT Messaging integration with KHIE (State of Kentucky)

Project 6 - Consolidate CCDs to CCDA CCD (State of Kentucky)

Environment: MS SQL Server 2008, MS Office Suite, TFS, SharePoint, MultiVue, Biztalk, .NET

Responsibilities:

Gathering business/functional requirements, analyze and align it to the existing systems, validate and document them accordingly,Responsible for creating Business Requirement Document (BRD), Functional Requirement Document(FRD) for Health Information Exchange (HIE) Enhancements, Electronic Health Records (EHR) and Personal Health Record (PHR) software development projects

Interact on a regular basis with State Health departments i.e. Wyoming, Kentucky and Missouri state during Requirement gathering sessions, Conduct Requirement Walkthroughs, seek formal approvals etc.

Conduct Requirement Walkthrough sessions with Dev and QA to crosscheck feasibility of System enhancement Requests, Financial Report Development Requests, etc.

Elicit, document, model, validate and prioritize functional and non-functional requirements using

Interviews, JAD sessions, questionnaires etc.

Used MS-Visio BPMN( swim lanes) for developing AS-IS and TO-BE business process flow

Conduct Joint Application Development (JAD) sessions with Business users, Business system analysts, SMEs, software developers, and QA team to discuss and validate the list of requirements and have a consensus on all of them

Developed Traceability Matrix, attend project status meetings, participated in the definitions of business rules and data standards

Conducting, Managing and leading the POC for detailed requirement gathering, validating, developing the business process mapping etc.

HUMANA Inc., Kentucky Oct 2010 – Nov2014

Business Analyst

Project 1: Physician Finder (Find a Doctor) is a website that integrates technology into care delivery, with the goals of increasing operational efficiency and improving satisfaction for members by providing an ability to find their physicians easily. It also provides members a convenient single point of access to health information, online tools and services in the context of their physician’s home page.

Environment: iOS, Android, MS SQL Server 2005, HPQC 10.0, Rally, MS Office Suite

Responsibilities:

Gather requirements from business owners, perform system analysis & create business and functional requirement documents /user stories in Rally for the Change Request/Enhancements. Created around 20 BRD/FSD & 110 User stories so far. Currently working on Responsive Web Design/ Mobile Web for Find a Doctor.

Analyze SQL Server databases, Query database to extract a set of data for the required condition to support analysis and manipulate using excel to arrive at a conclusion

Work with user-experience leads in the development of interactive design deliverables (i.e. wireframes, prototyping, visual design)

Analyze the website accessibility, usability impacts and performance needs for every business requirement.

Conduct bi-weekly iteration planning meeting with the team and maintain requirements status update log

Give requirement document walkthroughs to developers during story time.

Contribute in defining timelines and project plans; monitored estimates, feasibility, effort, time and compatibility

Create Release Notes for every production release.

Organized JAD/JAR Sessions to collect requirements from system users and prepared business requirement that provided appropriate scope of work for technical team to develop prototype and overall system.

Identified end to end requirements for all systems and business units that may be impacted by the project.

Ensured Use-Cases were consistent and covered all aspects of the Requirements document.

Established and maintained traceability matrix until business requirements were signed off.

Owned issues resolution and worked as a liaison between Business and IT for clarification of the project business requirements and change controls.

Involved in project status meetings, QA review meeting, and System Test meeting.

Created use cases, acceptance test cases, defect log in HP Quality Center & provided testing support in QA, staging & production.

Developed a Business Acceptance testing strategy and plan.

Coordinated and facilitated the execution of User Acceptance testing.

Project 2: The Claim Enhancement Project re-architected the claims processing system to support and enable component-based, service driven architecture, shifted common functionality to the national claim processing system, and enabled the retirement of the existing legacy system. The project also involved enhancing the system to implement HIPAA 5010 changes and to make the system ICD-10 compliant.

Environment: Windows 7, HP QualityCenter, MS Office / Visio / Access / SharePoint, XML, Mainframe.

Responsibilities:

Worked on day-to-day claim processing and wrote the change summary for claim processing errors.

Gathered requirements for HIPAA 4010 to 5010 conversion.

Performed analysis, mapping, implementation, and testing for HIPAA 4010 to 5010 conversion.

Identified policies and procedures impacted by the ICD-10 implementation.

Conducted Joint Requirement Gathering Session to capture ICD-9 to ICD-10 Code conversion rules.

Created project requirement document and change summary document to replace ICD-9 with ICD-10 code sets.

Used HIPAA 4010 transactions to support the analysis of current business processes and work with management to improve and implement enterprise solutions to ensure compliance and got involved in designing future state processes for HIPAA 5010 transaction processing EDI’s 837, 835, and 834 and ICD-10 Code sets.

Developed non-functional requirements and documented them as Business Rules, Quality attributes and constraint documents. Documented the Business Requirement Documents (BRDs), Functional Requirement Documents (FRDs) using Rational Requisite Pro.

Created Use Cases diagram and Activity diagram to depict the interaction between the various actors and the system for the Business Use Case and System Use Case.

Performed GAP analysis of 4010 and 5010 EDI transaction using implementation guide to identify the changes in the segments and data elements.

Analyzed HIPAA 5010 related to 837,835, 834. Transactions and performed gap analysis between the 4010 and 5010.

Discussed successfully ICD-10 Codes in compliance with HIPAA 5010 regulation and their impact on other related information

Analyzed the mainframe reports for member/eligibility/claims and mapped the fields with FACETS batch jobs and reports.

