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BA

Location:
Tempe, Arizona, United States
Salary:
65$
Posted:
November 27, 2018

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Resume:

Tanushree

Senior Business Analyst/Project Coordinator

Phone: 347-***-**** E-mail: ac7s3u@r.postjobfree.com

PROFESSIONAL SUMMARY

9+ years of IT experience in comprehensive Business Analysis over a widespread industry domain knowledge in Healthcare, Property and Casualty and Finance.

Worked in all phases of Software Development Life Cycle (SDLC) including Production and Deployment.

Extensive experience in Waterfall and Agile (Scrum) methodologies, enterprise environments, architectural and solution design, implementation and complex customizations.

Expertise in conducting in-depth Root-Cause Analysis, GAP Analysis, SWOT Analysis.

Liaison to several cross-functional teams and in-depth understanding of the AS-IS and TO-BE business processes.

Performed business process analysis of current business processes and provided recommendation for improvements.

Detailing user stories from Product Backlog, Sprint Backlog and clear understanding of Burndown charts.

Highly efficient in requirement gathering, Modeling, System Designing, Testing, Validation, Workflows and Data Management.

Lead planning meeting, Joint Application Development (JAD) sessions for eliciting requirements from stakeholders through focus groups and interviews for documenting the BRD, FRD and FSD.

Prepared graphical depictions of project processes using Use Case Diagrams, Wireframes, Mock-ups, including the business workflow using MS Visio and Balsamiq.

Experience in converting the business into technical specifications for preparing Test Plans.

Efficient in reformulating strategies through Process Re-engineering, Change Management, Release Management, Process Improvements and UAT Testing.

Traced Requirements throughout the development process and verifying adherence using the Requirement Traceability Matrix (RTM).

Knowledge in generating Reports, Analytic Snapshots and Dashboards, enabling Email Services and constructing Page Layouts.

Developed process mapping of current and future process.

Experienced in medical claims process, claim billing and terminology.

User training on the changes being released and conducting post production activities like getting feedback from users. In case of any issues - doing Root Cause Analysis, prioritizing tasks with business users.

Experience in creating test cases and participated in QA and User Acceptance Testing.

Worked with testing team while driving the Functional requirements and Wireframes.

DOMAINS

Good understanding about Electronic Data Interchange (EDI) standards: 270, 271, 835 and 837 which are used in various business processes.

Experience with HIPAA compliance and involved in upgradation of HIPAA 4010 transaction to HIPAA 5010 in healthcare with strong understanding of Medicaid and Medicare rules and claim adjudication.

Strong knowledge and understanding of ICD-9 and ICD-10 coding and claims processing.

Involved in FACETS billing, enrollment and claim processing and subscriber/membership module.

Validated variety of claims detail using FACETS data model.

Worked on analysis of FACETS claims processing system and gathered requirements to comply with HIPAA 5010 requirements.

Dealt with the 837 and 835 ANSI X12 transaction understanding the loops, segments, elements and structure.

SKILL SET

Domain Expertise Healthcare, Finance, P&C

Requirement Management HP ALM, Blueprints, ERP

Document creation/Management MS Office Suite – Word, Excel, Outlook, PowerPoint, MS Project, OneNote, Publisher, Adobe Acrobat, Lotus Notes

Content Management MS – SharePoint, JIRA, VersionOne

Database Management Oracle, MS SQL, MySQL, MS – Access, Informatica

Business Modeling MS – Visio, Balsamiq, Enterprise Architecture, Modelio

Business Intelligence Cognos, Business Objects, Crystal Reports, Tableau

Defect Tracking Rally, Bugzilla, HP Quality Center

Languages HTML, CSS, C, Python

Operating Systems Windows, MAC OS, Unix, Linux

Methodologies Agile – Scrum, Waterfall

CERTIFICATIONS

Salesforce – Admin (ADM) 201

Six Sigma Certified

WORK EXPERIENCE

Client: McKesson Specialty Health (Scottsdale, AZ) February ’17 – October ‘18

Role: Salesforce Business Systems Analyst

Project: Patient Assistant Services

Project Description: McKesson Specialty Health provides services of patient’s coverage information to patients and providers for the reimbursement of specialty drugs. Project was involved in migration the data form legacy Java based application to a Salesforce platform. The application helps in determining the patient eligibility for reimbursement of the specialty drugs and also for the patients to get the claims processed. The application also had integrations with various contracted third-party vendors and also involved reporting of data to the clients.

