Business systems analyst

Sunny Nahidul Islam

**********.***@*****.*** 945-***-**** Frisco, TX- 75034

https://www.linkedin.com/in/sunny-islam-834602206/

Summary:

Over 7 years as a Business System Analyst in Healthcare and distribution and logistics domain, specializing in client interfacing, requirements gathering, and data analysis. Extensive experience with Medicaid/Medicare, MMIS, and Facets modules, including claims processing and EDI transactions (837, 835). Skilled in creating user stories, mockup and facilitating JAD sessions. Proficient in Azure DevOps, JIRA, and backend testing. Strong project management, stakeholder communication, and documentation abilities. In-depth knowledge and experience in Hands-on experience in CRFs, portfolio analytics, and capturing client business needs as Business Requirements, which are then translated into technical requirements and specifications. Created Business Requirement Documents (BRD) and Technical Specification Documents (TSD), working with various data file formats such as XML, CSV, and delimited files. Experience in data mapping, and data flow diagrams. Created User Stories, Acceptance Criteria and Use cases. Involved with Gap analysis by identifying existing technologies, documenting the enhancements to meet the end state requirements and ability to maintain and build client relationships with Business Owners to identify, prioritize and document business requirements. Extremely organized and self-disciplined to successfully work independently especially in fully remote positions but also an outstanding team player and leader. Excellent track record of fostering and maintaining great work relations leveraging interpersonal skills, verbal and written communications as well as video conferencing professionalism and etiquette.

Technical Skills:

Business Process Improvement & Optimization

Requirements Gathering & Documentation

Stakeholder Management & Collaboration

Agile (Scrum, Kanban) & Waterfall Methodologies

Data Analysis & Visualization (Power BI, Tableau)

Risk Management & Mitigation Strategies

Business Process Modeling (BPMN, UML)

Project Management & Roadmap Development

Education:

Bachelor of Business Administration in Computer Information Systems North South University, Dhaka, Bangladesh 2012

Master of Science (M.S.) in Computer Information Systems Saint Mary's University of Minnesota, Minnesota, USA 2018

Professional Experience:

HealthCare Service Corporation (HCSC), Chicago, IL June 2025 - Present

Business Systems Analyst

Responsibilities:

Collaborated with business stakeholders to develop Business Requirements Documents (BRD), Functional Requirements Documents (FRD), and Technical Design Documents (TDD) validated IT technical designs against functional specifications.

Conducted Joint Application Development (JAD) sessions, interviews with Subject Matter Experts (SMEs), and stakeholder meetings to gather, validate, and prioritize requirements.

Documented business needs for ICD-10 based on HIPAA 5010 gap analysis, ensuring regulatory compliance and process alignment.

Performed “As-Is” vs. “To-Be” analysis using MS Visio, highlighting system enhancements and business process changes.

Acted as a liaison between stakeholders and technical teams to elicit, analyze, communicate, and validate requirements for changes in business processes, policies, and systems.

Assisted Project Manager in creating project timelines, milestones, and performing resource planning and coordination.

Led requirement elicitation workshops, brainstorming sessions with senior leadership and SMEs documented outputs into actionable specifications.

Participated in structured prototype walk-throughs, obtained formal business sign-offs for documented requirements and design artifacts.

Worked closely with the Product Team to create and manage product backlogs based on ROI and business value using Azure DevOps (ADO).

Migrated and validated data from legacy systems to new data warehouse, ensuring sync with FACETS medical claims tables.

Authored and executed SQL queries, including joins, subqueries, and data extraction scripts to support reporting and data validation.

Designed visual mockups, wireframes, and design documents to support UI/UX and requirement validation processes.

Created maps & layouts for HIPAA as imposed during Electronic Data Interchange (EDI) 837 – Claims and Encounters, 834 – Benefit Enrollment and Maintenance, 835 - Claim Payment/Advice, 270/271 - Eligibility Benefit Inquiry and Response, 277/275 - Claim Request for additional Information and Response, 276/277 – Claim Status Request / Response

Processed healthcare claims in FACETS, ensuring proper 835 X12 file generation and transmission to providers.

Worked extensively on Medicare/Medicaid claims, enrollment processing, and billing workflows across healthcare systems.

Led and participated in all Agile ceremonies Daily Stand-ups, Iteration Planning, Sprint Reviews, and Retrospectives authored and groomed detailed User Stories.

Conducted eligibility inquiries, enrollment, billing, and invoice testing within the FACETS system.

Authored design documentation for backend API integrations and system interface requirements.

Developed interactive dashboards in Power BI to track healthcare KPIs such as claims status, billing accuracy, member enrollment trends, and provider network utilization.

Performed functional testing, XML validation, and web service testing using SOAP UI for REST APIs.

Conducted Gap Analysis and developed workflows, process maps, and flowcharts to document system improvements.

Developed and maintained data mapping documents, created logical data models, class diagrams, and ER diagrams with SQL-based validation.

