Sai Karthik

Cell: 516-***-**** Email: acvde9@r.postjobfree.com

Summary

Accomplished Business Analyst with 7+ years in achieving operational efficiency and increasing revenue in the

financial services, health care and managed care industries with good knowledge in requirement gathering, Medical and

Rx Health-care claims including PBM Transactions, EDI Transactions, problem solving and delivery management,

Applying strong interpersonal communications skills, including teamwork, and building customer relationships. Business

process improvement, data analysis and IT asset management and exposure to change management, and maintenance

projects.

Highlights

Business Analyst with diverse experience in Information Technology with focus on Business Analysis, Business

Modeling, Requirement Gathering, Technical Documentation, EDI and PBM Transactions and Health-care

claims analysis.

Domain experience in which include multiple development, support and re-design, starting from fit gap analysis,

requirement gathering, and impact analysis till go-live, both banking and Health-care domain.

Rich experience in gathering (user) functional requirements using various requirements modeling and UML tools

including Rational Rose, Rational clear case and MS Visio.

Proficient in Technical and Business Writing, Business Process Flow, Business Process Modeling, Business

Analysis and Testing various methodologies.

Knowledge of 837, 835, 275, 276-277, 270-271, 278-13, 278-11, 4010, 5010 and ICD-9/ICD-10.

Experience in developing test cases, coordinating UAT sessions with SME's, QA's and test specialists.

Experience in Data Analysis, Data Mapping and good understanding of RDBMS concepts. Adept at writing SQL

queries for conducting data analysis

Experience in Joint Requirement Planning (JRP) sessions with Business User Groups, conducting Joint Application

Development (JAD) sessions with IT Groups and Conflict Management with Project team members.

Experience operating within Software Development Life Cycle (SDLC) using Waterfall and Agile

Methodologies. knowledge of UML diagrams - Use case diagrams, User Stories and Activity diagrams

Extensive experience in developing Use Cases, creating Screen Mock-ups, conducting Gap Analysis and Impact

Analysis, SWOT analysis, Cost Benefit Analysis, Risk Analysis.

Facilitated Change Management across entire process from Project conceptualization to Testing through Project

Delivery, Software Development and Implementation Management in diverse Business and Technical

Environments.

Experienced in understanding current (AS-IS) state and desired (TO-BE) business processes and converting them

into technical specifications for preparing test plans

Responsible to Track, Document, Capture, Manage and Communicate the Requirements using Requirement

Traceability Matrix (RTM) which helped in controlling numerous artifacts produced by the teams across the

deliverables for a project

Involved in Test Planning, Test Preparation, Test Execution, Issue Resolution and Report Generation to assure that

all aspects of a Project are in Compliance with the Business Requirements.

Possess excellent communication, people skills, project management competency, and the ability to successfully

influence and drive consensus across cross-functional teams

Technical Skills

Operating systems : Win 2000/XP windows 7,8,10

Methodologies : Waterfall, RUP, Agile

Microsoft Office Suite : Word, Excel, PowerPoint, SharePoint

Req Management Tools : Rational Requisite Pro, JIRA, MS project

Modeling Tools : MS Visio & Rational Rose.

Data Visualization : Tableau 8.1/7.1, Cognos, Business Objects

Databases : Oracle, MS SQL Server and MS Access.

Experience

State of Maine - DOE October 2014 to Current

Business Analyst

The project is a Nutrition Project Module enhancement for the School Nutrition system. This project has existing

architectural framework (NEO) requiring new technology and development using the latest Microsoft Business

Intelligence Technology. New Functionalities were added to the existing system, and a new better product is being put in

place and the project involves transforming the existing online site into a robust application including all the latest

functionalities available in the market and more in line with the Department of Education. I was primarily involved in

eliciting requirements and creating user stories for the online portal for reimbursement module.

Responsibilities:

Was involved in the creation of BRD, FRD for the project and also worked on defining Project Scope, Goals and

Deliverables that support Business Goals in collaboration with Project Team and Stakeholders and built User

stories for the project requirements.

Developed Communications Documents [Project status, project milestones, Notification, Training guide,

user-manuals etc.

Worked on Use Cases and collaborated with Support/Technical staff, Applications Development, and the Data

Owners/Subject Matter Experts during various phases of Project Lifecycle.

Identified, managed Project dependencies and Critical path and also worked on Requirement Traceability

Matrix.

