text
stringlengths 0
945
|
|---|
Exp Analyzed the business requirement as per the HIPAA rules and regulations to follow in creating business requirement documents. |
Exp Prepared various claims and member-eligibility files for the required test, submitting test output to the (vendor) clients through specific format and several similar functions. |
Exp Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Medicaid Claims. |
Exp Researched and understood the claims adjudication and reimbursement systems based on HIPAA X12 4010 standards. |
Exp Involved in creating 837(I, D, P), 835, 277-U, 270/271, 276/277, 278, 820 and 834 transactions processing flow. |
Exp For Project management purpose worked on Microsoft Project, used Microsoft Share Point for maintaining the updated documentation. |
Exp Scheduled meetings with technical personnel to determine technical parameters for EDI and other related processes, including communication, security, and privacy. |
Exp Created transaction sets requirements, usually with Microsoft Excel, for transactions such as: HIPAA 270/271, 276/277, 835, 837-(I, P, & D), 835 Remittances and others. |
Exp Handled Benefit Implementation/Configuration for Provider contract / pricing setup for FACETS. |
Exp Business process mapping - Preparation of process maps for as-is and to-be process highlighting the process changes and key system validation points. |
Exp Performed Requirement Analysis by gathering both functional and nonfunctional requirements based on interactions with the process owners & stake holders and document analysis, represented them in Requirements Traceability Matrix (RTM). |
Exp Met with client groups to determine requirements and goals. Utilized Rational Unified Process (RUP) to configure and develop process, standards, and procedures and create a Business Requirements Document. |
Exp Documented the project by generating forms & reports, Business Requirements document, Use case diagrams, activity diagrams and process flows. |
Exp Held several JAD and JAR sessions to facilitate interaction with Business Users. Conducted Gap Analysis on the AS-IS and TO-BE business processes. |
Exp Developed Use Case diagrams, Business flow diagrams, Activity/State diagrams and Sequence diagrams so that developers and other stake holders can understand the business process by using UML. |
Exp Prepared User Acceptance Testing test plans and conducted UAT Testing. Also, prepared user reference documentation. |
Exp Client: NATIONWIDE INSURANCE, Lincoln, NE Oct’10 – Dec’12 ◊ 2yrs. 2months |
Exp Role: Business System Analyst |
Exp Responsibilities: |
Exp Validated and processed insurance policy change requests, delegating to other departments/people when necessary. |
Exp Gathered Requirements from various business areas like Claims, Provider Relations, Enrollment, Finance and Benefits Administration for their updates to the Claim Processing Engine. |
Exp Documented business processes related to external agents, policy changes, including banks and clearing houses. |
Exp Optimized Stored Procedures, SSIS Packages, Table Indexes and was involved in performance tuning of Databases |
Exp Develop mappings/sessions to migrate these objects From SAP BW/R3 to SFDC application using Informatica and Data Loader. |
Exp Analyzed Database structures and data, developed Data Mapping Documents and User Manuals. |
Exp Participate in periodic meetings and maintain all applications for productions and plan appropriate various strategies. |
Exp Maintain effective relationships with various system administrators and development teams. |
Exp Coordinated with the off-shore QA Team members in evaluating and developing the Test Plans, Test cases, Test and Evaluation strategy and methods for unit testing, functional testing and usability testing. |
Exp Analytics – ability to aggregate large amounts of data, filter for importance, and tie together in a context relevant “story” designed to drive action. |
Exp Continuously drive better business practice and increased value to the business through consistent measurement and improvement of key activities Measurements. |
Exp Familiarity with XML and the ability to explain XML web service request and response elements and functionality to client development teams in the context of clients intended usage. |
