Software Development Business Analyst

AYESHA Parveen

Mob: +1-779-***-**** Email: *****************@*****.*** Plainfield, IL LinkedIn

PROFESSIONAL SUMMARY:

Business Analyst with over 7 years of industry experience in business analysis, software requirement analysis, process modeling, process flow, and quality assurance utilizing several techniques, primarily OOA, OOAD, and UML. Strong knowledge of the healthcare industry, including HIPAA and HIX insurance, with a focus on business and functional requirements. Extensive understanding of the entire software development life cycle (SDLC) including the iterative Rational Unified Process (RUP). A thorough understanding of enterprise data warehousing. Organized several Joint Application Development (JAD) and Joint Requirement Planning (JRP) sessions, as well as walkthroughs, interviews, workshops, and Rapid Application Development (RAD) sessions involving end users, clients, stakeholders, and the IT team. Proficient in utilizing UML in behavioral, structural, and architectural modeling—in building Use Case, State, Activity, Class, and Sequence diagrams using Rational

Results-oriented professional with strong communication, team-building, management, planning, and problem-solving abilities, as well as substantial experience in business system analysis, mainly in the healthcare industry.

In-depth understanding of the software development lifecycle and approaches, including waterfall, agile delivery models, and scrum methodology.

Experience with Agile, SAFE, and Waterfall software development techniques.

Experience conducting requirements elicitation sessions and working with business stakeholders to ensure agreement on scope, value proposition, and overall project goals across the SDLC.

Exposed to a variety of business processes, including those used in the healthcare and insurance industries.

Client management experience includes seeking, identifying, evaluating, and describing business needs, procedures, and regulations, as well as monitoring progress during the design, development, and testing phases.

Experience and understanding of healthcare and health insurance business models and operations, including enrollment, membership administration, claims processing, and client management.

Experience doing gap analysis (As-Is) for existing processes and system requirements and recommending ways to improve system capability (To-Be) across different systems.

Extensive expertise and experience developing thorough user stories with acceptance criteria, business requirement documents (BRD), and converting business requirements into functional specifications (FRD), nonfunctional specifications, and process flow.

Well-versed in documenting multiple user stories, improving them with stakeholders, and managing them using agile technologies such as JIRA and Rally.

Experience conducting the Daily Standup, Sprint Planning, Sprint Demo, backlog grooming, Sprint retrospectives, and monitoring the Product backlog, Sprint backlog, Release backlog, sprint burnt down and burn up the charts.

Experience developing annotated wireframes as part of a user story to capture in-depth understanding of requirements, as well as directing collaborations with the design team to build mockups.

Experience using SQL, R-studio, VBA macros, Advanced Excel, Tableau, Power Query, and Power Pivot to drive business solutions and create reports.

Facilitating backlog grooming sessions and prioritizing user stories for the forthcoming sprints.

Leading sprint user story walkthroughs with the development team to improve sprint planning and estimating.

Experience conducting biweekly sprint demos that showcase functionalities implemented throughout the sprint.

Strong experience developing test cases and test plans, as well as coordinating and carrying out User Acceptance Testing (UAT).

Project & Program Management experience including kickoff, planning, execution, review monitoring, risk control & mitigation.

Experience in designing test plans, defining test cases, developing, and maintaining test scripts, bug analysis and resolving defects with development team members.

Experience in project planning to increase ROI and promote open and transparent communication between the product owner and the scrum development team.

Experience in agile coaching, continuous process improvement, mediation, documenting changes from retrospectives, and maintaining a healthy and conflict-free working atmosphere conducive to productivity.

Experience identifying and removing obstacles to smooth operation or potential disruption of cross-functionality between local and international teams.

Technical Skills:

Data Base : SQL, MS Access, Oracle, DB2

Methodologies : Agile, Rational Unified Process RUP, Waterfall, JAD, UML, Scrum framework

Office Tools : MS Word, MS Excel, MS Outlook, MS PowerPoint, MS Access, One Note.

Defect Tracking Tools : HP Quality Center, Rational ClearQuest.