Responsibilities:

●Responsible for end-to-end reporting of business analysis for insurance domain

●Served as a liaison between business unit and development team for implementation requests

●Managed third party vendors and applications integrated into Salesforce Org and documented the updates

●Built custom reports and dashboards through Salesforce for ground level users and upper management

●Created and trained management users on Salesforce Knowledge implementation

●Kept up to date in SFDC releases, reviewed thoroughly for new feature opportunities and impact to existing functionality

●Maintained and configured Users, Roles, Page Layouts, custom objects, picklists to support vital business functions and requirements

●Gathered requirements and had a thorough understanding of interpreting customer/client’s business needs and process flows to translate them into operational requirements

●Involved in gathering customer requirements from business user teams spread over customer service

●Involved in creating gap analysis document, business process and work flows of the organization with respect to Salesforce.com implementations

●Documented and performed Data Analysis and migrated data from external sources and legacy applications into Salesforce

●Led project teams internally to achieve project defined milestones and deliverables

●Created custom formula fields, field dependencies, validation rules, and approval process for automated alerts and field updates according to the application requirements

●Translated business user concepts and ideas into comprehensive business requirements and design documents

●Planned, facilitated and reported on quality assurance testing efforts, issues and next action items

●Created Business Requirement documents, System requirement Documents and maintained Agile boards in JIRA

●Trained the Operations Team during UAT and walked over the requirement and how it corresponded with the system.

●Assisted Production Support Team, solve the user raised cases on daily basis

Environments: Salesforce, MS Office Suite – Word, Excel, Project, Visio, Share Point, JIRA, Confluence, SQL, Agile Methodology

Client: Baltimore CareFirst Administrators (Baltimore, MD) November ’15 – January ‘17

Role: Senior Business Analyst/Project Coordinator

Project 1: Pharmacy Claims

Project 2: Implementation of Salesforce

Project Description: CareFirst Administrators provides health benefit plan administration for employer groups who are self-insured. Project involved the enhancement of the regular claims process for purchases. The project’s goal was to improve the entire claims adjudication process from receiving the prescription to processing the payment process and updating accounts receivable. It will also eliminate the complex, inefficient and labors-intensive aspects of payment processing; including customizable workflow, compliance, document preparation management and customer relationship management.

Responsibilities:

Gathered requirements from Business users and SMEs, through interviews, surveys, prototyping and worked with teams to identify the gaps and defects.

Conducted GAP Analysis by creating process flows highlighting the differences between the current (As-Is) environment versus the target (To-Be) environment.

Prepared project initiation plan and created Standard Operating Procedure (SOP).

Documented Sprint Backlog to manage User Stories and clear understanding of Burndown charts.

Participated in Sprint Planning, Daily Scrums, Sprint Reviews and Retrospective.

Facilitated “Three Amigos” work sessions between developers, Product Owners and Business Analysts.

Created and Updated Issues (Epic, Stories and Tasks) onto JIRA application.

Created Flow Diagrams for UI Wireframes using Balsamiq.

Guided the development teams to breakdown large and complex user stories into simplified versions for executions.

Authored progress and completion reports which were then submitted to project management on weekly basis.

Joined requirement grooming sessions during the sprints.

Test the user stories for accuracy to ensure undisputed acceptance and validating stories.

Co-ordinated business and IT signoff on requirements documentation.

Assisted QA team to prepare Test Scenarios and Test Cases associated with UAT.

Provided additional adjudication processing assistance to team members with complex reimbursement/insights.

Generated Salesforce Reports and dashboards.

Worked on Salesforce workflows and Validation rules.

Customized tabs and dashboards for Stakeholders in Salesforce.

Created the Traceability Matrix to map the functional requirements with Test Scripts.

Trained users by documenting and giving presentation regarding the changes and new functionalities.

Environments: MS Office Suite – Word, Excel, Project, Visio, Share Point, Cognos, SQL, JIRA, Salesforce, Agile Methodology

Client: State of North Carolina (Raleigh, NC) March ’14 – November ‘15

Role: Senior Business Analyst/Project Coordinator

Project: Insurance Policy Administration and Enhancement

Multiple Projects:

Upgradation of HIPAA 4010 to HIPAA 5010

Upgradation of ICD-9 to ICD-10

Project Description: With the up gradation of some of the mandated standards of Centers for Medicare and Medicaid Services (CMS), all the healthcare systems had to adopt the new standards. North Carolina state division of Medicaid worked on complying the HIPAA 5010 and ICD-10 standards by the deadline specified by CMS.

Responsibilities:

Identified Stakeholders and aided in the collection of business requirements to create the Business Requirement Documentation (BRDs) using MS Word and MS Visio.

Impact analysis was performed to determine the impact of ICD-9 to ICD-10 migration.

Worked on full HIPAA compliance lifecycle from GAP Analysis, mapping implementation and testing for processing of Medicaid claims as well.

