Skills Requirement Management, SQL, Teradata, Defect Analysis, UAT, Data Warehousing, Report Generation Core Capabilities Business Analysis, System Testing Any Other Comments(Adaptability, flexibility and attitude towards work, communication skills etc..) Positive attitude to work, team player, quick Learner, easily adaptable to any situation, excellent communication skills Associates' Current Role Business Analyst Associates' Role Aspiration Business Analyst Current Work Visa Status (I-94 expiry date, where applicable) US Citizen Skill Classification Description Expérience Associates Self Rating Primary Skills Business Analysis UAT 5 Years 4 Years 5 5 Anubhuti is an experienced IT professional having close to 5 years of background primarily in the health care domain. Hard working, she is a team player and thorough professional with excellent communication skills, who aims to deliver results in a timely manner. Seasoned with exposure to various working environments, Anubhuti has an excellent blend of technical and functional knowledge that allows her to contribute her skills to various areas such as requirement analysis and elicitation, testing and defect management, and data mapping and validation.
SQL, Teradata 4 Years 4
Microsoft SQL Server 4 Years
2 Years 5
Tools Used Facets, MS Office, Initiate Inspector, ALM, Visual Studio 5 Years 5
Management Skills Team Management 2 Years 3
Domain knowledge HealthCare 5 Years 5 Skilled in analyzing business processes and maintaining and eliciting requirements
Expert Knowledge in SQL and PL/SQL programming for testing database integrity
Proficient in Data Warehousing with skilled focus in data mapping and data validation
Skilled in various data validation tools such as ALM and Clear Quest
Familiar using Mainframe for source system and report access
Proficient in converting user requirements into standard reporting solutions
Skilled in using Visual Studio for various SQL and reporting based techniques
Experience working with various source systems such as Facets 4.3 and 4.7, NASCO, EAB, NCAS, and FEP on front-end and back-end of the applications
Experience conducting Joint Application Development (JAD) and Rapid Application Development (RAD) sessions
Expertise in traditional Software Development Life Cycle (SDLC) methodology as well as variants such as Agile, Waterfall, and Spiral
Proficient in executing test cases for User Acceptance Training (UAT) and performing post deployment verification procedures
Experience with ICD 9 & ICD 10
Proficient using HIPAA Transactions and Code Sets
Hands on experience with business functionalities like Medicare, Medicaid, Commercial Claims, Managed Care, AR Reduction, Bulk Billing, Denial Analysis & Insurance Specific Trends
Strong communication, organizational and interpersonal skills that facilitate the interaction and coordination within the team FUNCTIONAL TECHNOLOGY
S/W development life cycle methodologies.
System Analysis and Design
Requirements definition, functional specifications and gap analysis.
Standard Report Designs and Solutions
Use Case Modeling and Analysis
Implementing projects, end to end testing and User Acceptance Testing (UAT).
Databases - Oracle, Microsoft SQL Server, Teradata
Operating systems - Windows (3.x, 95, NT, 2000, XP).
Testing Tools - HP ALM, Affinium Plan, ClearQuest
Front-End Applications - Facets, FEP
Express ScriptsJuly 2014 to CurrentCampaign Management Analyst
Project Summary: - Express Scripts is the largest pharmacy benefit management service in the United States that processes pharmaceutical claims for members through a network of retail pharmacies.
As an analyst on the Campaign Management team at ESI - I was responsible for heading a various number of campaigns related to Medicare where I worked to create test plans and ensure data validation and submit approval.
Leading various campaigns specifically in the Medicare domain to ensure all data is validated and appropriated with business requirements Writing test plans and test cases as per the needs of the business and specific work orders to ensure data is at per with its corresponding campaign's FRD Using Teradata and SQL queries to validate and load data Managing each campaign using Affinium Plan to track and modify all tasks Submitting approvals for all loads and FRD's Managing offshore team to ensure all tasks are completed in a timely manner and with full coordination of the team and utilization of all resources Participated in meetings with developers, Project Managers and Quality Analysts to discuss business requirements, test planning, resource utilization, and defect tracking Opening defects for any issues found and working to resolve them within giving timeframe Conducting lookups for various patients using e-service delivery manager to track member fill limits and make sure they are within the allocated amount Ensuring all patient service dates and fill limits are in conjunction with allocated amounts Using Mainframe to validate allocated amounts for data validation Compiling System Requirements Specification (SRS) documents and user documentations in accordance to guidelines and standards of a level where developers can interpret, design and develop the application with minimum guidance Verified the functional aspect as per the Business Processes and validated the interfaces with the other systems and data conversion from the legacy system.
August 2012 to June 2014Business Systems Analyst
Project Summary: - CareFirst is a BlueCross BlueShield affiliate that provides health insurance to the Maryland, Virginia, and Washington D.C.
As a business systems analyst, I was part of the Data Governance and Stewardship team under Data Intelligence and Integrity.
My role was centered in day to day support as well as to assist on projects such as the Revenue and Fee and Discount Project, EDW (Enterprise Data Warehouse) Sunset, and 15.18 EDM (Enterprise Dimensional Model) Membership Transformation.
