Business Analyst Process
Resume:
Akhila Erabelli
**************.**@*****.***
Summary:
Liaison between Business Systems and Information Technology and extensive Business Analyst skills Understanding of Software Development Life Cycle (SDLC), Business Process Reengineering (BPR), Test Lifecycle, Data Modeling, and Use Cases documentation.
Self-Motivated where I led meetings with stakeholders as a client representative, overseeing both the business aspects for the client and the IT side.
Good understanding of Gap Analysis (GAP) pertaining to risk analysis and project plans.
Highly experienced in requirement gathering by conducting personal interviews, developing questionnaire, brainstorming, conducting JAD (Joint Application Development) sessions, or role playing to get a better understanding of client business processes and creating requirements Traceability Matrix (RTM) for tracking agendas.
Knowledge of ITIL framework, app performance monitoring and production support.
Participated and facilitated FGA (Fit Gap Analysis).
Experienced in Business Process Improvement (BPI) identifying, analyzing, and improving business processes to achieve greater efficiency, effectiveness, and quality.
Highly experienced in Business Continuity with identifying areas of improvement by applying work around and long-term fix strategies.
Ability to meet deadlines and manage multiple projects simultaneously.
Proficiency in document management tools, databases, and analytics software.
Expertise in creating UML diagrams, flowcharts, screen mockups, systems requirements specifications, RACI charts, Project Kickoffs, Status reports.
Created page layouts, search layouts to organize fields, custom links, related lists, and other components on a record detail and edit pages.
Handson experience in working on document management, Claim attachments, Lab reports & Diagnostic reports.
Expertise in SAFe/Agile/Scrum Methodology.
Highly experienced in JIRA/Confluence/Smartsheet/SharePoint.
Extensive experience of Medicare (Part A, B, C and D) Medicaid rules, NCPDP PBM (Pharmacy Beneficiary Management), HIPAA, ICD9/ICD10 codes, CPT, EMR, EHR, EDI, HL7, FHIR transactional sets.
Experience in HIPAA 5010.
Experienced in working with FHIR security tags & Labels to keep PHI and PII data secure.
Technical Qualifications
Methodologies
Safe, Scrum, Kanban, & Waterfall.
Soft Skills
Process Mapping, Root Cause Analysis, Process Redesign, Requirements Gathering, Solution Evaluation, Change Management, Metrics and Monitoring, Stakeholder Engagement, Process Documentation, Continuous Improvement
Office Tools
MS Word, MS Excel, MS PowerPoint, MS Access, MS Project, MS Access & Outlook.
Process/Modeling tools
MS Office: Word, Excel, Access, Power point, Project, Visio, Smartsheet, Figma,
Database
MS Access, SQL Server 2016, 2012 Oracle 10g, AWS
Quality Management
HIPAA, SNIP.
Operating System
Mac, Windows Vista, NT/2000/2003/ XP/98, MS DOS
EDUCATIONAL QUALIFICATIONS:
Doctor of Pharmacy from Kakatiya University, India in 2014.
Master’s in business administration 2024.
Work Experience:
Work Experience:
Client: Anthem June 2024 –July 2025.
Business Analyst l
Project Description: EVIS tool (Enterprise vendor invoice system) was designed and implemented by Anthem to monitor vendor invoices. EVIS consists of business validation front end edits for claims processing and generation of acknowledgements. The tool is incorporated by rules for negotiations and termination of vendors invoices by generating several reports. Processed data is saved for Audit and data mining purposes. As a Business Analyst my job entails processing the data and generate the reports for the project.
Responsibilities:
Expertise in documenting Business requirements documents (BRD) and Functional requirements documents in compliance with the company system.
Facilitated communication between stakeholders across departments to resolve issues, gather requirements, and maintain project transparency throughout the lifecycle.
Coordinated project deliverables using Smartsheet to track tasks, dependencies, and milestones.
Created Smartsheet dashboards for real-time visibility into vendor invoice statuses and payment cycles.
Automated workflows in Smartsheet to streamline approval processes and reduce manual follow-ups.
Tracked and managed project issues using JIRA, ensuring timely resolution and clear documentation.
Created and maintained issue tickets with detailed descriptions, priority levels, and status updates
Worked on Enterprise vendor invoice system (EVIS).
Created reports for different Vendor invoices (Accept, Reject & Pend).
Created aging reports to check the outstanding balance of vendors and payment dates.
Involved in loading the voucher loads and processing the payments for accepted claims and sending the rejection claims back to vendors with reject reports.
Designed and created process flow charts for the project.
Played active role in standardizing the frontend edits and creating business validations.
Processed claims for the given Vendors and generated acknowledgements.
Hands on experience working with Ms Access database & oracle database.
Worked with Provider Audit & Data mining teams to process claims.
Worked on Claims recovery and Claims Overpayment.
Experienced in Agile methodology and involved in daily meetings and sprints.
Used JIRA to deal with active sprints and report issues.
