Senior Business Analyst
• Educational requirement - This position requires a candidate with a minimum of a Bachelor's degree in computer science, computer information systems, information technology, or a combination of education and experience equating to the U.S. equivalent of a Bachelor's degree in one of the aforementioned subjects.
• Designed and orchestrated the migration from the Legacy system to configured in the incipient applications/systems and validated the implementation.
• Worked in presenting transitional design framework and created an app prototype for UI/UX. Translated the requirements to the visual framework using Visio.
• Led a 4-member team of analysts and performed a wide range of mentoring responsibilities to promote
• knowledge within the entire Care1st project and Business Systems Analyst department as a whole
• Knowledge of Medicaid Plans and compliances associated with Medicaid Claims Processing.
• Knowledge of International Classification of Diseases (ICD-10), Place of service codes, Healthcare Common Procedure Coding System (HCPCS) Codes, CPT codes associated with Medicaid Claims Processing.
• Knowledge of HIPAA compliances associated with various Payers & Providers.
• Prepared Business Requirement Documents (BRD) and used Requisite Pro to manage, analyze, and convert business requirements into functional specifications.
• Functioned as the primary liaison between the Business Units, Technical Teams (IT and Configuration), and Consulting Partner(s)
• Validated the HIPAA/EDI transactions, tested the claims processing and Adjudication (EDI 837 & EDI 835).
• Involved in mapping data for various partners and clients transmitting EDI 837, 835, 270/271.
• Worked with Scrum master for UAT testing the responsiveness of the user interface across various platforms and performs UX validation to ensure that the right user experience is achieved.
• Presented user stories on PowerPoint to the different SMEs and project expectation during the sprint.
• Developed multiple documents like Business Requirements Document / Functional Requirement Document, User Acceptance Testing document, Quality-of-Service requirements document, and Requirements Traceability Matrix.
• Driver and facilitated walkthrough sessions for E2E (End to End) migration which is responsible for forecast current and future business needs.
• Analyzed and assisted in implementing the mainframe reporting needs for member/eligibility/claims and mapped fields with FACETS batch jobs and reports.
• Extensive day-day work and usage of Application Lifecycle Management (HP ALM), JIRA (tracking tool), Tableau, MS Office, SQL, FACETS, and other internal applications.
• Responsible for daily stand-up sessions with Business Stakeholders and Information Technology teams to comprehend roadblocks, flag potential risk, identify delays to prosperous completion and the potential challenges are addressed in a timely manner.
• Reviewed back with business teams to get buy off on the process documents and handed the requirements to development teams to code and quality teams to evaluate.
• Coordinate business partner User Acceptance Testing (UAT) and sign-off.
• Implemented incipient techniques, able to learn and keep up with the constant fast pace, business workflows and follow best practices for business requirements accumulating to meet industry business standards.
• Providing technical support for business activities through Systems Development Lifecycle (SDLC) phases in agile methodology.
Full Time direct hire