Used UML methodologies via MS Visio to define use cases, activity diagrams, and assisted with sequence & collaboration diagrams for technical documentation.

Authored end-user training manuals, supported change management, and conducted knowledge-sharing sessions.

Created UAT Test Plans and collaborated with UAT teams to ensure full acceptance criteria coverage for all requirements

Southern Glazer’s Wine & Spirit, Dallas, TX Nov 2024 – May 2025

Business Systems Analyst

Responsibilities:

Gathered requirements from sales, purchasing & warehouse teams to develop forecasts aligned with business objectives and created functional and non-functional requirement documents, BRDs, FRDs, Use Cases, end-to-end system workflows, interface diagrams, mapping documents.

Collaborated with the Project Manager/Team Lead to develop project documentation, status reports, and other deliverables as needed to support planning, tracking, and stakeholder communication.

Designed Use Cases using UML and managed the entire functional requirements life cycle using Agile/Scrum.

Reviewed the current version of the application, walked through key user flows such as login, data entry, and reporting, and documented each step with screenshots and descriptions in Azure DevOps.

Documented end-to-end purchasing workflows & developed SOPs to standardize processes & support compliance.

Facilitated JAD sessions for requirements gathering with the business and IT to create business required documents.

Document Source-to-Target mappings that provide transformation logic and business rules to onshore and offshore development and QA teams

Supported the creation, organization, and ongoing management of work items including Epics, Features, and User Stories within Azure DevOps to ensure accurate tracking of project scope, progress, and priorities.

Participated in meetings with team lead and clients to actively capture feedback, gather new requirements, and document change requests during solution presentations and discussions.

Designed Use case Diagrams, Workflow diagrams, Activity diagrams for most of Use Cases using MS Visio and and attended weekly change request meetings to document and implement testing procedures for approved changes.

Prepared interactive UI screens (wireframe / screen mockups) for To-Be system using a UI modeling tool Balsamiq to show Proof of Concept (POC) to business owners

Developed actionable dashboards & reports in Power BI to provide leadership insights on sales trends & inventory performance.

Wrote SQL queries for data analysis and manipulation.

Assisted the Development team to create API rules for the application.

Coordinated and verified successful completion of UAT for the program and provided end user training and prepared Test Cases with test scenario, acceptance/rejection criteria, and test data. Also, executed test cases by prioritization of requirements and tracked the testing progress with Requirement Traceability Matrix (RTM).

Envision Healthcare, Ft. Lauderdale, FL Aug 2022 – Oct 2024

Business Systems Analyst

Responsibilities:

Elicited requirements through interviews, surveys, client site visits, business process descriptions, use cases, scenarios, task and workflow analysis.

Worked on Provider Onboarding Platform in detail and effectively map product functionality with business needs.

Conducted JAD sessions and ultimately reducing the time spent in moving all the information from stakeholders and other team members.

Critically evaluate information gathered from multiple sources, reconcile conflicts, decompose high-level information into details, abstract up from low-level information to a general understanding, and distinguish user requests from the underlying true needs.

Followed every step of the Agile methodology to make sure overall quality control process for the project is ensured.

Worked with (SMEs) to gather and document product backlog items/user stories in MS Azure DevOps (ADO).

Conducts practice-specific workflow analysis and design, documenting current state workflows and assisting the practice in making future state workflow decisions based on the successful use of the EHR application.

Worked with the Product Owner to define product features, wrote epic acceptance criteria and user stories on monitor and track business value delivery.

Worked with a cross-functional and diverse team of business users and developers to enable accurate communication of requirements and ensure consensus on healthcare payer and claims.

Review EMR requirements for new projects to ensure compliance, regulatory, and user impacts are met.

Assisted in monitoring ancillary data transactions and addressed problems with HL7 messages.

Created detailed Business Flows, wireframes, mockups, and interactive prototypes to capture and refine user interface (UI) requirements using Figma, ensuring alignment with business needs and enhancing communication with development and UX teams.

Performed a Gap Analysis of client requirements, generated workflow process, flow charts and relevant artifacts

Developed straightforward DBMS queries, knowledge of HL7 and XML interface messaging.

Performed AS-IS Study of the system and TO-BE Analysis, revision of Business Process Procedures to incorporate necessary changes.

Maintain the business rules in a table for visibility to all required processes to develop Power BI reports & effective dashboards.

Created data mapping from XML tags to HL7 fields, and troubleshooting connection issues using SQL

Developed source to target data mappings, documented business and transformation requirements, performed source system data profiling and documented findings.

Validated business rules and all artifacts with users, approval and sign-off.

Created Use Cases that defined the role of users who receive claims, users who process claims, and users who adjudicate claims. Used MS Visio to develop UML diagrams.

Designed and Implemented REST APIs using various data formats (JSON, XML) to provide an interface to SOAP UI.

Performed Data Analysis to identify trends, develop interactive visualizations on traffic data using Power BI.

