Business Analytics,Project Management, Healthcare, EDI, Data Analytics

Paulami Chakraborty

*******.***@*****.***

PROFESSIONAL SUMMARY 423-***-****

Objective:

Dedicated and analytical business analyst with close to 8 years of experience in analyzing business process, identifying needs and implementing solutions to enhance efficiency and drive business growth. Proven track record of translating complex data into actionable insights. Seeking to leverage expertise in data analysis, project management and stakeholder collaboration in a dynamic business environment. Looking for a challenging role where I can challenge myself each day.

SKILLS :

Programming

Languages

Python, Java

Web Technologies HTML5, CSS3, Java Script.

Databases Oracle, SQL, MySQL, DB2, Teradata, Grid Gain Cache. Version Control GIT, CVS, Subversion, Source Tree. XML Editors XML Spy, Stylus Studio.

Operating Systems UNIX, Linux, Windows, IOS.

Methodologies Scrum, Waterfall, SDLC, TDD.

Bug Tracking Tools ALM, ClearQuest

Microsoft Office Tools MS Word, MS Excel, MS Visio, MS Power Point, MS Outlook. Content Management Confluence

Data Base Tools SQL Server Management Studio, PL/SQL developer, My SQL, TOAD, Flyway. Project/Test Mgmt.

Tools

Soap UI, HP Application Lifecycle Management (ALM), Quality Center

(QC), SharePoint.

Reporting Tools SQL Server Reporting Services (SSRS), Tableau, SAS Areas of Expertise Include

Requirements Gathering & Analysis, Business Proposals, Systems Development Life Cycle, KPI Dashboards & Scorecards, User Acceptance Testing (UAT), Project Management, SAS, BRDs/SRDs, Data Analytics, EDIFACT, ETL- Data Warehouse/Datamart.

WORK EXPERIENCE

Healthcare Systems Analyst

Client Caresource Feb 2024

Responsibilities:

● Working as an Healthcare EDI systems Analyst, with expertise in software development Life Cycle, with primary focus on Encounters Management for Medicaid and Medicare markets.

● Strong Working knowledge of healthcare EDI transactions (837 I/P/D, Response Transactions-835, 277CA, 277U, 999, TA1, etc)

● My role involves documenting business and Functional requirements, once a demand is raised for a code fix, following which I meet internally with the developers, to have a plan.

● So, the requirements are gathered thoroughly through meetings with stakeholders,and Analysis

(thorough backend analysis to reproduce the scenarios), I go forward with feature refinements with SOS, thereby, refining Stories for future iterations depending on the priority of the demand.

● Experience handling Vendors and guiding them to Encounters Aspects.

● Reviewing State documentation and come up with recommendations to implement solution engaging with our internal IT, cross-functional teams.

● Running SQL queries to assist in analysing the requirements, and SQA testing efforts.

● Writing manuals, SOPS, System guides,training material, and Deployment guides.

● Involved in daily scrums and taking meeting notes.

● Implementation and knowledge of HIPAA code Sets, ICD-9 and ICD-10 coding

● Very good experience handling projects though Rally, Jira and ADO boards.

● Experience with Healthcare System:Facets, Facets Data Dictionary. Technology lead

Client Molina Healthcare Jan ‘23- Feb ‘24

Responsibilities:

● Handled EDIFECS installations into Linux machines procured for SIT env, and validating them end to end.

● Deploying XEServer Projects and configuration files into UNIX/LINUX server(s) and maintaining them.

● Participating in all UAT State testing, to provide SME validation and recommendations for corrections or improvement.

● Understanding EDIFECS Encounter Management UI solution and encounter submissions to CMS and State Medicaid/Medicaid.

● Work in a fast-paced agile development environment to quickly analyze, develop, and test potential use cases for the business.

● Assist Client to effectively use EM solutions to meet the business requirements, and help identify gaps, if any.

● Working as an innovative part of the team and also guiding the respective team members to understand and complete the tasks.

● Giving technical and Operational training/KT to the internal IT/QA team, to make sure they understand the EM Solution, and deliver better.

● Involve in daily scrum calls, grooming and weekly meets. Environments:EM UI, Jira, SpecBuilder, EDIFECS, EAM, XEngine, XEServer, Git,Azure DevOps, Groovy, Drools engine,MapBuilder,ETL/Datamart, Transaction Manager, Eclipse, Oracle, Java, JavaScript, XML, HTML, SSMS.

Data Transfer Protocols: FTP, SFTP, https.

EDIFECS Developer

Client CIGNA Dec 2019 -Dec 2022

Responsibilities:

● Conduct business process analysis and identify critical issues and gaps for an established organizational process.

● Worked detailed on Edifecs products as part of the claim/remittances processing.

● Worked in Claim (837I, P, D) processing for Cigna end to end from getting in the gateway to going to Alliance partners.

● Have experience handling 835,276-277,270-271, NCPDP data, or other Pipe delimited formats.

● Modify Translation maps using MapBuilder for X12/HIPAA transactions as per new requirements.

● Validated the following:837(Health Care claims or Encounters), 835 (Health Care Claims Payment/Remittance), 270/271 (Eligibility request/response), 834

(Enrollment/Dis-enrollment to a Health plan)

● Having experience working on Sterling B2B integrator and file gateway, including B2B Sterling Map Editor.

● Experience with Scrum and different Scrum meetings like backlog refinement, Sprint planning meetings, Daily Stand Up meetings and retrospective meetings.

