Summary
Overview
Work History
Education
Skills
Timeline
Generic

ANGELA FRAGA

GARLAND

Summary

Over 6 years of experience working as a Healthcare Business Analyst. Expertise in Software Development Life Cycle methodologies (SDLC) and Business Process Re-engineering in Health Care Sector with focusing mainly on Requirements gathering, Documentation, Statistical and Data Analysis, and Test Planning and Execution. Hands on experience of delivery using the Scrum Methodology with Agile. Design and review of various documents including the Software Requirement Specifications (SRS), Business requirements document (BRD), Business document, Use Case Specifications, Functional Specifications (FSD), Systems Design Specification (SDS), Requirement Traceability Matrix (RTM) and testing documents. Created and maintained data mapping document(s) about the HIPAA mandated transactions 837I, 837P, and 835. Well versed with the conversion standards of HIPAA 4010 to 5010 and ICD-9 to ICD-10Codes. Exposure to HIPAA Compliance requirements and HL 7 standards. HIPAA Transaction and Code Sets (EDI 834, 835, 837, 270, 271, 276, 277, ICD-9, ICD-10), Electronic Health Record (EHR)/Electronic Medical Record (EMR). Strong project management skills from requirement analysis, process mapping and documentation. Hands-on experience on tools like Rally, JIRA, MS-Project, Confluence for collaboration and tracking. Having extensive domain knowledge in MMIS, EPIC, EDI X12, HL7, HIPAA, System, Medicare and Medicaid, CMS Compliances/Regulations. Excellent facilitation skills in conducting walk throughs, surveys, questionnaires, one-on-one interview sessions, groups' sessions, prototyping brainstorming, JAD and JAR sessions. Thorough understanding of preparation and use of Business Process Modeling Notation (BPMN) to Unified Modeling Language (UML) diagrams including Process Diagram, Activity Chart, Use Case Diagram, Sequence Diagram, Data Flow Diagram and ER Diagram. Excellent in analyzing and cresting Use-cases, various UML diagrams like Use case diagram, Activity diagram, E-R diagrams, Data flow diagram (DFD's) using MS-Visio, Balsamiq, mock-ups. Experience working in a large corporate environment in accordance to an agile project framework. Performed ETL using Informatica to load the data into the data warehouse from disparate sources, designing and deploying various reports through Tableau, and IBM Cognos. Recommend tactic to implement HIPAA 4010 (EDI X12 837,834,278,270) in the new System. In-depth knowledge of EDI transaction sets, 856 ASN hierarchal structures and EDI systems. Worked closely with the QA team to conduct functional testing, compliance tensing, performance testing and develop the test plan, test conditions, test cases, ensured adequate testing of software both before and after completion, and conducted UAT. Excellent Verbal and Written communication skills with the capability of maintaining effective.

Overview

4
4
years of professional experience

Work History

Business Analyst

Evolent Health
10.2021 - 09.2022
  • Involved actively throughout Software Development Life Cycle (SDLC)
  • Conducted meetings with business users and SME’s in eliciting information and gathering requirements and documenting requirements
  • Prepared Business Requirement Document (BRD) and Functional Requirement Document (FRD), to access all needs of software and solutions that are going to be needed by new program
  • Gathered requirements for new templates from doctors and nurses through interviews
  • Was responsible for creation and implementation of business requirements
  • Created artifacts such as Use Cases, Activity Diagrams, and Sequence Diagrams using MS Visio
  • Played key role in Planning, Testing, and Implementing system enhancement requests that were generated
  • Identified and documented Business Rules and defined Functional Definitions, Responsible for coordinating, tracking, and updating project issues, risks and change controls that impacted BA Team
  • Worked with Data Analyst in Data Mapping of feeds from reference data systems to in-house applications
  • Involved in updating system Test Plans and guided Software Quality Team in Developing Test Strategies during various Test Cycles
  • Assisted in Developing Test Scenarios and Deriving Test Cases based on Business Requirements, Technical Specifications in Test Director
  • Performed GAP analysis and analyzed EDI 837 (Health Care Claim) transaction and benefit structures in claims transactions from HIPAA 4010 to 5010
  • Worked on claim processing receipt and verification of claim forms (837) and claims attachments (275), claim Enquiry and Response (276/ 277)
  • Served as liaison between Clients and Technical Staff to resolve any conflicts
  • Worked on development of complete Use Case Diagrams, Data Flow Models and BRDs for Web based patient management system based on web services
  • Responsible for writing Functional Requirement Specifications (FRS) and User Requirement Specification (URS)
  • Coordinated with UAT testing group and provided technical assistance in planning and implementing Test Schedule for UAT
  • Worked with Application Development Team on Test Issues and conducted daily status meetings with Development and User Team during UAT.