Project Tracking Tools: MS Project, JIRA, Rally,

Programming Languages / Standards: C, C++, HTML, XML, SQL, HTTP, ANSIX12

Business Artifacts: Project Charter, BRD (Business Requirement Document), FRD (Functional Requirement Document), SRD or SSD (Software Specifications Document), Risk Management, Mock-ups, Use cases, Activity Diagrams and RTM (Requirement Traceability Matrix).

Business Modelling / Analysis Tool: MS Visio, Rational Rose, Draw.io, Balsamic, Top Team, Tableau, SharePoint

Healthcare: FACETS, HIPAA, Medicare, Medicaid, CHIP, ICD 9, ICD 10, Claims, EMR, EHR, HL7, COB and EOB.

Software Application : Data Warehouse, ETL, Facets

EDI Healthcare Transactions: 834 (Memberships), 835 (Payments from Payer), 837p (Professional Billing), 837i (Institutional Billing)

Testing Tools : ALM/Quality Center 11.0, Qtest, I Hub

Processes/Technologies : Rational Unified Process (RUP), Waterfall, UML & Microsoft Office SharePoint

EDUCATION:

Masters in Technology Management Lindsey Wilson College

Bachelor in Applied Nutrition Osmania University

PROFESSIONAL EXPERIENCE:

SCP Health (Atlanta, GA) Jun 2023 – June 2024

Sr. Business Analyst / System Analyst

Interacting with business heads to finalize the Business Requirements for the application.

Performing the requirement analysis and documented the requirements.

Functioned as a primary liaison between the business, operations, and the technical teams throughout the project cycle.

Conducted sessions with Stakeholders for gathering business needs and understand gaps in the existing business processes.

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

Worked on migrating Legacy Facets to new Facets (Gemstone)

Worked on several custom extensions in Facets developed by BCI like MMCP (Managed Medical Care program), Share of Cost of Viewer (Medicare/Medicaid services price calculator), Split claim extension.

Worked on project documentation that defines the process requirements required to implement Guiding Care.

Worked on DB objects comparison between Legacy (Sybase) and new facets (SQL Server) DB also validated data using SQL.

Involved in testing different interfaces and modules for Facets.

Tested the changes for the front-end screens in FACETS related to following modules, test the Facets batches(claims).

Utilized Agile Methodology to develop process, standards, and procedures in all phases of Software Development Life Cycle.

Worked in all the different processes of Claims processing from Claim Online editing /processing /Adjudication /Payments systems

Created new database objects like Tables, Procedures, Functions, Indexes and Views using T-SQL in Development and Production environment for SQL Server.

Was actively involved in the design of BRD, FRD, Use Case diagrams and Activity diagrams using MS Visio.

Prepared mock-ups, flow charts to depict changes between AS-IS vs TO-BE system.

Developed test plans with QA team and helped to develop test cases for system testing,

Conducted Functional Walkthroughs, User Acceptance Testing (UAT), and supervised the development of User Manuals for customers.

Working knowledge of implementing software development projects using methodologies such as Waterfall, Rational Unified Process, and Agile/Scrum.

Developed & executed several Optimized queries in SQL on this data.

Documented and published Functional and Non-Functional Specifications. Gathered and documented requirements that are critical to the business goals and prepared Use Cases to depict process changes.

Performing detailed gap analysis between client requirements and base system design, to identify areas for potential.

Experience in facilitating Joint Application Development (JAD) sessions, Rapid application development (RAD) sessions, conducting user interviews and acting as a liaison between the customers, development team and testing team

Tested the Use cases, Performed User Acceptance Testing and Use Case Analysis. Agile Methodology - SCRUM.

Developed UML Use Cases using Rational Rose and developed a detailed project plan with emphasis on deliverables.

Involved in analyzing and processing of managed care recipients and managed care plans.

Involved in reviewing, writing scenarios, reviewing scripts, helping data preparation, helping executing the scripts and supported the component testing, system test, model office test (MOD) and user acceptance testing (UAT).

Translated high level business / data requirements into Process, Workflow, and Data Flow Diagrams using MS Visio towards facilitating clear understanding of the business process.

