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Pankti
Panktidalal6368@gmail.com
732-723-7334
Piscataway, NJ 08855
Sr.Business Analyst
7 years experience W2
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Summary

  • Extensive experience of 7+ years as a Business analyst with extensive working knowledge in healthcare domain
  • Extensive knowledge and experience in Software development life cycle (SDLC) like Agile/Scrum, Waterfall.
  • Proficient in Elicitation techniques like interviewing, questionnaires, brainstorming, focus groups, prototyping, cost/benefit analysis and risk analysis and incident management sessions.
  • Proficient in Technical writing (FRD) and Business Writing (BRD).
  • Expertise in gathering of requirements through research, formal-informal sessions, JRP sessions and JAD sessions with SMEs (subject matter experts), Teams, Stakeholders and end users.
  • Performed Gap Analysis, Analyzed and documented current state and future state of a system (AS IS
  • TO be), Identified and Documented Change Request, Use Case, Functional Design Document, Story Boards and User Stories, Sprint Planning, User Story Estimation, Screen Mockups.
  • Expertise in preparing and reviewing User Requirement Specifications (URS), Functional Requirement Specifications (FRS) and Design Specifications (DS) in compliance with applicable FDA rules and regulations.
  • Strong knowledge of Health Insurance Portability & Accountability Act (HIPAA) standards, Electronic Data Interchange (EDI), Implementation and knowledge of HIPAA (Health Insurance Portability and Accountability Act) code sets, ICD-10 coding, HMO, PPO.
  • Experience in facilitating Joint Requirement Planning (JRP) sessions with Business User Groups, conducting Joint Application Development (JAD) sessions with IT Groups and Conflict Management with Project team members.
  • Conducted and participated in and all Agile SCRUM ceremonies including Daily SCRUM meetings, Sprint Planning, Backlog Grooming, Demo, Sprint Retrospective etc.
  • Experienced in creating EPICS, USER STORIES, USE CASES and further refining with detailed ACCEPTANCE CRITERIA.
  • Written Use cases and have produced Use Case Models, creating Behavioral diagrams (use case diagram, Activity diagrams and Sequence diagrams) based on UML Methodology & Business process flow diagrams.
  • Excellent experience on writing database queries (SQL).
  • Participated and conducted design walkthroughs and Inspection review meetings, experienced in conducting User Acceptance Testing (UAT) and documentation of Test Cases. Expertise in designing and developing Test Plans and Test Scripts and Involved in maintaining Test Matrix and Traceability Matrix and performed Gap Analysis.
  • In depth Knowledge about HIPAA Compliance, Medical Plans such as HMO, PPO, POS, EPO, and Medicare/Medicaid.
  • Excellent communication and interpersonal skills, self-starter, proven experience in working independently and in a team, timely delivery against aggressive deadlines.

Experience
Sr.Business Analyst
Insurance
Jul 2019 - May 2021

EmblemHealth is one of the United States' largest nonprofit health plans. It is headquartered at 55 Water Street in Lower Manhattan, New York City. Roles & Responsibilities:

  • The system streamlined patient registration, patient scheduling, and medical insurance checking, claims processing and reporting.
  • Involved in certain modifications to the claims processing system.
  • Gathered, managed, and documented business and functional requirements, communicated effectively with upper management, developers and QA Engineers.
  • EDI files successfully verified and processed into respective Database.
  • Gathered requirements by interacting with Stakeholders.
  • Performed GAP Analysis based on business needs and prioritized requirements.
  • Implemented software quality assurance development policies and test procedures.
  • Completed the documentation of Claims scenario's for the source system.
  • Helped in prioritizing, refining and managing Product Backlog.
  • Documented user stories to define the functionality the system must provide.
  • Created Story Boards and plans of project flow.
  • Coordinated User Acceptance Testing and helped in identifying relevant test data and reporting metrics.
  • Created Data Mapping Documents from source to target system.
  • Designed data models in collaboration with data architect and data modelers.
  • Competent in creating requirement traceability matrix (RTM) to list all the requirements and ensured all required documents like use cases, test cases are written and compiled.
  • Provided key initiatives in working with users in defining project and system requirements.
  • Helped in creating ER Diagrams defining entities, attributes, relationships and business rules.
  • Queried the databases writing complex SQL and presented the reports.
  • Engage client to gather software requirements/Business rules, and ensure alignment with development teams. Environment/Tools: Tableau, MS Visio, SQL, JIRA, Axure, Storyboarding, Star UML, Lucid Chart, Oracle DB, HP ALM, Jira.
Data Mapping SQL UML JIRA HP ALM MS Visio ERD (Entity Relationship Diagram) UAT Test Case Preparation Storyboarding Gap Analysis Business Analysis
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Business Analyst
Insurance
Mar 2016 - Jun 2019

Aetna Inc. is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, insurance and benefit programs, and through Medicare Roles & Responsibilities:

