BRANDON FREDRICK

ad0q6r@r.postjobfree.com 972-***-****

PROFESSIONAL SUMMARY

Over 7 years of experience as an IT Business Analyst. Excellent communication skills, writing skills as well as presentation skills. Experience working with business users as well as senior management.

Solid understanding of all phases of Software Development Life Cycle (SDLC) methodology (such as requirement, analysis, design, data modelling, business process modelling, implementation, and deployment).

Broad knowledge of Test plans, Test cases and test scripts from the Requirements Document.

In-depth knowledge of Rational Unified Process (RUP); risk engineering, data modeling and mapping, and design using UML (Unified Modeling Language), Rational Rose and Visio.

Good knowledge of Oracle and SQL. Excellent knowledge of HIPAA (Health Insurance Portability and Accountability Act) transaction codes such as 270/271 (inquire/response health care benefits), 276/277 (claim status), 470 (benefit codes), 835 (payment or remittance advice), 837 (health care claim) and 834 (benefit enrollment).

Conducted successful projects with the help of teams to achieve deadlines timely and proficiently.

Experience working in Medicare and Medicaid projects. Created Requirements Traceability Matrix to keep the stakeholders informed of the progress of the project.

Strong expertise in Health Insurance Claim process, social services, Medicaid and banking. Belief in teamwork, dedication, and professional ethics within the working environment.

Extensive experience in conducting Joint Application Development (JAD) sessions for project definition involving analyzing requirements, creating prototypes, user interface, database schema and system design.

Well versed with HIPAA, Facets, claim adjustments, claim processing from point of entry to finalizing, claim review, identifying claims processing problems, their source and providing corresponding solutions.

Extensive experience in gathering Business/Functional user requirements, creating Use Cases as per user requirements, developing/designing diagrams such as Activity, Class, and or Sequence diagrams, and in addition to creating Business Requirements Document (BRD).

Organized, goal-oriented, self-starter, and ability to master new technologies, manage multiple tasks while following through from start to completion. Flexibility in adaptation to a wide range of work environments.

Good in requirement gathering including Joint Application Development (JAD) and requirement analysis.

Extensive experience in working in a customer - oriented environment. Ability to inculcate new relevant skills with ease in a time sensitive frame.

Analysis was done to determine if the system abides by the HIPAA regulations.

Experience in writing Use cases and Functional Requirement Document.

WORK HISTORY

Business Analyst UST Health Proof - US 04/2020 - CURRENT

Continuously work for improving existing methods and investigating new methods within UX area

Configured facets modules such as Claims, Membership, Billing, Benefit and plan,

Part of the team for migration of HIPAA for EDI transaction code sets

· 835 – Claim payment/Advice/ 837 – Claim and encounters /834 – Benefit enrollment and maintenancAble to understand and implement Processing ICD-9 ICD-10

In dept. knowledge of Software Development Life Cycle SDLC methodology such as Agile, Waterfall and RUP.

Efficient in writing Business Requirements Document, Use Case Specifications, Functional Specifications and Workflows

Strong Knowledge of Software Development lifecycle and methodologies like Waterfall, agile methodology and Scrum approach.

Strong knowledge of Use Cases, and Activity Diagram.

Extensive Experience in Functional, Integration, Regression, User Acceptance UAT, System.

Knowledgeable working with ETL process Extract, Transform and Load of data into a data warehouse.

Designed and implemented basic SQL queries for testing and report/data validation.

Experienced in client interaction, deep understanding of business systems functionality and technicality.

Proficient in Developing and executing Test Plans, Test Case, Test Scenarios, also performing functional, usability testing and ensuring that the software meets the system Requirement.

Knowledgeable about preparing RTM documents.

Experience in developing project plans and estimating project timeline.

Excellent working knowledge of Project Life Cycle and clear understanding of Project Management.

Experienced in performing Gap analysis by identifying existing technologies, documenting the enhancements to meet the end-state requirements.

Business Analyst Molina Healthcare - Los Angeles,CA 02/2018 - 03/2020

As a Business Analyst Involved in implementation of HIPAA EDI Transactions (834, 835,837)

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

Managed Backlog and User storied using JIRA tool.

Conducted release planning, product grooming and iteration planning meetings.

Gathered high-level requirements for all the external projects in a release.

Performed the requirement analysis, impact analysis and documented the requirements

Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping,implementation, and testing for processing of Medicaid Claims.

Developing a single application to process data from multiple integration points, convert the data for reporting purposes and feed data into mainframe system to be compliant to reporting requirements.

Performed Analysis on Data mapping between different data models.

Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Medicaid Claims

Used different ad-hoc analysis, the Reports assist in defining strategy for each customer category. Informatics was used for ETL process and Business Objects.

Worked on EDI transactions: X12,835, and 837 P.I to identify key data set elements for designated record set. Interacted with Claims, Payments and Enrollment hence analyzing and documenting related business processes.

Executed the test cases and test scenarios using HP Quality center QC .

Prepared Business Requirement Documents BRD's after the collection of Functional Requirements from System Users that provided appropriate scope of work for technical team to develop prototype and overall system.

Experience in developing projects and estimating project timeline.

Facilitated and led JAD sessions aimed at functional requirement walkthroughs for all the impacting projects and updated the documents based on recommendations if any. Created various reports such as billing payment reports, Billing Grouping Payment and discount reports.

Use HP Quality Center to house all test documentation and report/track all issues and defects Defect Management.

· Environments: ETL, MS Office, SQL, ERP, Jira and TFS Defect tracking tool, Agile Methodologies.

Associate Business Analyst Kaiser Permanente - Oakland, CA - - Oakland, CA 03/2016 - 01/2018

Acted as a liaison between Business and Technical teams Translated the business needs into Business Requirement Document and User stories.

Administered User Acceptance Testing to obtain sign-off from business.

Performed functional testing on iOS and Android devices Participated in User Acceptance Testing

Setup meetings with KP application & testing subject matter experts (SMEs).

Completed surveys for applications; interviewed application owners & populated checklist with data provided by SMEs.

Led WebEx sessions to understand native database, conduct validation, build requirements per audit protocols & controls.

Analyzed functional specification documents. Compared samples with production data. Produced workbooks summarizing walk-through findings.

Orchestrated workload distribution among team members.

Attended weekly meetings with client & project manager; advised on developments; reported audit results.

Informed users of critical information via email &discussion boards, working in concert with management

EDUCATION

Fortis Institute

Associates of Applied Science

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