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Technical Business Analyst Resume


  • Over 6+ years Sr. QA Analyst and Quality assurance of Testing Client/server application using Microsoft SQL Server and BI suite Development, UAT and Production Environment)
  • Proficient experience in Manual and Automated Testing of GUI and functional aspects of the Client - Server and Web based Applications on multiple levels of SDLC and Testing Life Cycle (STLC)
  • Knowledge in the ETL (Extract, Transform and Load) of data into a data ware house/date mart and Business Intelligence (BI) tools like Business Objects Modules (Reporter, Supervisor, Designer, and Web Intelligence).
  • Extensive experience in writing SQL and PL/SQL scripts to validate the database systems and for backend database testing.
  • Having expert level experience with Functional testing in Functional System Integration testing, User Acceptance Testing, End to End Test Management, Running Automation scripts in Regression Suites and Non - functional security testing areas. Hands on experience in Project change control mechanisms, Impact Analysis, Risk Analysis, Defect Management, End to End Testing and Production issues/defects ad-hoc and regression Testing & support Having expert level experience with Functional testing in Functional System Integration testing, User Acceptance Testing, End to End Test Management.
  • Performed Testing Life Cycle during the various phases of the application. Involved in converting manual test cases into automated scripts using TSL on Mercury Win runner, QTP.
  • Expertise in broad range of technologies, including business process tools such as Microsoft Project, MS Excel, MS Access, MS Visio, technical assessment tools, MicroStrategy Data Warehouse Data Modeling and Design.
  • Excellent experience on Teradata SQL queries, Teradata Indexes, Utilities such as Mload, Tpump, Fast load and Fast Export
  • Ability to deliver comprehensive Business Intelligence through integration of BI suite of products (SSIS, SSAS, SSRS) including MS solutions like MS EXCEL 2007/2010, Microsoft Office
  • Developed Test cases for manual testing and automated them using Win Runner, Silk, Load Runner, Silk performer and QTP.
  • Strong in manual testing, Automated testing in Visual Basic & other protocol of automation tools Experience in testing applications under. Net, Windows.


Confidential, Montgomery, AL

Technical Business Analyst


  • Well-versed with leading industry tools like Jira, Version1, Caliber, MS Visio, MS Word, MS Excel and MS PowerPoint to develop various project deliverables
  • Worked with 837, UB92, UB04, CMS 1500 claims and HIPAA 835, 270/271, 276/277, 278 transactions.
  • Performed Requirement Analysis and developed UML Use Cases, Activity Diagrams using Rational Rose to understand the requirements.
  • Worked closely on 834 transaction code for Benefit Enrollment and was involved in Validation of HIPAA for 837, 270/271, 276/277, 835, 834 EDI transactions.
  • Performed testing for Medicare, Medicaid and X-Over claims for Medicaid Management Information System (MMIS)
  • Experience with healthcare system, Medicaid and with prime focus on claims adjudication, provider, eligibility and prior authorization.
  • Experience in Claims Processing, claim encounters and Claims Scrubbing in HMO, PPO, Medicaid and Medicare
  • Process and data flow models for STD (Short Term Disability), LTD (Long Term) and FMLA claims processes as well as interfaces to Human Resources.
  • In-depth knowledge and experience in full SDLC with Agile/SCRUM and waterfall methodologies.
  • Facilitate all agile ceremonies including daily stand-ups, weekly grooming, retrospective, and review and planning session.
  • Performed workflow analysis toward automated disability claims process. Detailed comparison of two competing proposals, including HR interfaces. Facilitated requirements definition for new system.
  • Introduced Agile to the product team and organized releases into SCRUM sprints, incorporated elements of XP
  • Experience with Medicare, Medicaid and commercial insurances in HIPAA, ANSI, X12 formats including 270/271, 276,277, 278, 835, 837, 997.
  • Utilized Microsoft Team Foundation Server TFS to manage the team's software development lifecycle including deriving product backlog items, assigning sprint work items to developers and conducting sprint review meetings
  • Followed the Rational Unified Process (RUP), Agile methodology and Extreme Programming concepts for project development. Analyzed and incorporated User Stories in different release plans for the sprints in Scrum process.
  • Ability to analyze engineering product support issues described within a bug-tracking system (JIRA) and provide guidance to other Client Services members in an advisory capacity, focusing on the quick resolution of the production issue and using this as a training opportunity for other team members
  • Involved in processing claims in FACETS and validating the full cycle process to make sure the checks are generated and 835's are generated.
  • Re-engineering and capturing of EDI transactions with legacy systems Enrollment -834, Eligibility Transaction (270/271), Claims (837), Claim Status Request and Response (276/277), Remittance (835) .
  • Performed extensive data modelling to differentiate between the OLTP and Data Warehouse data models
  • Identified/documented data sources and transformation rules required populating and maintaining data warehouse content.
  • Wrote test cases based on user stories in Team Foundation Server TFS using Microsoft Test Manager MTM and Wrote user stories utilizing the Visual Studio component for TFS in a gherkin format.
  • Responsible for creating test scenarios, scripting test cases using testing tool and defect management for Policy Management Systems, Payables/Receivables and Claims processing.
  • Involved with all the phases of Software Development Life Cycle (SDLC) methodologies throughout the project life cycle.
  • Served as conduit for managing system requirements between the business and the software development team.
  • Responsible for conducting the overall System Testing to verify operations of key FACETS modules involved in the processing of claims (including benefits), providers and members.

