7+years Business Analyst (Healthcare)
Resume:
FAHAD
********.**@*****.***
PROFESSIONAL SUMMARY
• 7+ years of experienced as a Business Analyst.
• Thorough knowledge of Software Development Life Cycle (SDLC) including Iterative Rational Unified Process
and Agile (Sprint) and Software Product Life Cycle Management (PLM)
• Adept at analyzing the current and future business processes.
• Experienced in project management, working with various internal teams and clients in tracking project progress
and maintaining Change Request and Requirements logs
• Skilled at gathering business requirements, functional requirements, non-functional using Rational Requisite
Pro.
• Experienced in creating data mapping documents
• Experienced in using different methods including conducting meetings, passing questionnaires and interviewing
stakeholders to gather requirements.
• Astute understanding of value created by AS-IS and TO-BE analysis and experienced in conducting process
evaluations and writing recommendations based on the analysis.
• Experienced in working with Project Management teams in various stages of the project to identify high level
requirements, and resource needs for the project.
• Experienced working with remotely located teams, off shore development model.
• Experienced in creating Unified Modeling Language (UML) diagrams including, use cases, activity diagrams,
using MS Visio and Rational Rose.
• Excellent understanding and hands on experience with HL7 Messaging Standards and EDI transactions.
• Expert level skills in MS Office products and other tolls including MS Project, MS Word, MS Power Point, MS
Visio, MS FrontPage, MS Excel and IRise Studio.
• Supervising the progress and mentoring team members’ within the Project Team and Configuration Management
Team for build releases.
• Adept at understanding new applications and conducting manual testing on the applications.
• Experience in conducting UAT and writing test cases for business users for multiple scenarios.
• Experience in working on Data Dictionaries with explanation of concepts in the form of use cases.
• Strong functional expertise in the Healthcare Payer Area - Membership claims, benefits, eligibility check, ICD10,
HIPAA, CMS HCPCS Exposure to Health Care Industry standards like HIPAA / PHI.
• Working Knowledge of Claims Processing, Insurance Workflow, HMP, PPO, HIPAA, COBRA
• Experience with all modules on Quality Center. Worked in the capacity of Project Admin for QC, also managed
requirements and test cases and created various custom reports.
• Experienced documenting XML reference documents for data sharing.
Experienced in documenting User acceptance test plan and training users for working with the application.
Excellent Knowledge of data warehouse database design, data definition, System capabilities, and data integrity
issues.
Expert in conducting GAP analysis, User Acceptance Testing (UAT), Cost benefit analysis and ROI analysis.
Excellent Written and oral communication skills.
Education
Master's In Business Administration. New York.
Outstanding student honor.( GPA 3.97)
Technical Skills
Methodologies RUP, Waterfall, Agile/Scrum.
Environment Mainframe, Oracle, MS Office Suite, SharePoint, C++, VB
Operating Systems: Win 95/98/NT/2000/XP
Change Management Tools Rational Clear Quest, Test Director.
Business Modeling Tools Rational Rose, Microsoft Visio.
Version Control Systems Rational Clear Case.
Project Management Microsoft Project, Microsoft Office.
Data Bases Oracle, SQL Server
Testing Tools Rational Suite, Test Director
Methodologies RUP, Waterfall, UML, Six Sigma, Business Modeling, Process Modeling
Professional Experience
Kindred Healthcare, Louisville, KY Jun 2012 – Present
Business Analyst
Kindred Healthcare, Inc. is a healthcare services company that through its subsidiaries operates hospitals and
nursing centers across the United States. The project was a web based Health care application. The system
connected a group of doctors and gave them a forum to interact, both at the personal and public level, where they
could discuss diseases and treatments, receive and offer advice, improve their knowledge levels and even access a
remote database. Additionally, this enabled team members to securely access and print time-sensitive materials
anywhere in our enterprise or over the Web regardless of file format.
Responsibilities:
• Participated in creation of Business Process Workflow Diagrams with Stakeholders.
• Conducted meetings with business users and SMEs to identify and gather various functional and non-functional
requirements.
• Analyzed business requirements and organized high-level and low-level Use Cases.
• Utilized Rational Unified Process (RUP) to configure and develop process, standards, and procedures to create a
Business requirement Document (BRD).
• Conducted GAP analysis of the different reports that are being presented to clients to accommodate their
requirements.
• Created artifacts such as Use Cases, Activity Diagrams, and Sequence Diagrams using MS Visio. Planned all the
RUP iterations and documented the artifacts throughout various phases.
• Participated in team meetings to improve overall implementation process.
• Also participated in HIPPA 4010 to 5010 upgrade (Level 1)
• Knowledge of HIPAA 5010A rules to store the transactions.