Did the UAT Testing for the Agile Iterations and also updated the Project Tasks in the Project Charter.

Created User Manuals for end user and Business User purpose.

Evaluated third party products and shared analysis with stakeholders and elicited requirements for the new

application through interviews,observation and prototypes

Documented requirements into User Stories and created the product backlog

Contributed in prioritization of the product backlog along with the Scrum team

Collaborated to create detailed Sprint / Iteration plans for the project in the Agile Methodology

Participated in Daily Stand-up meetings and iteration review meetings

Obtain feedback from project teams regarding the overall effectiveness of processes and procedures – Forward

to appropriate stakeholders and process owners. Was a solution analyst for the project development phase and

also worked on Scrum technology.

Proactively managed changes in Project Scope, identified potential risks, and devised contingency plans and did

the Gap Analysis.

Involved in daily scrum meetings helping the developers understand the requirements and Business plan.

Facilitated the Business Development/ Project Planning meetings and also wrote Test Scripts for Sprint Testing.

Implemented Change Management processes and procedures when needed.

Created Activity Diagrams for Business Flow and Data Flow diagrams.

TD Bank October 2013 to August 2014

Business Analyst

TD Bank, in its effort to be the most convenient US bank, has initiated major projects related to its Core Online Banking

Applications. Bank is migrating from the legacy applications to a more robust Next Gen Platform which is customer

friendly and dynamic. I was primarily involved in eliciting requirements and creating user stories for the Bill Pay and Customer Alerts module.

Responsibilities:

Studied critically the existing guidelines, training guides, customer suggestion logs and Scope documentation to

understand the features and bottlenecks of the legacy application

Discussed with Product Owner the objective and scope of the project to understand the high level needs of the

stakeholders

Researched current trends in the online banking applications and online applications used by competitors, listed

out the functionalities commonly used in the industry

Simulated the tasks performed by the customers online on the application (AS IS analysis) and suggested the

improvements in the business processes

Evaluated third party products - Fiserv and DocuSign and shared analysis with stakeholders

Elicited requirements for the new application through interviews,observation and prototypes

Documented requirements into User Stories and created the product backlog

Contributed in prioritization of the product backlog along with the Scrum team

Collaborated to create detailed Sprint / Iteration plans for the project in the Agile Methodology

Participated in Daily Standup meetings and iteration review meetings

Assisted Project Manager in executing the transition plan and managing any deviations

Created source to target data mapping and documented metadata in excel

Prepared detailed data assessment document using SQL Queries

Build queries and reports, analyzed qualitative and quantitative data

Created report layouts and Screen mocks/designs on Visio

Created test cases in collaboration with developers and SME. Facilitated the User Acceptance Testing (UAT) with

System Administrators and Business Users and documented any issues or defects

UnitedHealth Group July 2012 to September 2013

Business Analyst-Claims management

Employer & Individual (Customer Implementation) part of UHC with the project of IBAAG, TOPS and ACIS for

transitioning of the Policy administration portal where customer IBAAG's are uploaded enabling to view their benefits

on the go complying on the new Health care reform guidelines. The project involved creating adding new functionalities

into customer intranet site based on WebSphere portal technology as the existing web was stagnate intranet with

restricted capabilities housed on platform with outdated content and limited functionality.

Responsibilities:

Gathered legacy system requirements by shadowing employees in various departments. Also prepared

questionnaires, to identify limitations in the current system and GAPS in the proposed system.

Elicited the user and business requirements of the new intranet website (IBAAG) through open-ended discussions,

brainstorming sessions and role-playing.

Participated in all phases of Business improvement processes, meetings & roadmaps, documented Mock-up

forms in MS word for better visualization and understanding of the software solution.

Trained new hires and Onshore counter parts on new issue tracking and ensuring quality metrics are maintained

as par with departmental goals and working knowledge of Health Insurance Portability and Accountability Act

(HIPAA).

Participated in all Iteration, Scrum, Daily stand-ups and Iteration review meetings working in agile development

methodology

worked with Product Owners and other Stake Holders to identify priority on the stories based on the high level

estimate

Contributed in prioritizing the backlog so that the stories are ready for the sprint well in advance.

Was involved in analyzing Insurance policy and determine extent of coverage based on the Certificate of

contracts, build insurance policy documents. Collaborate with implementation managers and attend interviews to

correct errors and investigate questionable issues.

