My Name is Vikas Thadishetti., I am a Staffing Agent working at Tek Pyramids Inc a Michigan based company. I am reaching out to you to see if you have any possible opportunities for our consultants. Currently, we have a Business Analyst candidate Poojitha on C2C basis. I have included candidate skills details below: Request: please take a minute and add vikas@tekpyramids.com in your mailing list for current and future requirements. Professional Summary Experienced Business Analyst with 8+ years of expertise in the following areas: - Eight years’ experience as a Business Systems and Facets Business Analyst in Health Care, Banking Industry.
- Experience in Pharmacy Claims Analysis for both Paid/Rejected claims as part of Oversight activities.
- Experience in Healthcare Application Facets in different modules like Claims, Payer, Membership, and Provider modules
- Well versed with Relational Database Management System (RDBMS)
- Experienced in working with Business Intelligence tools, in different tools like Tableau, Microsoft BI, Business Object
- 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)
- Well versed in writing SQL queries, together with inner and outer Join commands for data analysis and retrieval
- Experience in documenting the As-Is and To-Be process and analysis
- 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
- Experience in source to target mapping process and documentation
- Good Knowledge of Health Care reform - Risk Adjustment
- Proficient in Medicaid, Medicare (Part A, B, C, and D), Procedural and Diagnostic codes, and Claims Process
- Experienced working with Claim Transactions such as 837 P/I/D - medical claims, 835 - Health Care Claim Payment/Advice, 270 - Eligibility, Coverage or Benefit inquiry, 271 - Eligibility, Coverage or Benefit response, 276 - Claim status request, 277 - claim status response, 820 - Payment Order/Remittance Advice, and 834 - Benefit Enrollment and Maintenance.
- 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.
- Experienced in handling Change Management process
- Skilled user in Clear Quest for defect tracking, bug reporting tools like Test Director and Quality Center
- 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
- Possess understanding and experience in using Rational Requisite Pro to trace and update business requirements throughout the lifecycle of a project and keep stakeholders informed about the progress of the project utilizing Requirement Traceability Matrix (RTM)
Best Regards, Vikas Tek Pyramids Inc Phone: 248 618 2141 x 203 Email: vikas@tekpyramids.com
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