Ahsan Amin

E mail Id acqool@r.postjobfree.com

Contact 949-***-****

WORK EXPERIENCE

Business Analyst

Cognosante- McLean, VA - March 2014 to June 2015

Responsibilities

Work in partnership with Project Team, functional Team Leads and functional end-users to identify and document

business process improvement opportunities and complete the definition of requirements for system design,

implementation & training.

Worked as a Project Manager within the QA Team, leading a team of 7 to interpret and conduct proper analysis of

consumer claims.

Acted as a liaison between client and payer/intermediary. Experienced in payer rules, requirements, governmental

regulations and HIPAA compliance.

Interacted with claims payment and enrollment to review, analyze and document business processes. Worked with

HIPAA 270,271,835,837 transactions. Performed validation of 270,271,835 and 837 Professional and Institutional

format files according to EDIFECS engine

Used Microsoft SharePoint for Project document management.

Adept at gathering, analyzing and evaluating data to formulate creative solutions to existing or anticipated

challenges

Worked closely with both IT and the business to understand system and training needs for applications and

packages supported.

Created workbooks using excel and analyzing 1095-A Insurance Forms .

Create flow diagrams illustrating the work flow of both ‘as is’ processes and ‘to be’ processes.

Used QNXT in order to interpret claims Understand and analyze the functionality and Impact on all

the applications involved.

Documented the Use Cases and prepared the Use Case, Activity, Sequence diagrams and Logical views using MS

Visio and MS Office for a clear understanding of the requirements by the development team.

Facilitated Joint Application Development (JAD) sessions with all IT group members for communicating &

managing expectations and to discuss various means for integrations with current system using an adoption

through execution strategy.

Skills Used: MS Visio, X12 EDI Sets, Quality center, BRD, FRD, Test Director Rational Clear Quest, VPN, Filezilla

Business Analyst

Relay Health/McKesson - Atlanta, GA - June 2012 to March 2014

Responsibilities

Work in partnership with Project Team, functional Team Leads and functional end-users to identify and document

business process improvement opportunities and complete the definition of requirements for system design,

implementation & training.

Acted as a liaison between client and payer/intermediary. Experienced in payer rules, requirements,

governmental regulations and HIPAA compliance.

Analyzed trading partner specifications and created EDI mapping guidelines Interacted with the “End-

Users” by interviewing them, by preparing appropriate questionnaire to better understand end-user needs

and the business process.

Extensive HIPAA EDI 4010 transactions knowledge - 835,837,277,278,270,271 and the new 5010

formats. Worked closely with both IT and the business to understand system and training needs for

applications and packages supported In charge of assessment and development of training materials

Created test cases for Testing (Testing Environment), Integration Testing (UAT) and Production (Post

Implementation Review) in Agile environment.

Used Microsoft SharePoint for Project document management.

Adept at gathering, analyzing and evaluating data to formulate creative solutions to existing or anticipated

challenges

Utilizing SDLC and project methodology as well as political prowess, archived greater synergy between

the stockholders, business and technology units. Collaborated in project status reporting, weekly and

monthly project progress reviews.

Creating and executing SQL queries within relational and star schema databases for analysis, problem

solving and evaluating data quality/validity

Responsible for gaining a good understanding of user needs and accurately representing them in a well-

documented software functional specifications document.

Worked with stakeholders to obtain deliverable sign-offs. Provided functional direction to other systems

analysts and used the meta-data definition and workflow needs and how these functions map to business

processes.

Creating and interpreting BRD’s and FRD’s as required by Business Stakeholders and Development

team. Extensively work on EDI transactions 834, 835, 837I, 837P, 820, 270/271, 276/277, and 999.

Create flow diagrams illustrating the work flow of both ‘as is’ processes and ‘to be’

processes. Understand and Analyze the functionality and Impact on all the applications

involved

Documented the Use Cases and prepared the Use Case, Activity, Sequence diagrams and Logical views

using MS Visio and MS Office for a clear understanding of the requirements by the development team.

Facilitated Joint Application Development (JAD) sessions with all IT group members for communicating &

managing expectations and to discuss various means for integrations with current system using an

adoption through execution strategy.

Conduct ICD-9/ICD-10 conversion analysis through ICD 9 and ICD 10 proposed mapping documents and

HIPAA 5010 system capabilities of EDIFECS tools. Update mapping documents as required for version

upgrade and change requests.

Created and maintained data mapping document(s) in reference to the HIPAA transaction: 837.

Involved in developing Test plan and Test cases based on Use cases and Functional Specifications

Documented, reviewed, and verified testing procedures for compliance to Interface Quality Assurance

and Development standards and policies.

Skills Used : Agile, PL/SQL, HTML, MS Office, X12 EDI Sets,MS Visio, HP Quality Center, EDIFECS

Spec builder, Caliber RM, VSS, HTM, Cognos, ETL, Salesforce, Microsoft Excel, Microsoft Word,

Microsoft Power Point, EDIFACT.

Business Analyst

Cigna Health - Stamford, CT - December 2010 to June 2012

Responsibilities

Facilitated JAD sessions with SMEs’, Product owner, and Development managers to understand the

business process, gather Business Requirements and identify enhancements for the application.

Followed AGILE methodology viz. Scrum throughout the project.

Prepared release plan and iteration plan for the project working with the stakeholders

Re-factor Epics to Stories and maintain the prioritized Sprint backlogs

Resolves problems by examining and evaluating data; selecting corrective steps

Researched/Analyzed the various steps involved in claims processing life cycle and then wrote the BRD in

such way that developers could construct the system to identify riskier claims.