Analyzed claims related data from databases using MS Excel and SQL to identify trends and created analytic

templates using MS Excel to identify repetitive fraudulent patterns.

Has worked closely with the IT Departments and Operations department heads in solving complex issues on the

policy administration

Trained on HIPAA set rules and 4010-5010 transactions, code set rules such as EDI 837, 834, 835, 270, 271, 276,

277.

Defined AS-IS, TO-BE in terms of process planning. Coordinated with SME's, QA, test specialists and assisted the

Project Manager to define, estimate and schedule business analysis work plan and tasks.

Created wireframes and mockup screens for web based application using MS - Visio

Ensured that the Acceptance criteria are clear and precise to avoid ambiguity in the requirements. Also that the

requirements are written in the (Given, When, Then) format so that the team is on the same page throughout the

project lifecycle

Involved in every aspect of story identification and in the interaction design for the system and maintained data

integrity by ensuring quality and accuracy prior to implementation of new system

Documented Source to Target mapping using excel and SQL

Validated and updated the Attributes and Traceability of the Requirements - High level and Low level

Requirements

Played a key role in planning, testing, and implementation of system enhancements and conversions and worked

with Quality Assurance Lead to develop detailed Test Plan and Test Cases during the planning phase.

Hosmac India Pvt. ltd. May 2011 to July 2012

Business Analyst – Healthcare Consulting

At Hosmac Consultants Pvt. ltd. the project was about healthcare consulting for wide range of public and private healthcare providers to go through the ISO certification for improving healthcare delivery and management and also was involved in supporting Self-funded schemes, Government Health plans.

Responsibilities:

Worked with business stakeholders to understand business needs and translated into functional and operational

requirements.

Identified application problems and recommended solutions and strategies to resolve the issues.

Reviewed and evaluated financial monthly closing procedures and re-engineered the processes resulting in

significantly improving the performance by 20%.

Streamlined monthly reconciliation procedures of the data feeds between financial systems and signed-off

Monthly interface journals to ensure the accuracy and quality of critical financial data for internal control

purposes.

This project was implemented using water fall methodology.

Performed financial processes to support the monthly closing activities of finance groups.

Conducted Brain storming sessions and put together road-map for the development.

Developed functional, conceptual, and logical design specifications based on business requirements.

Created and modified change management requests on behalf of the client business.

System testing, including database testing to have completeness of the process.

Co-ordinated between testers and developers for faster resolution of issues.

Apollo Health Resources Ltd. January 2009 to March 2011

Jr. Business Analyst

At Apollo Health Resources Limited the project was about a comprehensive range of services aimed at supporting

Healthcare delivery, Medical tourists, International Assistance and Claims Management. This project is based

on the Medical Tourism Revenue Cycle Management Solutions for Allied Health Insurance of Maldives and Globality

project of the German based Health Insurance Company.

Responsibilities:

Participated in all phases of the revenue life cycle from requirements definition through product delivery and

support including configuring, testing, and implementing technical and business process solutions;

Responsible for leading project meetings with the business/user community in gathering comprehensive business

requirements and translating them into automated solutions, to include workflow technical design and

implementation.

Participated in project team meetings and created detailed technical implementation plans, serving as the

technical liaison with the software programming team as applicable.

Conducted Gap Analysis between current and future Project initiatives;

Implemented workflow solutions and project monitoring, to include ongoing workflow maintenance.

Clarified system, workflow, and process needs with operations to understand the purpose and content of requested

enhancements.

Assisted customers with understanding system functionality and process flows.

Documented business requirements and technical details utilizing a variety of tools including Word, Excel and

Visio.

Identified system enhancements that will improve business processes and support future business needs.

Analyzed and changed business rules in the Revenue Cycle Management Workflow (internal application

Developed on visual basic with Excel as the user front-end)

Developed detailed technical design for workflow automation, and implement system changes including

monitoring for successful and intended outcomes.

Utilized operational and system knowledge to provide recommendations for increased efficiencies and

automation through proprietary workflow system.

Wrote SQL queries to identify and analyze data discrepancies;

Advanced use of excel functions such as Pivot Tables, V-Lookups, Conditional formatting, IF, SUMIF, COUNT,

SUM, to assist with the preparation of data reports;

Followed Agile development methodology best practices (Iterative development and release of work flows based

on evolving customer requirements, light weight documentation and intensive team collaboration).

Education

Institute of Clinical Research

MBA: Health care Management

Hyderabad, Telangana, India

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