• Monitored all the HIPAA transactions through the gateway.
• Participated in ICD 9 to ICD 10 codes mapping sessions as well as status meetings and provided comments and
suggestions on challenges.
• Adopted Rational Unified Process (RUP) methodology with emphasis on its six best practices for iterative and
incremental development.
• Played a key role in planning, testing, and implementing system enhancement requests.
• Conducted JAD sessions during the various stages of upgrading the matching system and discuss the current
system preference.
• Reviewed System Test Plans, wrote test scripts and worked with business folks to validate and execute the test
scripts.
• Functioned as the primary liaison between the business line, operations, and the technical areas throughout the
project cycle.
Environment: RUP, MS Office (MS Word, MS Excel, MS PowerPoint, MS Visio), MS-Project, Windows 2000 server,
Clear Case, Clear Quest.
Assurant, NYC Mar 2010 – May 2012
Sr. Business System Analyst
Worked on the project focused on upgrading HIPAAX12 4010 transaction to X12 5010 where as a Healthcare
Business Analyst, I was responsible for the maintenance and support of EDI Gateway system, and also the testing
and implementation activities of the 5010 system for the client.
Responsibilities:
• Worked as a liaison among stakeholders in order to elicit, analyze, communicate and validate requirements for
changes to business processes, policies and information systems.
• Interacted with the Business users, SME’s, Developers, PMs and QA teams to better understand the business
processes and application knowledge.
• Contributed in implementation of 4010 to 5010 transition in accordance with HIPAA standards.
• Performed Gap Analysis for HIPAA 5010.
• Met with Supervisors and business users and defined the scope of the project, gathered business requirements,
and conducted gap analysis
• Worked closely with Business Team, SME’s, Infrastructure team, and coordinated with Offshore Team.
• Wrote BRD’s for 834(member Eligibility),Provider files and Claims tracking system, Use-Case Narratives including
business process workflow diagrams and Requirements Traceability based on any of the projects need.
• Documented and gathered Functional specifications for 837 (claims), 278(Authorizations) and 270/271 (Eligibility
and Benefit Response)
• Conducted Requirements Walk-Thru JAD Sessions and resolved all issues/findings.
• Successfully received Sign-Offs by utilizing Clear Quest tool for all projects on time after resolving all open
questions.
• Lead daily team meeting and co-ordinate with different cross-functional teams, offshore as well as onshore.
• Lead & Facilitated numerous meetings to help answer any question on requirements during Design,
Development, Testing and Implementation phase.
• Communicated with all the key stakeholders, business teams, contributors, operations and technical experts to
ensure help and involvement in completing the assigned task.
• Developed business requirement updates while working with different concerned authorities to define priorities
concerning business requirement.
• Organized brainstorming and JAD sessions with stake holders, business users, technical teams, testing team to
analyze and validate the business requirements, system life cycle and explained the key performance indicators
and documented the specifications.
• Created Use Case diagrams by analyzing the business process followed by Activity diagrams using MS-Visio and
participate in production of HIPAA 5010 EDI Test data.
• Developed use case Designed process flow diagrams using MS-Visio and also Business Context Diagrams
• Coordinated with users in doing UAT and conducted UAT testing.
Environment: MS Office (MS Word, MS Excel, MS PowerPoint, MS Visio), MS-Project, Rational Rose
Health Springs, Nashville, TN Aug 2009- Feb 2010
Business Analyst.
Based in Nashville, Tennessee, Health Spring got its start in 2000 and is now one of the country’s largest and fastest-
growing coordinated care plans whose primary focus is Medicare Advantage plans and prescription drug plans. The
project was in Coordination of Benefits (COB), a Federal Health Care Financing Administration (HCFA) Program.
Medicare Coordination of Benefits is the process for ensuring that payment of Medicare beneficiaries’ claims is
properly shared among insurers when the beneficiary is covered by private insurance in addition to Medicare. By
coordinating benefits, the COBC assists Medicare in paying claims more accurately the first time, which saves costly
follow up and mistaken payments.
Responsibilities:
• Used UML diagrams for data capture activities which required working with SMEs ensure consistency and
accuracy of data during the data loading process and that the data passes validation and integrity constraints with
corporate database repositories.
• Clear understanding of Medicare (Part A, Part B and Part D) and Medicaid benefits as well as business
processing.
• Involved in process analysis and defined executed data migration plans for local data for global applications.
• Worked with 837, UB92, UB04, CMS 1500 claims and HIPAA 835, 270/271, 276/277, 278 transactions.
• Database support that includes activities required correcting, deleting or summarizing medical history of members
as well as provider information.
• Experience in CMS and MMA Guidelines.
• Collaborated on the development of user requirements and design specifications using standard UML techniques
such as use case, activity, sequence, and class diagrams.
