Business Data Analyst
Resume:
VENKATA SUMEDHA
Business Data Analyst
****************@*****.***
Overall 7 Years of Industry experience as a Sr. Business Analyst with thorough understanding of Business Requirements Gathering, Business Requirement Analysis, Quality Assurance, Quality Control (QA/QC) and business process re-engineering with proven ability to articulate business values with expertise in Banking & Healthcare Industries.
PROFESSIONAL SUMMARY
•Served as the Liaison between IT and the Business in understanding key business processes, business data, and requirements, as well as analysed processes for technology service solutions.
•Extensive experience in Data Analysis and data visualization using various tools.
•In-depth knowledge of Software Development Life Cycle (SDLC) methodologies and extensive experience in Waterfall and Agile (Scrum, enterprise environments, architectural and solution design, implementation, and complex customizations.
•Expertise in detailing user stories from Product Backlog, Sprint Backlog, and clear understanding of Burndown charts.
•Efficient in reformulating strategies through Change Management, Release Management and Process Improvements.
•Involved in delivery of projects in production environment with release engineers.
•Expertise in gathering, analysing, and documenting business requirements and developing Business Requirement Documents BRD and Functional Requirement Specifications FRD.
•Analysed user problems, including automated and manual business processes and identified, researched, investigated, defined, and documented business processes.
•Worked extensively with SMEs in understanding and documenting their requirements.
•Expertise in Unified Modelling Language in designing and developing use cases and business flow diagrams.
•Planned and defined system requirements to Narrative Use Cases and Use Case Scenarios using the UML methodologies. Created UML Diagrams like Use Case Diagrams and Activity Diagrams using MS Visio.
•Responsible for conducting JAD Sessions with different IT Group department managers and refined the requirements.
•Experience in working on Agile tools like VersionOne and JIRA.
•Extensively involved in Data Extraction, Transformation and Loading (ETL process) from Source to target systems using Informatica Power Centre 7.1
•Designed and implemented report layouts according to reporting standards of the department.
•Owned the assigned reports, worked on them, and updated the Report Development Scheduler for status on each report.
•Worked on daily basis with lead Data Warehouse developers to evaluate impact on current implementation, redesign of all ETL logic.
•Assessed scope and impact of business needs throughout analysis and completion of all enhancement specifications using detailed knowledge of application features and functions.
•Directed and managed the Change Control process for the project by facilitating group meetings, one-on-one interviews, and correspondence through emails with work stream owners to discuss the impact of change request on the project.
•Expertise in conducting in-depth Root-Cause Analysis, GAP Analysis, SWOT Analysis to derive requirements for existing system enhancements and to check the compatibility of the existing system infrastructure with the new business requirements.
•Developed SQL Queries to fetch complex data from different tables in remote databases using joins, database links and formatted the results into reports.
•Expertise in writing and implementing Test scenarios, Test cases and maintaining Traceability Matrices for baseline documents.
•Strong knowledge of Healthcare industry including HIT (Health Information Technology) Standards, GS1 Standards with emphasis on Business Requirements and Functional Requirements.
•Involved in standardizing the documents to meet the HIPAA Compliance Standards.
Proficient in programs like Medicare (Part A, Part B, Part C, Part D) & Medicaid.
•Involved in creating documents and diagrams for Membership Enrollment according to the HIPAA 834 Compliance Standards for Membership Enrollment, Health Insurance Portability and Accountability Act (HIPAA) Accredited Standards Committee (ASC) X12 version 5010
•Understanding of Clinical Trial phases; systems validation Data domains; ICH–GXPs, 21CFR-part-11; CDISC data models; MedDRA terminology in preparation for FDA-NDA submissions.
TECHNICAL EXPERTISE
Modeling Tools
UML, MS Visio, Rational Rose, MS Project
Concepts
SDLC (RUP, Agile/Scrum, Waterfall), SMLC; Change Management; Cost-Benefit; Six-Sigma, Quality and Risk Management (QRM), QA, QC
Applications/Project Management/ Version control
ServiceNow, Azure DevOps (VSTS), MS Team Foundation Server (TFS), JIRA, SharePoint, MS Teams, Project, Requisite Pro, Clear Quest, Clear Case, VersionOne
Testing/Management Tools
Service Now, VSTS, QTP, Win Runner, Load Runner
BI Tools
Business Objects (SAP BO), Tableau 9.1, Advanced Excel, Power Pivot
Change Management
Clear Case, SharePoint, Doors, StarTeam
WORK EXPERIENCE
Client: Well Care
Duration: Mar 2019 - Present
Location: Tampa, Florida
Role: Business Data Analyst
Project Description:
Well Care health plans provides managed care services through Medicaid, Medicare advantage and Medicare prescription Drug plans across the country. In this project, I am working on enhancements for WellCare’s website with functionalities connecting to MMIS system to improve user experience. I am also a part of claims team.
Job Role description:
•Prepare the Business Requirement Document (BRD) and ensure that technical delivery team has full understanding of business goals and objectives as stated in the requirements.
