Summary
Overview
Work History
Education
Skills
Timeline
Generic
Tamisha Best

Tamisha Best

Summary

  • Over 15 years of Experience as Business Analyst in Healthcare and Finance domain include understanding of Business Requirement Gathering, Business Analysis, Joint Application Development JAD sessions with clients and referring to accessible documentation and procedure.
  • Functional Knowledge of Medicaid Management Information System MMIS and CMS Medicare.
  • Exposed to Medicare and Medicaid domains of the healthcare systems and industry for inpatients, outpatients, Reimbursement Methodology.
  • Extensively Knowledge in the Member Enrollment and Billing information.
  • Knowledge and Experience on Membership, Billing, Claims Payment Processing in relation to HIPAA,, ICD-9 ICD-10, codes 834, 837,835, and 270, 271.
  • Strong Knowledge of ICD-9/ICD-10 business analyst with healthcare.
  • Able to understand and implement Processing ICD-9 ICD-10
  • In dept. Knowledge of Software Development Life Cycle SDLC methodology such as Agile, and Waterfall
  • Efficient in writing Business Requirements Document, Use Case Specifications, Functional Specifications and Workflows.
  • Strong Knowledge of Use Cases, and Activity Diagram.
  • Extensive Experience in Functional, Integration, Regression, User Acceptance UAT , System.
  • Knowledgeable working with ETL process Extract, Transform and Load of data into a data warehouse.
  • Designed and implemented basic SQL queries for testing and report/data validation
  • Experienced in client interaction, deep understanding of business systems functionality and technicality.
  • Proficient in Developing and executing Test Plans, Test Case, Test Scenarios, also performing functional, usability testing and ensuring that the software meets the system Requirement.
  • Knowledgeable about preparing RTM documents
  • Experience in developing project plan and estimating project timeline.
  • Excellent working Knowledge in Project Life Cycle and clear understanding of Project Management.
  • Experienced in performing Gap analysis by identifying existing technologies, documenting the enhancements to meet the end-state requirements.
  • Excellent business communication and presentation skills. Adapt at creating, editing, and coordinating extensive communication networks, to keep executive staff and team members apprised of goals, project status, and resolving issues and conflicts.
  • Conducted successful projects with the help of teams to achieve deadlines timely and proficiently.
  • Organized, goal-oriented, self-starter, and ability to master new technologies manage multiple tasks while following through from start to completion.
  • Experienced in analyzing business requirement at all stages of Software development of life cycle SDLC .

Seasoned Business Professional of 15 years of healthcare industry success. Expert on business and systems requirements, user acceptance testing and end-user training. Accomplished at leveraging past lessons to inform future decision-making. Personable business professional bringing successful 15-year career in financial roles within large and fast-paced corporations. Release-planning specialist trained in advanced Excel modeling. Creative solutions architect with real-time problem-solving flexibility.

Overview

11
11
years of professional experience

Work History

Health Care Business Analyst/Business Scrum Master

Autumn Breeze Health Care Center
Marietta, GA
06.2020 - Current

Role: Healthcare Business Analyst/Agile Scrum Master

The project was to make enhancement that enables organizations to manage all clinical documentation, including comprehensive assessments, physician orders, visit notes, medication profiles, labs and X-ray reports, pictures and maintaining the EHR. Agile Scrum methodology was used throughout the project.

Responsibilities:

  • Prepared Business Requirements Documents, Functional Requirement Documents for 110 bed facility.
  • 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
  • Performed GAP analysis by performing system analysis between scheduling systems and documented gap items.
  • Conducted JAD sessions, meetings, workshops to gather requirements from various stakeholders and SMEs.
  • Facilitated all Aspects of scrum framework, including product backlog, release backlog, sprint planning session, daily scrum meeting, sprint reviews and sprint retrospectives.
  • As scrum master communicated dependencies and potential risk to completion of sprints including resources, costs and systems.
  • Created data mappings to transform data according to business rules.
  • Developed Test Cases for unit testing, prepared spreadsheet for testing criteria, including regression, positive and negative testing, process flow testing and screenshot for test results to complete expected and actual results.
  • Prepared various diagrams by using MS Visio.
  • Prepared documents for wireframe and prepared data dictionary for same
  • Managed testing for various functionalities using Quality Center tools.
  • 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

Tools Technologies:

