Priti Shah

Sr. Business Analyst

Cell: 848.283.3031
Email: business.analyst249@gmail.com
Professional Summary
 Around 9 years of experience as a Business Analyst, specializing in payer-side projects within the
healthcare industry.
 Extensive expertise in understanding and translating client requirements into technical solutions aligning
with business objectives.
 Good understanding of health care plans, Claims Management process, Medicaid and Medicare Services.
 Proficient in all phases of Requirement Management, including gathering, analyzing, detailing, and
tracking requirements.
 Involved in Test Planning, Test Preparation, Test Execution and creating defect issues.
 Business Analysis knowledge for business process, the need to understand all aspects of the company's
operations. Identify, analyze and design processes to improve the overall flow of information within the
company
 Interacting with stakeholders, gathering requirements, elicitation techniques like interviewing,
questionnaires, brainstorming, focus groups, cost/ benefits analysis and risk analysis.
 Excellent knowledge of Software Development Life Cycle (SDLC), Iterative Software Development Life
Cycle Process
 Proficient in Rational tools including Rational Rose, and Requisite Pro. Excellent skills in Business
Analysis, Requirement Analysis, Business Process Modeling and Use Case Development using UML
methodology.
 Skilled in creating logical diagrams like Use Case, Activity, Sequence, Data flow, Collaboration and
Deployment using CASE Tools like Draw.io and MS Visio.
 Excellent understanding of Data services, Data ETL using SQL query tools and applications.
 Profound understanding of insurance policies, HIPAA 4010/5010 EDI transaction codes, and healthcare
plans.
 Skilled in Requirement Management, Business Analysis, Business Process Modeling, and Use Case
Development using UML methodology.

Professional Experience
Tenet Healthcare Corporation Dallas, Texas (Mar 2022 - Present)
Senior Business Analyst

Responsibilities:
 Lead a cross-functional requirements team and served as a subject matter expert in healthcare payer
systems, facilitating efficient communication and collaboration between technical and non-technical
teams.
 Ensure compliance of Electronic Data Interchange (EDI) processes with HIPAA and ANSI X12
standards, ensuring data security and adherence to regulatory requirements.
 Collaborate closely with payer clients to gather and convert business requirements into comprehensive
system and operations requirements, ensuring alignment with organizational goals and client needs.
 Develop and maintain detailed Business Requirements Documentation (BRD), emphasizing ICD-10
mandate analysis, and ensuring thorough understanding and documentation of requirements for
development and implementation teams.
 Utilize Agile-Scrum methodologies for the Software Development Life Cycle (SDLC), promoting
flexibility and adaptability in project management, and ensuring timely delivery of high-quality software
solutions.
 Proficiently utilize SQL to query databases, extract and analyze data, and generate reports to support data-
driven decision-making and system improvements.
  Conduct database performance tuning, optimization, and maintenance tasks to ensure optimal database
functionality, efficiency, and reliability.
 Collaborate with database administrators and data engineers to design and implement database structures,
ensuring data integrity, security, and efficient data retrieval processes.
 Create and manage database documentation, including data dictionaries, data flow diagrams, and entity-
relationship diagrams, to provide a clear understanding of the database structure and relationships for
stakeholders.
 Assist in data migration and integration efforts, ensuring smooth and accurate transition of data between
systems and platforms.
 Collaborate with the development team to ensure seamless integration of front-end applications with
back-end databases, optimizing overall system performance and data retrieval efficiency.

Northwest Community Healthcare - Arlington Heights, IL (Apr 2020 – Feb 2022)

Healthcare Business Analyst

Responsibilities:
 Conducted comprehensive claims and trend analysis for payer clients, meticulously ensuring accurate
documentation and approvals for claims' issue resolution.
 Applied Agile/Scrum methodology to gather payer-specific requirements and adeptly created HIPAA-
compliant test cases to enhance system robustness and accuracy.
 Executed extensive market research and competitive intelligence initiatives for various healthcare payer
clients, enabling informed decision-making and strategic planning.
 Analyzed intricate healthcare workflows, translating them into precise UML models and creating
comprehensive technical/functional design documents, promoting seamless integration and improved
efficiency.
 Proficiently utilized SQL Server databases to extract and manipulate complex data, empowering the
generation of insightful business reports and actionable insights for stakeholders.
 Demonstrated advanced expertise in SQL querying, database design, and data manipulation, ensuring
optimal data integrity and security within the healthcare information systems.
 Collaborated with cross-functional teams to streamline data retrieval processes, contributing to faster
report generation and better decision-making capabilities for the organization.
 Implemented rigorous quality control measures for data extraction processes, guaranteeing high accuracy
and reliability in all generated business reports and analytics.
 Acted as a key liaison between technical and non-technical stakeholders, ensuring effective
communication and alignment of project objectives, timelines, and deliverables.
 Spearheaded database maintenance activities, ensuring data consistency, accessibility, and security,
playing a pivotal role in enhancing overall system performance and compliance with industry standards.

Client Company: Volkswagen Group of America, Auburn Hills, MI (Oct. 2016 – Jan. 2018)
Dealer Support Representative
 Research, analyze, and monitor data integrity in the database
 Clean and transform data files on Salesforce CRM to generate reports and dashboard
 Assisted project manager in analyzing and documenting case logs and procedures
 Communicated with clients verified information and updated database
 Developed and maintained monthly and weekly reports and dashboard
 Pull reports from reporting tools and prepared data files for subject matter expert
 Collaborated on various issues – verbally or through written documentation to the project manager and
engineering team
 Manipulated large volume of data using advanced Excel methods likes – VLOOKUP up, pivot tables,
filters, searching
 Contributed in consolidated various Excel files in the one master file
Ipsos RDA, 888 W Big Beaver Rd, Troy, MI 48084
Market Research Analyst (May 2013 – Jun. 2016)
 Coordinated aspects of national and global research studies to meet customer’s objectives
 Experience in generating quick scorecards, dashboards, and reports using analytical tools like SPSS and
Tableau to obtain insight in data
 Entered and verified data entry for the survey records
 Communicated and coordinated with software developers, architects, team leaders, business analysts,
statistical team to confirm requirements and explain business rules of the projects
 Supervised call center and managed more than ten pseudonym accounts for the better customer services
 Contributed to project plan, execute fieldwork, analyzed data, and deliver reports to clients
 Analyzed data from survey results using different statistical and translated into actionable insights
 Experienced in finding data quality issues, testing them, and proving solutions to overcome the issue
 Prepared collateral material, presentations, and reports for the senior management team
 Managed all the invoices for various projects and outside vendor requests
 Worked on various projects to help other team members to meet their deadlines
Education
Maharaja Sayajirao University of Baroda, India
 Master’s in Communications
 Bachelor’s in Home Economics and Communications

Completed the following courses at Oakland Community College with a GPA of 4.0
 Microsoft Office
 Business Communication
 Internet and Web Page Design
 Fundamentals of Information System
 Introduction to Database System
 Medical Terminology