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Business Analyst Health Care

Location:
South River, NJ
Posted:
August 31, 2021

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Resume:

ANNA BAIG

BUSINESS ANALYST

adogua@r.postjobfree.com

Professional Summary

Over 5+ years of rich, end to end Business Analysis experience in IT and Service Industry, expertise in full software life cycle implementation, upgrades, support, rollout, go-live assistance with a proven track record of working with cross functional teams in the development, documentation, operations, and delivery process driving the attainment of business goals

Excellence in designing solutions for various Business Domains. Expert understanding of SDLC and Agile based development methodologies (Waterfall, scrum, agile framework).

Good experience in gathering, analyzing, and documenting business requirements and Functional Requirement Specifications.

Proficient in performing Impact analysis and gap analysis and expert in maintaining the customer relationship. Expert in conducting market survey.

Experienced in managing various aspects of the Software Development Lifecycle (SDLC) including requirements gathering, design, development, testing, deployment, and support.

Strong experience in Claims Processing and Claims in Medicaid and Medicare.

Solid Experience in Healthcare claim engines and claims processing.

Excellent writing and analytical skills in preparing business requirements, system requirements, system design, functional specifications and defining project plans.

Strong knowledge of Health Insurance Portability & Accountability Act (HIPAA) standards, Electronic Data Interchange (EDI), Implementation and knowledge of HIPAA (Health Insurance Portability and Accountability Act) code sets, ICD-10 coding, HMO, PPO.

Worked on various line of business HMO, PPO, POS, Medicare, and Medicaid claims.

Key Skills

Requirement Gathering & Analysis

Meticulous and Team Leadership

Risk Management

Documentation

Strong communication and Interpersonal skills

Software Development Life Cycle

Customer Relationship Management

Time Management

Presentation Skills

Microsoft office suite

TOOLS USED

Project Management

JIRA, Assembla

Methodologies

Agile, Waterfall, RUP, UML, SDLC, Scrum

Change Management Tools

Rational Clear Quest, Rational Clear Case.

Business Modeling& Versioning Tools

MS VISIO, Rational Clear Case, SVN

Slack, SharePoint, Microsoft Teams

MS Office

MS Project, MS Word, MS Excel, MS PowerPoint, MS Access

Programming Languages

Structured Query Language (SQL). HTML

Operating System

Windows NT/Windows 7/Windows 10

Databases

Access, Oracle 9/10/12g, Teradata V2R5.1, DB2, MS SQL Server 7.0/2000

Education Details

New York Institute of Technology, Old Westbury, NY, GPA 3.45

oB.A. in business administration

oAreas of Concentration: establish a deep understanding of modern business practices using the latest tools, techniques, and strategies, IT Management and Contributed to team projects.

Certifications:

HIPAA Certified

WORK EXPERIENCE

COMPANY NAME

CIGNA, SUNRISE, FL

JAN 2019 – PRESENT

ROLE

BUSINESS ANALYST

RESPONSIBILITIES:

Working to automate repetitive tasks and processes to maximize performance.

Collating business requirements, and then translating these into functional specifications and detailed test plans.

Providing information to operations management teams to enable them to look at different angles.

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

Maintaining system protocols by writing and updating procedures.

Participating in meetings, workshops, and technical meetings.

Establishing and maintaining communication channels with senior managers, key team members and stakeholders.

Write up and maintain complete and accurate business process documentation.

Conducting research into project-related issues and products.

Document business requirements and define its scope and objectives.

Planning business analysis activities.

Using analytical tools, reports, and Key Performance Indicators to monitor operational performance.

Applying company IT, design, and documentation standards to all tasks.

Developing estimates for business analysis tasks.

Working with UX team to incorporate the workflow into wireframes

Working with UI designer in creating designs and UI developer to cover all UI elements

Used SharePoint for document management, used it primarily to upload/download content or any important documents shared with the team.

Analyzed User Requirement Specifications (URS) and Functional Requirement Specifications (FRS) to understand business rules of application.

Responsible for getting the signoffs for BRDs and FRDs.

Designed and developed Use Cases, Activity diagrams and Sequence diagrams.

Environment: - Agile Methodology, JIRA, MS Visio, MS Word, MS Excel, MS PowerPoint, SQL Server 2017, HIPAA, Power BI, SharePoint,

Company Name

Wells Fargo, NJ

Jan 2017 – Dec 2018

Role

Business Analyst

Responsibilities

Elicited requirements using document analysis, requirements workshops, business process descriptions, use cases, scenario analysis, task, and workflow analysis

Create a UX (User Experience) that supports their users and gives them the ability to perform the tasks on tablet the goal is to deliver Next Generation UI experience.

Proactively communicated and collaborated with external and internal business stakeholders to analyze information needs and functional requirements and deliver

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

Worked independently with business stakeholders to define concepts and under direction of project managers

Collaborate with developers and subject matter experts to establish the technical vision and analyze tradeoffs between usability and performance needs.

Drive completion of UAT and Production validation with the different business teams, including coordinating testing of report changes, gathering test scripts, and managing issue resolution JIRA.

Liaison between the business units, technology teams and support teams.

Environment: Agile Methodology, JIRA, MS Office, Windows, OmniGraffle, SQL Server

COMPANY NAME

BLUE CROSS BLUE SHIELD ASSOCIATION, CHICAGO, IL

MAR 2015 – DEC 2016

ROLE

BUSINESS ANALYST

Responsibilities:

Involved in designing business requirement collection approach based on the Project scope and SDLC Methodology.

Coordinated and prioritized outstanding risks and enhancement/system requests based on business requirements, allowing enough time frame to ensure accuracy and consider deadlines.

Worked on Quality Center to capture, trace and manage requirements during the project’slifecycle.

Conducted JAD sessions with Project’s Stakeholders identifying problems and coming up with best alternative to resolve that. Created targeted Questionnaires for SME’s to gather requirements.

Implemented UML methodologies to design Use Case Diagrams, Data Flow Diagrams, Activity Diagrams, and Sequence Diagrams.

Created Use-Cases and Business Use-Case Model after accessing the status, scope of the project and understanding the business processes.

Interviewed Subject Matter Expert’s to recorded requirements that could be reviewed and understood by management and all other stakeholders.

Managed all the requirements in MS Word templates, making requirements available to all team members.

Performed Feasibility Analysis and Risk Analysis on vendor/third party tools.

Conducted walkthroughs with the development team and QA Team and other relevant stakeholders to review Testing Strategies and Test Plans ensuring that the test cases reflect the user needs.

Assisted team to prepare test plan for the system. Developed and implemented test cases on the GUI interfaces to ensure that requirements were met.

Led client facilitation meetings to gather Interface and Business Process Requirements from Subject Matter Experts.

Gathered business requirements from SMEs and drafted Business Requirement Documents (BRD).

Created user stories and use cases for analyzing and gathering requirement for effective project management. Also made sure that all deadlines were met and delivered in time.

Reported bugs to development team using JIRA

Understand and articulate business requirements from user interviews and then convert requirements into technical specification.

Environment: Windows, Requisite Pro, Agile Methodology, SharePoint, Contact Center, MS Office Suite, UML, Microsoft Visio, Oracle 11g, SAP Business objects

Accomplishments

Single point of contact between the business key stake holders and the development team

Efficiently managed projects helping the clients to achieve their cost saving targets



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