Exp Created User Training Manuals for Equity and Fixed Income trades and provided the training to Portfolio managers, Director, Investment Managers, SME’s and Analysts. |
Exp Actively participated in Triage calls, Huddle boards and performed Usability Standards Validation, Story Acceptance Testing, User Acceptance Testing and Regression Testing. |
Exp Reviewed documents developed by other team members in the group for adherence to standards, consistency, and readability. |
Exp Worked in conjunction with testers(QA), developers and other team members in validation and testing of complex project scenarios and in the maintenance of Quality standards of projects |
Exp Well versed in Requirements/Change management, Impact Analysis and Gap Analysis. |
Exp Developed a Root Cause Analysis report using MS Office. |
Exp Client: GM Electrical Systems Pvt. Ltd, Hyderabad, India Jun’08 - Sep’10 ◊ 2yrs. 3months |
Exp Role: Business Analyst |
Exp Responsibilities: |
Exp Played a vital role in the creation and maintenance of iteration plan, documented and prioritized the scope by identifying the client's requirements. |
Exp Developed Cost-Benefit Analysis and gathered requirements to drive small-budget IT-driven technology projects. |
Exp Provided executives with analytics and decision-support tools used as the basis for reorganization, consolidation and relocation strategies. |
Exp Performed quality assurance, system integration and user acceptance testing facilitating on-time & on-budget of enterprise implementations. |
Exp To interface with risk officers both locally and in globally dispersed regions, gaining both insight into requirements, priorities and specific needs, but also to manage expectations and lead their thinking through end-to-end solutions (both process and technology) |
Exp Collaborated with stakeholder groups across the organization to ensure business and technology alignment. Proposed solutions meeting defined specifications and needs. |
Exp Created Context diagrams, DFD’s, Process flow diagrams, ER diagrams using Class, Sequence, Component, Package diagrams. |
Exp Organized meetings and presented story boards to ensure accurate comprehension of the existing situation with regards to mismatched scenarios. |
Exp Provided expertise on project templates and processes; reconciled project data and generated project reports. |
Exp Efficiently and effectively managed the backlog of requirements for future releases and played a pivotal role in the timely release of the project. |
Exp Developed a systematic plan for future release of the backlogged use cases after getting the priority of the features from the product managers. |
Exp Conducted integrated change control including project plan updates and performance reports. |
Exp Reviewed and provided input on test scripts to ensure thorough testing of new functionality and triaged defects and enhancement requests. |
PI NARENDRA LENKA |
PI 973-910-8941 |
PI ___________________________________________________________________________________________ |
PI Summary |
Sum 9+ years of experience in Analyzing Business Needs, Gathering Requirements, Planning, Organizing, Documenting, Business Process Definition, Risk Analysis, Use Case Analysis and testing software applications. |
Sum Expertise Domain Knowledge: Finance (Insurance, Mortgage), Web/E-Commerce, Healthcare, Media and Manufacturing. |
Sum Expertise on Software Development Life Cycle (SDLC) including Software Architecture, Object Oriented programming, Designing & Prototyping, Development, Debugging, Testing, Database Activities, Integration, Maintenance and Production Support of Software Applications in Client/Server environment. |
Sum Experienced with Rational Unified Process (RUP), Agile (Scrum) Software Development, Waterfall Methodology and UML. |
Sum Extensive knowledge in working with Agile methodology, Scrum sessions, creation of product backlog, Sprints as a part of the team with shared aim and shared responsibility and participated in Sprint planning and Sprint review meetings. Experience conducting Scrum meetings. |
Sum Expertise knowledge and experienced in Enterprise Resource Planning (ERP) and Customer Relationship Management (CRM). |
