OBJECTIVE:

Obtain a stable, challenging position that utilizes my analytical and leadership skills.

SUMMARY:

• 17 years of experience working in the QA and BA aspects of the healthcare, insurance, IT and financial industries; expertise in benefit - mapping, HIPAA compliance, 3rd party/commercial card processing and data analysis
• 14 years of business (systems) analysis-experience: writing business requirements, SOPs, desk procedures, creating business rules, process flowsuser stories, change requests, security-testing and data-mapping; implementation-analysis, risk assessments, gap analysis
• 12 years of QA and testing experience re: UAT, SIT, Cloud, Penetration, Performance, BI-Business Intelligence...Smoke, Cloud, Black Box and Regression testing...Defect Triage and Resolution via Business Objects, Teradata and Data Warehouse (tools)
• 11 years of technical writing experience; including traceability matrices, project plans, Defect Management Plans, SOPs, training manuals.
• 5 years of Manager and Project Management experience: coordinating team efforts, setting objectives and deadlines for a project SDLC; HEDIS & EDI configuration and coding: facilitating status calls and generating reports for stakeholders
• Proficient at analytical and testing duties from initial-stages through implementation throughout SDLC; delegating tasks, leading resources/staff, meeting with--and providing status reports for clients and stakeholders:
• Expertise at determining project goals, web and android test planning and monitoring; defining in and out of scope objectives, project deadlines, test stages, facilitating progress/status meetings with stakeholders and determining report frequency.
• Extensive and proficient knowledge of how to analyze, configure and test data of various types using MS Office, SQL,TSYS, XML, ClearQuest, Quality Center/Test Director, RQM, QTP, Rational, Unix, Oracle, PBM, SharePoint, Agile, Waterfall and SMART methodologies.

PROFESSIONAL EXPERIENCE:

Confidential

Senior Business-Test Analyst

Responsibilities:

Duties: Write test plans, business requirements, define test requirements (criteria) and functional test cases for each software project. Perform EDI, RHIS and HEDIS configuration and testing; write SOPs and perform contract-gap analysis for different states. Document project outcomes, identify risks and downstream effects…log change requests and defects via Telecom, MS Project, Oracle, Quality Center and SharePoint. Note project milestones and QA outcomes via PBM, Rational, SOA, Test Director, and HP. Train junior analysts, manage some projects: determining the scope, maintaining the SharePoint site and other repositories. Assigning tasks to resources to ensure full test coverage of all aspects of the project by established deadlines. Generate progress reports and give the status of defects to stakeholders onsite as well as remote, via conference call and WebEx.

Confidential

Test Architect

Responsibilities:

Duties: Wrote business rules, business requirements, test plans, test cases and defect-handlingprocesses for all healthcare, IVR/Telecom and IT projects in Waterfall and Agile environments. Wrote training procedures and requirements manually (via MS Office) and automated tools. C oordinated UAT and Cloud Test efforts across onsite, remote & offshore teams via webex and using industry tools (HP, SQL, TSYS, PBM, Test Director, Oracle, and Rational). Ran queries and analyzed data trends to identify risks via Data Warehouse.

Confidential

QA Manager

Responsibilities:

Duties: Managed test planning onsite and offshore for various financial (banking) and insurance clients. Wrote test plans, business rules and test requirements for all projects...participated in test execution efforts-manually & automated for UAT, functional, regression and performance testing Agile projects related to banking application-upgrades, medical and benefit-handling-HEDIS and AMA coding…banks’ merchant card and 3rd party-billing software upgrades. Android and application analysis (using TSYS, Rational, HP, PBM, Unix and Quality Center). Other duties as assigned.

Confidential

Senior Business Analyst

Responsibilities:

Duties: Gathered data and wrote documentation related to software and configuration updates per project. Wrote test cases, test plans, business requirements and project goals for projects- including UAT, SIT, Smoke/Cloud and Performance testing-objectives. Identified and tracked defects, implemented change- requests...tested applications, websites and software upgrades manually as well as through Quality Center, Oracle, and Unix; employed RHIA & HEDIS coding skills while creating medical claims for test purposes and for conducting internal audits.

Configured updates to software, trained staff post-implementation and wrote desk procedures per HIPAA compliance.

Confidential

Senior Business & Test Analyst

Responsibilities:

Duties: wrote test and business-requirements for various banking-software projects; made configuration updates to databases, created data dictionaries, analyzed data trends for credit card, banking and IVR-related projects. Wrote and executed test scenarios, tracked defects: delegated testing duties to team of analysts...assisted with (UAT, Smoke, Cloud & Penetration) test-execution, bug-tracking & resolution via TSYS, RQM, Business Rules, Unix, CISCO and Oracle.

Confidential

QA Lead

Responsibilities:

Duties: recovered medical claim overpayments, calculated benefit limit/overage-fees, configured benefit codes and error messages; tracked anesthesia, private-duty-nursing and dialysis-claim payments... created training-documents and QA checklists, other duties as assigned.

Confidential

Billing and Coding Instructor

Responsibilities:

Duties: taught medical claims’ and services billing procedures to students. Taught courses related to assigning appropriate HCPCS, CPT, ADA and Revenue code s to medical claims for payment. Created practice exercises and exams for students; explained day-to-day tasks related to billing providers for medical services.

Confidential .

Technical Advisor, Data Analyst, Appeals Specialist, Claims Processor and Coder

Responsibilities:

Duties: assigned medical, dental, vision & pharmaceutical codes to medical claims; monitored benefit usage/limits for members, provided technical and training support to claims' handlingappeals/grievance and billing departments...documented and investigated member inquiries.