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Click here or scroll down to respond to this candidateCandidate's Name
PHONE NUMBER AVAILABLE EMAIL AVAILABLEPROFESSIONAL SUMMARY:Accomplished Senior Business Analyst with 9+ years of experience in the Healthcare, Insurance, Finance and Banking domains. Skilled in optimizing financial software systems, streamlining business processes, and aligning them with organizational needs. Extensive knowledge of Medical Management Information Systems (MMIS), Medicaid, Medicare, Procedural and Diagnostic codes and Claims Process. Exposed to Medicare and Medicaid domains of the healthcare systems and industry for inpatients, outpatients, Reimbursement Methodology.Expertise in Banking, Mortgage corporate finance, valuation, SWIFT, ACH, FP&A, treasury management, financial reporting, hedge funds, private equity, venture capital, investment management, wealth management, and financial technology (Fintech).Adept in all stages of the Software Development Life Cycle (SDLC), including the deliverables at each phase. Proficient in industry-standard methodologies such as Waterfall, Agile, Scrum, and Waterfall-Scrum Hybrid approaches.Spearheaded a transformative initiative, integrating Salesforce CRM to revolutionize the Account Opening Process, elevating system efficiency, data consolidation, and regulatory compliance (ISO 20022, 27001) for enhanced data security within the financial industry.Gathered business requirements by employing interviews, surveys/questionnaires, workshops, brainstorming, document analysis, focus groups, JAD, storyboarding, data mining, reverse engineering, contextual inquiry, user story mapping, and Delphi technique.Performed documentation like Business Requirements Document (BRD), System Requirements Specification (SRS), Functional Requirements Document (FRD), Requirement Traceability Matrix (RTM), Business Case Document, Systems Design Document, Use Case Document, User Stories, Process Flow Diagrams, Data Flow Diagrams, Entity-Relationship Diagrams (ERD), and User Manuals.Hands-on experience with Policy Center, Billing Center, and Claim Center for Guidewire Insurance Suite, including comprehensive configuration of user stories to tailor solutions to business needs.In-depth understanding of Insurance Policy Admin, Underwriting, Billing & Claims Systems, Payment transactions, and Document Management, ensuring optimal functionality and efficiency.Gathered all applications used by Property and Casualty users across all Business Units like Claims, Consumer, Underwriting, and Specialty LinesOptimized business performance through extensive analysis methods such as Gap, Impact, Stakeholder, feasibility, risk, cost-benefit, SWOT, root cause, and competitive analysis.Comprehensive assessments guided informed decision-making, effectively mitigated risks, and facilitated the optimization of operational processes. By leveraging insights, we streamlined operations, identified areas for improvement, and strategically enhanced overall business functionality, ensuring sustained growth and competitiveness.Experience with Data Mappings including HIPAA ANSI X12, 4010 and 5010 ICD9 and ICD-10 implementation guidelines electronic formats including for institutional, professional, and commercial claims.Worked on different EDI healthcare transactions like 837-Institutional, 837-Professional, 837 - Dental, 835-Claim Payment/ Remittance Advise, 270/ 271 - Eligibility Benefit Inquiry/ Response, 276/ 277 - Claim Status Inquiry/ Response Transactions.Good knowledge of Health Insurance Plans (Medicare Part A, B, C and D), managed care concepts (Medicaid and Medicare) and experienced in determining the membership eligibility, billing experience within life and disability in health plans.Conducted successful projects with the help of teams to achieve deadlines timely and proficiently AND Worked on FACET claim processing system.Utilized MS Visio, Lucidchart, Balsamiq, Figma, Adobe XD, and BPMN tools to create UML (Sequence, Activity, and Use Case), BPMN diagrams, wireframes, and prototypes, ensuring clear visualization and effective communication in software development.Experienced in Scrum environment, actively participating in Sprint Planning, Daily standup, Sprint Review, and Sprint retrospective and documented Product Backlog, Sprint backlog, and burn-up/burn-down charts, High and low-level grooming sessions.Proficient in data mapping, data profiling, ER diagrams, data cleansing, normalization, databases, data analysis, data integration, data modeling (Conceptual, Logical, and Physical), OLAP operations (Roll-up, Drill down, Slicing and dicing), and data governance.Directed successful