Conducted GAP Analysis of AS IS and TO BE business processes.

Developed Data Flow, Work Flow and Process Flow in MS Visio.

Assisted with data analysis by generating reports in MS Access.

Conducted validation sessions / walkthroughs with technical and business SME to identify and resolve open issues in the existing design document for technical logic additions / changes based on the dynamics of desired business flow.

Worked closely with senior management, business and technical SME to facilitate impact analysis, business process and technical design decisions and created baseline documentation on the same.

Created test cases for components and identified the test data needed to execute the test cases.

PNC Bank, NJ Feb 2009– Sept 2010

Business Analyst

Project: Interactive Voice Response (IVR); Call centers today already use IVR based technology, for automated responses between client and customer. Some of financial/banking systems prefer storing such voice responses for future references, and also storing voice conversation interaction between human client and customer. MASC compression technology facilitates excellent compression, enabling archiving of voice files, and also excellent speech recognition capabilities for IVR. The project involved the integration of MASC technology into call center based IVR systems.

Environment: Windows XP, MS Office, MS Project, Visio, Requisite Pro, MS SQLserver

Responsibilities:

Facilitated process movement to standards and procedures that involved implementation of MASC codec for IVR systems.

The process involved in gathering information from the stake holders about their existing IVR based system, and then implementing the compression speech technology to enhance storage and quality of speech.

Analyzed trends and design phases in the industry and applied the knowledge gained to creating comparisons, and tradeoff summaries.

Created Business process Workflow Diagrams.

Held several JAD and JAR sessions to facilitate interaction with Business Users.

Modeled the detail design of the system using Use case diagrams.

Provided Business Requirement Documentation (BRD and FRD) for the customers after thorough market and technology research and by analyzing current market trends.

Conducted GAP Analysis between the legacy reports and the New Built report to incorporate all the necessary information in the new report.

Facilitated collection of requirements from system users using Rational Requisite Pro.

Used Iterative Software Process for the development of the Reports.

Involved in Configuration Management and Requirement management.

Created a Traceability Matrix to maintain the Traceability of the requirements.

Used MS Project Gantt charts create the different modules of the project.

Performed regression and user acceptance testing during various stages of the development

Held weekly meetings with developers and QA/testers to ensure project deadlines were being met.

Provided weekly, monthly and quarterly reports to supervisors on the progress being made on the project.

PNC Bank, NJ Feb 2007 – Jan 2009

Business Analyst

Project: The project involved building on-line mortgage processing system where customers can check their application status, view existing mortgage application, refinance or work on home equity account. Several mortgage tools and calculators were also developed.

Environment: Windows XP, MS Office, MS Project, MS Visio,, UML, Requisite Pro,, Business Objects XI 3.1 for reporting

Responsibilities:

Participated in the research and development of business opportunities and ideas within the scope of the project.

Conducted interviews with key product owners to collect requirements and business process information.

Performed extensive requirement analysis including data analysis and GAP analysis.

Developed business requirement specification documents as well as high level project plan.

Designed and developed project document templates based on Agile methodology.

Set up definitions and process for test phases including product test, integration test, system test and User Acceptance Test (UAT).

Worked on the impact of changing requirements on the mainframe application during change management procedure.

Analyzed operational procedures and methods to recommend changes for improvement, with an emphasis on automation and efficiency.

Prepared project reports for management, assisted project managers in the development of weekly and monthly status reports, documented process flows, policies and procedures.

Created Traceability Matrix to reflect how the Business Requirements, at a high level, will be satisfied throughout the lifecycles (Requirements, Design, Build and Testing) of the project.

Understood core processes of the department to provide input on reverse–engineering and to develop new blueprints for the process flow

Closely worked with development team to make sure whether the software application fits within the architecture and has the required behavior

Overseen change control to ensure that all system revisions, upgrades, and enhancements are thoroughly tested and documented to ensure business as usual.

Translated insurance analysts and surveyors requirements into functional specifications for the development of insurance online system & managed changes to those specifications.

KPL, India Oct 2004 – Jan 2007

Project Coordinator/ Assistant PM

Project: KPL Architecture business Division provides architectural design services for commercial, residential, industrial, community, interiors and landscaping infrastructure. KPL also provides clients a single point contact to all services, further adding interdisciplinary coordination between consultants.

Environment: AutoCAD REVIT, Google Sketch-up, MS VISIO, Photoshop, MS office Suite, MS Project, etc.

Responsibilities included but not limited to; Job duties included initial client contact, program development, proposal writing, and QA and CA phase services. Responsible for construction administration, site meetings, progress reports, change order request review, application for payment review, product and equipment submittal and shop drawing review, and construction close out. Consulting services. Meet with stakeholders to understand their business needs and ultimately their business requirements

Detailed role included to translate the business requirements into business requirement document that delivery teams (such as architects and designers) can interpret.

Initiate and run meetings as part of requirements gathering activities

Document the requirements in an objective, clear and meaningful format

Raise any risks that may impact the requirements on a project

Facilitate the requirements review and approval process

Clarify any requirements to designers and Quality assurance team assigned to the project

Establish a requirements traceability approach and matrix to be utilized by the project

Manage any requirements change requests from a requirements point of view

Contribute to the project management plan in terms of requirements approach, risks, constraints, assumptions and planning.

Provide delivery time based estimates to the project management team for requirements deliverables

EDUCATION & CREDENTIALS

Bachelor of Architectural Engineering (2004)

Planned Certification

PMI – ACP (Agile Certified Professional) Planned for Mar 2016.

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