Worked on different Reject reasons involved in processing claims and updating vendors.
Worked on ACR, COR, M204 & Edward to process claims.
Worked on test plans and test cases and UAT (User Acceptance Testing).
Validated on end-to-end testing (SIT) and performed UAT.
Client: GCRS July 2021 – December 2021
Clinical Research Coordinator
Project Description:
Responsibilities:
Prepared and coordinated study startup activities, including protocol review, obtaining necessary approvals, and setting up study materials.
Ensured compliance with regulatory requirements, including FDA regulations, ICH guidelines, and institutional policies.
Developed and implemented study plans, timelines, and budgets.
Identified, screened, and recruited potential study participants, obtaining informed consent and maintaining participant records.
Coordinated study visits, procedures, and data collection, ensuring protocol adherence and accurate documentation.
Maintained accurate and complete study documentation, including participant files and study logs.
Recruited study participants and arranged patient visits.
Maintained accurate case reports and met with monitors on routine site visits.
Coordinated with study sponsors, CROs, and other stakeholders to ensure study progress and compliance.
Demonstrated strong working knowledge of ICHGCP, regulatory guidelines, and protocols.
Ensured compliance with regulatory requirements, including IRB approvals and informed consent.
Maintained accurate and up to date knowledge of regulatory guidelines and updates.
Coordinated data collection, entry, and verification, ensuring data accuracy and completeness.
Maintained accurate and complete study records, including CRFs, study logs, and participant files.
Collaborated with study sponsors, CROs, and other stakeholders to ensure study progress and compliance.
Communicated effectively with study participants, investigators, and study staff to ensure study success.
Coordinated with internal departments, such as pharmacy and laboratory, to ensure study requirements were met.
Client: PrimEra Medical Technologies March 2019 – January 2020
PICORE MEASURES EXECUTIVE
Project Description:
Responsibilities:
Utilized national standardized processes and best practices to reduce complications and lead to better patient outcomes.
Implemented evidence-based practices for common conditions, such as Stroke and Sepsis.
Worked to provide the right care at the right time, ensuring timely and effective treatment.
Worked on Meditech concurrent software, ensuring accurate and efficient data management.
Utilized technology to streamline clinical processes and improve patient care.
Worked at Desert Valley Hospital and Paradise Valley Hospital, gaining experience in diverse clinical settings.
Collaborated with healthcare teams to ensure high-quality patient care and outcomes.
Focused on delivering high-quality patient care, ensuring safety and effectiveness.
Participated in quality improvement initiatives, identifying areas for improvement and implementing changes.
Worked to reduce hospital acquired conditions and improve patient satisfaction.
Client: Viglare Biopharma February 2018 – July 2018
DRUG SAFETY ASSOCIATE(MICC)
Project Description:
Responsibilities:
Identified and reported adverse events, including serious and unexpected events, to the responsible Pharmacovigilance function.
Ensured timely and accurate reporting of safety information, including off label use, medication errors, and misuse.
Collaborated with internal stakeholders, including clinical research teams and regulatory affairs, to ensure compliance with pharmacovigilance regulations.
Identified and reported quality complaints on pharmaceutical products to the relevant quality function.
Ensured thorough investigation and resolution of quality complaints.
Collaborated with quality teams to implement corrective actions and prevent future quality issues.
Worked for Aurobindo client, providing pharmacovigilance and drug safety services.
Ensured compliance with client requirements and regulatory standards.
Client: AGS Health August 2015 – April 2016
Junior Process Associate
Project Description:
AGS Health is analytics driven, technology enabled Revenue Cycle Management ("RCM") Company providing medical billing, medical coding and business analytics services to leading healthcare providers across the US. Award winning track record of over 17 years. Over 5000 RCM specialists across offices in US and India. Blue chip clients (large health systems and hospital corporations, physician groups, academic medical centers, billing companies, revenue cycle management companies, coding companies and providers of other healthcare services)
Responsibilities:
Worked as a liaison between client (Jackson Medicine) and technical team to understand and deliver the needs of the business.
Worked on Same day Surgery (SDS) sheets by decoding them into the given deliverables.
Worked on Emergency department sheets (ED).
Highly experienced in Medical Coding.
Extracted SDS (SamedaySurgery) sheets using 3M (coding generator) and loaded batch files using CITRIX software.
Accurately reviewed and coded patient medical records using ICD10, CPT, and HCPCS coding systems.
Ensured compliance with HIPAA regulations and maintained strict confidentiality of patient information.
Collaborated with healthcare providers to resolve coding discrepancies and clarify documentation for accurate billing.
Stayed current on coding guidelines, regulations, and changes in medical terminology to ensure coding accuracy.
Trained and mentored junior coders, providing guidance on industry best practices and coding protocols.
Demonstrated proficiency in using electronic health record (EHR) systems and medical coding software.
Reduced claim denial rates through diligent review and correction of medical coding errors.
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