Test Cases Project
Resume:
Shivangi N
**********@*******.***
Business Analyst
Professional Summary
Results driven, versatile consultant with over 3+years of experience as a BA .
Specialize in Healthcare, Insurance, Risk and Compliance, Data Analytics & Document management.
In-depth knowledge of specific healthcare issues, products and diseases.
Expert in knowledge of Business Analysis methodologies, Iterative and Incremental Software.
Experience of working on Waterfall & Agile methodology with Scrum processing framework.
Software Development Life Cycle (SDLC) using Rational Unified Process (RUP)
Managed key deliverables through the project lifecycle from requirements gathering to design, development, testing and deployment within allocated timeline and budget. Proficient in gathering Business and Functional requirements from both formal and informal sessions through interviews, NetMeeting, questionnaire, video conferencing, JAD sessions and conference calls.
Service provided as Good Communicator, excellent facilitation and presentation techniques and comfortable presenting to all levels of management. Provided context to decisions by communicating the bigger picture.
Coordinate and lead BA tasks across multiple programs/projects including Program-level Business Analysis, competitive analysis, feasibility studies and business cases. Worked independently and with minimal guidance from management to plan, resource and execute against goals and plans.
Participated in high level design, Detail level design, Test Strategy and Test Review sessions to provide key inputs and ensure adherence to overall business requirements/intent of projects.
Knowledge on medical necessities and healthcare compliance auditing.
Experience with Analyze healthcare EDI claims for Billing/Reimbursement process.
Hand on experience with Data mining, modify/add/remove internal & external databased on project implementation.
Analyze Vendors based on Quality, Delivery speed and Cost of products and services (Perform benchmarking).
Experienced in performing Feasibility Studies, Traceability Matrix, SWOT analysis, GAP analysis and Risk Analysis.
Broad Knowledge in reviewing Test Procedures, creating Test plans and detailed test plans for UAT, Test scenario, defining Test cases, both System & Integration and executed many test cases Test Data reviewing and maintaining and executing detailed Test scripts for UAT.
Functional Skills
Experience in Claims Processing and Claims Scrubbing in HMO, PPO, MCO, Medicaid and Medicare.
Knowledge with Medicare, Medicaid and commercial insurances in HIPAA,
Experience in (EDI) ANSI ASC X12 formats including NCPDP, 834, 835, 837 I & 837 P, 997.
Sound analytical and problem solving abilities.
Worked on healthcare standards such as HIPPA 5010, CPT, HCPCS, ICD-9, ICD-10.
Worked on various professional billing and hospital billing products.
Technical Skill
Methodologies: RUP, Agile, UML, Business Modeling, Process Modeling and Data Modeling.
Office Tools: MS Word, MS Excel, MS PowerPoint, MS Access, MS Project, MS Outlook, MS VISIO, SharePoint.
Languages: C/C++, SQL, HTML, CSS, WordPress.
METHODIST HEALTH SYSTEM Dec’16-June’17
Business Analyst
IMPLEMENTATION OF EMR SYSTEM
Conducting information gathering and kick-off sessions to gather information from users about their daily processes and workflow for implementing EMR System.
Evaluating and documenting clinical workflows and office operations.
Requirements gathering from the Sales team, EMR vendor, and Physician’s office and Participating in the logical and physical design sessions, developed documents like BRD, FRD.
Track requirements using Requirements Traceability Matrix (RTM).
Involved in ICD10 EMR testing and documentation.
Involving in JAD sessions for quickly and efficiently defining user requirements and eliminate project errors.
Participated in Code Reviews, System Testing and UAT followed by production verification, post production testing and support.
Worked with Claims Team members and stakeholders to give them a better understanding of business processes and HIPAA compliance.
Analyzed and wrote SQL queries in the database environment.
Updated requirement document as per business user's feedback and changes in functionality of the applications.
State of Illinois (MMIS Project) Aug’15-Nov’16
Business Analyst
ICD-10 IMPLEMENTATION
Elicit Business and Functional requirement documents following Waterfall as well Agile methodology.
Identified, analyzed and enhanced the existing system to allow receipt, storage and processing of ICD-9 and ICD-10 code sets
Identified, analyzed and updated existing documentation, reports and screen to incorporate changes related ICD-9 & ICD-10 code sets.
