1. Zain Siddiqui
214-608-1585
bazains@gmail.com
SUMMARY
 7+ year’s expertise in Business Analysis, Quality Assurance and Testing with hands on experience in Healthcare
and IT Sector.
 Extensive experience with Medicare/Medicaid processing as well as the Claims/Billing.
 Strong knowledge of the Software Development Life Cycle methodologies (phases and gates) like Agile and
Waterfall models.
 Knowledge of using automation tools - Win Runner, QTP, Load Runner, Quality Center and Test Director.
 Good working knowledge of Claims processing, Excellent knowledge of HIPAA standards, EDI (Electronic
data interchange) Transaction Set EDI X12 837, 270/271, 276/277, 278, 835, Implementation and Knowledge
of HIPAA code sets, ICD-9, ICD-10 coding and HL7.
 Experience with HIPAA 4010 and 5010 EDI healthcare transactions and transition of ICD 9 to ICD 10 codes.
 Broad knowledge of Medicare, Medicaid, PPO, HMO, POS, diagnostic codes and claims process.
 Experience with Iterative Software Development Life Cycle Process as per Rational Unified Process (RUP),
involved in inception, elaboration, construction & transition phases using rational tools like Requisite Pro, Clear
Case, Clear Quest during various phases of RUP.
 Deep knowledge of RDBMS structures including schema creation, modification, monitoring and performance
tuning, backup and recovery techniques, in depth troubleshooting.
 Extensive experience in Business Requirements gathering and writing skills with expertise in developing and
documenting Business Requirement document (BRD), Functional Requirement Document (FRD),Software
Requirement Specification (SRS) across the deliverables of a project.
 Effectively used Rational Requisite Pro to organize, track and change requirements of the system. Conducted
JAD (Joint Application Design) sessions.
 Expertise of UML in visualizing and documenting the artifacts using Use Cases, Use Case Diagrams, Activity
diagrams, Class diagrams, Data Flow Diagrams, Business Flow Diagrams, Sequence Diagrams using MS
Visio.
 Facilitated User Acceptance Testing (UAT) with the stakeholders and the business users as well as trained users
to use the system configured.
 Analytical, methodical and resourceful approach to problem solving, identifying root causes and corrective actions
to meet short and long-term business, financial and system requirements.
 Consultant with proven record of over 6 years of experience in Business Analysis, Business Process Modeling,
System Analysis, Requirements management using SDLC methodology, UML Modeling, Prototype design,
project team management in healthcare, pharmaceutical and other domains.
 Experience in understanding and supporting both the Business and Technical teams in all Phases of Software
Development Life Cycle (SDLC) by using different Methodologies like Iterative, waterfall, agile-scrum and
Rational Unified Process (RUP).
 Emphasis on requirements gathering from business stakeholders by using methods like Elicitation, conducting
Interviews with users as well as Subject Matter Experts (SMEs) by asking detailed functionality aspect of
business process, Requirement workshops, organizing Joint Application Development (JAD) sessions and
carefully updating the information to create a Business Requirements Document (BRD).
 Extensive experience in gathering business and functional requirements, feasibility studies, risk analysis, Gap
impact analysis, creating narrative Use Cases and UML diagrams- Class diagrams, Use Case diagrams, Activity
diagrams, Data flow diagrams using UML Tools like MS Visio and Rational Rose.
 Expertise in the areas of writing Scope documents, Request for Proposal (RFP), BRD, Functional
Requirements Document (FRD), incorporating use cases in creating System Requirements.
 Experience in Object Oriented Design Technologies and maintain traceability of Requirements using
Requirements Traceability Matrix (RTM). Experience in using Tableau to generate Business Intelligence based
performance reports.

2. Zain Siddiqui
214-608-1585
bazains@gmail.com
 Working with QA and testing teams in close co-ordination in developing Test Plans, building Test Conditions and
Test cases, creating test data, analyzing bugs, Interacting with development team to fix the errors; Facilitated
User Acceptance Testing (UAT) with client representatives.
 Experienced in Data Warehouse Environment including Data Analysis, Data Modeling, Data Mapping, Data
Integration and Data Migration using ETL tool- Informatica.
DEGREE/CERTIFICATION-
Bachelors In Commerce.
Certified Scrum Master from internationally recognized institute.
SKILLS
Business / Modeling Tools MS Project, MS Visio, MS Excel, MS Word, MS PowerPoint, Rational Rose
Requirements Management Tools Rational Requisite Pro
Databases SQL Server, Sybase, MS Access, Oracle
SDLC Methodologies Rational Unified Process (RUP), Agile, Scrum, Waterfall, Iterative
Operating Systems Windows 95/98/2k/NT/XP/Vista/Window 7
Web Technologies Java, JSP, VB Script, VB 6.0
Testing Tools HP ALM, Quick Test Professional (QTP), Load Runner, Rational Test Manager,
Rational Clear Quest
PROFESSIONAL EXPERIENCE
Children's Health, Dallas, TX July 2016- Present
Business Analyst/EDI Analyst
A global team of approximately 80,000 people, working collaboratively across the health system to improve care delivery,
quality and cost-effectiveness. Optum focuses on three key drivers of transformative change: engaging the consumer,
aligning care delivery and modernizing the health system infrastructure.
