Hi partner, Hope you are doing great today! This is Loka Sai representing Captevo Inc. Currently, We have an Excellent Business Analyst Is ready for new projects. Below is the summary of My Consultant Dathri. Please forward suitable requirements to lokasai@captevo.com ROFESSIONAL SUMMARY Over 7+ years’ experience as a Business Analyst in Health Care and Facets Application. -
Experience in Healthcare Application Facets in different modules like Claims, Membership, Provider and Billing. -
Experience in Finance industry and Customer Support. -
Extensive experience and knowledge on all stages of the Software Development Life Cycle (SDLC) and Object Oriented Analysis and Design (OOAD) utilizing project life cycles such as Agile, Rational Unified Process (RUP), and Rapid Application Development (RAD). -
Well versed in writing SQL queries, together with inner and outer Join commands for data analysis and retrieval. -
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). -
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. -
Good Knowledge of Health Care reform - Risk Adjustment, Reinsurance and Risk Corridors. -
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. -
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). -
Energetic and creative. Dynamic team player with integrative thinking skills. -
Excellent problem solving, conflict managing, decision making and leadership skills. -
Excellent analytical, written, communication, presentation and interpersonal skills. Thanks & Regards, LokaSai Captevo Inc., Direct: (248) 294-1006 | | |
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