KRUTHI RAJ KALYANAPU

Email: ad217a@r.postjobfree.com PH: 618-***-****

Sr. Business Analyst

PROFESSIONAL SUMMARY:

8+ years of experience as a Business Analyst with solid understanding of Business Requirement gathering, Business Process flow, Business Process Modelling, Data Analysis, Data Mapping, application upgrades, and Business Analysis.

Excellent communication, organization, Team coordination, Project management, Time management and customer service skills with attention to details.

Advanced research, writing, analytical skills with ability to take a directive and perform efficiently under pressure.

Self-starter, Independent and critical thinker, with focus on target/deadline without micro-management and oversight.

Proficient in using MS Office (Visio, Project, Macros, Word, PowerPoint, Outlook, and Excel), Prezi online presentations, WPM: 50, online tools to develop animated videos for presentation. Ability to navigate through project tracking tools like SharePoint.

Experience working in fast paced Healthcare IT industry as a Business Data Analyst, working with technical staff to implement business owner’s requirements into software application. Agile/Scrum and Waterfall Methodologies for Software Development Life Cycle (SDLC cycle). Experience working with Database management tools like Netezza, Teradata, MS SQL Server. Adept at creating, co-ordinating and facilitating Joint Application Development sessions and interviews, reports, project status reports, PowerPoint presentations, e-mails.

Firm understanding of HIPAA regulations and experienced working in all phases of healthcare insurance processing like defining Membership Eligibility and Enrollment and various Medical Claims processing, including Medicaid and Medicare claims processing.

Well versed in Project Management tools like MS Project for status reporting and planning.

Extensive knowledge of Medicaid Management Information Systems (MMIS), Health Insurance Portability and Accountability Act (HIPAA) standards, HEDIS standards, Electronic Data Interchange (EDI) and implementation of HIPAA code sets, ICD-9, ICD-10 and using FACETS/ QNXT for claim processing.

Performed in-depth analysis of workflows, data collection, report details, and other technical issues associated with the software. Developed and implemented the validation sessions for the current and future state analysis and documentation.

Experience in creating business process flow diagrams using MS Visio. Experience in developing and writing functional business requirements and process flows. Experience in Business Process definition, Risk Analysis, and Use Case Analysis.

Experience in Business Analysis using Functional Flow charts, Check sheets, Interrelationship diagrams,Workshops and Brainstorming Sessions. Experience with User Acceptance Testing (UAT) & release skill sets

Developed use case diagrams, sequence diagrams, state diagrams and activity diagrams using UML to make users and developers understand the system. Hands on experience on creating UML diagrams on Lucid and Visio.

Ability to develop SQL query for data validation and data retrieval.

Can easily grasp any new computer applications or software, learning SAS, SPSS and other statistical/ analytical tools

Hand on experience on creating user stories and maintaining dashboard and tracking project progress and filling bug on Jira.

Experience in creating and maintaining documentation on confluence.

Able to delegate work and provide lead directives to subordinate administrative staff and work directions to clerical and technical personnel.

Hands on experience in working on google suit used for all the documentation, meetings and tracking the project progress, making it easy for all the team members to update and check their progress and overall project progress.

PROFESSIONAL EXPERIENCE:

Lowes, Mooresville, NC May 2022 to Present

Role: Sr. Business Analyst

Responsibilities:

Responsible for gathering business requirements from business owners and SMEs through interviews and discussions, reviewing existing documents including centennial care contract and responses.

Part of Technology Integration and worked as a liaison between core workstreams and product teams, Internal Provider Finder (IPF), preparing system requirements for successful implementation of Project

Preparing technical EPICs and user stories from requirements and getting validation and due dates from business owners as a part of PPP phase

Prepared EPIC diagram with Solution architect for Technology integration

Delivering EPICs/user stories to product teams with EPIC diagram (System/Application details with file/data transfers), getting estimates for planned work and reporting back to business

Prepared data mapping document with source and target data fields and data types.

Worked on creating data reports using Tableau.

Liaisoning with third party vendors(Transportation, Pharmacy, Dental, Translation service etc.) for proposed change requests and creating EPICs/user stories for the same.

Worked extensively on different workstream which involves member enrollment, claims and payor

Worked on creating stories for EDI transaction involving 276 and 277 and EDI 837 for payment remittance involving insurance provider(payors).

Experience in following MITA goals for secure data exchange and integration of out of network services to care coordinator portal.