Confidential, Toledo, OH

Application Business Analyst


  • Manual testing of both web and stand-alone applications (Agile/Scrum development)- majority testing: System Testing, Function Testing, Integration Testing.
  • Utilize data-driven and compartmentalized test automation practices using Mercury Interactive Test Suite and Compuware Products.
  • Proficiency with Microsoft Office applications (Word, Excel, PowerPoint, and Visio and Project Management Software), and Atlassian (JIRA, and Confluence)
  • Hand on experience in test and defect management tools such as Quality Center, TFS, Clear Quest, Clear Case, Rational Functional Tester RFT, Microsoft Test Manager MTM, Team Foundation Server TFS and JIRA
  • Involve in testing of FACETS Implementation, involve an end to end testing of FACETS Claims Processing module, Membership and benefits.
  • Knowledge on HIPAA Compliance EDI Transaction Sets 834, 837 and Good understanding of the EDI transaction sets 834, 837
  • Utilized corporation developed Agile SDLC methodology. Used Scrum Work Pro and Microsoft Office software to perform required job functions.
  • Experience with healthcare system, Medicaid and with prime focus on claims adjudication, provider, eligibility and prior authorization.
  • Used FACETS Analytics for fast and easy retrieval, display and grouping of information for performing queries and generating reports.
  • Tested the changes for the front-end screens in FACETS related to following modules, test the FACETS batches (membership, Billing, Provider, etc).
  • Experience in analyzing test result and submitting the bugs using Bug Tracking tool Quality Center QC and Team Foundation Server TFS .
  • Analyzed Business Requirements and segregated them into high level and low level Use Cases, Activity Diagrams / State Chart Diagrams using Rational Rose according to UML methodology thus defining the Data Process Models.
  • Build Platform features, user stories, and maintain backlog with priorities, using Rally and JIRA platforms; Drive HLD, Low Level, and Integration (SOAP, REST, JSON, XML etc).
  • Worked with providers and Medicare or Medicaid entities to validate EDI transaction sets or Internet portals. This includes EDI 837, 835, 270/271 and others.
  • Created presentations explaining the entire report development process, while drawing a comparison between the legacy & the new report.
  • Involved in making Use Case Diagrams, Activity Diagrams, and using analysis and design models tools like MS Visio, Rational Rose through RUP, Agile and Waterfall Model
  • Tracked the defects in legacy reports as per account managers and end users. Compared the results and tracked the differences in excel
  • Reviewed Stored Procedures for reports and wrote test queries against the source system (SQL Server) to match the results with the actual report against the Data mart (Oracle).
  • Attending agile meetings and working on monthly sprint backlog items and updating the activities in Microsoft TFS and Identify, Log and follow-ups on all defects found during testing by using TFS.
  • Developed SQL scripts and wrote stored procedures to validate the flow of data from Legacy source to target application database and ability to perform data validation (of ETL processes, schema and DDL check, data flow from data warehouse to application databases, data marts, return marts, referential data, repositories).
  • Installed & Configured Cognos Office Connection and Developed Templates for Cognos, Office Word, Excel and PowerPoint.
  • Used QTP Checkpoints (GUI, Database and Bitmap) for comparing behavior of Application from previous builds.
  • Responsible for creating test scenarios, scripting test cases using testing tool and defect management for Policy Management Systems, Payables/Receivables and Claims processing.
  • Wrote Test Plans in MS Word for Manual Testing, System Testing, Integration Testing, Performance Testing, Regression Testing & reviewed their consistency with the business requirements.
  • Responsible writing Test Plans, Test Cases and Test Scripts using manual and automated testing tools from Rational and Mercury Interactive such as test Director, Winrunner.
  • Designed and development of test cases based on functional requirements for Institutional and Professional claims for EDI and HIPAA Transactions 837/835, 834, 276/277, 270/271 testing.
  • Authored test plans, test cases for various test scenarios and helped testing team to better understand the test scripts.
  • Executed Test Cases Manually, once the application is stable and documented the successful or unsuccessful completion of each test case in HP Quality Center (QC) for End-to-End Scenario based testing.
  • Used Test Director and Mercury Quality Center for updating the status of all the Test Cases & Test Scripts that are executed during testing process.
  • Established traceability matrix using Rational Requisite Pro to trace completeness of requirements in different SDLC stages.