Scope- While working as a Business Analyst my job was to collect the requirements and prepare business requirement
documents for a web application used for managing detailed Health Plan System that involved Health Maintenance
Organization (HMO) and Claim Processing system.
Responsibilities:
 Conducted interviews, meetings and JAR sessions during the process of Requirement Gathering.
 Developed the deliverables using the Agile-Scrum methodology, and helped develop and maintain user stories to track
requirements.
 Experiencedinperformance tuningandoptimizing forSQLServer applicationbyusingperformance monitor
 Experienced in OLTP, OLAP, GUI, Relational Database Management Systems (RDBMS) and Report Development
 Extensive experience in MS SQL Server 2012/2008R2/2008/2005/2000, BI tools like SQL Server Integration Services
(SSIS),SQLServerReportingServices(SSRS),andSQLServerAnalysisServices(SSAS).
 Proficient in using T-SQL for developing complex Stored Procedures, Triggers, Tables, Views, User Functions,
common table expressions(CTEs, Relational Database Models and Data Integrity, SQL joins and Query Writing.
 Active participant of all the scrum meetings, and helped maintain the product backlog and scrum backlog. Co-
ordinated with scrum team for efficient delivery within designated sprint cycle.
 Performed validation of X-12 270, 271, 835 and 837 Professional and Institutional format files according to EDIFECS
engine.
 Created the static mock-up UI screen using Axure and helped the UI/UX team create the dynamic prototype.
Coordinated with the developers to create the input and output XML-schema.

3. Zain Siddiqui
214-608-1585
bazains@gmail.com
 Involved in the conversion of ICD-9 to ICD-10 codes, and vice-versa using GEM. Billing and claims submission were
effected due to new rules associated with ICD-10.
 Extensively involved in Conducting Market Research, Feasibility Studies, Data Analysis, System Analyses, Gap
Analyses, and Risks Analyses.
 Helped create web-methods for web-services, which used JAVA as the framework.
 Worked on the Data mapping and storing the analytical data using OLAP and updated to the SharePoint 2013.
 Helped create the SQL queries and procedures, tested these for correctness.
 Evaluated testing results for each potential release build using HP-ALM, listing summarized bug information in priority
sequence, recommended viability of release for production.
 Created performance reports and interactive visualizations of data using Tableau for data analysis
 Worked with Quality Control Teams to develop Test Plans in HP ALM and Test Cases.
 Interacted with the developers and testers to report and correct bugs.
 Conducted UAT (User Acceptance Testing) to make sure that all the user requirements are catered by the application.
 Use HL7 implementation methodology to create specifications, assist with unit testing, and perform integrated testing for
messaging between the state Departments of Health and the location office.
Environment: Agile-scrum, Java2 (JDK 1.3), XML, XSLT, MS Visio, HP ALM, SQL, HTML, CSS, JavaScript, HL7,
EDIFECS, Axure, MS Word, MS Excel, MS Access, MS Project.
Providence Health Plan & Services, Beaverton, OR January 2014- June 2016
Business Analyst/ Systems Analyst
Client Description: Providence Health Plan & Services is a Hospital run IT Department, mainly work in Oregon and Seattle
Area, related to Health Care Clients.
Scope- Objective of the project was to develop Medicaid Management Information System for State of New York following
HIPAA standards. The web based Health Care Management System is developed using HIPAA guidelines and regulations
which keeps track of Healthcare transactions like Eligibility Request/ Response, Request and Response for Claims Status,
Prior Authorization, Claims Vision and Claims Payment. This application also keeps record of all transactions, subscriber's
medical history and provides data to other State agencies as required.
Responsibilities:
 Conducted the scrum meetings as the scrum master, and helped maintain the product backlog and sprint backlog.
Co-ordinated with scrum team for efficient delivery within designated sprint cycle.
 Extensive experience in using SQL Server Profiler to monitor the SQL server for deadlocks, long running queries and
fine tune the same toimprove performance.
 Created Use Case Diagrams, and Use Case Specification document (USD). Validated the following: 837 (Health Care
Claims or Encounters), 835 (Health Care Claims Payment/ Remittance), 270/271 (Eligibility request/Response), 834
(Enrollment/Dis-enrollment from a health plan).
 Conducted JAD sessions with management, SME, vendors, users and other stakeholders for open and pending
issues.
 Worked with relational database models and XML schemas to create technical/system design documents, and
developed crystal reports. Performed OLAP and ETL for storing analytical data in the database and helped the DB
team in performing data analysis.
Environment: Agile-scrum, MS Project, MS Office Suite, SQL, UML, MS Visio, Requisite Pro, Clear Case, Rational Clear
Quest, JAVA/J2EE, XML, ETL, OLAP.
