HAFEEZ MUNAWAR

Business Analyst

929 224 5586 hafeezmunawarba@gmail.com

www.reallygreatsite.com

PROFILE SUMMARY
Worked as a Business Analyst individual with over 10 years of
EDUCATION diversified experience in Healthcare and Finance IT industry.
Bachelor of Expertise in Project Planning, Project Design, creating functional
Cybersecurity and specifications and data flow diagrams.
Information Security, Extensive experience as Business Analyst in the Healthcare
Osmania University, Industry with expertise in Affordable Care Act (ACA), HL-7, EDI
Hyderabad, Transactions (834, 835, 837), HIPAA, MMIS, Confidential and
Telangana, India - 2012 Medicaid.
Experienced in business process flows, business process
Wardiere University
modeling, case tools, business analysis, gap analysis and
2006 - 2008
organizational change management.
Experienced in conducting sessions and worked with
executives, developers, and end-users to define the exact
requirements.
Solid understanding of Membership, Claims Processing, Billing,
EXPERTISE Benefit/ Eligibility, Authorization/ Referrals, COB, and have
experience in HIPAA standards and corresponding EDI
Management Skills
transactions (837, 834 and 820).
Negotiation Knowledge of health care services regulatory environment in
Critical Thinking compliance with HIPAA, ICD, MITA, and MMIS.
· Have good understanding of Equity, Cash management,
Communication Skills
Capital market, SWIFT and Credit risk, Derivative Securities
fundamentals with hands on experience
· Exposed to Medicare and Medicaid domains of the healthcare
systems and industry for inpatients, outpatients,
Reimbursement Methodology and Medicaid Management
Information System MMIS.
Knowledge on Confidential, Medicaid, MMIS, HIPAA EDI
transactions 278, 820, 834, 835, 837, ICD-9, ICD-10, HL7, HMO,
PPO, ANSI X12 Procedural and Diagnosis codes.
LANGUAGE
Used Microsoft SharePoint as a Web-based Content
Management System as well as a Document/ Project
English
Management tool.
Excellent knowledge of HIPAA (Health Insurance Portability and
Accountability Act) transaction codes such as 270/271
(inquire/response health care benefits), 276/277 (claim status),
470 (benefit codes), 835 (payment or remittance advice), 837
(health care claim) and 834 (benefit enrolment).
 Cigna Corporation, Albany (NY)
Business Analyst
Responsibilities :
Played an active and lead role in gathering, analyzing, and writing business requirements.
Project was implemented in phases, enabling system to deliver as many business
requirements as early as possible.
Involved in Requirement Scoping and analysis of high priority requirements for implementation.
Worked on Transaction-835 claims payments and remittance advice, which deals the
payment from payer to provider.
Involved in HIPAA EDI transactions such as 270, 271, 837 (P, D, I), 276, 277, 834, 820, 278, 999/TA1,
and 277 CA.
Evaluated confidential requirements and benefits in Confidential Health Plans for member
enrollment and management.
Coordinated, implemented and provided on-going support of the Quality Performer as
outlined in the Specifications Manual for Well Care Inpatient Quality Measures Centers for
Confidential & Medicaid Services (CMS).
Used HP Quality Center for writing Test plans and Test Cases.
Worked on documenting business rules to be defined in the business rules management
engine (IBM ODM).
Working knowledge of implementing software development projects using methodologies
such as Waterfall, RUP, and Agile Scrum.
Used HIPAA guidelines and regulations to keep track of Healthcare transactions like Eligibility
Request/ Response, Request and Response for Claims Status, Prior Authorization, Claims Vision
and Claims Payment.
Complying with the consistent development and maintenance of the healthcare industry
databases, health care insurance and health care industry related aspects with adherence to
HIPAA compliances.
Wrote SQL scripts for back-end testing.
Liaison and Coordinated in resolving HIPAA/EDI mapping issues arising from the third party
systems.
Experience conducting GAP Analysis, SWOT Analysis, and ROI analysis.
Proficient in conducting Meetings, Interviews, and Joint Application Development JAD sessions
with various Stake holders and flexible in coordination across various groups and vendor
partners.
Worked on Agile SDLC during the project phase, performed the role of Product Owner and Team
member in Scrum Meetings.
Acted as a liaison between the business users and technical teams to build applications based
on the business requirements - provided a single point of contact for user communication
(managed issue tracking, prioritization and resolution).
Hands on experience with JIRA for issue tracking & User stories / requirements
Created complex reports utilizing SQL Server Reporting Services (SSRS)
Developed and Deployed of SQL Server Integration Services (SSIS) Packages
· Gathered Requirement for Data Mart integrating data from UDB/DB2, Oracle, SQL Server, text,
Excel, and Access.
Extensive Experience in Functional, Integration, Regression, MMIS, HL7, FRD, User Acceptance UAT,
MITA, System.
 IBM Global Services, Rochester (NY)
Business Analyst
Responsibilities :
Analyzed and improved business processes, increasing efficiency by 30%.
Facilitated stakeholder meetings to gather requirements and align project objectives.
Developed and maintained comprehensive project documentation, including business
requirements, user stories, and workflows.
Conducted data analysis using SQL and Excel to support business decision-making.
Implemented new technologies that resulted in a 25% reduction in processing time.
Coordinated with cross-functional teams to ensure smooth project delivery within set
deadlines.
Created interactive dashboards using Tableau to provide insights into business performance
metrics.
Managed user acceptance testing (UAT) to ensure the final products met business needs.
Trained over 50 staff members on new systems and processes to enhance adoption and
usage.
Negotiated with vendors to secure software that met company specifications while staying
under budget