Involved in Functional Testing for UAT (User Acceptance Testing) and SIT (System Integration Testing).

Worked closely during UAT with the Product Management and Business Owners to ensure that quality standards are met.

Used Service Now tool for opening tickets and service requests. Lead defect review meetings, reporting and tracking.

Triaged production issues that were reported to the team and reviewed fixes in test environment prior to the production deployment.

Emory Healthcare - Atlanta, GA Sep 2022 – May 2023

Business Analyst / System Analyst

Played key role in System Development Life Cycle Process consisting of: Design and Gap Analysis, Business Requirements, Systems Requirements, Test Criteria, and Implementation to have the outputs of project dealt with the automation of correspondence directed to Insurance policy owners.

Worked with Subject Matter Expert from different functional areas to define requirements specification.

Facilitated the JAD Sessions with stakeholders and developers to elicit ate the requirement for the enhancement of the application.

Conducted interviews with key stakeholders to analyses existing data and gather requirements.

Conduct Presentations periodically to the management and end users during various phases of the Software Development Life Cycle (SDLC).

Performing Claims validation of facets applications required

Performed validation of Facets application under the guidelines and instructions of senior staff.

documented process requirements required to implement Guiding Care.

As a Sr. Business Analyst on balancing ERA or 835 transactions. There were quite a few balancing issues due to the way the claims were adjudicated, I spearheaded the analysis on such issues and resolutions to ensure the ERA Transactions were balanced and generated appropriately.

Created Business Requirement Document (BRD) and then translating into functional specifications and test plans. Closely coordinated with both business users and developers for arriving at a mutually acceptable solution.

Used UML to create use case diagrams, sequence diagrams and activity diagrams.

Analyzed Business Requirement Document (BRD), Technical Requirement Specification and Functional Requirement Document (FRD).

Tested the changes for the front-end screens in FACETS related to following modules, test the Facets batches(claims).

Performed validation of Facets application under the guidelines and instructions of senior staff.

Experienced on Facets and used different Modules (Application)Claim, Member/Subscriber, and others.

Maintained Traceability Matrix throughout the project.

Worked closely with the QA team and Developers to clarify and understand functionality, resolve issues, and provide feedback to identify defects.

Conducted Joint Application Development (JAD) sessions with IT groups. Identified the Key Changes, and participated in Stakeholder Management to communicate effectively with them

Designed and development of test cases based on functional requirements for Institutional and Professional claims for EDI and HIPAA Transactions 837/835, 834, 276/277, 270/271 testing.

Wrote stored procedures and triggers for the Business components using T-SQL and SQL Server

Experience in EDI automated first-pass claim adjudication, requiring thorough understanding of claim processing, both front and backend operations

Tested the changes for the front-end screen in FACETS related to following modules, tested the FACETS batches membership, Billing, Provider.

Developed, coordinate and support Information Technology Division on all operational requirements of FACETS claims processing system and production management.

Involved in mentoring specific projects in application of the new SDLC based on the Agile Unified Process, especially from the project management, requirements and architecture perspectives.

Assigned tasks among development team, monitored and tracked progress of project following agile methodology.

Extensive involvement in data mapping using Facets data model.

Extensive use of Facets back-end tables and front end application system for data validation purposes.

Worked and gained knowledge with different upstream domains and applications of Claims such as Plan Sponsor domain, Member domain, Channel domain & SRQ domains.

Conducted GAP analysis, documented the AS-IS and TO-BE states into UML use case diagrams to provide stakeholders with a clear illustration on the functionality the new website would provide

Developed process flow and data flow diagrams using MS Visio for requirement.

Worked on JIRA as a project management tool for creating Feature and user stories and track the development and testing task.

Executed SQL queries for data analysis in regards to the requirement.

Worked with the testing team on the issues and reviewed test cases.

Created traceability matrix document to track all requirements have been covered in test cases.

Gathered and analyzed the User requirements and Functional Requirements and documented Use Cases, Process Maps, Wireframes & Non-Functional Requirements.