data migrations, ensuring seamless alignment with business goals. Leveraged robust analysis and utilized Informatica PowerCenter for quality assurance and risk mitigation, streamlining efficient transfer processes.Proficient in SQL, adept at crafting complex queries, utilizing various joins (inner, outer, left, right) to consolidate and analyze data from multiple tables.TECHNICAL SKILLS:Project Management Tools MS-Project, MS Share Point, JIRA, Rally, Team Foundation Server,Confluence, Trello Load RunnerLanguages C#, SQL, Python C++, R, HTML, .Net, VB 6.0, VB.NET and VBARequirement Management MS Office, JIRA, Version-One, HP ALM, Blue PrintData Profiling and Scrubbing DQ Analyzer, DataFlux Management StudioBI and Reporting Tools MS office Suite, Tableau, IBM Cognos, QlikView, Power BI, Crystal, OBIEE,Looker, OmoModeling Tools Rational Rose, MS Visio, Gliffy, Erwin, Balsamiq, Justin Mind, Invision, LucidchartETL Tools Informatica Power Centre 7.x/8.x/9.x, SSIS, IBM Data StageDatabases MySQL, SQL Server, H-base, MS Access, Oracle, Teradata, IBM DB2Oracle, Snowflake, MongoDB, HadoopOffice Tools MS Word, MS Excel, MS SharePoint, MS Project, MS Visio, MS AccessVersion Control Tools Bitbucket, GitHub, Source TreeAPI Testing Tools Testrail, JIRA, Load Runner, Selenium, HP ALMSwagger, POSTMAN, Jenkins, SoapUI,Analytics Tools MS Excel, MS Access, Power BI, Tableau 9.1Defect Tracking Tools Test Director, HP ALM, JIRAUI/UX Design Tools Figma, Adobe XD, SketchCollaboration Tools Slack, MS Teams, ZoomWORK EXPERIENCE:Client: UnitedHealth Group, Phoenix, AZ October 2022-PresentRole: Senior Business AnalystDescription:A leading healthcare company where I serve as a Healthcare Business Analyst, focusing on translating business requirements into user stories and technical specifications. Expertise includes healthcare claims processing, HIPAA compliance, and collaboration with stakeholders to drive project success and SDLC adherence.Responsibilities:Translate business requirements into user stories, use cases and technical requirementsCollaborate with Product Owners, Subject Matter Experts (SMEs) and end-users to understand product backlog and develop detail acceptance criteria for user storiesWork closely with the ScrumMaster to establish Release, and resolve impedimentsConduct grooming sessions to prioritize user stories in the backlog for future sprints.Interact with business owners, SMEs, and management team to identify the scope of the project and to prepare Use Case, and Activity Diagrams to further develop technical requirements for developmentEnsure that project documentation is complied with SDLC policies and guidelines.Facilitate defect review meetings involving stakeholders to review defects, identify severity and set priorities as per client requirementsSuccessfully transitioned 20+ complex dashboards from OBIEE to Google Looker over a 6-month period, achieving a 99% accuracy rate in data mapping and visualization.Developed and customized 15+ interactive reports and dashboards in Google Looker, leading to a 30% increase in data accessibility and user engagement.Managed and optimized 10+ dashboards, ensuring data accuracy and consistency, resulting in a 20% reduction in report generation time.Created and refined 30+ interactive dashboards in Tableau, enhancing data visualization capabilities and supporting a 25% increase in data-driven decision-making.Integrated data from 15+ sources into Tableau, ensuring comprehensive and accurate analysis, which improved report accuracy by 35%.Developed 20+ custom data models and reports in PowerBI, providing tailored insights and contributing to a 20% improvement in reporting accuracy and timeliness.Executed over 200 complex SQL queries for data extraction and analysis, managing datasets of up to 10 million records, ensuring precise and reliable reporting outcomes.Applied Epic Clarity Revenue Data Model to analyze and report on healthcare revenue cycle data, supporting accurate financial reporting and compliance, impacting 5+ major revenue processes.Ensured compliance with industry standards through detailed data analysis, resulting in a 15% improvement in regulatory reporting accuracy.Produced over 100 detailed reports and documentation using Microsoft Office and Google Suite tools, facilitating clear communication and effective project management.Managed and collaborated on 20+ projects using shared documents and tools, enhancing team coordination and project efficiency by 25%.Use Jira to create and manage product and sprint backlog.Review test results and report bugs/issues using JIRA.Develop and execute SQL query to analyze data and validate data.Assist QA to write and execute test