Business Systems Project Management

AISHWARYA GAONKAR

904-***-**** Jacksonville, Fl - 32256 *******@*****.***

SUMMARY

Business Systems Analyst with 8+ years of experience in system analysis, process engineering, and project management. Highly adept in developing, deploying, and managing complex business systems to optimize business operations and increase user productivity. Expertise in identifying and resolving system issues to ensure customer satisfaction. Results-driven Implementation Consultant with a history of successful implementations and customer satisfaction. I am skilled in project management, risk management and software solutions. Possesses excellent communication and problem-solving skills.

PROFESSIONAL SKILLS

Vendor Relations

Requirements Analysis

Reporting

Windows 8/10/11

MS Office

Postman

Manual Testing

Oracle SQL

PostgreSQL

UAT testing

Data Mining

Operations Improvements

Solutions Management

HTML

Agile Testing

Analyzing and mapping EDI files

Troubleshooting EDI issues

Managing EDI data

Healthcare claim processing

Client facing applications

WORK EXPERIENCE

Sr. Business System Analyst/PO Mar 2023 –

Blue Cross Blue Shield of Florida (Florida Blue, Guidewell company) Florida, FL=Dec 2024

Worked on claims processing application (DIAMOND 950) including pricing, adjudication and adjustment of claims in accordance with the plans provision and provided contracts.

Involved in the project to implement a platform for Florida Blue members to provide their consents and preferences.

Captured detailed business, functional and technical requirements by engaging with providers, vendors and payers.

Utilized SQL to analyze claims data, contributing to critical insights that led to a 10% improvement in claim resolution outcomes using claim adjudication times, denial, percentage of holds on the claims and accuracy in payments to the providers.

Implemented a quarterly benchmarking strategy which empowered the team to exceed KPIs by an average of 20% each quarter.

Worked extensively with claims pricing team, adjudication team and adjustment team for effectively processing an average of 250,000 claims daily with a 99% accuracy rate.

Responsible for the overall mapping and analysis of EDI data

Worked closely with suppliers to understand EDI requirements and ensure proper integration for seamless data exchange.

Designed EDI maps to ensure the accuracy of data transmission adhering to the industry standards and HIPAA regulatory requirements.

Conducted regular testing of EDI systems for functionality

Worked on Power BI to create reports depending on the requirements by setting filters.

Have in- depth understanding of EDI concepts, processes and standards such as ANSI X12 for accurate data exchange. Familiar with healthcare files like 837(Claims), 835(payments) and 834 (Benefits enrolment).

As an analyst involved in day-to-day production support. Go over the emails/ ticketing system for any issues raised by stakeholders, acknowledge the mail and do detail analysis going by going through logs for any errors, data analysis by running queries on databases and look for any ETL job failures that may have caused the issue.

Utilized Postman for building and test API (POST) calls by ensuring data is secured by configuring and testing API endpoints.

Create JSON objects to manage API specifications through Postman

Creating use cases/system requirement specification, functional specifications, impact assessment, technical specifications, walkthroughs of SDLC artifacts with participating teams, and defect triage.

creating use cases/system requirement specification, functional specifications, impact assessment, technical specifications, walkthroughs of SDLC artifacts with participating teams, and defect triage.

Worked extensively on Smart/Visual Interactive Voice Recognition (VIVR) using chatbot to simulate human conversation and answer queries before passing on to agent (Assisted service). Chatbot queries internal database to retrieve information for the user helping organization personalize customer interactions at scale. This use case reduced the response time and human involvement.

Worked to decompose requirements and statements of work into functional test approaches that help with UAT testing.

Written detailed defect reports and worked with development to assist with their troubleshooting, resolution and validation.

Analyze and present results of testing to test members, managers and customers.

Performed Installation Verification Procedure (IVP) after production implementation to ensure all components were correctly implemented and configured.

Product Support analyst Dec 2016 – Feb 2023

Fidelity Information Services

FIS Post Trade Processing Platform (FISCD) is cloud-based software-as-a-service platform that provides greater transparency and control by modernizing post trade operations.

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Facilitated stakeholder workshops to gather requirements and delivered actionable insights, ensuring project alignment with corporate goals acting as a key liaison between internal and external stakeholders.

Assisted with production applications and platforms, resolving any issues or bugs.

As a Technical Account Manager (TAM), manage and develop technical solutions for multiple clients, focusing on customer satisfaction and delivering high quality results.

As a SME, I worked closely with clients/stakeholders/cross-functional teams for any concerns raised.

Collaborating with clients through regular meetings to understand their needs, address additional scope requirements, and resolve concerns while building a strong relationship with clients.

Analyze issues raised by clients by going through logs, technical requirement document (TRN), data analysis by running queries against databases and if necessary, escalate it to the development team for further analysis and offering ongoing support to meet client satisfaction.

Continuous integration, providing a rationalized system and the ability to adapt more quickly to uncertain or last-minute regulatory requirements, and improving overall time to market.

Worked on XML and FIXML messages read by gateways.

Deployed FISCD product as an Enterprise solution, or via FIS Managed IT Services or FIS Full-Service Operations depending on the requirements of clients and their line of business.

Worked on Kafka/ MQ messages that are sent down and consumed by gateways and analyze the data for accuracy.

Created incidents using ServiceNow ticketing system for tracking .

Perform End-to-End testing and UAT testing with clients for prompt delivery of the product depending on the requirements agreed upon.

Worked on disaster recovery activity during the instances of flipping from one server to another.

Analyzed business processes and identified areas for improvement, resulting in cost savings of 10% by providing user friendly and granular audit trail to enhance traceability of events, customizable operational dashboards to monitor and manage activity in real time.

Assisted with system installation and configuration for new and existing systems.

Collaborated with IT teams to identify system performance issues and develop solutions.

Identified and resolved system errors and performance issues, improving system response time by 20%.

Led cross-functional teams to implement system improvements resulting in a 90% decrease in operational costs and enhanced user satisfaction.

Debug and troubleshoot software defects through effective testing strategies and test plans.

Design and execute regression and functional tests.

Proactively identify, analyze, and resolve system issues by monitoring system performance and troubleshoot any issues if raised.

EDUCATION

Master’s degree: Biochemistry

University of Mysore, Karnataka, India

Bachelor’s degree: Botany, Biochemistry, Microbiology

Training: Computer Science

NIIT, National Institute of Information Technology

CERTIFICATIONS

Certified Scrum Master (CSM)

FIS Post Trade Derivative Core

FIS Cleared derivative certification

Permanent Resident (Green Card)

Immigration Status

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