HIPAA: Following areas updated based on ICD-10 implementation – PDDB prefix, Description size for Diagnosis & procedure codes, Co-pay, Prior approval, Program coverage code, category of service, surgical codes, procedure type codes, Age limit, Logical place, Logical role, child & adult values, clinical laboratories improvement amendments, etc.
GEMS: Extracted analyzed and refined general equivalent mapping for ICD-9 to ICD-10 codes for migration the data into new MS SQL database.
Handled the modifications to the Medical Data Code Set Standards for ICD-10-CM (Clinical Modification) and ICD-10-PCS (Procedure Coding System) by the federally regulated compliance.
Created new database for diagnosis and procedure code sets thought Microsoft ETL tool.
Ensured comprehensiveness and traceability to all of the business requirements involved in the development of test plans and created test cases and test scripts needed to validate the requirement for Databases and EDI.
Elaborated business rules, identify flows and prepare Flowcharts/Pseudo code, Activity and Sequence Diagrams.
Reviewed Implementation Plan and refined testing types, techniques and environmental needs.
Defect Management & triage, provided expertise to resolve defects that raise business issues.
Actively involved in documentation of User Acceptance Test, Functional Test, Integration Test Scenarios and Bug Log.
Actively participated in weekly status meeting with team members and managers, business analysts & technical team and also generated Weekly Status Reports to the team manager.
Identified scope systems that will be modified by the ICD-10 project to accommodate ICD-10 code and /or downstream impacts steaming from ICD-10 codes.
Helped in preparing the ICD-10 context diagram.
Mapping of ICD-10 codes to procedure and diagnostic codes in DRG Grouping. Reviewed all codes and appropriately applied them.
Conducted meeting with the stakeholders and assess their accurate involvement with ICD-10.
Developed and coordinated implementation timelines with Trading Partners including readiness assessment and coordinated testing.
Identified processes and systems to enable to trade files with non-ICD-10 complaint trading partners.
Emblem Health Feb’15-july’15
Business Requirements Analyst
Acted as a liaison between business and technical team to obtain detailed functional, Business requirements, User requirements, business rules, that will help make system development easier for the technical team.
Critically evaluate information gathered from multiple sources, reconcile conflicts, decompose high -level information into details, abstract up from low -level information to a general understanding, and distinguish user request from the underlying true needs.
Provided reports on the project schedule to the project manager, as well as supporting other team members to ensure project success.
Supported configuration management team with software release information or enhancements, managed and maintained all project artifacts.
Used SDLC {System Development Life Cycle} Methodologies like RUP and waterfall.
Independently interacted regularly with clients of varying associate /management levels to gather and analyze business requirements and interpret business needs and issues in order to design solutions that will solve technical and or business issues.
Planned and conducted meeting including, but not limited to application development sessions, fit gap analysis sessions, design reviews, documentation reviews etc.
Infilon Technologies Dec’13-Dec’14
Junior Business Analyst
Responsible for continuous process improvement and for identifying and maintaining a clear and measurable
Development Process that is deployable throughout the enterprise using Waterfall Methodology.
Developed the flow diagrams for business process of the company using Microsoft Visio and analyzed and documented the requirement in Microsoft Word.
Conducted workshops for internal users to provide training. Worked with stakeholders on Joint Application development (JAD) during prototyping phase of SDLC. Involved throughout the business System Development Life Cycle (SDLC).
Conducted GAP analysis of the different reports that are being presented to clients to accommodate their requirements for the new enhancements.
Created SQL scripts to validate the inputs.
Worked with QA team to develop performance test cases based on projected user load.
Involved in all stages of testing process-Development of Test scripts and Test cases based upon requirements for Functional Testing, Integration Testing and support for User Acceptance Testing.
Used Rational tools to document and manage requirements, enhancement requests, and other documentation issues for the application. Worked with management to create and communicate critical information to the user community via email and discussion boards.
Other Activities :
Providing free classes for candidates, who are entering in healthcare IT professions or who are already employees and struggling to provide performance for their companies requirements. Tutoring basic concepts of most healthcare systems, compliances, EHR, claim processing, all healthcare EDI in order to analyze, analytics and reporting, and Business Analysis Guidance etc.
Education:
MS in Computer Science
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