Business Analyst

Care first
10.2021 - 09.2022
  • Worked extensively with developing business rules engine enabling business rules such as referral, prior authorization, eligibility, claims processing and billing essential
  • Utilized Agile Software Methodology using Scrum framework
  • Actively participated in creating user stories and prioritizing user stories along with tracking of burn up, burn down charts to estimate sprint delivery
  • Implement new services and programs via MMIS for Medicaid program by directly interfacing with customer and system engineers on regular basis
  • Wrote user acceptance testing (UAT) scripts and led testing/ quality assurance for both HL7 ADT interface and application
  • Designed, developed, tested, and maintained Tableau functional reports based on business requirements
  • Creating documentation such as BRDs and FSDs (Business and Functional design specs) with elaborate Use Cases and process flows
  • Worked on FACET claim processing system and gathered and documented functional requirements in Functional Requirements Document (FRD)
  • Performed GAP analysis by performing system analysis between scheduling systems and documented gap items
  • Analyze and document Medicaid EDI transactions issues related to implementation of HIPAA 5010 and ensure these issues are documented and addressed in approach to HIPAA 5010 version
  • Conducted JAD sessions, meetings, workshops to gather requirements from various stakeholders and SMEs
  • Prepared Business Requirements Documents, Functional Requirement Documents
  • Worked on analysis of FACETS claims processing system and gathered requirements to comply with HIPAA 5010 requirements
  • Helped in initiatives such as HL7 integration data mappings, web service mapping, API data exchanges
  • Facilitated all Aspects of scrum framework, including product backlog, release backlog, sprint planning session, daily scrum meeting, sprint reviews and sprint retrospectives
  • Worked closely with QA and Developers to clarify/understand functionality, resolve issues and provided feedback to nail down bugs
  • Maintained close and strong working relationship with teammates and management staff to achieve expected QA result for project team
  • Conducted project related Presentations periodically to management and end users during various phases of Software Development Life Cycle SDLC.

Sr. Business System Analyst

Fifth Third Bank
05.2018 - 09.2020
  • Worked closely with Product Owner in defining product road map and capabilities for enhancements to enterprise claims management application
  • Actively participates and drove continuous improvement for process and productivity to improve overall customer satisfaction and delivery of services, meeting requirements of product
  • Continually verified requirements individually and collectively through project lifecycles, writing formal specifications, process workflows, communicating such documentation with stakeholders and technology teams
  • Assisted testing teams in translation of requirements into test cases and ensured application architecture and systems functionality met business requirements
  • Acted as focal point to coordinate resolution of 'difficult issues' with regards to cross-team collaboration including communication of status, escalation with management etc.
  • Performed ad-hoc analysis to meet needs of all internal business partners leveraging various data sources
  • Prepared presentation materials to be shared with management, business groups and other relevant stakeholders
  • Worked closely with Product Owner in designing and implementing a more accurate, efficient and productive process of capturing business requirements in form of user stories
  • Assisted Scrum Master in facilitating Scrum Ceremonies like Daily Standup, Spring Review, Planning and Retrospective.

Education

Skills

  • Agile
  • Waterfall
  • Rational Unified Process (RUP)
  • UML
  • MS Project
  • JIRA
  • Confluence
  • Rational Rose
  • Rational ClearQuest
  • Rational Clear Case
  • MS Visio

Timeline

Business Analyst

Evolent Health
10.2021 - 09.2022

Business Analyst

Care first
10.2021 - 09.2022

Sr. Business System Analyst

Fifth Third Bank
05.2018 - 09.2020

ANGELA FRAGA