cases.Worked on Member Management, Eligibility, Claims, and Provider modules within Facets.Conducted extensive analysis on migration and conversion of Provider and Member data.Clarified QA team issues and reviewed Test Plans and Test Scripts developed by Development team and QA team to make sure all requirements have been covered in scripts and tested properly.Worked in Healthcare Claims Processing (837/835/834) includes facility claims and professional claims.Coordinated the upgrade of Transaction Sets 837P, 835 and 834 to HIPAA complianceValidate EDI Claims Process according to HIPAA compliance.Performed Gap analysis by identifying existing technologies, documenting the enhancements to meet the end state requirements.Responsible for checking member eligibility, provider enrollment, member enrollment for Medicaid and Medicare claims.Performed claims adjudication using Facets.Was responsible for tracking issues that are detected and updating the status of existing issues based on the daily meetings with the offshore team.Clear understanding of Medicare (Part A, Part B and Part D) and Medicaid benefits as well as business processing.Worked with project manager and other users and created workflow diagrams using MS Visio/UML.Worked directly with software engineers to ensure clear communications on requirements and defect reports.Environment:Jira, SQL, Facets, MS Visio, .Net, PostgreSQL, PL/SQL, Oracle, SharePoint, LoadRunner, BlazeMeter.Client: Barclays, Jersey City, NJ November 2020-September 2022Role: Senior Business AnalystDescription:The project focused on integrating Guidewire Suite to enhance insurance processes. Developed and configured solutions for Policy and Billing Centers, documented business flows, and created data visualizations with Tableau. Supported agile development by managing requirements, performing testing, and ensuring system integration.Responsibilities:Participated in brainstorming sessions with project managers and SMEs to understand requirements for the Guidewire Suite, contributing to the development of the Business Requirements Document (BRD).Collaborated with business stakeholders to gather and document current and future business flows in Guidewire Insurance Policy Center.Configured user stories within Policy Center and Billing Center during development sprints and created translation documents for requirements between the two systems.Contributed to backlog meetings, demoed user stories for acceptance criteria, and participated in retrospective meetings.Designed and implemented 25+ multi-dimensional reports in OBIEE, integrating data from 10+ disparate sources, which improved decision-making efficiency by 40%.Managed overall Requirements Management and built the Requirements Traceability Matrix to monitor project progress.Designed and optimized 10+ database schemas, improving data retrieval performance by 25% and supporting efficient data management.Developed 15+ detailed database schemas, improving data organization and accuracy, which enhanced reporting capabilities and reduced data inconsistencies by 30%.Created 10+ data flow diagrams, aiding in the design of efficient data systems and ensuring a 20% reduction in data processing errors.Involved in generating Test cases for property and casualty Insurances for Different Levels of Business.Developed a file of ACORD Forms used as the standards in all Property and Casualty markets, for both Personal and Commercial Lines of Business integration requirementsCreated various project documents including project scope documents, functional requirement documents, non-functional requirement documents, and user interface documents.Updated Business-related documents and Project Deliverables on Confluence, Lotus Notes, and SharePoint Project Repositories.Conducted JAD and JRP sessions with stakeholders for various use cases related to Policy Center and Billing Center functionalities.Created UI mock-ups based on Insurance user requirements for premium, rating, underwriting, losses, and billing.Supported development team during design and implementation phases of agile development process, and participated in analysis and testing phases.Created UML diagrams including Use Case Diagrams, Activity Diagrams, and Sequence Diagrams using Smart Draw.Constructed process flows for policy transaction types and collaborated with business users and SMEs on workflows.Interacted with the Guidewire Billing center team to understand stakeholder requirements for billing plans, payment allocation plans, and return premium plans.Conducted integration and data content discussions with various teams for integration points between systems.Developed Tableau data visualizations