Business Analyst for the Vedic Sadhana Foundation

Perform coordination with multiple different teams and departments. Engage in Human resource activities and work on front gate management. Work on other office file management and day to day admin responsibilities.

• Responsible for requirement analysis and elicitation for Health Insurance Marketplace project; a key component of the PPACA (Patient Protection Affordable Care Act) aka Obamacare.• Provide business analysis and lead requirements for the Federal and State-based Exchanges (MHBE and DCHBX) as part of the Affordable Care Act. • Worked with the technical team to complete application development, and communicated system requirements to software engineers via functional specifications, flow… Show more • Responsible for requirement analysis and elicitation for Health Insurance Marketplace project; a key component of the PPACA (Patient Protection Affordable Care Act) aka Obamacare.• Provide business analysis and lead requirements for the Federal and State-based Exchanges (MHBE and DCHBX) as part of the Affordable Care Act. • Worked with the technical team to complete application development, and communicated system requirements to software engineers via functional specifications, flow charts, use cases, and process diagrams.• Analyze the needs of the client to help identify any technical and business problems, illuminate any gaps that exist in the SDLC framework, and provide solutions that could improve processes.• Lead design, elaboration and implementation of business processes, also actively participate in the requirements, design phases; delivering high quality deliverable.• Involved in conducting Joint Application Development (JAD) sessions for project definition involving analyzing requirements, creating prototypes, user interface, wireframes, database schema and system design.• Prepare System Requirements Specifications, Project Requirement Documents from the defined Business Requirements, in conjunction with the Architects and the System Component Technical team.• Prepare the Requirements Traceability Matrix to trace the Requirements from Business Requirements through to the Test Cases to ensure that the Compliances are captured at each phase.• In Depth knowledge in FACETS Front End applications for the Enrollment and Eligibility Module.• Hands on experience in project management activities including scheduling project kick off meetings, creating project schedule, coordinating with cross functional groups, requesting QA content packages and also well versed in project management tools like MS-Project for status reporting and planning. Show less

•Conducted and performed analysis of EDI transactions sent from FFE and other State Based Exchanges. •In depth analysis, understanding and breakdown of FFM and SBE companion guides for 834 and 820 transactions. •Working as a Senior EDI BA to translate the companion guides rules into requirements for our development teams. •Responsible for requirement gathering and analysis for enrollment and premium payment system for SBE’s.•Strong knowledge of existing Federal and state-level… Show more •Conducted and performed analysis of EDI transactions sent from FFE and other State Based Exchanges. •In depth analysis, understanding and breakdown of FFM and SBE companion guides for 834 and 820 transactions. •Working as a Senior EDI BA to translate the companion guides rules into requirements for our development teams. •Responsible for requirement gathering and analysis for enrollment and premium payment system for SBE’s.•Strong knowledge of existing Federal and state-level initiatives for health insurance exchange.•Configuration and setup of rules and validations in our TIBCO Foresight Validator. •Point of contact to work with CMS for issue resolutions for EDI related concerns and queries. •Client interaction on a regular basis to capture requirements, conduct gap analysis, and translate them into business requirements and functional specification documents •Translate EDI information into technical design documents using State’s/FFE HIPAA compliance companion guides•Serving as an SME for the development team and clients for all HIX related implementation projects.•Performed in depth gap analysis between 820 v218 vs v306 for one of our clients to help them implement a system which allow them to perform this conversion. •Related Skills: MS Project, MS Visio, Excellent presentation skills, MS Excel •Technology and Tools Used: TIBCO Foresight EDISM, TIBCO Foresight Validator Show less

• EDI Hosted Support: Providing support to112 TriZetto Clients in Hosting services. • Strong ability to understand and troubleshoot issues related to processing of claim processing and adjudication. • Experienced in understanding and analyzing 999/997 to provide client with RCA regarding the acceptance/rejection of member eligibility issues. • Worked with internal and external customers to elicit requirements. • Strong background in claim processing (X12 Transactions) in Real… Show more • EDI Hosted Support: Providing support to112 TriZetto Clients in Hosting services. • Strong ability to understand and troubleshoot issues related to processing of claim processing and adjudication. • Experienced in understanding and analyzing 999/997 to provide client with RCA regarding the acceptance/rejection of member eligibility issues. • Worked with internal and external customers to elicit requirements. • Strong background in claim processing (X12 Transactions) in Real Time and through Batch. • Providing support to newly 5010 upgraded customers. • Hands-on experience in development, implementation and production activity associated with X12 Transaction set (270/271, 276/277, 834,837,835) • Responsible for supporting clients using different products like FACETS, QNXT, QicLink and ClaimsExchange. • Multitask projects including EDI mapping, system support. Client and vendor problem resolutions and test processes. • In-depth understanding of technical design of the system. • Strong experience in setting up new Trading Partners on BizTalk 2006, 2009. • Perform the testing of the changed maps and scripts by preparing test cases and test files • Provide timely reporting to management regarding production issues and trends. • Prioritized outstanding defects and system problems, ensuring accuracy and deadlines were met. • Act as a liaison between developers and end users to ensure technical compatibility and provide written business requirements for development projects. • Review technical specification documentation to ensure the software developed met the business and functional requirements. • Analyze Systems/Application requirements and translate user and or system requirements into functional specifications for both on-shore and off- shore teams. • Responsible for providing support to clients like UNITED, CMC, LHP, QCA, BCN, NHP, Fallon etc. • Well versed in processing and handling a lot of Third Party Administrators. Show less

• IT Business Analyst: responsible for identifying and implementing enhancements to http://ilovemountains.org• Successfully designed and created an extensive database of Mountain Top Removal permits.• Identified, resolved and provided recommendation for Database performance issues. • Technology Used: MAMP’s, VISIO, UML

Project Name: OLTP (Online Transaction Processing) Client: First Data Commercial Services (Gift Cards) Nov 2005-May 2008• Roles and responsibilities: Programmer Analyst.• Worked with QA team to design test plan and test cases for User Acceptance Testing (UAT). • Created Issue Resolution documents and Unit test plans for multiple project enhancements.• Participated in TQM corrective action team to streamline and improve coding methods… Show more Project Name: OLTP (Online Transaction Processing) Client: First Data Commercial Services (Gift Cards) Nov 2005-May 2008• Roles and responsibilities: Programmer Analyst.• Worked with QA team to design test plan and test cases for User Acceptance Testing (UAT). • Created Issue Resolution documents and Unit test plans for multiple project enhancements.• Participated in TQM corrective action team to streamline and improve coding methods and procedures. • Awarded ‘Syntel Star Award of Excellence’ for contribution to the company. Show less