Driving weekly calls with internal product teams and external vendors to discuss updates including UI changes, compliances, data sources

Meeting test coordinators to provide additional information as and when required and get updates on ongoing testing activities as a part of Post PPP phase

Prepared non-technical EPICs/user stories for State and community outreach workstream.

Providing utility services to the customers.

Providing Log Service useful to collect, consume, query, and analyze log data in real time.

Worked on creating user stories using AGILE Exposure and Scrum based project, and Agile principles to complete the project.

Environment: Agile Methodology, SharePoint, MS Office (MS Word, MS Excel, MS PowerPoint), MS Project, MS Visio, JIRA, Windows.

Merck Pharma, Branchburg, NJ October 2020 to April 2022 Role: Sr. Business Analyst

Responsibilities:

Collaborate with CMS business project sponsors to define scope of projects and timelines associated with completion of project.

Sorted, scanned, assured the quality of uploads and reassembled all the documents once uploaded onto Salesforce.com

Prioritize and manage projects and initiatives in accordance with the requirements of CMS business needs.

Act as a Coordinator of On-shore & Off-shore resources.

Conduct meetings and facilitate collaborative discussions for requirement changes and new functionality needs as per Salesforce specifications.

Worked on the EDI 834-file load to Facets through MMS (Membership maintenance sub-system)

Worked with FACETS edits and EDI HIPAA Claims (837/835/834) processing.

Worked on different 5010 HIPAA EDI transactions and code sets including 278 (Referrals), 834 (Enrollment), 270/271 (Eligibility), 276/277 (Claim status), 837 (Claims), 835 (Claims Payment).

Responsible for the full HIPAA compliance lifecycle from gap analysis, mapping, implementation and testing for Medicaid Claims.

Played the role of a Business Analyst in a Waterfall SDLC environment by participating in meetings and planning of the project.

Managed requirement activities using an iterative and incremental methodology such as User stories and Acceptance Criteria.

Analyzed the “As is” and “To be” system documents to show the current and proposed functionalities of the system using MS VISIO.

Developed and maintained Requirement Traceability Matrix (RTM).

Prepared SWOT analysis and impact analysis for project.

Created Used Case documents and captured the process flows for various claims processes, Providers processes,and Subscriber processes.

Worked With HIPAA compliant ANSI X12 837 formats for both professional claims and institutional claims.

Matched the requirements for programs such as Medicare and Medicaid which are part of the Social Security Act.

Assist with project implementation and control monitoring process related to quality assurance (QA) and user acceptance testing (UAT).

Prepared and maintained Request for proposals (RFP), Request for information (RFI) and Request for Quotation (RFQ) for communicating in-house requirements to vendors.

Gather, document, and analyze data and information; develop and execute training materials and training activities to high-level Salesforce operators.

Used JIRA for tracking the project progress and yracking the defects and its fixation.

Define and implement improvements to business process and ad-hoc tasks in the face of ever-changing marketplace and consumer needs.

Environment: Windows, MS Office (MS Word, MS Excel, MS PowerPoint, MS Project, MS Visio), .NET, Oracle, HP QC, RUP, UML, SQL, SWOT analysis, GAP Analysis, JIRA.

Fifth Third Bank, Evansville, IN May 2018 to September 2020 Role: Sr. Business System Analyst

Responsibilities:

Facilitated Joint Requirement Planning (JRP) sessions with SME’s in understanding the Requirements pertaining to Loan Origination to Loan Processing.

Gather requirements by conducting meetings and brainstorming sessions with end users and SME and document them using Requisite Pro - the documentation tool offered by Rational.

Participated in the identification, understanding, and documentation of business requirements, including the applications capable of supporting those requirements.

Monitor questionable debit card and account activity looking at trends, patterns and velocities. Locating stolen and counterfeit card behavior and ID theft. To reduce losses to bank customers and to the bank itself.

Data mapping, logical data modelling, created class diagrams and ER diagrams and used SQL queries to filter data within the Oracle database

Introduced Agile and RUP methodologies to reflect liquid nature of front-office improving time-to-market

Establish documentation for agile methodology for implementation with a very water-fall-centric development team.

Conducted Asset Management, Risk Analysis of the Requirements and Traceability focus areas of the various projects and worked with the project team to help them identify the high-risk areas.

Analyzed User Requirement Document, Business Requirement Document (BRD), Technical Requirement Specification and Functional Requirement Specification (FRS).

Collaborated with business users and software development team within AGILE framework to ensure rapid and successful implementation of the solution

Utilized Agile SCRUM methodology to develop User Stories, Product Backlog, and Sprint Backlog.