Lazard Ltd, Buffalo (NY)

Business Analyst
Responsibilities :
Developed requirements into business Use Cases, Activity diagrams, Sequence diagrams, and
UI flow for Mobile application.
Created detailed SRS and FRD by identifying functional and non-functional requirements.
Developed work flow processes documents/SDD for different functionalities/transactions to be
utilized on mobile platform by providing complete impact analysis and risk analysis.
Prepared Risk Assessment matrix and mitigation plan for banking services on mobile platform.
Involved in revising the Trading Process Flow documents which involves preparation of different
technical documentations for different process like trade capture, execution, booking, validation
and confirmation, clearing settlement, Accounting, Client billing process, Cost basis accounting,
etc.
Interacted with representatives from Custodians and Clearing house stakeholders to
understand the processes and ensured Dodd-Frank compliance are satisfied by requirements.
Coordinated with business group for compliance of Basel-II Standards, Due-Diligence
procedures, AML regulations to apply to different transaction of Derivatives, Bonds, Securities
and other financial instruments while preparing the data modeling, Risk Reporting and
requirement documentation.
Mapped detailed Service Error Scenarios/Error codes of Vendor Mobile platform to Bank's
Existing Web platform to be utilized by QA team.
Participated in change management, provided solution for required enhancement by legal
team and business team.
Identified the key Stakeholders and the business users of the application.
Conducted research and investigation of all discrepancies.
Reconciled discrepancies efficiently and in a timely manner for customers. Tracked and
maintained accounts to identify any discrepancies.
Conducted research and investigation of all discrepancies. Notified supervisor of all issues and
Resolved account reconciliation issues quickly
 Involved in GAP Analysis, Risk Analysis and Technical Feasibility study with the technical leads
and other SME's.
Detailed user story and documented the product requirements and the workflows
Created various UML models like Use Case diagrams, Activity Diagrams and State Diagrams in
MS Visio.
Created process flow diagrams in MS Visio.
Collaborated with legal and regulatory advisors to update AML policies and procedures,
ensuring all updates were accurately reflected in the Traceability Matrix.
Designed and implemented a Traceability Matrix to track AML compliance across all digital
platforms, ensuring seamless alignment with regulatory changes.

Mount Sinai Health System, Binghamton (NY)

Business Analyst
Responsibilities :
Developed the scope and vision documents that defined the primary goals, objectives and scope
of the project
Validated batches of medical claims data, patient details, and service line data in the EDI 837 and
EDI 835 files, 270 (Eligibility) and 276 (Claim Status) data.
Gathered requirements and developed project scope for implementation.
Collaborated with colleagues providing knowledgeable insight to customers and business
partners. Interacted with client and the Technical Team for requirement gathering and translation
of Business Requirement to Technical Specifications.
Created and managed Impact Analysis Documents, Business Requirement Documents, Design
and Solution Documents, Use Case Specifications and Requirement Traceability Matrices (RTM).
Conducted interviews, meetings and JAD sessions during the process of Requirement Gathering.
Created project plans for customer master process development and testing. Identified various
business processes and developed process flow diagrams for the business processes and
validated the same with SMEs.
Identified Requirements and grouped them into Business Requirements, non- functional
Requirements and Functional Requirements.
Recommending effective methods for documentation based on the complexity of the project.
Prepared Use Case Diagrams and Use Case Documents.
Worked closely with the Enterprise Data Warehouse team and Business Intelligence Architecture
team to understand repository objects that support the business requirement and process.
Involved in testing data mapping and conversion in a server based data warehouse.
Recommend tactic to implement HIPAA 4010 ( EDI X12 837,834,278,270) in the new System
Validated all the incoming/Outgoing data from EDI 837/835 interfaces.
Followed the RUP based methods using Rational Rose to create: Use Cases, Activity Diagrams /
State Chart Diagrams, Sequence Diagrams.
Work with EDIFACT messages like ORDERS, ORDRSP, INVOIC, ORDCHG, and REMADV.
Developed and supported startup for MVS and PC based EDI systems and various application
integrations and interfaces.
Create EDI Transaction (invoice file) and EDIFACT Documented various key elements of HIPAA
compliance and made sure that they are understood complied and followed by the development
team members. Conduct manual Regression testing for the developed test cases on BizTalk
environment.
Used COVAST EDI and HIPAA Accelerator for BizTalk 2006 R2.
Delivered solutions and closed problems in the Problem Queue assigned by running the tests in
CLAREDI, HIPAADESK and other applicable Clearing Houses.
Analyzed 4010A1 and 5010 TR3 Implementation guides to identify and document the changes for
HIPAA EDI Transactions such as 837 P, 835, 276/ 277 and 270/271.
Created class diagrams, use case diagrams and sequence diagrams to view the system from