Confidential, Carbondale, IL

QA Analyst / Tester


  • Used Quality Center for storing test cases and QTP scripts, also used Team Track for defect tracking and reporting purpose.
  • Analyzed research on operational procedures and recommend changes for improvement with an emphasis on automation and efficiency.
  • Performing quality assurance functions covering the full software development life cycle, including development and implementation of test plans, test infrastructure and project plans.
  • Conducted overall quality assurance responsibilities including writing test plans, detailed test cases, test scripts, and test automation development, test execution, defect reporting and tracking, full documentation, and supervision.
  • Wrote Test Plans in MS Word for Manual Testing, System Testing, Integration Testing, Performance Testing, Regression Testing & reviewed their consistency with the business requirements.
  • Extensive knowledge of Medicaid, Medicare, Procedural and Diagnostic codes, Claims Process, Health information Exchange (HIE), Electronic Health Record (EHR) and Electronic Medical Record (EMR
  • Responsible for integrating with Facets. Designing test scripts for testing of Claims in Development, Integration and production environment.
  • Experienced in software development life cycle such as Waterfall, Agile-SCRUM methodologies, Business Analysis and Modelling.
  • EDI X12 transactions code sets version and translation of ICD 9 codes into ICD 10 codes.
  • Expertise in the EPIC Medical software application (EMR, EHR) as it relates to hospital workflows and setting up the infrastructure for a software implementation in a clinic environment.
  • Provided business and mapping expertise during a transition of the EDI applications from the GXS Application Integrator (AI) to GIS.
  • Experience with healthcare system, Medicaid and with prime focus on claims adjudication, provider, eligibility and prior authorization.
  • Identify Member, Provider, Coverage, Medicare, and Medicaid and Utilized JIRA to develop and track agile epics, stories and tasks.
  • Developed business level activity diagram utilizing UML (according to Agile Unified Process) to visualize use cases, identified gaps between the current model and future model.
  • Performed Defect Tracking and Project Tracking using Jira - Change Notification Request (CNR) and Created Mapping Documents, Report Mockups and modified existing report mockups as to CMS requirements and finalized for development
  • Worked on the Patient Management System (integrated version of Patient Information System with EMR/EHR)) is intended to remotely communicate with a compatible pulse generator from BSC CRM and transfer data to a central database (HIT EHR).
  • Provide technical expertise as an early engagement to different modules and enhancements to access impacts and define scope.
  • Formulated logical statements of business requirements researched and evaluated alternative solutions and recommend the most efficient solution for system design.
  • Instructed and modeled core Agile principles of collaboration, prioritization, team accountability and visibility, ensured consistent application of SCRUM methodologies across the enterprise
  • Review requirements and understand technical recommendations and constraints, and develop comprehensive and accurate functional specifications; Data Mapping, and process flows.
  • Work with Compliance and Regulatory operations to follow and monitor different IT process bound by CMS Regulations.

