HASNAIN MOMIN

Summary

• **+ years of experience specialized in Healthcare Business Analysis, Implementations, System Configuration, QA testing, and auditing claims for correct payment.

• Experience working on Agile and waterfall methodology and QNXT including Claim processing, Case management and customer service.

• Experience in Member and Provider Portal (Health Plans) Business Requirements development, creating Epics and User stories, driving user acceptance.

• Manage the project key initiatives with tasks such as prioritization, tracking, Preparation of meetings etc.

• Translate requirements from operation to functional requirements.

• Experience working with business requirements and preparing and analyzing functional requirements.

• Proficient at coordinating with stakeholders, vendors, Subject Matter Experts (SMEs), Project Manager (PM) and end users and elicitation of requirements through Joint Application Design (JAD) sessions, Brain storming sessions, interviews, Surveys and questionnaires, Requirements workshops, document analysis, Joint Application Requirement (JAR) sessions.

• Skilled in gathering and converting User Requirements into High Level and low-level documents (HLD/LLD) like Business Requirements (BRD), Functional Requirement Documents (FRD), Functional Requirement Specifications (FRS) System Requirement Specification (SRS).

• Expertise in Gap Analysis.

• Organized review meetings with various stakeholders and preparing the requirements

Manage traceability Matrix to track the status of requirements.

• Preparing design documents for functional and technical requirements.

• Experienced in conducting sessions and worked with executives, developers, and end-users to define the exact requirements.

• Evaluating user requests for new programs or modified program components to determine feasibility, cost and time required, compatibility with current systems, and computer capabilities.

• Analyzing business requirements, generating project specifications, and converting them into code, and applying knowledge of computer programming techniques and computer languages.

• Writing and analyzing business requirements, generating project specifications, and applying knowledge of computer programming techniques and computer languages.

• Analyzing high level business requirements; developing lower level functional and technical requirements.

• Working with software development Life Cycle (SDLC) concepts and Conducting system tests using Agile principles and Scrum methodologies

• Performs project analysis, development, implementation, and documentation.

• Collaborates with application owners on project requirements, quality, progress, user stories, and user acceptance testing.

• Dedicated Healthcare Administrator with experience coordinating hospital staff and departments to ensure the highest level of functionality and productivity. Adept in working with patient records, medical billing, and all aspects of healthcare administration in a fast-paced environment. Committed to utilizing my strengths and experience working in healthcare systems to support smooth administrative processes.

• HIPAA experience in protecting patient health information, namely The Privacy Rule, the Security Rule, and The Breach Notification Rule.

Senior Business Analyst

Coventry Healthcare, Minneapolis, MN (Jan 2020 to Present)

• Lead experience in Member and Provider Portal (Health Plans Aetna) Business Requirements development, creating Epics and User stories, driving user acceptance. Worked on QNXT system linking participating providers to their appropriate pay to and contract configuration in the QNXT system.

• Actively analyses current business processes (Claims, Recipient eligibility and enrolment etc.) and worked with management to improve and implement enterprise solutions to ensure compliance.

• Document the Requirements and circulated them to Business & Technical teams for Sing-offs.

• Maintain traceability through updates to the Requirement Traceability Matrix (RTM) using Requisite Pro.

• Involved in impact analysis of QNXT adjudication system because of change in EDI transactions.

• Analyzed and tested various Common Eligibility Outbound Interface process and other inbound/outbound QNXT interfaces.

• Develop, share, and incorporate organizational best practices into business applications.

• Diagnose problems and identify opportunities for process redesign and improvement.

• Formulate and update departmental policies and procedures.

• Analyses program policies, procedures, and initiatives to determine the impact on business systems and functional areas.

• Develops and maintains test cases for system and user acceptance testing.

• Reviews, analyses, and executes test cases with a formal testing tool.

• Tracks, documents, and reports the status of testing.

• Evaluates proposed test strategies to ensure appropriate test coverage.

• Interact with a diverse level of staff to exchange and/or extract information.

• Experience with business analysis related to documenting and validating business requirements and business processes.

• Work with business SMEs to gather business Requirements and translate into functional specifications.

• Clarifying requirements which are not clear to Business Analyst.

• Collecting test data for requirements to perform testing.

• Analyze requirements to ensure testability, report gaps and discrepancies.

• Executing test cases and log defects in JIRA.

• Retest the scenarios post defect fix.

• Adding scenarios, test data and screen shots used for testing to Test Ready User Stories in JIRA.

• Prepare and present weekly status reports to management.

• Interact with offshore team to share & provide required information on planned work items for the sprint.

