Janki Patel

• Over 7 years of diverse experience in the Information Technology industry with a focus on Business System Analysis. • Experience in business process analysis, modeling and Business requirement gathering. • Ability to collaborate with peers in both business and technical areas to deliver system solutions. • Highly proficient in HL7 and EDI X12 analysis, implementation of interfaces using various SDLC methodologies, business tools and Integration engines such as Mirth, Cloverleaf, and IBM Integration Bus, working on various projects within the HL7 domain including migration projects from legacy systems, implementation of new interfaces and enhancement of existing interfaces. • Designed and developed Enterprise level applications supporting various business units. • Extensive experience in analyzing and requirements gathering and writing system functional specifications including use cases. • Experience in Identity and Access Management products like SailPoint. • Experienced in EDI and HIPAA with multiple transactions involving claims handling and processing, with payer and provider experience ( 270 & 271 , 276 & 277, 820, 837 P/I/D, 834, 835 ) Proficiency in documenting Test Cases, Test Plans, Test • Functional experienced in Claim Life Cycle and Health Care Payer domain process along with various line of health insurance system like PPO, HMO, POS. • Experience in ServiceNow on implementing end - to-end Service Catalog. • Extensive Experience in Functional, Integration, Regression, User Acceptance UAT, System. • Utilized corporation developed Agile SDLC methodology. • Industrial experience includes Healthcare HIPAA and EDI, EHR clinical Systems. • Functional Knowledge of Medicaid Management Information System MMIS. • Excellent in Developing and evaluating business process Models. • Ability to support prototyping activities that will validate business requirements and solution definition. • Hands on experience in creating Use Cases, Activity Diagram, and Sequence Diagrams • Comprehensive knowledge of RUP, Waterfall and Agile (Scrum & Xp) methodology. • Expertise in creating Data flow diagrams, Entity Relation diagrams, Gap Analysis, Developing Business Process Re-Engineering and Process Modeling using MS Visio . • Work for support the application of the Scrum and SAFE Agile Methodologies in developing and managing the application development process. • Good knowledge and extensively used RDBMS, Oracle, SQL, PL/SQL. • Well versed with HIPAA, Facets , claim adjustments, claim processing from point of entry to finalizing, claim review, identifying claims processing problems, their source and providing corresponding solutions. • Experience in Medicaid Management Information System (MMIS). Expertise in various subsystems of MMIS- Claims, Provider, Recipient, Procedure Drug and Diagnosis (PDD), Explanation of Benefits (EOB).