Business Analyst It Service

Zeel Patel

Business Analyst Remote Availability – 2 weeks’ notice

Cell - 848-***-**** Email - *********@*****.*** Permanent Resident

PROFESSIONAL SUMMARY

Accomplished Business Analyst with over 5 years of progressive experience in the healthcare industry, working with mid-sized payers, providers, and health tech vendors to deliver impactful digital transformation initiatives.

Proven expertise in leading end-to-end requirement gathering, process optimization, and systems design for mission-critical healthcare solutions such as claims processing, patient portals, provider credentialing, and IT service management.

Deep understanding of healthcare regulations including HIPAA, CMS mandates, NCQA accreditation standards, and ADA/WCAG digital compliance, ensuring every project aligns with legal, clinical, and operational expectations.

Adept at conducting cross-functional stakeholder interviews with clinicians, claims specialists, provider relations teams, and IT leadership to extract business needs and convert them into actionable user stories and solution roadmaps.

Exceptional skill in visualizing complex healthcare workflows using tools like Microsoft Visio, Lucid chart, and creating traceable documentation (BRD, FRD, SOPs) for regulatory audits and operational transparency.

Hands-on experience with Agile and Scrum methodologies; consistently led sprint planning, backlog grooming, and UAT cycles to drive high-quality deliverables on time and within budget.

Strong data analysis capabilities using SQL to support data validation, historical audits, claim rejection analysis, and user behavior metrics to inform decision-making and process tuning.

Proficient in building interactive dashboards using Power BI and Tableau to empower business users with real-time insights into claims aging, onboarding KPIs, and support ticket resolution.

Expertise in managing knowledge and documentation portals using SharePoint, with a focus on retention policies, version control, and accessibility for cross-departmental teams.

Known for bridging the communication gap between business and IT teams translating clinical or operational pain points into elegant, compliant, and scalable digital solutions.

Demonstrated success in modernizing legacy healthcare systems, driving digital adoption among non-technical users, and building solutions that enhance patient/member satisfaction, operational efficiency, and provider engagement.

WORK EXPERIENCE

Business Analyst

Trinity Health, Edison NJ

Nov 2023 – Present

As a key liaison between clinical operations and IT, I drove initiatives to enhance the digital patient experience while streamlining the backend claims processes. I facilitated cross-departmental workshops to uncover pain points, gathered insights from clinicians and billing experts, and translated them into clear, actionable requirements. My role demanded empathy with patients’ needs, precision in compliance matters, and constant alignment with business outcomes.

Responsibilities:

Conducted stakeholder interviews with physicians, administrators, and billing staff to define digital experience gaps.

Authored user stories focused on improving appointment scheduling, secure messaging, and claims transparency.

Led Agile ceremonies, including sprint planning and backlog grooming, ensuring alignment with clinical workflows.

Collaborated with developers to design a mobile-friendly patient portal interface with HIPAA-compliant messaging.

Created detailed process maps using Visio to model current and future states of claims lifecycle workflows.

Partnered with EDI teams to validate and improve 837P/837I submissions, reducing claim rejection rates by 22%.

Performed root cause analysis on claim denials using SQL and partnered with billing for process optimization.

Facilitated UAT with end users including providers and finance analysts, documented results and triaged bugs.

Created real-time Tableau dashboards to track claims aging and payment cycle timelines.

Maintained a living knowledge base on SharePoint to support ongoing system adoption and training.

Business Analyst

WellCare Medical Management, Remote (Edison NJ)

Jun 2021 – Oct 2023

Tasked with modernizing a fragmented provider enrollment process, I collaborated with compliance, credentialing, and IT teams to simplify and digitize provider intake. My role involved identifying regulatory gaps, automating redundant tasks, and driving better coordination between departments. The result was a more transparent and accountable credentialing journey for thousands of providers.

Responsibilities:

Engaged with provider services and compliance leaders to capture key operational challenges in the credentialing process.

Created workflow diagrams to visualize provider onboarding and identify bottlenecks and duplicate reviews.

Authored detailed BRDs that outlined business logic for provider approval rules and license verification triggers.

Partnered with development teams to integrate with third-party credentialing APIs and state license registries.

Built Power BI dashboards to track onboarding SLAs, license expirations, and compliance flags in real time.

Defined KPIs and success metrics for credentialing turnaround and regulatory adherence.

Conducted SQL-based data validations for historical provider profiles and aligned with audit requirements.

Delivered change management support by creating training sessions and quick-reference guides for end users.

Championed Agile best practices by running sprint retrospectives and driving continuous process refinement.

Maintained secure SharePoint folders to manage compliance checklists, audit trails, and documentation archives.

Junior Business Analyst

SYSCOM Global Solutions, Edison, NJ

Jun 2020 – May 2021

Under mentorship of senior BAs, I served as a crucial contributor in understanding client needs, capturing requirements, and validating system behavior. I assisted in bridging gaps between customer support, sales, and IT teams by translating feedback into documentation, user stories, and functional flows. My efforts accelerated CRM adoption and improved data integrity during migration.

Responsibilities:

Helped schedule and facilitate interviews with stakeholders from sales, customer support, and service operations to identify pain points in the existing CRM.

Documented business requirements and supported the creation of user stories and acceptance criteria for features like account creation, service ticketing, and escalation workflows.

Developed as-is and to-be process maps in Visio, highlighting inefficiencies and suggesting process improvements.

Participated in daily Scrum stand-ups and sprint reviews, contributing observations and clarifications to product and QA teams.

Assisted with data migration efforts by running Excel and SQL-based data validation checks to ensure CRM data accuracy and completeness.

Drafted training materials and quick-reference guides for customer service representatives to support new workflows.

Coordinated UAT test cycles by logging user feedback, tracking issue resolution, and verifying fixes with QA.

Stored and managed all project artifacts, meeting minutes, and change requests within SharePoint for version control and team access.

Observed usability testing sessions to capture user interactions and reported usability challenges.

Supported QA in preparing test scripts and verifying system functionality during sprint testing.

EDUCATION

Bachelors of Engineering in Information and Technology (MBIT)

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