•Maintain a close interaction between business users and developers to avoid any gaps in understanding or implementation of requirements.
•Articulate in detail all the phases of the SDLC process and the PMI project lifecycle. Well versed in specific Business Analyst deliverables including, requirements elicitation, Business Requirements document, Functional Requirements document, Traceability Matrix, data diagrams, process flows.
•Coordinate support and communication with cross-functional partners
•Conduct GAP Analysis by creating process flows highlighting the differences between the current (As-Is) environment versus the target (To-Be) environment.
•Eliciting Requirements based on Beneficiary Eligibility criteria as per the Medicaid Health & Human Guidelines
•Gathered requirements to enable comprehensive healthcare services to beneficiaries through Case Management Process flow.
•Gathered, Validated and Analyzed requirements for data migration and Data mapping from Legacy Systems to new systems
•Coordinated with Functional Team and SMEs to validate their requirements and make them understand about new system
•Conducted Trainings, PKT (Present Knowledge Transfers), RKT (Reverse Knowledge Transfer) on new system implementation across different functional teams.
•Documented Sprint Backlog to manage User Stories and clear understanding of Burndown charts.
•Actively involving in designing EDI transactions using the new HIPAA 5010 version and ICD -10 codes and analysing HIPAA compliance and EDI transactions.
•Document data quality and traceability documents for each source interface.
•Design and implement data integration modules for Extract/Transform/Load (ETL) functions.
•Part of data warehouse design.
•Experience with various ETL, data warehousing tools and concepts.
•Work with internal architects in the development of current and target state data architectures
•Provide various strategies to implement HIPAA 4010 in the new MMIS system and ultimately move to HIPAA 5010
•Hands on experience with various sub-systems of MMIS - Provider subsystem, claims subsystem, reference subsystem and recipient subsystem.
•Process and verify the Eligibility Benefits Inquiry/Response (270/271), Claims Inquiry /Response (276/277) for the Member/Dependent patients with different Service Type Codes against the Use cases and the Transformation Mapping documents.
•Work on Claims, Subscriber/Member, Plan/Product, Claims, Provider, Commissions and Billing Modules of Facets.
•Expertise in claims processing subsystem - Enrollment and Eligibility verification for recipients and providers, claims processing, Claims Pricing, Claims Adjudication and payment scheduling and claims reporting.
•Process Medicaid claims and worked on X12 format of EDI 837 for Medicaid claims.
•Analyse and document system release/deployment issues as per version management, backward compatibility, load balancing of components in production environment.
•Conduct impact analysis for changing requirements and coordinated with business users for prioritizing the testing/release of the changes.
Environment: Windows XP, SQL, MS-Visio, UML, Agile SCRUM, JIRA, ServiceNow.
Client: Cigna Health
Duration: Jan 2018 – Feb 2019
Location: Dallas, Texas
Role: Business Data Analyst
Project Overview: Cigna is the most diversified health care company in the United States. The project that I worked is to improve the Claims Reimbursement user interface of Cigna for a better user experience and incorporate changes as per HIPAA guidelines. The main object of the system is to secure the health information entered by the user at the time of submitting the claim and ensured the integrity and confidentiality of the user information.
Job Role Description:
Involved in all phases of software development life cycle (SDLC) in RUP framework.
Analysed the current billing and claims data provided from existing BRD’s.
Provided input to the HEDIS system that used Quality Compass to provide a selection base for various healthcare plans.
Performed data analysis, data profiling data reconciliation and data retrieval from various systems along with identification of data gaps and data quality using SQL on various sources systems including Oracle and SQL Server.
Participate in Product Discovery Teams, develop A/B Testing strategies, develop prototypes, success metrics and provide recommendations
Collaborate to develop user acceptance testing (UAT) specifications and work with the Project Manager to help facilitate and ensure successful testing
Partner with other analysts to develop data infrastructure (data pipelines, reports etc) and other tools to make analytics easier and more effective
Assist with the definition of how the data will be sourced, managed, and consumed within and across business processes
Create dashboards by pulling data from different sources and present them to management team
Tested the ETL Informatica mappings and other ETL Processes (Data Warehouse Testing).
Daily validation of batch files for Enrolment, Billing, and discussing error with internal and external parties.
Used TriZetto Facets Application Groups: Claims Processing, Guided Benefit Configuration, Medical Plan, Provider, Subscriber/Member, Utilization Management.
Created ServiceNow process flows, dashboards, and reports.
Worked on HIPPA compliance as well as strong knowledge of Medicare (Parts A, B, C, D) & Medicaid, NCPDP Version D.0, FACETS, EDI, HL-7, CPT, and ICD-10 codes.
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 Enrolment hence analysing and documenting related business processes.
Verify and generally investigate circumstances surrounding insurance claims, to determine validity of claim.
Worked within a growing knowledge of X12 4010 HIPAA 837 I, P, D, 835, 834, 820, 270, 271, 276, 277, 278, EDI, Privacy, Security, and Medicaid.