● Have done analysis, design, development and E2E integrated testing also.

● Develop a roadmap for short- and long-term work, manage prioritization, and monitor the work to meet objectives.

● Worked together with the clients to gather and freeze the requirements for the elements of different transactions in the design document and used these documents for development purposes.

● Also, I always believed in creating an Evidence Document once I am through the development phase, considering the scope of the change, and acceptance criteria being met, with the comparison of the pre and post test results being captured too.

● Developed business plans, determine Key Performance Indicators and co-ordinate the measurement result.

● Taken leadership in resolving Production issues, scheduling calls with different stakeholders involved.

● Worked with Architects to create features for different scrum teams.

● Collaborated with stakeholder’s groups across the organization to ensure business and technology alignment. Proposed solutions meeting defined specifications and needs.

● Have been an integral part of PI Plannings and Sprint plannings, understanding the EPIC/Feature requirements, User Story requirements, and helping the team members to task them down under Jira/Rally.

● Gave demos to the clients after the development is done, and promoted to INT.

● Worked as an innovative part of the team and guided the respective team members to understand and complete the task.

● Assisted writing SQL queries, to manage and extract information from a database by using SQL.

● Performed EDI analysis, research and documentation of transactional data set requests and issues from internal and external sources.

● Involved in daily and weekly team meetings.

Environments: Rally, Jira, SpecBuilder, EDIFECS, EAM, Sterling B2B Integrator, Sterling Map Editor, XEngine, XEServer, Git, Jenkins, Groovy, Drools engine, Udeploy, MapBuilder, Transaction Manager, Facets (for claim processing), Eclipse, Oracle, Java, JavaScript, XML, HTML, SQL Developer. EDI Concepts: EDI, HIPAA/X12(4010, 5010 version), NCPDP Post Adjudication. Data Transfer Protocols: FTP, SFTP, https

Business Analyst / Data Analyst

INSOFE, Bangalore April 2017- Nov 2018

Responsibilities:

● Involved in functional and non-functional requirements gathering activities with end users, managers, stakeholders and SMEs.

● Played a key role in the Scrum team and used the bug tracking tool ClearQuest for clarification and prioritization of tasks in the project backlog.

● Wrote user stories defining the system functionality in Rally tool.

● Conducted Meetings and review sessions using PowerPoint with different teams, business requesters and Project Managers for all documents requiring sign offs and Approvals.

● Worked with the PM and higher management to determine the project timeline and plan the timeframe required for requirement gathering sessions.

● Implemented End to End Testing and assisted business in User Acceptance Testing (UAT) and performed Postproduction validation.

● Worked with development teams to discuss, resolve production issues, and improve performance of application.

● Acted as a liaison between the offshore development team and onsite business team within PMO.

● Performed Data Analysis using Oracle as a backend and PL/SQL developer as the querying interface.

● Performed Data mining and cleansing for large sets of data across all financial systems using SAS and SQL.

● Liaison between Finance team and business partners to resolve questions and or issues related to data and report requirement.

● Analyzed production data and mined them and created reports that give business valuable insights.

● Helped the Development team to create a solution based on the outcome of mined data and its impact to the business.

● Experience in improving reporting performance significantly in tableau using extracts and context filters.

Environment: ClearQuest, Confluence, MS Office, SQL Server, File manager, FileNet, Oracle, SAS 9.0, Teradata 14.10, SDLC/Agile, Scrum, Tableau.

Management Lecturer

Punjab Technical University April 2009 to Jan 2010 Responsibilities:

● Was involved in teaching courses in management and business administration, o Accounting,

o HR,

o Operations research and marketing.

● The most essential duties were preparing and delivering lecturers, evaluating and grading class work, compiling and administering work assignments, preparing course materials, and maintaining student attendance records.

● Creating course content that was at par with state standards and ensuring rigorous learning experience for students, regardless of skills.

● Participated in Students Induction week activities and Student placement testing. Data Analyst

E-NXT, Guwahati, INDIA May ‘08 - Feb’09

Responsibilities:

● Converting data into actionable insights by predicting and modeling future outcomes.

● Involved in requirement gathering and creating Business and User requirement documents for approval and sign off.

● Created Functional Specifications document and conducted walkthrough sessions with the stakeholders to get approval and sign off.

● Created Test approach and Test plan for the project, conducted walkthrough for both documents and achieved approval and sign off form all stakeholders.

● Analyzed the Business Requirements document and the system requirement document to come up with a detailed Test Plan.

● Successfully led the team to provide meaningful business oversight from the data analysis of customer and sales data.

● Identified areas of potential revenue increase using data mining techniques.

● Collected and analyzed data on established and prospective customers, competitors, marketing channels and sources.

● Worked with different vendors to ensure collaboration among different stakeholders.

● Scripted several SQL queries to create ad-hoc reports for different business teams to validate and maintain data integrity.

● Working with business stakeholders to translate business requirements into functional requirements.

Environment: Confluence, MS Visio, MS Project, MS Office, SQL Server, PL/SQL, File manager, MS Excel, SharePoint.

EDUCATION

PB business analytics certification program from University of Tennessee, Chattanooga (USA), 2015-2016 with GPA 4.

MBA (Finance and Marketing) from Assam University, June 2006-May 2008

Bachelor of Commerce (Advanced Accountancy) from Assam University, June2003-May 2006

Higher Secondary from CBSE, 2003

Matriculation, CBSE 2001

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