Naga Sumedha

Business Analyst

646-***-****

adk3nq@r.postjobfree.com

Overall 7 years of Industry experience as a. Business Analyst with thorough understanding of Business Requirements Gathering, Business 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.

•In-depth knowledge of Software Development Life Cycle (SDLC) methodologies and extensive experience in Waterfall and Agile (Scrum) methodologies, enterprise environments, architectural and solution design, implementation and complex customizations.

•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.

•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.

•Also, conducted JAD Sessions periodically with internal teams at various phases of the Software Development Life Cycle (SDLC) to discuss open issues with the application and resolve them.

•Expertise in writing and implementing Test scenarios, Test cases and maintaining Traceability Matrices for baseline documents.

•Conducted Trainings, PKT (Present Knowledge Transfers), RKT (Reverse Knowledge Transfer) on new system implementation across different functional teams.

•Experience in working on Agile tools like VersionOne, JIRAand Service Now

•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.

•Experience in creating ServiceNow process flows, dashboards and reports.

•Familiar with claims processing; Facets-HMS; ICD-9/ICD-10. PHI; HIPAA.

•Analysed user problems, including automated and manual business processes and identified, researched, investigated, defined and documented business processes.

•Developed SQL Queries to fetch complex data from different tables in remote databases using joins, database links and formatted the results into reports.

•Worked on functionality testing, tracking the defects, preparing the defect reports using HP Quality Centre and HP ALM

•Interacted with client to present future functionality of the application and gathered information from them to understand their need and send this information to test manager.

•Worked closely with the application development team, design team and testing team to resolve technical issues and interacted with them to ensure overall quality of the software.

•Expertise in detailing user stories from Product Backlog, Sprint Backlog and clear understanding of Burndown charts.

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: February 2019- Present

Location: Tampa, Florida

Role: Business 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 was part of EHR (Electronic Health Records) development. It was for a hospital to convert all the hard data to electronic format and ease the access to these records amongst the facilities and demographics.

Job Role description:

•Prepared the Business Requirement Document (BRD) and ensured that technical delivery team has full understanding of business goals and objectives as stated in the requirements.

•Maintained a close interaction between business users and developers to avoid any gaps in understanding or implementation of requirements.

•Maintained Requirement Traceability Matrix (RTM) to make sure that all the requirements are covered in test cases.

•Developed Use case diagrams, activity diagrams and system design diagrams.

•Worked withEPIC Software, an Electronics health record system.

•Conducted GAP Analysis by creating process flows highlighting the differences between the current (As-Is) environment versus the target (To-Be) environment.

•Documented Sprint Backlog to manage User Stories and clear understanding of Burn-down charts.

•Participated in Sprint Planning, Daily Scrums, Sprint Reviews and Retrospective.

•Facilitated “Three Amigos” work sessions between developers, Product Owners and Business Analysts.

•Created and Updated Issues (Epic, Stories and Tasks) onto JIRA application.

•Guided the development teams to breakdown large and complex user stories into simplified versions for executions.

•Actively involved in designing EDI transactions using the new HIPAA 5010 version and ICD -10 codes and analysing HIPAA compliance and EDI transactions.

•Provided 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.

•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.

•Processed Medicaid claims and worked on X12 format of EDI 837 for Medicaid claims.

•Joined requirement grooming sessions during the sprints.

•Test the user stories for accuracy to ensure undisputed acceptance and validating stories.

•Created authorisations and attached them to medical claims for payments, entered demographics, and verified insurance.

•Analysed and documented system release/deployment issues asper version management, backward compatibility, load balancing of components in production environment.

•Did impact analysis for changing requirements and coordinated with business users for prioritising the testing/release of the changes.

•Created data analysis, created data mapping and data interface documents and kept the documents updated with changes in requirements and functional specifications.

•Assisted in the design and implementation of test cases for testing the web portal of New MMIS system and assisted in the User Acceptance testing (UAT).

Environment: Windows XP, SQL, MS-Visio, UML, Agile SCRUM, JIRA.

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.

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.

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.

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.

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.

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.

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).

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.

Environment: SharePoint, HP Quality Center, Crystal reports, MS Office Suite, Waterfall Methodology

Client: Andhra Bank

Location: Hyderabad, India

Duration: Jul 2013 - Jan 2016

Role: Junior Business Analyst

Project Overview: HSBC BANKoperates in 25 states in India and is a leading banking and financial services institution.Project involves enhancement of the company’s mobile application with new functionalities for better user experience.

Job Role Description:

Participated in focussed group meetings andInterviews with the Stakeholders to gather requirements and incorporated the outcomes to business requirements.

Analysed consumer and business need 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,

Support and Testing Teams on regular basis.

Assisted in the development of business cases, considering financial, resource, and technological constraints.

Environment: SharePoint, MS Office (Outlook, Word, Excel, Visio, Access, etc.), waterfall Methodology

EDUCATION:

Bachelor's in Computer Science, JAWAHARLAL NEHRUTECHNOLOGY UNIVERSITY, Hyderabad, INDIA

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