Worked extensively with MS Excel and MS access

Planned and defined system requirements to Wire Frames with Use Case, Use Case Scenario and Use Case Narrative using the UML (Unified Modeling Language) methodologies.

Created and managed Project Templates, Use Case Project Templates, Requirement Types and Traceability Relationships in RequisitePro.

Assisted in building a Business Analysis Process Model using Rational Rose and Visio.

Performed extensive Requirement analysis and developed use cases and workflows.

Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams and OOD

Converted various SQL statements into stored procedures thereby reducing the Number of database accesses.

Involved in creating automated Test Scripts representing various Transactions, Documenting the Load Testing Process and Methodology. Created meaningful reports for analysis and integrated the Performance Testing in the SDLC.

Developed and managed Project Plans and Schedules. Managed resolution of Project issues and conflicts.

Conducted Functional Walkthroughs, User Acceptance Testing (UAT), and supervised the development of User Manuals for customers.

Worked as a User/Customer advocate and negotiated with user as well as with developers and management staff to resolve any requirement conflict to bridge the Gaps between IT and Business.

Various versions of the documents generated during the project were maintained and managed using rational ClearCase and performed defect tracking using Rational ClearQuest.

Tested the final application for Usability testing to verify whether all the User Requirements were catered by the application.

Environment: Mainframes, JCL, Db2, Oracle, Rose, MS Project, Salesforce, MS Word, MS PowerPoint, MS Excel, MS Visio, Load Runner, WinRunner

Couth Infotech Pvt Ltd, Hyderabad, India November 2016 to February 2018 Role: Business Analyst

Responsibilities:

As a business analyst, responsible for Requirements gathering from various insurance companies to develop a system to check for the outstanding balance from various accounts using the highly efficient Waterfall methodology of software development.

Liaison between the Business needs (business users and sponsor) and the Technical solutions (development and testing staff), ensuring technical solutions satisfied business requirements.

Experienced in creating gap analysis from “As-Is” to “To-Be” process.

Web Page Mock-Ups using MS Visio and thus defining the Business Process Model and Data Process Model.

Ensured that the claims processing is strictly under the HIPPA compliance regulatory document to safe guard patient information.

Part of the team assisting in documentation involved in this project such as Request for Proposal (RFP/RFI), proposal, evaluation criteria, proposal approval, design document, project plan, project scheduling, project report, release document. Deliver Statement of work (SOW).

Define, measure, analyze and improve KPIs for each milestone and project.

Authored Business and Functional requirements (BRD) with data flow diagram, sequence diagram, flow charts, use cases and training manuals for Provider Portal web-based application.

Developed and maintained Requirement Traceability Matrix (RTM).

Developed training material and trained the users on newly developed applications.

Analyzed and wrote technical documentation for risk analysis on customer support issues.

Extensively worked in creating Test Procedures, Test plans and Test Case for User acceptance testing (UAT).

Experienced in Quality Center for Tracking defects and interacting with team members in fixing errors

Prepared and presented monthly collection reports.

Involved in training and quality of the overall workflow process.

Documenting workflow and results of analysis for the aging accounts. Environment: Waterfall Methodology, SharePoint, MS Office, MS Visio, Microsoft CRM 3.0, Rational Requisite Pro, Rational Rose, HP ALM, Windows.

Jr. Business Analyst

Brio Technologies Private Limited Hyd India June 2015 to October 2016 Responsibilities:

Worked closely with the Product Owner in defining the product road map and capabilities for enhancements to the enterprise claims management application

Actively participates and drove continuous improvement for process and productivity to improve overall customer satisfaction and delivery of the services, meeting the requirements of the product

Continually verified requirements individually and collectively through the project lifecycles, writing formal specifications, process workflows, communicating such documentation with stakeholders and technology teams.

Assisted testing teams in the translation of requirements into test cases and ensured application architecture and systems functionality met business requirements.

Acted as the focal point to coordinate resolution of “difficult issues” with regards to cross-team collaboration including communication of status, escalation with management etc.

Performed ad-hoc analysis to meet the needs of all internal business partners leveraging various data sources

Prepared presentation materials to be shared with management, business groups and other relevant stakeholders

Worked closely with the Product Owner in designing and implementing a more accurate, efficient and productive process of capturing the business requirements in the form of user stories

Assisted the Scrum Master in facilitating Scrum Ceremonies like Daily Standup, Spring Review, Planning and Retrospective

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