Sum Experienced in design and development stages of E-Commerce reporting needs through ad-hoc queries to ensure the reporting tools are to the department’s standards, which in turn will be used as a means for the decision-making process. |
Sum Hands on experience in various business applications to support and improve business operations including day to day administrations of IBM AS 400 iSeries. |
Sum Extensively worked on FACETS & compliance of ICD 9 to ICD 10 and HIPAA (Health Insurance Portability and Accountability Act) 4010 and 5010 EDI transactions. |
Sum Experience with Medicare, Medicaid and commercial insurances in HIPAA ANSI X12 formats including […] […] 820, 835, 837, 997. |
Sum Experience with the working of Medicare (Part A, B, C and D) and Medicaid Health Insurance Policies, Personal Injury Protection (PIP) insurance, billing experience with life and disability in health plans with thorough understanding of CPT coding, HCFA-1500 and CMS-1500 claim forms and reimbursement forms. |
Sum Experience in Development, Administration, Configuration, Implementation, Lightning and support experience with Salesforce CRM platform. |
Sum Skilled in Tableau Desktop for data visualization through various charts such as bar charts, line charts, combination charts, pivot table, scatter plots, pie charts and packed bubbles and use multiple measures for comparison such as Individual Axes, Blended Axes, and Dual Axes. |
Sum Experienced conducting Joint Requirement Planning (JRP) and Joint Application Development (JAD) sessions with end-users, SMEs' and development team for project meetings, walkthroughs and customer interviews. |
Sum Documentation includes: Business Process Documentation, Business Process Modeling, HLDD's (SRS/SSR/BRD) and LLDD's (FRD/RTM). |
Sum Developed Use Case Diagrams, Sequence Diagrams, Data Flow Diagrams, Process Flow Diagrams and Activity Diagrams. |
Sum Experienced developing User Interface Requirements, User Interface Specifications, UI/Front End mockup screens, Wireframes using Visio and PowerPoint and Usability Standards. |
Sum Experienced in using ARIS, VISIO, MS office, Power BI & Sway. |
Sum Worked extensively with IBM tools for dimensional modeling, data migration, data transformation, data loading, data modeling, metadata model, catalog creation, cube modeling, SDK development and performance tuning. |
Sum Experienced in understanding database structures and write SQL/PLSQL. |
Sum Extensively experienced in data analysis, ETL techniques for loading high volumes of data and smooth structural flow of the data. |
Sum Adept at writing Data Mapping Documents, Data Transformation Rules, Maintaining Data Dictionary, Data Migration Documents and Interface Requirements Documents. |
Sum Experienced in writing Test Plans, Test Cases, Generate Test Scripts and Maintain Reports for defect tracking. |
Sum Experienced in test automation, identifying tests to be automated, designing test automation framework, building automated scripts, modifying existing scripts, executing and result analysis. |
Sum Experienced in Integration Testing, System Testing, User Acceptance Testing (UAT), Functional Testing/Black Box Testing, Grey Box Testing, Regression Testing, GUI Testing, Performance Testing. |
Sum Extensively experienced of XML and HTML. Worked with XML format and being able to read XML files and use XMP parsing tools. |
Sum Experienced using Confluence (wiki) for documentation. |
Sum Experienced in generating reporting and business intelligence using Crystal reports and Tableau. |
Edu Education |
Edu Masters of business administration (MBA) – ICFAI University, 2009, India |
Edu Bachelors of Life Sciences (MBBC) – ANU University, 2007, India |
Skill Technical Skills |
Skill Platforms: MS-DOS, Windows (95, 98, Me, NT, 2000, XP, Vista, 7), UNIX, Linux |
Skill Methodologies/Process: SDLC, Waterfall, Agile, SCRUM, UML, RUP |
Skill Modeling Methodology: UML, MS-Visio |
Skill Modelling Tool: IBM system architect, ARIS |
Skill Databases: Oracle, SQL Server, DB2, MySQL, MS Access |
Skill Database Tool: TOAD |
Skill ETL Tools: SSIS, Informatica Power Center 9.X |
Skill Tool: JIRA, Confluence |
Skill Reporting/BI: Crystal Reports, Tableau |
Skill Languages: SQL, PL/SQL, COBOL85, SCOBOL, UNIX/Linux shell |
Skill GUI: SharePoint, Visio, MS Office (Word, Excel, PowerPoint, Access) |