Incorporated and implemented all the HIPAA standards, Electronic Data Interchange (EDI) transaction syntax like ANSI X12, ICD-9, ICD-10 and HL7.

Conducted HIPAA 834 data mapping and interpretation, as well as the conversion of this type of data through uploading to the facets application, via the MMS application.

Worked with multiple clearing houses to ensure their EDI files are complaint with the internal format for State of North Carolina Medicaid and helped resolve issues.

Migrated documents from shared drives to SharePoint environment.

Recommended corrective actions, if necessary along with the progress against Development/Action Plan routinely to the Project Manager.

Identified critical areas of business risk and modified business processes to reduce risk by using the Risk-Management Process.

Worked with the Source System Subject Matter Expert (SME) to ensure that the extracts are properly mapped using SQL for data mapping and querying.

As part of the data mapping procedures, assisted in writing requirement document for ETL – Data Extraction, Data Analysis and Loading process of collected data.

Prepared presentations to highlight the changes made.

Extensively involved in in HIPAA 5010 UAT. Defined and maintained Test Cases for EDI Transactions.

Delivered production support and post-production support, clarified changes to the business users, organized one on one sessions, one on many sessions to make sure the business users are aware of the system variations.

Environment: Facets 4.21, SharePoint, HP Quality Center, Crystal reports, MS Office Suite, Waterfall Methodology

Client: All State Insurance Company (Bridgewater, NJ) June ‘11 - January ’14

Role: Business Analyst

Project: Insurance Quote Generation

Project Description: All State is the second largest personal lines insurer which also holds personal lines insurance operations. My project in ‘All State’ was related to creation of comprehensive online request for auto insurance quote processing. The system runs on Mainframe and has a Web-integrated front end that provides free auto insurance quotes to individuals and for families this information was collated and transferred to data warehouses for creation of business intelligence reports.

Responsibilities:

Worked as BA for multiple module wise development teams.

Experienced as a JAD facilitator and meetings coordinator with excellent interpersonal and conflict negotiation skills.

Suggested measures and recommendations to improve the current application performance.

Facilitated story points, Sprint planning, daily Stand-ups, Sprint Demo/Review and retrospective meeting to track progress and eliminated project impediments.

Worked on creation of wireframes during the Elaboration Phase.

Evaluated the information gathered from multiple sources, decomposed high level information into details to gain understanding of end-to-end solution.

Assisted in grooming the Sprint and Release Backlog.

Identified/Documented data sources and transformation rules required to populate and maintain the data warehouse content.

Assisted in designing the organizational tools and forms to facilitate accurate data collection and recordkeeping.

Was part of Triage Meeting and Release Ceremony.

Involved in Documenting the results of Load Testing Process and created meaningful reports for analysis.

Communicated business risks and project cross-impacts to Project Manager and BSA Manager- Support.

Reviewed Test Plans that contains Test Scenarios, Test Cases, Test Data and the expected results for the UAT.

Environment: SQL Server, Balsamiq, MS Office Suite, Agile Methodology

Client: Fortress Investment Group (New York, NY) August ’09 – June ‘11

Role: Business Analyst

Project: Liquidity Management system

Project Description: Fortress Investment Group, LLC is a leading global investment management firm. The project was an In-house application, Neptune is NextGen Liquidity Management System, which is entitled to replace the existing manual/excel based process application. It also aids in creating the desired dashboards and reports. The purpose of the project is to replicate the current liquidity management process in an official application environment, constructing a foundation for upcoming advance and progressive features.

Responsibilities:

Interacted extensively with SMEs to understand corporate actions, extracting requirements from discussions to refine and document them into Business requirements.

Created FRD, UML, Use Cases and different Use Case Diagrams related to Software Requirement Document using Enterprise Architecture and MS Visio.

Conducted Gap Analysis and gathered user requirements by Interviews and User Meetings.

Documented JAD Minutes and incorporated business needs to Business Requirements.

Worked as a liaison between users and developers refining and explaining user requirements.

Associated between Development and Quality Assurance team to streamline the process.

Conducted weekly meetings for deciding the Policies and Procedures to be followed while constructing new sites.

Created and designed mock-up screens for the development process.

Participated in User meetings and discussing the issues to be resolved and translating user inputs into design documents.

Assisted in initial project timelines/deliverables/strategies for effective project management.

Assisted in documenting Test Plan, Test Scenarios and Test Cases to be used in testing, based on business requirements.

Document Requirement Traceability Matrix for tracing Test Cases and Requirements related to them.

Environment: Enterprise Architecture, HP QC, Balsamiq, JIRA, Share Point, Waterfall Methodology



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