Confidential, Nashville, TN

Quality Analyst


  • Prepared Test plans which includes an introduction, various test strategies, test schedules, QA teams role, test deliverables, etc.
  • Explored Mercury Interactive Tools (QTP, Quality Center and Load Runner) and Rational tools (Clear Case, Clear Quest, Test Manager and Functional Tester), JIRA for Client/Server and Web-Based Applications.
  • Developed and maintained hundreds of programs for the Blood Inventory System to ensure the safety of the blood supply for all regions using our system
  • Extensive healthcare experience in Medical Imaging, EHR/EMR, Mobile Apps, Medicare-Medicaid, HIPPA, HIX on EPIC software applications
  • Provide technical, business, management expertise, and support the Department of Health and Human Services and Centers for Medicare and Medicaid Services \(CMS\) in building and maintaining a comprehensive enterprise architecture program
  • Experience with healthcare system, Medicaid and with prime focus on claims adjudication, provider, eligibility and prior authorization.
  • Writing Epics and user stories, managing sprints and backlog grooming, and tracking project progress in JIRA.
  • Expertise in performing Bug and Defect management using bug-tracking tools like JIRA and HP QC/ALM
  • Analyzed business and technical requirements, thus creating the Business Use Case and Functional Use Case documents.
  • Gathered requirements for making changes to the existing Electronic Medical Records(EMR), Electronic Health Records(EHR) and Ambulatory Services for the existing Epic Interfaces.
  • Experience in EDI automated first-pass claim adjudication, requiring thorough understanding of claim processing, both front and backend operations
  • Assisted JAD sessions to identify the business flows and determine whether any current or proposed systems are impacted by the EDI X12 Transaction, Code set and Identifier aspects of HIPAA.
  • Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Medicaid Claims.
  • Worked on EDI transactions: 270, 271, 834, 835, and 837 (P.I.D) to identify key data set elements for designated record set. Interacted with Claims, Payments and Enrollment.
  • Facilitated review of Enrollment, Claims, Commissions, and membership portlets’ designs with architects and developers to ensure that the goals of the portal requirements were satisfied
  • Utilized Microsoft SQL 2005 and associated business intelligence tools (SSIS, SSAS, SSRS) to provide focused transaction and task monitoring and error handling on an enterprise level.
  • Produced UML Activity diagrams with defined swim lanes using MS Visio as part of claims process analysis
  • Brought valuable knowledge and solutions to business groups to enhance competitive edge with Facets Extended Enterprise(TM) administrative system implementation
  • Contribute in the build and design of an automated documentation system that met business process needs by providing comprehensive knowledge of workflows, policies and procedures, patient care objectives, regulatory requirements, and industry best practices for membership management
  • Analyzed & Tested HIPAA Gateway Application Interface for all inbound and outbound messages (Healthcare Eligibility 270 and 271, Healthcare Claim Status request 276 and 277, Healthcare Claim 834)
  • Participated in all phases of the Facets Extended Enterprise(TM) administrative system implementation including the planning, designing/building/validation (DBV), testing, and Go-live support phases
  • Used Agile and Rational methodology in the project development for Rational Test Suite for various phases of RUP.
  • Working knowledge of implementing software development projects using methodologies such as Waterfall, Rational Unified Process, Agile/Scrum.

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