WellPoint Inc., Virginia Beach, VA November 2012-December 2013
Business Consultant/ Systems Analyst
WellPoint Inc. is working to transform health care with trusted and caring solutions. Our health plan companies deliver
quality products and services that give their members access to the care they need.

4. Zain Siddiqui
214-608-1585
bazains@gmail.com
Scope- The project was based on the implementation of New Electronic Health Record System and transferring all the
existing patients’ medical records into the new system. The additional components of this project involved Computerized
Physician Order Entry (CPOE) inbound e-referrals from hospitals, nursing homes and other healthcare facilities, Electronic
Prescribing (e-Rx) and outbound E-referrals, Recording of Demographics, Patient Reminders, Intake and Scheduling,
Clinical Decision Support (Coding & Claims), Electronic copy of health info, Clinical Summaries, and Exchange of clinical
information, with Practice Management and Billing Software.
Responsibilities:
 Worked in an Agile Development Environment fractioning out the functionalities of Electronic Health Record (EHR)
and Practice Management and Insurance verification.
 Created user stories and assigned values to each, coordinated with the client and the team to update the sprint
backlog. Ran the sprint cycles and made sure the sprint velocity never decreased to unacceptable levels.
 Documented detailed Business Requirements Documents (BRD) and Functional Requirement Documents (FRD) using
Rational Requisite Pro.
 Experience with JAVA and web-services; wrote web-methods for various functionalities.
 Created UML diagrams with the help of MS Visio to understand the process flow.
 Participated in ICD 9 to ICD 10 codes mapping sessions as well as status meetings and provided comments and
suggestions on challenges faced with the outsourced medical coding partner company.
 Identified the business flows and determined whether any current or proposed systems are impacted by the EDI X12
Transaction, Code set and Identifier aspects of HIPAA.
 Used Electronic Data Interchange (EDI) codes for verifying patient eligibility and receiving the insurance benefits,
patient information, health care claim request, and healthcare claim through the new EHR System.
 Developed Test Plans and Test Cases according to Business Requirements, using HP-ALM.
 Assimilated testing reports from developers and testers and created the RTM; made sure all the test cases were run on
the application.
Environment: Agile-scrum, UML, HP-ALM, Rational Clear Quest, Windows, MS Office, HTML, XML, SharePoint, JAVA.
Medical Mutual of Ohio, Columbus, OH January 2012-October 2012
Business Analyst
Medical Mutual of Ohio is an American mutual health insurance company. It is the oldest and largest health insurance
company based in Ohio and serves more than 1.6 million customers.
Scope- The Project was to develop a Centralized trial management tool, web-based software solution that effectively serves
as central trial dashboard for sponsors, coordinating centers, and site personnel. The essential clinical trial workflow
processes are embedded into the operations of the system. It facilitates clinical workflows and data sharing in single and
multi-site settings with patient care. Along with dashboard function, a trial management tool required a significant IT
infrastructure consisting of large-scale database and application servers.
Responsibilities:
 Involved in business analysis, coordinating between the team members, and was involved in each phase of SDLC
(Agile-scrum) to ensure valid business requirements. Created full life-cycle documentation from product requirements
in the developmental stage to functional specifications.
 Expertise in HIPPA, Phases of Clinical trials, Clinical trial designs, safety reports, adverse event management and
reporting, Protocol designing and regulatory requirements.
 Followed the Agile-scrum methodology for the entire SDLC.
 Created Use case scenarios according to business needs and specifications and Implemented UML methodologies to
design Use Case Diagrams, Data Flow Diagrams, Activity Diagrams, Sequence Diagram and ER diagrams.
 Involved in the Data mapping and Data Modeling, and documented the data architecture of the databases to notify the
SMEs’. Used ETL process in helping the DB team in data migration.
 Wrote test plans and test scripts using HP QC, followed up with the developers and testers regarding reported bugs.

5. Zain Siddiqui
214-608-1585
bazains@gmail.com
Environment: XML, MS Visio, SQL, MS Word, MS PowerPoint, MS Access, MS Visio WSDL, Oracle, Mercury Quality
Center, ETL, SharePoint, HP QC.
LifeWise Health Plan of Oregon, Portland January2011-December2011
Business Analyst
LifeWise Health Plan has been providing high quality health, life, vision, and dental, stop-loss, and disability products to
satisfied customers since 1986.
Scope- the Project was to upgrade the existing EOB (explanation of benefits) system to provide online EOB support to
Medicare Part D members. Other features included claims processing related to prior authorization.
Responsibilities:
 Conducted detailed walkthrough of Business requirement and functional requirement.
 Chalked out the scope, timeframe, risk analysis, cost and maintenance procedure.
 Microsoft Visio was used to create various documents such as Use Cases and Activity Diagrams.
 Wrote Test Cases in HP ALM and assisted the testing team in executing them.
 Helped the DB team with data warehousing and data mapping.