MS Visio, MS Excel, MS Word, Mural, Jira, MS Office, Agile Scrum

Healthcare Business Analyst

Cartersville Center For Nursing And Healing
Cartersville, GA
01.2019 - 06.2020
  • Conducted weekly meetings for deciding Policies and Procedures to be followed while constructing new sites. Gathered high-level requirement for all external projects in release.
  • Performed requirement analysis, impact analysis and documented requirements.
  • Involved in full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Medicaid Claims.
  • Developing single application to process data from multiple integration points, convert data for reporting purposes and feed data into mainframe system to be compliant to reporting requirements.
  • Performed Analysis on Data mapping between different data models.
  • Involved in full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Medicaid Claims.
  • Used different ad-hoc analysis, Reports assist in defining strategy for each customer category. Informatics was used for ETL process and Business Objects.
  • Created ICD-9-CM/ICD-10-PCS comparison document through CMS files.
  • Documented ICD9 to ICD 10 mappings one to one/one to Many according to GEM files from CMS with functional and structural changes related to conversion
  • Involved in Able to understand and implement Processing ICD-9 ICD-10
  • Worked on EDI transactions: X12,835, and 837 P.I to identify key data set elements for designated record set. Interacted with Claims, Payments and Enrollment hence analyzing and documenting related business processes
  • Executed test cases and test scenarios using HP Quality center QC .
  • As Scrum Master maintained capacity plan, iteration board, sprint backlog, velocity charts and burn down charts.
  • As Scrum Master facilitated all aspects of scrum framework, including sprint-planning sessions, backlog-grooming session, daily scrums product demos, sprint reviews and sprint retrospectives.
  • Prepared Business Requirement Documents BRD's after collection of Functional Requirements from System Users that provided appropriate scope of work for technical team to develop prototype and overall system.
  • Facilitated and led JAD sessions aimed at functional requirement walk-throughs for all impacting projects and updated documents based on recommendations if any .
  • Created various reports such as billing payment reports, Billing Grouping Payment and discount reports
  • Use HP Quality Center to house all test documentation and report/track all issues and defects Defect Management .

Business Analyst/Director of Finance Administration

Boro Park Center For Rehabilitation & Healthcare
Brooklyn, NY
03.2013 - 07.2018
  • Mapped current business and operational processes and recommended areas for improvement within 540 bed facility.
  • Documented business processes and analyzed procedures to align with changing business needs.
  • Met with stakeholders to establish favorable business relationships and support mutually beneficial interests.
  • Worked closely with software development and testing team members to design and develop robust solutions to meet client requirements for functionality, scalability and performance.
  • Applied honed problem-solving skills to analyze and resolve issues impacting business operations and goal achievement.
  • Improved business direction by prioritizing customers and implementing changes based on collected feedback.
  • Analyzed key aspects of business to evaluate factors driving results and summarized into presentations.
  • Led cross-functional teams to analyze and understand enterprise-wide operational impacts and opportunities of technology changes.
  • Reviewed files, records and other documents to obtain business information and key data informing responses to development requests.
  • Analyzed business developments and monitored market trends.
  • Conducted interviews with key business users to collect information on business processes and user requirements.
  • Created workflow diagrams and Gantt charts to clearly demonstrate processes and timelines.
  • Synthesized current business intelligence data to produce reports and polished presentations, highlighting findings and recommending changes.
  • Assigned tasks to associates, staffed projects and updated all involved parties to enhance optimal business flow.
  • Diminished process gaps and encouraged optimal productivity by closely supervising workflow of claims analysts and mail clerks.
  • Facilitated interview, one on one and brainstorming sessions with SME's User's in understanding requirements pertaining to billing Origination to billing Processing.
  • Assisted and written System Requirements Documents SRD , including Functional and Non-Functional requirements.
  • Gathered business requirements through interviews, surveys, prototyping and observing from account managers, finance manager, and independent advisors and got accurate understanding of their needs.
  • Developed Use cases and activity diagrams and analyzed business requirements.
  • Created UML-based feasibility studies and Use Case Models to communicate those ideas to developers.
  • Followed UML based methods using Microsoft Visio to create: Use Cases Diagrams, Activity Diagrams, and Sequence Diagrams.
  • Worked with SME's and business users to gain in-depth understanding of business' mission, objectives, purpose and processes.
  • Responsible for sales and marketing specializing in practice management, managed care systems, thin-client technology, Electronic Media Records EMR/EHR/PHE/technology, and full integration tools.
  • Enhanced business to articulate and prioritize their ideas, and assisted in development of training materials for new technology and process improvements.
  • Collaborated with QA testing team to develop test plan, test conditions and test cases to be used in testing based on business requirements, technical specifications and/or product knowledge.
  • Conduct project related Presentations periodically to management and end users during various phases of Software Development Life Cycle SDLC .
  • Involved in User Acceptance testing to check reliability for end users.

Education

Certified Scrum Master -

Scrum Alliance
Remote USA
08.2023

BBA - Sociology

SUNY College At Old Westbury
Old Westbury, NY
05.1997

Skills

  • Agile and Scrum
  • Business Analysis
  • Data Analysis
  • Project Management
  • Process Improvement
  • Change Management
  • Documentation
  • MS Visio, MS Excel, MS Word, TFS,
  • Power BI
  • Strategic Decision making
  • Product roadmap
  • Supply Chain Management
  • Capacity Planning
  • Corporate Finance and Budgeting

Timeline

Health Care Business Analyst/Business Scrum Master

Autumn Breeze Health Care Center
06.2020 - Current

Healthcare Business Analyst

Cartersville Center For Nursing And Healing
01.2019 - 06.2020

Business Analyst/Director of Finance Administration

Boro Park Center For Rehabilitation & Healthcare
03.2013 - 07.2018

Certified Scrum Master -

Scrum Alliance

BBA - Sociology

SUNY College At Old Westbury
Tamisha Best