Project Quality Assurance

Aditya Babu Senior Business Analyst

Phone 609-***-**** *************@*****.***

Professional Summary:

Result oriented Senior Business Analyst with more than 8 years of industry

experience in SDLC with proven track record of implementing enterprise wide

software development projects for increasing usability, performance,

efficiency and traceability of business processes to deliver enhanced

results.

. Strong knowledge of Software Development Life Cycle (SDLC); SDLC

Models - Waterfall, Prototyping, and Methodologies - Agile (SCRUM),

Rational Unified Process (RUP).

. Worked closely with Project Stakeholders, Subject Matter Experts

(SMEs), and Business Users to understand the requirements and

specifications for new applications as well as projects with re-

engineering of existing applications.

. Extensive experience in writing Vision & Scope Document, Business

Requirement Document (BRD), Functional Requirement Document (FRD), Use

Cases, maintaining Requirement Traceability Matrix (RTM).

. Proficient in developing Use Case Diagrams/Models, Workflow Maps, and

Activity diagrams based on UML using Rational Rose and MS Visio.

. Extensive experience in producing Wireframes for UI extensive projects

and specifying Usability requirements.

. Used elicitation techniques such as interviews, questionnaires,

brainstorming sessions, JAD sessions, observation, and document

analysis for requirement gathering.

. Solid understanding of Gap Analysis and converting requirements in to

test plans.

. Experienced in performing Business Process Analysis and creating AS-IS

and TO-BE Business Process Models (BPM's).

. Participated in Change Management Processes and performed Impact

Analysis to ensure Changes/ New Requirements are aligned to the Scope

and agreements of the project.

. Proficient in facilitating and performing User Acceptance Test (UAT)

by working with internal and external Users / Customers and obtaining

delivery approval for the project.

. Knowledge of Medicare (Part A, B, C, D), Medicaid, and Commercial

Insurances.

. Knowledge of HIPAA ANSI X12 4010/5010 formats including EDI

transactions (270/271, 276/ 277, 837/835, 834, 997) and codes (NPI,

ICD9/ICD10 NDC, DRG, CPT, NCPDP).

. Good knowledge of Claims Adjudication Processes. Have profound

knowledge in various domains such as Healthcare, Insurance, Trading

and Finance.

. Excellent written and oral communication skills with the ability to

communicate appropriately in business and technical situations at all

levels.

. Involved in Quality Assurance (QA- Manual Testing and Automation

Testing); Experienced in reviewing test procedures, defining Test

cases, reviewing and maintaining test scripts, analyzing bugs,

interaction with team members in fixing errors.

. Adept problem solving skills and learning new technologies.

. Expertise in creating Ad Hoc Reports using Business Objects and

Crystal Reports tools.

Technical Skills

Software Models, Waterfall, Prototyping, Agile

Methodologies (SCRUM), RUP

Business Modeling Tools MS Visio and Rational Rose

Wireframing Tool Balsamiq, iRise

Requirement Management Rational Requisite Pro, DOORS

Tools

Content Management System SharePoint 2010

Defect Tracking Tools JIRA, QC

Databases SQL Server - 2008, Oracle

ETL Tools Cognos

Desktop Tool MS Excel, MS Word, MS PowerPoint.

Reporting Tools SAP Business Objects, Crystal

Reports

Automation testing QTP

Data mining tools SAS, SPSS, R

Professional Experience:

Client: Fresenius Medical Care, Waltham, MA May 2012 - Till Date

Project: Fresenius Integration Hub (FIH)

Role: Senior Business Analyst

Fresenius Medical Care offers quality health care products and services

designed exclusively to meet the changing health care needs of customers.

They provide kidney dialysis services and renal care products, including

treatment options for later stage Chronic Kidney Disease to Medicare

patient with End Stage Renal Disease (ESRD).

This project called for integrating the Renal Care Group (RCG) clinics

patient data in the Fresenius Integration Hub. This included upgrading the

RCG ADT (Admission, Discharge and Transfer) HL7 messaging system to

Fresenius ADT HL7 messaging system. As a part of this system migration and

data integration, error reports were created to examine if the interface

accurately transformed the messages.

Responsibilities:

. Worked with business representatives to understand requirements and

priorities and ensure that software development work is appropriately

aligned

. Involved in the meeting with Business Process Owners, Subject Matter

Experts (SME) and Health Center users for Requirement gathering in

Definition Stage using Rational Requisite Pro.

. Facilitated Requirements Sessions, as well as weekly client & team

meetings.

. Performed Gap Analysis to identify the deficiencies of the current

system and to identify the requirements for the change in the proposed

system.

. Documented Transfer Specifications and Implementation Guide for ADT

messaging.

. Organized system risks into high, medium and low impact to help

business analyze the level of effort for remediation activities and

ease resource allocation work.

. Participated in user meetings to understand requirements for the Data-

Warehouse design.

. Created various Use Cases and workflow diagrams, using MS Visio..

. Maintained Traceability Matrix in Excel.

. Created Report Mockups and Sample Mapping documents for the Error

Reporting.