Conducted requirement sessions, identifying business needs, getting sign-off on requirements and

capturing requirements in CaliberRM and Rally.

Creating and interpreting BRD’s and FRD’s as required by Business Stakeholders and Development team.

Tested various enhancements of the applications like Rcopia Web, Rcopia mini browser, Rcopia Update,

Payor Engine, SSpoller/Runner/Server

Conducted HIPAA 4010 - 5010 Conversion Analysis – contribute in the documentation of HIPAA 5010

changes to EDI 837, 834, 835, 276, 277 transactions sets.

Performed Analysis of ICD 9 Procedure and Diagnosis Codes in accordance with ICD 10-CM and ICD 10

PCS Conversion Compliances using GEM.

Facilitated pre-planning meetings, demos and daily stand ups.

Assisted Project manager in establishing project methodology, estimating resource needs, handling

conflicts with finances and deadlines and presenting propositions to project sponsors.

Wrote test cases and test scripts for the User Acceptance Testing (UAT).

Responsible for the development and implementation of HIPAA EDI Map sets 270, 271, 276, 277, 820,

834, 835, 837 and 5010.

Identified gaps between current policies and procedures and new HIPAA 5010 compliance and developed

an action for the migration process.

Tested the ANSI X12 Version 5010 / EDI transactions (HIPAA) for Claims Status and Eligibility (270, 271,

276, 277, 834, 837P, 837I, 837D, 835 remittances and NCPDP Claims).

Prepared graphical depictions of Use Cases, Use Case Diagrams, State Diagrams, Activity Diagrams,

Sequence Diagrams, Component Based Diagrams, and Collateral Diagrams and creation of technical

design (UI screen) using Microsoft Visio.

Working with clients to better understand their needs and present solutions using structured SDLC

approach. Provided mapping, and gap analysis for HIPAA codes sets and EDI transaction processing

between Trading Partners and Regence

Assured that all Artifacts are in compliance with corporate SDLC Policies and guidelines.

Worked with design team to prepare Project plan for User Interface documents.

Worked in B2B, B2C and Ecommerce portals web application developments.

Gathered the requirement, completed the proof of concept, Designed, Developed and Tested Physical

Layer, Business Layer and Presentation Layer of OBIEE.

Designed and Developed Dashboard Pages Like Total Spend Overview, Trends, Exceptions, Purchase

Requisitions, Purchase Orders, Purchase Receipts and Employee Expenses in Procurement and Spend

Dashboard in OBIEE.

Analyzed specific business areas, making recommendations and participating in implementation of B2C

projects to meet current and long-range goals.

Involved in creating test cases for EDI 837 Claims (I & P) Transactions. Designed

and implemented Mainframe EDI system utilizing ANSI X12 standards.

Prepared graphical depictions of use cases (activity diagrams, system context diagrams, sequence

diagrams, use case diagrams, wire frames, etc

Planning/Implementing Testing Standards and Guidelines for Functional / Smoke / Unit / Systems

integration / Regression / User Acceptance Testing and thrust for enhancement of software product

quality.

Created and maintained SharePoint repository for project/program portfolios.

Coordinated management of projects on MS SharePoint

Used Rally and TFS for updating the status of all the Test Cases & Test Scripts that are executed during

testing process.

Created traceability matrix to map requirements with test cases.

Managed and assigned defects to the development team in Microsoft Team Foundation Server.

Skills Used : Agile, PL/SQL, HTML, MS Office, MS Visio, EDI, HP Quality Center, EDIFECS Spec builder,

EDIFACT Caliber RM, VSS, HTM, Cognos, ETL, Microsoft Excel, Microsoft Word, Microsoft Power Point.

Account Manager/VNG Tech

3DDS Imaging –West New York, NJ –February 2009 to September 2010

Responsibilities

Obtain patient insurance information and proper identifications. Document and maintain

accounting and banking records, process payroll and perform medical transcription.

Coordinate with insurance companies regarding coverages and billing information.

Reach out to other doctors for medical related issues and laboratory services.

Work with insurance companies and billing information for the patient's record.

Record patients' medical history, vital statistics, and information such as test results in medical

records.

Update and maintain patient information in the system.

Trained in Fraud prevention program in order to prevent statistical error.

Created and maintained SharePoint repository for project/program portfolios.

Acted as a liaison between client and payer/intermediary. Experienced in payer rules, requirements,

governmental regulations and HIPAA compliance.

Working extensively with Medicaid, Medicare, and various other insurances (Horizon, AmeriHealth, Cigna,

Aetna, Humana)

EDUCATION

Bachelor of Science in Finance

New Jersey City University - Jersey City, NJ

2012 to 2014

SKILLS

Exceptional leadership, organizational, interpersonal, analytical and problem resolution skills, Thrive

in both independent and collaborative work environments, Training in Fraud Prevention and Check

Fraud, Accountancy, Marketing, Data Entry, Customer Service, Atm, Banking, Billing, Cashier, Sales,

Payroll Processing, Policy Analysis, Statistics, Funds, Insurance

ADDITIONAL INFORMATION

Software proficiency in Microsoft Word, Excel, Access, SharePoint, and PowerPoint. Proficient in SDLC,

SCRUM Methodology, UML, Visio, Lucidart, SQL Queries. Also knowledgeable of QuickBooks. Able to

utilize both PC and Macintosh platforms.

X12 EDI Sets and writing FRD and BRD.

Contact this candidate