Experience and understanding of Healthcare and Health Insurance business models and operations including Enrollment, Membership Management, Claims Processing, and Client Management

Gathered user requirements for new reports through JAD/JAR sessions, which eliminated duplicate and obsolete data and provided a uniform reporting environment across the multiple trading desks.

Conducted walkthrough of requirements to technical team and helped resolve open issues and Change Requests through Impact Analysis.

Created wireframes using Balsamic cloud to help articulate solutions to business and technical teams which helped to mitigate the risk of time loss in requirements understanding.

Led backlog refinement with technical teams on Jira to increase understanding of functionalities to be developed and helped with estimation.

Created UAT plans with several test cases for each project to ensure that the system runs smoothly after the proposed enhancements or changes have been made.

Utilized corporation developed Agile SDLC methodology. Used Scrum Work Pro and Microsoft Office software to perform required job functions.

Successfully conducted JAD sessions, which helped synchronize the different stakeholders on their objectives and helped the developers to have a clear-cut picture of the project.

Involved with Development team with On-Demand EOB process for Hardcopy Claims printed in-house

Interacted with client and the Technical Team for requirement gathering and translation of Business Requirement to Technical specifications.

Conducted interviews, meetings and JAD sessions during the process of Requirement Gathering.

Conducted User Acceptance Testing with stakeholders and system users to uncover latent defects in the system. The defects were corrected and verified through a new cycle of regression testing.

Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Medicaid Claims. Worked on EDI transactions: 270, 271, 834, 835, and 837 (P.I.D) to identify key data set elements for designated record set. Interacted with Claims, Payments and Enrollment hence analyzing and documenting related business processes.

Acert IT Solutions Pvt Ltd-INDIA Apr 2019 – Oct 2021

Business Analyst

Collaborate with Product Owners, Subject Matter Experts (SMEs) and end-users to understand product backlog and develop detail acceptance criteria for user stories.

Interact with business owners, SMEs, and management team to identify the scope of the project and to prepare Use Case, and Activity Diagrams to further develop technical requirements for development.

Facilitate defect review meetings involving stakeholders to review defects, identify severity and set priorities as per client requirements.

Assisted the QA team in designing the Test Plan and Test Cases for User Acceptance testing.

Ensure that there is regular and effective communications of issues and corrective actions between teams.

Was actively involved in the design of BRD, FRD, Use Case diagrams and Activity diagrams using MS Visio.

Develops customer deliverables, including Requirements Validation Specification documents, General System Design documents and Detailed System Design documents.

Designed and development of test cases based on functional requirements for Institutional and Professional claims for EDI and HIPAA Transactions 837/835, 834, 276/277, 270/271 testing.

Facilitated JAD sessions with SMEs and business analysts from other feeder systems for a detailed analysis and a better understanding of impact of various projects on each other.

Worked on data strategy i.e. how to deliver quality data, maintain live data, historical data and data accuracy.

Tested web services to determine whether acceptance criteria have been met by user stories.

Worked with the Project Manager on various Project Management activities like keeping track of Project Status, Deadlines, Environment Request, and Compliance Issues

Scheduled meetings with technical personnel to determine technical parameters for EDI and other related processes including communication, security, and privacy.

Responsible for setting priorities, managing projects, and providing timely and experienced application support.

InfoComm IT Services Pvt Ltd (INDIA) Jul 2016 – Mar 2019

Business Analyst

Coordinated and developed QA activities with team members to support the Scrum methodology.

Proactively communicated with development team regarding the status and potential impacts on the delivery date and/or expected quality of the tasks and/or the projects.

Identified and analyzed the data requirements for the various site teams and made sure that the required data is available in the testing environment.

Designed and developed various reports and dashboards that could be easily accessible and tracked bug fixes using JIRA.

Helped with test case preparations, defect management and resolved defects.

Perform unit testing and integrated testing with the customer including developing and executing test scripts to ensure proper system functionality.

Facilitated and coordinated discussion between business and technical team to clarify requirements.

Developed test scripts, performed end-to-end system process testing, and lead user acceptance testing sessions.

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