Checked the data flow through the front end to backend and used SQL queries, to extract the data from the database.

Coordinated with the development and QA team in terms of prioritizing tasks, creating milestones and providing business context to development efforts and preparing test plan, test scenarios, UAT and test cases

EnGen Healthcare- Highmark BCBS, Pittsburgh, PA Jan 2021 – Jun 2022

Business Systems Analyst

Responsibilities:

Acted as a liaison between business stakeholders and technical teams, collaborating with SMEs to create and manage BRDs, PRDs, FSDs, and Change Requests for system development and enhancements.

Defined functional requirements and led the implementation of claims audit automation using OCR technology, improving audit accuracy and reducing processing time.

Conducted JAD sessions, one-on-one interviews, and cross-functional workshops to elicit, analyze, and validate business and system requirements across multiple departments.

Gathered and documented requirements for large Excel-based datasets integrated BOT (Build-Operate-Transfer) automation models to enhance operational accuracy and efficiency.

Processed claims in Facets and verified 835 X12's were generated and sent to Provider.

Performed analysis of structured and unstructured data, ensuring data consistency using data dictionaries, metadata standards, and logical data models.

Created and maintained project plans in JIRA tracked progress, reported deviations, and recommended corrective actions.

Developed business/system workflows and functional specifications for claims processing systems produced Current State Analysis, Project Briefs, and obtained stakeholder approvals.

Defined test data and designed test scenarios for family/individual enrollment, eligibility validation, and benefit cancellation workflows under Medicare and Medicaid programs.

Designed and built interactive dashboards and reports, utilizing bar charts, pie charts, tree maps, waterfall charts, and gauges for data visualization and stakeholder reporting using Tableau

Responsible for completion of the migration of tables to new data warehouse which were being synced with Facets medical claims tables.

Maintained and enhanced database structures, including tables and views documented comprehensive Source-to-Target (S2T) mappings in alignment with business rules.

Applied Agile methodology across all project phases collaborated with onshore and offshore teams to promote knowledge sharing and continuous improvement.

Conducted As-Is and To-Be process analysis for Member Claim Submission workflows to identify improvement opportunities and streamline operations.

Completed all phases of the SDLC independently, validating conceptual solutions and delivering high-quality requirements artifacts throughout the project lifecycle.

Designed UI mockups, wireframes, and interactive prototypes to support UI/UX validation and improve user interface requirements gathering.

Documented user stories and acceptance criteria in Azure DevOps (ADO) managed Agile backlogs, epics, burn-down charts, and velocity metrics for Scrum teams.

Modeled requirements using UML diagrams, including activity, sequence, and state diagrams documented Software Requirements Specifications (SRS) to capture system functionality using MS Visio

Defined and reviewed API specifications for front-end and back-end integrations coordinated with developers and client teams to ensure alignment and successful implementation.

Participated in HIPAA/EDI validation for transactions including 270/271, 276/277, 837P / 837I, and 835 across professional, institutional, and billing domains authored test plans and test cases.

Developed and optimized SQL and PL/SQL queries for patient data creation and claims analysis performed Teradata performance tuning for high-volume data operations.

Supported UAT and QA testing activities evaluated test results and ensured alignment with business requirements and project delivery timelines.

Cox Health, Springfield, MO Sept 2019 - Nov 2020

Business Analyst

Responsibilities:

Led requirements gathering sessions with CMS, Medicare-Medicaid Plans, and cross-functional teams to capture, analyze, and document business needs for Encounter Demonstration and HIPAA 5010 migration projects.

Prepared Functional Specification Documents (FSDs) by breaking down BRD requirements into detailed business rules, data mappings, mathematical formulas, and logical workflows using BABOK standards.

Worked with UI/UX team to proactively address the feedback received during the demos

Created comprehensive User Stories and Acceptance Criteria in JIRA, ensuring full traceability and alignment between business objectives and development deliverables built dashboards for sprint tracking and velocity

Designed wireframes and mockups using Figma for POC developed workflows, business flows, and prototypes.

Designed “As-Is” and “To-Be” process models using BPMN and MS Visio, and implemented new workflows that improved efficiency and eliminated redundant steps in the Facets billing and claims processing modules.

Collaborated with developers, QA teams, and product managers to validate requirements, review technical documents, and communicate feedback, ensuring accurate implementation of business functionality.

Executed functional and UAT testing for Facets Implementation, including Billing, Claims, and Member modules verified EDI X12 transactions such as 837, 835, 834, 270/271, and 276/277 for accuracy and compliance.

Managed full functional requirements lifecycle in Agile/Scrum methodologies maintained product/sprint backlogs and conducted user stories workshops.

Implemented and enhanced data representation through Tableau, developing filters, parameters, and calculated sets to visualize claims, enrollment, and payment data, which boosted analytical insights for leadership.

Drafted and presented project charters, SOWs, and status reports to senior stakeholders, defining project objectives, deliverables, and measurable outcomes for data migration and system modernization initiatives.

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