using cross tabs, heat maps, pie charts, and bar charts.Wrote SQL queries for data filtering and integration between policies and billing, managing defects using JIRA.Performed smoke testing and collaborated with testing team for Progression and Regression Tests for new Guidewire functionalities.Formulated the ER diagrams of Property and Casualty data and data flow diagrams in order to interact with database developers.Migrated data from legacy systems to Guidewire Billing Center using Guidewire data hub process.Developed Tableau dashboard reports and KPIs, consulting with business clients and collaborating with developer teams.Created dual-axis bar charts with multiple measures for effective data visualization.Environment:Guidewire Suite, Jira, Tableau, Smart Draw, SQL, Confluence, Lotus Notes, SharePoint, ER Diagrams, UML, JAD/JRP sessions, Legacy Systems Integration.Client: Celonis, New York, NY April 2018-November 2020Role: Business AnalystDescription:Developed Salesforce CRM solutions for efficient data management and account opening. Implemented custom features, managed ETL processes, and utilized SQL, Tableau, and AWS QuickSight for data analysis and reporting.Responsibilities:Leveraged Salesforce platform to create a unified customer data repository, facilitating a 360-degree view of client interactions and transactions, enabling personalized services, and improving overall customer satisfaction and Streamlined Account Opening.Designed and implemented custom Salesforce Lightning components and Visualforce pages to meet specific project requirements, enhancing the user experience, and enabling tailored functionalities for financial services and compliance needs.Developed comprehensive documentation including Business Requirements Document (BRD), Functional Requirements Document (FRD), System Requirements Specification (SRS), and User Manuals using Confluence for content collaboration.Conducted stakeholder interviews, workshops, and Joint Application Development (JAD) sessions to elicit, analyze, and prioritize business needs and functional requirements and performed gap analysis, As-is, and To-be analysis on the AOX process.Collaborated with stakeholders to align the organization's objectives, system capability, and financial regulatory guidelines.Employed techniques like MoSCoW (Must-have, Should-have, Could-have, Won't have) to prioritize project requirements based on business value, risk and leveraged Story Points and Planning Poker to accurately estimate the effort and duration.Utilized UML diagrams such as use case, sequence, and activity diagrams using tools like Visio and Lucidchart to visually represent securitization workflow, system interactions, and data flows in the securitization system for asset-backed securities.Employed UI/UX design methodologies by creating intuitive user interfaces through tools like Figma, Adobe XD, and InVision, implementing mockups, wireframes, and prototypes to enhance the user experience and ensure streamlined account opening and compliance functionalities within Salesforce CRM.Implemented JavaScript, HTML, and CSS within Salesforce Lightning components and Visualforce pages to create tailored functionalities and enhance the user experience, ensuring streamlined account opening and compliance enhancement.Facilitated key Scrum ceremonies (Backlog Grooming, Sprint Planning, Daily Stand-up, Sprint Review, and Sprint Retrospective) for collaboration, transparency, and iterative development in alignment with Agile principles and established the Definition of Ready (DoR) and Definition of Done (DoD) criteria to ensure the clarity and completeness of requirements and deliverables.Leveraged OLAP (Online Analytical Processing) and OLTP (Online Transaction Processing) techniques within Salesforce CRM to analyze and gain actionable insights from extensive customer data, employing advanced data mapping and migration strategies to seamlessly integrate information from legacy systems, ensuring data consistency and accuracy in real-time interactions.Employed SQL extensively for tasks involving data retrieval, manipulation, and analysis, which encompassed optimizing complex joins and aggregation, applying filters, executing CRUD operations, creating stored procedures, and scheduling CRON jobs for automation.Also utilized window functions for analytics and crafted scripts for ETL (Extract, Transform, and Load) processes.Engineered ETL (Extract, Transform, and Load) procedures for seamless data migration and integration among source systems by harnessing the capabilities of informatica PowerCenter.This involved constructing workflows, mappings, transformations, SQL overridden