Dear Partner,
Hope you are doing great today!
This is Robert representing Captevo Inc. Currently, We have an Excellent "Healthcare Business Analyst".
Below is the summary of our consultant Gorati Tejaswini. Please forward suitable requirements to [email protected]
Professional Summary
A highly dynamic result oriented professional with strong analytic and technology expertise with almost 8 years of experience as Business Systems and Facets Business analyst in Health Care, Banking Industry. Possess the ability to think out of the box and develop innovative business solutions which offer maximum business value to projects; to develop perfectly detailed result by working with dynamic teams.Strong skills in dealing with software development lifecycles (SDLC), both Waterfall, and Agile/Agile scrum, Rational Unified Process (RUP).
- Expertise in defining and documenting Business process flows and “As-Is” & “To-Be” processes.
- Experience in data collection from multiple sources, interpretation, presentation, and management of reporting and decision making.
- Expertise in creating Business Requirements Documentation (BRD), Requirements Traceability Matrix (RTM), Business Rules Spreadsheet (BRS) and Functional Requirements Documentation (FRD).
- Expertise in project management activities like defining/managing project scope, planning various activities for execution, estimating business value/impact and providing a periodic status report to management.
- Experience in working with cross functional and cross-cultural team environments, different levels of management and liaison between system users, management and development teams.
- Experience in Healthcare Application Facets in different modules like Claims, Membership, and Provider.
- Extensive experience and knowledge on all stages of the Software Development Life Cycle (SDLC)
- Well versed in writing SQL queries, together with inner and outer Join commands for data analysis and retrieval.
- Extensively involved in web service and user interface development, covering Provider, Claims, and Reimbursement Processing domains.
- Knowledge and experienced on Health Insurance Portability & Accountability Act (HIPAA 4010 and HIPAA 5010), Affordable Care Act (ACA), International Statistical Classification of Diseases and Related Health Problems, 9th Revision and 10th Revision (ICD-9 and ICD-10), Current Procedural Terminology (CPT).
- Experience with Medicare Advantage Programs, HIPPA 5010 EDI transaction codes such as 834(Benefit Enrollment), 835 (Payment), 837(Health care claim).
- Excellent in generating and analyzing reports. Extensive use of reporting tools like Tableau, Business Object and Power BI.
- Proficient in Medicaid, Medicare (Part A, B, C, and D), Procedural and Diagnostic codes, and Claims Process.
- Proficient in using UML for Business Process Modeling, Use Cases, Activity Diagrams, Sequence Diagrams, Data Flow Diagrams, Collaboration Diagrams, Class Diagrams and document them using Microsoft Visio and Gliffy.
- Experienced in working in Agile Scrum, Scaled Agile Framework, Agile XP, Waterfall, RAD and SDLC methodology environments.
- Highly skilled in conducting SWOT Analysis, Feasibility Analysis, Cause & effect Analysis, Risk Analysis and Impact Analysis.
- Expert in creating database tables, joins, indexes, stored procedures, views, triggers, user defined data types and functions in MS SQL server
- Experienced in developing and executing test cases performing functional testing, usability testing to ensure the product meets the system requirements.
- Experienced in preparing test data and validating data using SQL Queries.
- Experience in Data mapping, Data mining, Data warehouse concepts, OLAP and OLTP Technologies.
- Experience in Rational Rose, Clear Case, Requisite Pro, Clear Quest and MS Visio.
- Excellent communication and interpersonal skills.
- Experienced in training users and developing training manuals.
- Experience of Microsoft Word, Excel, PowerPoint, Outlook, Project and HP Quality Center.
- Good Knowledge of Health Care reform - Risk Adjustment
- Strong understanding on Electronic Data Interchange(EDI), both in 4010 and 5010 formats.
- Extensive experience in organizing and facilitating joint application development (JAD) sessions, interviews and workshops with user(s), subject matter experts (SME’s), and business stakeholders.
- Proficient in producing Business Requirement Documents (BRD), Functional Requirement Document (FRD) and Software Requirement Specification (SRS) across the deliverables of a project.
- Developed business Process flows for different department functions using MS Visio.
- Expertise on website Wireframes and Business Process Modeling with excellent skills on Use Case, Activity, Sequence, Data-Flow diagrams using Unified Modeling Language (UML), in MS Visio and Rational Rose.
- Well versed in Relational Database Management System (RDBMS).
- Skilled user in Clear Quest for defect tracking, bug reporting tools like Test Director and Quality Center.
- Experienced in handling Change Management.
- Working knowledge of Structured Query Language (SQL) for data manipulation and retrieval from data ware house and transform it to required Database like DB2, Oracle and so on.
- Excellent analytical skills with extensive experience on performing GAP analysis, User Acceptance Testing (UAT), Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis, Impact Analysis, Risk Analysis and Mitigation plan, Cost benefit analysis and Return on Investment (ROI) analysis.
- Proficient in handling functional and non-functional requirements with exceptional understanding and skill set in writing Test Scenarios, Test Conditions, Test Cases, and Test Scripts.
Robert
Captevo Inc.,
Phone: (248) 301-3002
Email: [email protected]
Hangouts: [email protected]
***My Hotlist: IOS, Tableau, Linux Admin, Business Analyst
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