Defined, developed specs for federal reporting specific to Medicare Advantage.
Conducted 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.
Worked closely and collaboratively with other team Business Analysts, System Architects, Data Architects, Development team, and QA team to clearly articulate defined requirements, and clarifications when questions arose.
Environment: Agile Scrum, JIRA, MS Office Tools, MS SharePoint, ServiceNow
Client: AXA advisors
Location: Fort Worth, Texas
Duration: Feb 2016 – Dec 2017
Role: Business Analyst
Project Overview: AXA is a leading provider of insurance and end-to-end mortgage. Project involves a need to eliminate its current document management system being used for various Borrowers across the United States. The Borrower uploads the documents on the PHH site, and they are further imaged and archived in their current system. For Lead/Loan purposes via the Loan Origination System (LOS), the documents need to be generated, imaged and then, archived for further transactions.
Job role Description:
Worked with waterfall Software development Life cycle (SDLC) and agile framework to carry out different phases of project including gathering and documenting business requirements.
Conducted user interviews, gathered requirements, analysed, and documented business requirements based on the analysis of mortgage loan processing workflow model.
Proactively communicated and collaborated with external and internal customers to analyse information needs and functional requirements and delivered the following artefacts: Project Plans, Business Requirement Documents (BRDs), Functional Requirements Document (FRDs); Business Communication Documents (BCDs), Test Case Documents (TCDs) for QA and UAT Technical Requirements include architecture, interfaces, security and business continuity; user stories and Use Case documentation.
Drive and challenge business units on their assumptions of how they will successfully execute their plans.
Created user guides/run book for reference to be used by the downstream teams and the business users
Gained hands on experience on creating cases in Remedy STAR (case management System), Sales Originations and menu options of Loan Servicing System LSAMS
Collaborated with developers, architects, subject matter experts, and other IT team members to establish the technical vision and analyse trade-offs between usability and performance needs.
Assisted in the development of business cases, considering financial, resource, and technological constraints, developed cost estimates with consideration to business impacts and risks.
Performed analysis and created Source to target mapping document for incoming LOB and existing projects for process improvement.
Worked on creating Mock-ups/wireframes to give the visual representation of the requirements
Assisted PMs in preparing weekly/monthly project status reports to be provided out to senior level management/project stakeholders.
Interacted with business customers to define, analyse, and deliver customer testing requirements and complete Users acceptance testing (UAT).
Attended Change Control Board (CCB) meetings to seek approval or facilitate any pertinent changes including changed requirements, change timelines occurred during project phases.
Worked with Third Party Vendors (partners) including Hope Loan Portal and Venture as part of the project requirements. Dealing with Venture mainly included assisting on creation of NSM files and transmitting files to venture via Secured FTP server and creation/printing of letters or statements.
Extensive Creation and execution of SQL queries (using MS SQL and MS Access) and scripts to validate data movement perform data-based QA testing and validate UAT testing results.
Created product implementation documentation, including online help, Business communication document (BCD), printed user manual, and training materials.
Participated in closure activities or other quality initiatives including setting up realistic project scope and goals of project with Project managers.
Involved in production support inclusive of creating incident tickets and Incidents tickets resolution as part of 30 days warranty window frame.
Environment: SharePoint, HP Quality Center, Crystal reports, MS Office Suite, Waterfall Methodology
Client: Andhra Bank
Location: Hyderabad, India
Duration: Jul 2013 - Jan 2016
Role: Associate Analyst
Project Overview: Andhra bank operates in 25 states in India and is a leading banking and financial services institution. Project involves enhancement of the company’s mobile application for its users with disability. It allows users family members to access their account.
Job Role Description:
Participated in focussed group meetings and Interviews with the Stakeholders to gather requirements and incorporated the outcomes to business requirements.
Analysed consumer and business needs for application development.
Documented requirements and translated into proper product specifications.
Actively involved in testing the responsiveness of the GUI (Graphical User Interface).
Identified gaps between the AS-IS and newly developed system by performing GAP Analysis.
Provided system developers with a better understanding of the system requirements.
Assisted in Data analysis, data pulling, data Verification and quality checks on the Client database to make it perfect for Delivery.
Assisted in identifying Client’s issues & understanding requirement, conducting the study & root cause analysis, finding the solution & recommendations for the business growth.
Liaising between with Business Users, Product Owners, Sr. Management, Planning, Design, Analysis, Development, DBA, App
Support and Testing Teams on regular basis.
Lead training sessions for US bank managers to make sure they know all features of the new application.
Assisted in the development of business cases, considering financial, resource, and technological constraints;
Worked with Third Party Vendors (partners) including Hope Loan Portal and Venture as part of the project requirements. Dealing with Venture mainly included assisting on creation of NSM files and transmitting files to venture via Secured FTP server and creation/printing of letters or statements.
Environment: SharePoint, MS Office (Outlook, Word, Excel, Visio, Access, etc.), Waterfall.
EDUCATION:
Bachelor's in Computer Science, Jawaharlal Nehru Technological University, Hyderabad, INDIA
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