• Conducted JAD sessions, Focus groups and individual interviews to facilitate elicitation with regards to analysis,
specifications, and design of the relevant business processes and systems.
• Thorough understanding of health benefit products, assisted in consolidating the summary of Benefits.
• Involved in Smoke, Functional, Integration, End-to-end and Regressions Tests in each environment by
tracking the test status in Quality Center (Test Director).
• Applied advanced Excel skills (pivot tables, macros, lookups, charts) and Access database querying skills in
streamlining and automating accounting processes.
• Documented detailed business, functional, and User Interface system specifications using standardized company
templates for the business, development, and QA team.
• Build relationships with Information Systems and other relevant business partners, balancing practicalities with
innovative and efficient business systems solutions.
• Knowledge of HCFA 1500 and UB 92 claim forms.
• Helped developers with the following list of HIPAA-EDI Transaction Code sets: (837, 835, 270/271, and
276/277).
• Created test cases and participated with QA team in testing of the functionality of the application by inserting
varying data on different test runs.
• Documented Requirement Traceability Matrix in Requisite Pro for traceability of requirements through test
cases.
• Developed Forms using MS Access using Forms and Reports for reporting.
• Produced clear user manuals & training guides for User Acceptance Testing (UAT) and deployment for end-
clients with step-by-step instructions and created appropriate GUI screenshots.
Environment: SQL Server, UML, Rational Requisite Pro, Test Manager, Clear Quest, Windows XP, MS Visio, MS
Access, MS Project, UAT, JAD, UML Diagrams
Life Bridge Health System, Baltimore, MD Mar 2007- Jul 2009
Business Analyst
LifeBridge Health consists of four hospitals, one nursing home and their subsidiaries and affiliated units. The purpose
of the project was to deploy a solution to access, analyze and share patient information wherever it resides. The
project team standardized LifeBridge's data model and created consolidated, researchable databases; implemented
several business intelligence products to facilitate the secure sharing of information across the enterprise.
Responsibilities:
• Analyzed existing reports and defined business requirements and business process flows
• Conducted JAD sessions with PM, SMEsand facilitated interviews with end users and hospital
administrators to collect business requirements
• Built a business process model using Rational Rose and MS Visio
• Gathered detailed business and technical requirements and participated in the definitions of business
rules and data standards
• Facilitated SME interviews and assisted in identifying and analyzing the possible technical solutions
to existing business problems
• Performed requirement analysis and developed use cases according to the flow of patient data and
rules of security sharing
• Participated in all phases of the software development life cycle for assigned projects and
coordinated business issues resolution throughout each project
• Maintained proper communication with the developers ensuring that the modifications and
requirements were rightly addressed &revisions were monitored
• Validated business rules and all artifacts with users for approval and sign off
Environment: Rational Rose, Rational Requisite Pro, MS Project, Oracle, MS Access, MS Excel, MS PowerPoint,
Windows
Wesley Medical Center, Wichita, KS Jul 2006 – Feb 2007
Business Analyst
Wesley Medical Center is one of the, health service organizations whose mission is to improve the health of the
communities through a values-based, comprehensive and cost-effective regional health system. The project consists
of the following modules: In-Patient Information, Out-Patient Information, Bill Payment and Inquiry, Hospital Staff
Details, Physician Information, Information about Wesley Inn and Appointment Fixing. Designed and programmed
several Electronic Claims processing between hospital and insurance companies and Medical Labs, to a variety of
platforms
Responsibilities:
• Identified and validated high potential business opportunities for stakeholders and develop customized
business strategies that are aligned with corporate strategic objectives.
• Interviewing business area experts, asking detailed questions and carefully recording the requirements in a
format that can be reviewed and understood by both business people and technical people.
• Conducted JAD Sessions to develop an architectural solution that the application meets the business
requirements, resolve open issues, and change requests
• Prepared Business Process Models that includes modeling of all the activities of business from conceptual
to procedural level.
• Followed the UML based methods using Rational Rose and Visio to create Use Cases, Activity
Diagrams/State Chart Diagrams, Sequence Diagrams, Collaboration Diagrams
• Cleaning Validation and Software Validation.
• Involved in the documentation of extraction, of the data from various tables in the Data warehouse.
• Performed Unit and System testing, before integrating all the separate modules for further testing to assure
an efficient operation.
• Involved in weekly walkthroughs, inspections and verification meetings with various
stakeholders in the project.
• Conducted periodic Software Quality Assessment meetings to come up with test metrics
and gauge the progress of the testing effort.
Environment: Java, JSP, FDA Regulations, Windows NT, MS Office (MS Excel for reporting), Rational Rose,
Requisite Pro.
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