Environment: RUP, MS Office, MS Visio, UML, Adobe Acrobat, MYSQL, Oracle,

Windows 7,

Client: United Healthcare, Chicago, IL Apr 2011 -Apr 2012

Project: ET Migration (4010-5010)

Role: Senior Business Analyst

Project involved a regular optimization and standardizing of claims

processes such as maintaining historical data, ad Hoc request/reports

tracking and addressing the problems encountered by Providers, Vendors,

Health plan groups etc. on timely manner. It was also intended to manage

changes in the internal CAS (Claims Adjudication System) while

transitioning from 4010 to 5010 transactions and to manage changes of codes

from ICD9 to ICD10.

Responsibilities:

. Studied existing system requirements, environment, and operation by

interacting with the Project and Business team members.

. Conducted interviews with the SME and gathered information about

Health care Enrolment, Billing and Claims processing.

. Involved in creating and modeling the AS IS diagrams and TO BE

business process flows.

. Performed a detailed GAP Analysis and documented scope.

. Documented the Business requirements, and communicated these

requirements to the development team for the design and implementation

of business solutions.

. Maintained ad hoc report requests for the clients as per requirements.

Created SQL queries to fetch complex data from different tables in

remote databases.

. Facilitated JAD sessions with business SMEs and analyzed the

Functional Requirements and documented Use Cases, Process Maps and

Wireframes & Prototypes.

. Conducted walkthrough of requirements to technical team and helped

resolve outstanding issues.

. Managed Change Request Process and performed Impact Analysis for

several changes.

. Exposure to EDI transaction (837,276, 277) quotes sets and validations

and insurance claims.

. Exposure to HIPAA Compliance standards.

. Gathered requirements for impacted system and business areas for ICD-

10 and their needs to embrace the changes.

Environment: Waterfall, SharePoint 2010, UML, HIPAA EDI, Windows XP, SQL

server 2008, MS Visio, Balsamiq, DOORS, Windows Xp/7.

Client: All State Insurance, May 2010- Jan 2011

Chicago, IL

Project: Integrated Policy

Management Portal

Role: Business Analyst

All state is the world's leading international insurance and financial

services organization, with operations in more than 100 countries and

jurisdictions. Its member companies serve commercial, institutional and

individual customers through the most extensive worldwide property-casualty

and life insurance networks of any insurer. The IPMP project was to build a

solution, which integrates All States four existing policy management

systems including P&C, Workmen's Compensation, Life and Annuity and extends

their functionality for web-based access by the company's countrywide

network of independent producers.

Responsibilities:

. Performed Gap Analysis to check the compatibility of the existing

systems infrastructure with the new business requirements.

. Accumulated system requirements from Workmen's Compensation and Life

and Annuity groups through surveys and interviews.

. Conducted JAD sessions with management, SME, vendors, users and other

stakeholders for Business Requirements.

. Documented Functional Specifications using IBM Rational DOORS.

. Created Use Case Model, Activity Diagrams using UML in MS Visio.

. Created Use Case narratives and Use Case relationships and Traced them

to Functional and Business specs.

. The user interface (UI) screens were mocked up in Microsoft Visio and

reviewed with the end users prior to programming to solicit user

acceptance.

. Involved in Performance Measurement to develop measurable indicators

that can be systematically tracked to assess progress made in

achieving predetermined goals.

Environment: Windows XP/2000, SQL Server, MS Office Suite, SharePoint, MS-

Project, JIRA, XML.

Client: Misys Healthcare, Austin, TX Nov 2009 - Apr

2010

Project: Misys Fast Services System (MFSS)

Role: Business Analyst

Misys Healthcare Systems, a member of the Misys Group of Companies,

develops and supports reliable, easy-to-use software and services of

exceptional quality that enable physicians and caregivers to more easily

manage the complexities of healthcare. Misys Fast Services System (MFSS) is

a HIPAA compliant system designed for both real-time & batch environments,

it caters to the needs of the various Misys systems such as Tiger, Vision,

Payer path and third party clearing houses. MFSS is a set of web services

that are connected to MISYS payer network; the system consolidates the

process of creating and validating the HIPAA transactions in a centralized

location. Some of the HIPAA transactions that are supported by MFSS are

eligibility verification, claim status, claim submission and referral. The

project also involved generation of certain Health Check reports for the

system.

Responsibilities:

. Worked on Problem opportunity analysis, user interviews, gathered,

analyzed and documented business requirements based on the analysis of

HIPAA transaction processing workflow model.

. Gathered the requirements by customer interviews to define and

document user requirements.

. Reviewed Project Charter Documents, Business Requirement Documents and

RTM for tracing to Use-Case Specifications, System Requirements

Specification and UI Functional specification documents.

. Designed and developed Use Cases, Activity Diagrams, using UML.

. Facilitated and managed sessions with committee of SMEs from various

business areas including Payer network, payer path, Tiger.

. Clarified QA team issues and reviewed test plans and test scripts

developed by QA team to make sure that all requirements will be

covered in scripts and tested properly.