  • Upgraded and enhanced the existing user interface and organization's web portal and internal claim and billing systems to improve performance, user interface and user experience.
  • Conducted weekly meetings for deciding the policies and Procedures to be followed while upgrading systems.
  • Performed the requirement analysis, impact analysis and documented the requirements.
  • Documented the requirements for billing system, cash management module and enhanced the encrypting standards that are required for the application.
  • Created and managed Business Requirement Document, Use Cases for the upgraded functionality.
  • Followed a systematic approach to eliciting, organizing and documenting requirements of the system.
  • Reviewed the Joint Requirement Documents (JRD) with the cross functional team to analyze the High Level Requirements.
  • Analyzed and translated business requirements into system specification utilizing UML methodology.
  • Interacted with line of business managers and coordinated the transition into the security database to ensure business compliance with HIPPA.
  • Developed UML Use Cases using Rational Rose and developed a detailed project plan with emphasis on deliverables.
  • Reviewed basic SQL queries and edited inner, left, and right joins in Tableau by connecting live/dynamic and static datasets.
  • Developed Technical Documentation
  • System Analysis created Design Documents, Technical Specification Documents, System Context Diagrams, Interface Control Documents and Service Level Agreements.
  • Collaborated with testing teams for running detailed UAT tests before roll out.
  • Created snapshot views and reporting views to support various customer needs.
  • Verified the data models and data dictionaries.
  • Identified critical data elements and responsible for defining name, definition and various data attributes.
  • Facilitated discussions and workshops with senior business and technology stakeholders.
  • Performed data reconciliation with source systems and reporting systems.
  • Responsible for conducting GAP Analysis.
  • Participated in Scrum Sprint Planning, Daily Stand-Up, Sprint Review and Sprint Retrospectives. Environment/Tools: MS Visio, Excel, MS Office 365 (SharePoint, Project, PowerPoint, Visio), EDI, Rational Requisite Pro, MS Access, SQL, JIRA, Oracle 12, HP ALM, UML.
Business Analysis Compliance Data Dictionary EDI HIPAA Microsoft Excel SQL System Analysis UML UAT Stakeholder Engagement Pharmaceutical Medicare HP ALM JIRA Scrum
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Business Analyst
Information Technology
Jun 2014 - Feb 2016
The project was to build data driven strategies to support business operations. The goals were to produce models, create forecasts reports, and predict trends to assist senior management for more effective decision making on Access and identity management. Roles & Responsibilities:
  • Often leads responsibilities related to capturing action items and tracking milestones in team project environments.
  • Gathered requirements and evaluation/analysis of their data and also conducted JAD Sessions to develop an architectural solution that the application meets the business requirements.
  • Created and maintained Business Requirements Documents [BRDs], Functional Requirements Documents [FRDs] and system requirements specifications (SRS).
  • Used MS SharePoint to Upload and share various documents like BRD, FSD, design document, test cases, RTM (Requirement Traceability matrix) and other deliverables with other teams and departments.
  • Interface between application stakeholders and the technical engineers who are responsible for the overall onboarding process of moving applications between the legacy and new systems.
  • Analyze data provided by the application technical teams to ensure it is accurate and complete, validate that it passes pre-checks to provide the accurate onboarding of the datasets involved and that it will integrate properly.
  • Manage timelines by ensuring that deadlines are met by adhering to project guidelines, working within team and client provided schedules and managing client expectations.
  • Developed business use cases, generated UML based diagrams for a better understanding of the user community.
  • Reviewed basic SQL queries and edited inner, left, and right joins in Tableau by connecting live/dynamic and static datasets.
  • Assisted architects in designing design document which has logical and physical architecture along with data models.
  • Finalized the querying considerations and validated the database against the reporting requirements.
  • Interacted with system developers to resolve questions and discrepancies in Business Requirement Documents.
  • Assisted in development of Test Scenarios and documented Test Plans that contains test scripts, test cases, test data and expected results for the System Integration, Functional testing, Performance and User Acceptance Testing.
  • Assisted in preparation of UAT test plan, Test Cases, Testing Cycle schedules, Test Scenarios and implemented them with QA team Created, functional test materials, set up test plans, schedules and scenarios. Environment: Waterfall, MS Excel, MS SQL 5.5, Rational Requisite Pro, Rational Rose, Rational Clear Quest.
BRD Business Analysis Microsoft Excel SQL UML UAT Test Planning Test Case Preparation Functional Testing JAD Waterfall Rational Rose
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Edit Skills
Non-cloudteam Skill
Education
Pioneer College
Skills
Business Analysis
2021
6
SQL
2021
6
UAT
2021
6
UML
2021
6
HP ALM
2021
5
JIRA
2021
5
Microsoft Excel
2019
4
Compliance
2019
3
Data Dictionary
2019
3
EDI
2019
3
HIPAA
2019
3
Medicare
2019
3
Pharmaceutical
2019
3
Scrum
2019
3
Stakeholder Engagement
2019
3
System Analysis
2019
3
Test Case Preparation
2021
3
BRD
2016
1
Data Mapping
2021
1
ERD (Entity Relationship Diagram)
2021
1
Functional Testing
2016
1
Gap Analysis
2021
1
JAD
2016
1
MS Visio
2021
1
Rational Rose
2016
1
Storyboarding
2021
1
Test Planning
2016
1
Waterfall
2016
1
Requirements Gathering
0
1