Business Analyst
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• Over 8 years of work experience as Business Analyst/ Business System Analyst/ Data Analyst in IT field with hands on experience with Data Warehouse, Provider Audit, AP-DRG, Data evaluation, Underwriting. • Worked closely with project stakeholders, SMEs and testing staff to understanding the requirements and specifications for new applications along with re-engineering the existing applications. • Excellent writing skills in preparing Business Requirements Documents (BRD), Software Requirements Specifications (SRS), Use case classifications, System Design Specification (SDS), Inventory Management, Requirement Traceability Matrix(RTM) across the Deliverables of a project. • Experience in Business Analysis methodologies, Iterative and Incremental Software Development Life Cycle (SDLC) using Rational Unified Process (RUP). • Successfully created UML diagrams, Functional Requirement Specifications (FRS) and User Requirement Specification (URS) documents and implemented processes, procedures, guidelines and policies for the Development and QA Teams. • Performing Gap Analysis, SWOT Analysis, RISK Analysis, and COST/BENEFIT Analysis. • Proficient in gathering business and technical requirements from both formal and informal sessions through interviews, NetMeeting, questionnaire, video conferencing, JAD sessions and conference calls. • Researched client and internal data integrity issues using SQL database queries, Business Objects reporting, and other forms of analysis. • Strong Experience in Claims Processing and Claims Scrubbing in HMO, PPO, Medicaid and Medicare. • Worked on healthcare standards such as HIPPA 4010, 5010, DICOMM, CPT, ICD-9 and SOAP. • Experience in working with HHS, CMS or Medicaid Programs, RHIOs, IHDNs. • Experience in EDI (270,271,835,834,837) transactions. • Possess excellent knowledge on, HIPAA Compliance, Healthcare Information Technology (HIT) Standards and NHIN. • Expertise in ICD-9 to ICD-10 Conversion.
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