. Participated in the bug review meetings, updated requirements document

as per business user feedback and change in functionality of the

application.

. Worked on SCRUM for the Reporting requirements. Participated in daily

standup meetings and owned daily milestones to gather and create

reporting specifications.

Environment: SQL Server 2000, Windows, Crystal Reports, UML, MS Office, MS

Visio

Client: Bajaj Allianz, Bangalore, INDIA Jun 2007 - Aug 2009

Project: Customer Relationship Management

System (CRMS)

Role: Business Analyst

Bajaj Allianz is one the leading health insurance providers in India. The

project was about individuals seeking health insurance. The goal of the

CRMS Project is to increase the use of the current Web platforms by

expanding its capabilities to provide more services including FAQ. With the

success of this project, the business intended to see a significant

reduction in the calls handled by technical support personnel, thus leading

to both short and long-term cost savings.

Responsibilities:

. Acted as a liaison between the Business and Technical teams to deliver

requirements deliverables - beginning with assisting Senior Business

Analyst.

. Involved in all four phases of the requirements development including

Elicitation, Analysis, Specification and Quality Validation.

. Conducted GAP analysis and Impact Analysis to identify customer

channel usage trends and interactions focusing on likelihood to buy

product recommendations and reduce customer attrition.

. Conducted Joint Application Development (JAD) sessions with SMEs from

Market Research Group, Hospital Survey Group and Web Management Stem

to gather Business and Functional requirements including Use Cases and

UML Models for the CRMS project.

. Involved in finding and documenting requirements where the new data

capture solution would be compatible with existing Customer Interface

Control Systems (CICS).

. Developed Screen Mock-ups / Prototypes to provide demonstration to the

Business teams.

. Supported Design and Development activities, by providing walkthroughs

and feedback.

. Ensured that the clients adhere to the Change Management Notification

(CMN) process.

. Responsible for managing the Change Request Log and RTM.

. Extensively involved in writing and executing Test Cases and User

Acceptance Testing (UAT).

. Assisted in developing end user training material and training

sessions.

Environment: RUP, Microsoft Office, Visio, Microsoft Project, SQL server,

UML.

Client: Apollo Health Street, Hyderabad, Jun 2006 - May 2007

INDIA

Project: Revenue Cycle Management Application

(RCMA)

Role: Business Analyst

Apollo Health Street is a global healthcare service provider for healthcare

clients in US. Project was to develop a tool to measure the performance of

the BPO project and teams and bill the client accordingly. Functionality of

RCMA (Revenue Cycle Management Application) included analyzing the data

from client. Other functionalities included tracing the claims status based

on status codes and sending back to client for corrections or write off's.

RCMA was to be designed to reverse interface the client Practice management

system to reduce the manual efforts.

Responsibilities:

. Acted as primary liaison between the client departments and the

Information systems IT department to perform analysis, review, and

estimation of client requests.

. Performed Gap Analysis to check the compatibility of the existing

system infrastructure with the new business requirements. Followed

solely RUP methodologies during the course of the project.

. Accumulated system requirements from various departments through

surveys and interviews.

. Involved in prioritizing the defects and writing Business Requirements

to resolve them.

. Conducted JAD sessions with management, SME, vendors, users and other

stakeholders for open and pending issues. Planned and defined system

requirements to Wire Frames with Use Case, Use Case Scenario and Use

Case Narrative and UML (Unified Modeling Language).

. Created Use Case Diagrams, Activity Diagrams, Sequence Diagrams and ER

Diagrams in MS Visio.

. Responsible for creating test scenarios, scripting Test Cases using

testing tool and defect management.

Environment: MS Word, MS Access, Waterfall, UML, HTML, SQL Server 2000, MS

Visio, iRise, Share Point.

Client: HDFC Standard Life Insurance, Jun 2004 - May 2006

Hyderabad, INDIA

Project: CPS Upgrade

Role: Business Analyst

HDFC Standard Life is one of the largest insurance companies in its class

with approximately 3500 insurance contractor agents. The project

requirement was to develop a system to integrate and upgrade the CPS

(Claims Processing Service) and other disparate systems on a common

environment for their Life Insurance division. Project involved in

assimilating its isolated systems into a synchronized system, providing

remote access through a web interface and maintaining the infrastructure

required for these systems.

Responsibilities:

. Researched and assessed client systems and business processes.

. Explored all aspects of the Claim Processing lifecycle, starting from

identifying a claim to its closure.

. Worked intensively on various phases in the project lifecycle to

design the system in such a way that the high risk claims could be

easily identified and monitored.

. Participated in preparing basis for Project Requirement documentation.

. Involved in walkthroughs with business team, architects and developers

to refine the requirements.

. Implemented Traceability Matrix and User Requirement Specification

Document (URS) to verify the functionality.

. Streamlined clerical work processes and mapped to the automated

system.

. Involved with the Software Quality Assurance (SQA) Team to develop

Test.

Environment: Microsoft Office Suite, Microsoft Visio, Unix, Windows NT/XP,

Oracle

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