tasks, scheduling sessions, and workflows, as well as implementing error and exception handling via event handlers.Successfully Configured and customized Salesforce CRM workflows, automation rules, and triggers to streamline data capture and processing, significantly improving the efficiency of customer onboarding processes and ensuring rigorous compliance checks.Implemented ISO 20022 standards within Salesforce CRM to enhance the interoperability and consistency of financial data messaging, ensuring seamless communication and compliance with global financial industry standards.Streamlined Automated Clearing House (ACH) processes by integrating ACH functionalities within Salesforce CRM, optimizing transactional efficiency and compliance with electronic payment standards.Drove the implementation of comprehensive data governance initiatives within Salesforce CRM, which included the establishment and strict enforcement of data policies, industry-specific standards, and meticulously defined procedures to foster accountability, data ownership, and meticulous data management, ensuring data quality, accuracy, and regulatory compliance.Developed comprehensive CRUD (Create, Read, Update, Delete) for API documentation, detailing endpoints, payload structures, and conducted API testing (test cases, test plans) using tools like Postman to verify API functionality, integrity, & error handling.Implemented and rigorously upheld robust data quality management strategies, meticulously ensuring the accuracy, consistency, and reliability of data to empower well-informed decision-making, all within the framework of stringent data governance protocolsWorked with the QA team to create comprehensive end-to-end test strategies, defining test parameters, environments, and inclusive coverage.Created test scenarios and cases using Tricentis Tosca aligned with user stories, encompassing various edge cases.Recorded identified issues with accompanying screenshots in JIRA for transparent and streamlined issue tracking.Leveraged Jira, Confluence, and SharePoint to effectively manage, plan activities, monitor, document, & track progress.Utilized AWS QuickSight to create visually compelling dashboards and reports, enabling stakeholders to gain actionable insights, monitor key performance indicators (KPIs), and make informed decisions for the Securitization of Asset-backed securities.Created Tableau-based ROI reporting by establishing connections to SQL databases.Environment:Salesforce CRM, Lightning Components, Visualforce, Confluence, JIRA, Figma, Adobe XD, InVision, Visio, Lucidchart, SQL, Informatica PowerCenter, OLAP, OLTP, AWS QuickSight, Tableau, Postman, Tricentis Tosca, ISO 20022, ACH, ETL Processes, HTML, CSS, JavaScript.Client: Atrium Health, Charlotte, NC March 2016-April 2018Role: Healthcare Business AnalystDescription: Mapped business requirements to system implementations, prepared detailed documentation, and managed user stories and backlog using Jira. Led FACETS implementation, ensured HIPAA 5010 compliance, and performed data analysis and validation with SQL.Responsibilities:Conduct gap analysis between the current system and new requirements to be implemented thereby mapping the business requirements to the applicationInvolved in training and test session on HIPAA Privacy policy.Prepared high level and detailed system requirements documents for the application.Actively participated in daily Stand-Up meetings and Sprint Planning meetingsWorked with internal stakeholders creating, prioritizing, and monitoring application feature/issue backlog.Created and maintained user stories using Jira.Analyzed HIPAA 5010 standards for 837P transactions, related to providers, payers, subscribers and other related entitiesIdentified the requirements for accommodating HIPAA 5010 standards for 837P transactions and captured these requirements to develop new GUI for the internet-based applicationManaging and Billing Medicare, Commercial HMO/PPO claims daily.Involved in FACETS Implementation, involved end to end testing of FACETS Billing, Claim Processing and Subscriber/Member module.Extracted data from various sources using SQL queries as per the requirements.Used SQL queries to validate data sets.Set claim processing data for different Facets Module.Involved EDI Claim Process according to HIPAA compliance.Involved in daily Scrums to determine the status of the project and impediments if anyInvolved in sprint planning meeting to identify the tasks for the sprint and getting team members acceptance/ commitment for the assigned tasks.Involved in Sprint review meeting with the team and stakeholders to review the achievements from the sprint and get approvalsIdentified