• HIPAA experience in protecting patient health information, namely The Privacy Rule, the Security Rule, and The Breach Notification Rule.

Skills: Agile/Scrum, JIRA, Rally, MS Visio, Content Central, MySQL Azure DevOps.

Senior Business Analyst

Health Alliance, Champaign, IL (Oct 2017 – Jan 2020)

• Built an Information Security Risk Assessment (ISRA) for the secure exchange of health insurance data as part of the Affordable Care Act (ACA)

• Compile, validate and report system-wide metrics to attest meaningful use of EHR to the Centers for Medicare and Medicaid Services.

• Served as a liaison between patients and medical professionals.

• Provided efficient and timely administrative support to ensure the smooth running of the office.

• Aimed to provide the highest level of customer service by remaining organized, punctual, and accurate.

• Provided direct support to the Chief Financial Officer by handling correspondence and schedules.

• Oversaw and executed new employee orientation activities.

• Worked to maintain accurate and detailed information for patient records.

• Utilized automated systems to expedite patient scheduling, registration processes, and check-in processes.

• Worked collaboratively with other office professionals to ensure productivity and efficiency.

• HIPAA experience in protecting patient health information, namely The Privacy Rule, the Security Rule, and The Breach Notification Rule.

Skills: Windows, Oracle, MS Office (MS Word, MS Excel, MS PowerPoint, MS Visio), MS Access, Agile, SQL, ETL, UML, Quality Center, and SharePoint.

Business Analyst

Medcath Corp; Charlotte, NC (April 2015 to Sep 2017)

• Played a key role in the planning, testing, and implementing system enhancements and conversions.

• Provided key project inputs by working with users in defining the project and system requirements.

• Reviewed business process, and functional requirements.

• Worked on Hospital data processing for improving database for storing user files.

• Analyzed business needs, created, and developed new functionality to meet real time data integration that facilitated decision.

• Experience of managing multiple stakeholders across the organization, and in QA integration of systems.

• Involved in detailing project mission, data process flow diagrams, and timelines.

• Worked with SQL queries for data manipulations.

• Used ETL process in helping the DB team in data migration.

• Assisted in building a business analysis process model using Rational Rose, Requisite Pro and Visio.

• Designed and developed Use Cases, Activity Diagrams and Sequence Diagrams.

• Assisted in process modeling; conducted and participated in JAD sessions with system users; helped with design walkthroughs with stakeholders for base lining architecture.

• Developed strategic partnerships with the business unit to develop a solid knowledge base of the business line, including the business plan, products, and processes.

• Research operational procedures and methods and recommended procedures for improvement –with an emphasis on automation and efficiency.

• Assisted Test Lead, Testers understanding business process and help them successful completion of Unit Testing, Integration Testing, Functional Testing and SIT.

• HIPAA experience in protecting patient health information, namely The Privacy Rule, the Security Rule, and The Breach Notification Rule.

Skills: RUP, Rational Rose, Requisite Pro, MS Visio, RUP, MS Project, SQL, MS Access, MS Excel, and MS Word.

Healthcare Business Analyst

Senior Whole Health; Cambridge, MA (Feb 2011-March 2015)

• Analyze change requirements for Providers, Contracts and Claims processing modules configuration in Assist Healthcare Business Offices in the electronic remit processing cycle to ensure timely posting of funds to patient accounts.

• Administer reports to match electronic remits (835) to electronic payments (EFT)

• Assist with 834 enrollments and implementations.

• Work as a liaison with close contact with vendors/payers & National Payment Adjustment Center to obtain missing 835.

• Pass COB data to the CMS COB contractor.

• Identify and resolve any COB discrepancies between the health plan and Corporation.

• Served as a liaison between the internal and external business community (Claims, Billing, Membership, Capitation, Customer service, membership management, provider management, advanced Healthcare management, provider agreement management) and the project team.

• Responsible for all 835 downloads from multiple Payers sites

• Created business requirements document, functional specifications document and design documents.

• Identified the scenario based on business requirement and HIPAA compliance for each transaction such as 837 and 276/277

• Documented and gathered functional specification for 837(claims), 276/277(Claim status/response), 834(enrollment) and 835(Remittance Advice).

• Used XML and other type of formats to transport, store, and structure and represent data and derived information from source to destination data maps.

• HIPAA experience in protecting patient health information, namely The Privacy Rule, the Security Rule, and The Breach Notification Rule.

EDUCATION:

• Bachelor Of Arts (1996) Psychology

• Master Of Arts (1999) Psychology

Bachelor of Education (2000) English and Psychology

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