Gathering data from various source systems such as Facets 4.3 and 4.7, NASCO, FEP, and EAB through back-end applications such as Oracle SQL Developer and Microsoft SQL Server, along with front-end applications such as Mainframe and Facets.
Using and running SQL queries to analyze and test data from various sources for ensuring proper validation and integrity Loading and deleting data into tables with SQL in Oracle developer for necessary testing Gathering the necessary requirements to ensure proper communication between business and IT Developed detailed Business Requirements Document's (BRD) and Technical Requirements Documents (TRD's) to communicate and facilitate the needs of business to IT Conducting various UAT testing to support revenue and fee and discount projects for Facets and NASCO Reported, Tested, and Closed defects for all projects worked on using ALM as the defect tracking tool Using IBM software Initiate Inspector to sort through memberships and validate their unique identification codes Conducting monthly Sox Audits for Facets, NASCO, and EAB and analyzing and compiling the results through various backend and front-end testing Completing the EDM Month End Balancing Process Compiling source to target data mapping between the soon to be sunset EDW database to the EDM for all given source systems Created and maintained Data Dictionary for given databases and tables Heavy analysis using Facets to identify issues such as voids, total deletes, and subscriber identification number changes in order to modify memberships Running and analyzing TRMS reports to see errors and dropouts for memberships across all source systems Analyzing CareFirst cafeteria accounts to filter out members whose ancillary coverage was greater than subscribed Maintaining corporate SharePoint site for project and team related information.
Assurant Health InsuranceAugust 2011 to July 2012Business Analyst
Project Summary: Assurant Health Insurance website provides health insurance directly to individuals and families.
I worked on a project where we teamed with client personnel for a claims processing system where we received the claims as input from various sources like the EDI Gateway systems, electronic applications and few other manual entries.
Interacting with the appropriate area such as, Membership, Provider, Contracts, Plans, Products, further processed the claims.
Identified, researched, analyzed and documented business process work flows Developed detailed Business Requirements Document (BRD), Technical Requirements Document (TRD) and Use Case documents to effectively communicate the requirements Prepared Gap Analysis for the consumer website Facilitated highly interactive JAD sessions with project stakeholders, subject matter experts (SME), end-users, developers, testers and project management team for identifying and resolving issues Performed the gap analysis for the various loop segment elements like ICD 9 and ICD 10 diagnostic codes Worked with defect tracking and reporting tools like Rational Clear Quest Conducted extensive user interviews to understand medical claim submission and billing procedures Extensively used SharePoint to communicate and version control project processes/procedures documentation Backend Testing using SQL queries on SQL Server tables and generating reports to ensure data integrity.
Reviewed test strategy and test plans to ensure that test cases reflects user needs for the functional, user interface (UI), usability and security requirements Developed test cases and performed User Acceptance Testing (UAT) Conducted extensive user interviews to evaluate the process flow and recommended alternate flows for business process improvement Assisted Project Manager in managing requirements by coordinating and facilitating requirement tracking using Requirement Traceability Matrix (RTM) Actively monitored client expectations during all phases of SDLC Identified the scenarios based on business requirement and HIPAA compliance for each transaction Involved in Medicaid business configuration with focused primarily on claims adjudication, pricing, provider, member, enrollment, prior authorization In depth knowledge of Medicare/Medicaid Claims processes from Admin/Provider/Payer side which were later part of the training program to vendors Conducted training for Business and IT team on effectively using Use Cases.
Eisai IncSeptember 2009 to July 2011Business Analyst
Project Summary: This project was concerned with the development of application based on FDA and CFR guidelines, with which the business users can process the application through electronically and process on-line, to have all the providers on the same account to detect the updates and needs of the researchers and development teams at Eisai.
Developed and executed test scripts, test cases, data sets and user procedures Worked to create, design, and assemble necessary reports based on requirements from users Created targeted questionnaires for SME's to gather requirements Followed Rational Unified Process (RUP) methodology for creating artifacts Worked with business and technical teams to develop business requirements for implementation Provided the primary liaison between business/operations/vendors and development Studied and analyzed competitor's applications and brainstormed to gather effective requirements for a quality product.
Participated in design walk-through with SME's to baseline the business architecture.
Used Visio to carry out the business modeling and object modeling effort to develop the business architecture for the application for rapid and controlled application development.
Created Business Requirements and converted them into System Requirement Specifications (SRS) Involved in Requirement Scoping and analyzing high priority requirement for implementation Analyzed Requirements and created UML diagrams of Use Cases, Use Case Diagrams, Activity Diagrams using Rational Rose and Microsoft Visio Used Rational Requisite Pro for managing and configuring the requirement analysis effort Wrote PL/SQL statement and stored procedures in Oracle for extracting data.
Familiar with clinical practices, clinical research ethics, ICH guidelines, FDA CFR, pharma codes, and other applicable local regulations Created user acceptance testing designs, test procedures and scripts Drove UAT testing.
Thomas Edison College of New JerseyBachelor of Arts
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