the requirements that go in each sprint, collect them in the sprint backlog and collecting and managing the requirements that are not part of the current sprint into the product backlogWrite high-level and low-level business requirements and design mock-up screens for the applicationAnalyzed the existing data model and provided suggestions and recommendationsTranslated the requirements prepared for SDLC methodology to User Stories and implementing Agile methodology as a standard for the ongoing projectWrote user stories and acceptance criteria for the requirements of the projectInvolved in daily scrum meeting to discuss any roadblocks or impediments in the project pathInvolved in sprint planning session to identify the features and functionalities that should be achieved by the new applicationPreparing Requirements Traceability Matrix and Test cases to ensure the desired functionalities are presentIdentified various points of integration among the new and existing applications and required integration with other IT componentsWorked closely with the business team, development team and the quality assurance team to ensure that desired functionalities will be achieved by the applicationProvided business and technical suggestions and recommendations during the project life cycleEnvironment:FACETS, HIPAA 5010, EDI Claims, SQL, Jira, Agile, SDLC, Microsoft Office, Confluence, MS Visio, Data Modeling, Scrum, Daily Stand Up Meetings, Sprint Planning, Sprint Review, Testing and Validation, Backlog Management, Business Requirements Documentation.Client: Arvan technologies Pvt Ltd, India June 2012-July 2014Role: Business AnalystDescription: At Arvan Technologies, analyzed financial instruments and business processes to improve operations. Facilitated JAD sessions, designed dashboard mockups with Balsamiq, and developed BRDs and SRS documents. Led data ETL processes using Informatica and created insightful reports with Tableau for stakeholders.Responsibilities:Developed an in-depth understanding of financial instruments such as Portfolio, Asset Allocation, Commodities, Corporate Bonds, Money Market Instruments, ROI, Yield, Liquidity, Volatility, and Dividend.Conducted structured walkthroughs using workflow diagrams to identify, understand, and analyze processes, aiming to improve business operations through Business Process Reengineering (BPR) and modeling.Facilitated Joint Application Design (JAD) sessions with business stakeholders and engineers to gather and understand dashboard requirements, including charts, KPIs, filters, and drill-downs.Utilized Balsamiq to design dashboard mockups and wireframes, which were shared with BI developers.Analyzed prior documentation and business processes for a full understanding of the project. Conducted interviews with Subject Matter Experts (SMEs) and stakeholders, carefully recording requirements.Created use cases, use case diagrams, workflow diagrams, and sequence diagrams based on user requirements using MS Visio for visual representation.Contributed to the development of the Business Requirement Document (BRD) and the System Requirement Specification (SRS), conducting analysis, refinement, verification, and validation of these documents.Managed requirement changes by performing impact analysis and assessing the feasibility of maintaining the project's scope, schedule, and budget constraints.Participated in data normalization and implemented data verification and validation processes to maintain data precision and efficiency.Implemented all stages of the data development process, including extraction, transformation, and loading (ETL) of data from various sources into the data warehouse and data marts using Informatica Power Center - Repository Manager, Workflow Manager, and Monitor.Assisted in creating a deployment flowchart in collaboration with development, infrastructure, and network teams to provide a visual representation and facilitate collaboration, reduce errors, and improve the efficiency and reliability of application deployments.Collaborated with the QA team to facilitate the execution of functional and regression testing processes.Leveraged Tableau to create insightful and visually compelling reports, empowering stakeholders with data-driven insights.Environment:Informatica PowerCenter, Tableau, Balsamiq, MS Visio, Business Process Reengineering (BPR), Data ETL, Workflow Diagrams, Joint Application Design (JAD), Business Requirements Document (BRD), System Requirements Specification (SRS), Data Warehousing, Data Validation, Business Analysis, Reporting and Visualization, Confluence.EDUCATIONPace University, New York (2015)Master of Science in Information systems |
