Summary:

Dedicated and accomplished Senior Quality Assurance Analyst with a diverse history in the Healthcare, Government, Retail, and Insurance industries. Experienced in multi-tiered software projects using industry-standard project management and testing methodologies and processes. Experienced in all areas of claims testing using Quality Center and other claims testing tools. Experienced in testing all types of claims, including medical, hospital, outpatient, dental, and pharmaceutical. Proven track record of achieving business and client objectives using high-quality standards. Maintains a committed work ethic of responding proactively to project deadlines and release schedules. Exhibits strong interpersonal skills with the ability to merge resources from diverse cultures into a single highly-productive team.

Skills:

• Knowledge of EZ Test Web Interface, used to setup test data and test CVS business requirements for membership and claims data
• Advanced experience with EDI transactions: 837, 271, 276, 278, and 835
• Advanced knowledge of quality assurance and quality control techniques
• Collaborative project work with development, business analysts, and internal/external groups during all phases of SDLCs
• Development, recording, execution and verification of functional end-to-end test scripting and reporting on testing metrics
• Experience using Agile and Waterfall methodologies in project development
• Obtain final code release signoff for production from the appropriate Project Sponsor
• Perform manual testing, system analysis, implement and maintain test plans and scripts using various products including Quality Center, Team Foundation Server TFS , and other proprietary software tools
• Creation and maintenance of all testing processes to ensure that defects in the software products have been corrected and test results are documented

Professional Experience Details:

Confidential

3 month assignment requiring testing of CVS' RxCLAIM system using EZ Test tool. EZ Test is a utility built into RxCLAIM designed to enhance existing methods and validating benefit plan design. The EZ Test Web Interface is a website used for processing and retrieving test results and can also be used to compare test results. The project was completed early as to not conflict with the healthcare open enrollment period.

Confidential

QA Tester

During this time, I was transferred from Sogeti's Phoenix office to their Dallas office. I was waiting for a client assignment.

Confidential

QA Tester

• Have the Blue Cross and Blue Shield website ready for the roll out of the Affordable Care Act ACA on October 1, 2013
• Add new accounts to the Global Voice Protocol GVP
• Test HIPAA transactions for compliance
• Provide HIPAA transaction training to facilitate onboarding of new BCBSAZ employees
• The goal of this assignment:
• GVP technology provides for members of new accounts to be able to register for membership and to check the status and payment of claims over the phone. To accomplish this, the following tasks were performed:
• Worked closely with BCBSAZ management, and SME's, to fully test the functionality incorporated into the website. Tested the layout, mapping and pricing models for the new site
• Worked closely with the telecom division to verify the routing setup for the new account's phone numbers
• Used Visio to diagram call workflow
• Monitored defects and re-tested once correct and reported on the expected outcome
• Analyzed business requirements and detailed designs for Electronic Technology Services ETS change requests and projects
• Created test plans, detailed test cases, and tracked defects using HP Quality Center
• Participated in the deployment of code to Production

Confidential

Senior Consultant

• Humana's prescription mail-order delivery service RightSourceRx allows members to easily order a three-month supply of medications and reduce prescription drug costs with 90-day pricing, generic alternatives and convenient home delivery.
• During this assignment, the following tasks were performed:
• Responsible for taking a lead role in investigation and diagnosis of problems encountered in migrating the old system, Mail Order Rx, system into an open source online application known as EpostRx
• Documented and processed defects and enhancements
• Created test cases from no written requirements documentation
• Created test cases by gathering the information through talking with SME's and upper level management
• Recorded defects and tracked defect progress and status for weekly reporting
• The major areas of testing were item entry, screening, failed claims, inventory and distribution using EpostRx.
• Confidential

QA Tester

• The responsibility of this assignment is to test software upgrades, enhancements and major projects on an AS400 Mainframe. Each enhancement and major project centered around an in-house claims application.
• During this assignment, the following tasks were performed:
• Analyze functional requirements to determine software application testing requirements and developed test plan and test cases
• Provide Project Leader with testing estimate and timeline
• Develop test cases and documented the expected results to satisfy the testing requirements
• Set up test case data for test environments and execute the test cases proving the results
• Report problems resulting from test execution and identify testing steps that produced the problem
• Work with development team to resolve reported problems and retest defect fixes to confirm successful fix.
• Provide each project team member with a weekly status report giving graphical representation of defects found in the last week, total number of defects found during the project, number of defects by priority high, medium, low .

Confidential

Business Analyst/Tester

• The goal of this assignment was to implement a mandatory HIPAA 5010 technology upgrade and convert their electronic claims software to ForeSight's TI software. Working with BCBSAZ Electronic Technology Services ETS , group test plans and test cases were developed to verify correct processing of all types of claims, including medical, hospital, outpatient and dental. Testing was performed using 5010 837 HIPAA transactions.
• During this assignment, the following tasks were performed:
• Worked closely with BCBSAZ management, and SME's, to fully test the functionality incorporated in ForeSight's TI software verifying HIPAA 5010 compliancy, and compliancy to BCBSAZ's business rules
• Monitored defects and re-tested once correct and reported on the expected outcome
• Analyzed business requirements and detail designs for ETS change requests and projects
• Created test plans, detailed test cases, and tracked defects using HP Quality Center
• Participated in the on-call rotation schedule for Production Support
• Created 837 HIPAA transactions for all claim types
• Followed the EDI procedures for submitting and verifying the results in ForeSight's TI tool
• Served as the Change Control Coordinator and executed the test region control process

Confidential

Business Analyst/Tester

• The goal of this assignment was to test the 2.9 release of the MetaVance application. To accomplish the task, many claims were set up and processed using Claims Manager Tool for BCI claims, Claims Number Requestor and Quality Center. Test cases were developed to verify correct processing for all types of claims including medical, hospital, outpatient and dental. Experience in processing 837 HIPAA 4010 transactions was required.
• During this assignment, the following tasks were performed:
• Worked closely with BCBSAZ management and area SME's to fully test the functionality incorporated with the 2.9 upgrade release of the MetaVance product
• Tested approximately 150 180 test sets per week which contributed to an earlier than expected completion date for the project. MetaVance 2.9 was successfully implemented on Labor Day weekend 2010. The initial release date was 11/2010.
• Analyzed business requirements and detailed designs to create master test plans, detailed test cases, and tracked defects using HP Quality Center, Aldea, or through a Heat ticket
• Used Quality Center to document Test Plans and to record the outcome of the testing results
• Used Claims Manager to generate claims for testing of BCI claims
• Used Claims Number Requestor for automation claims number generation for BCI claims
• Used SpecBuilder to test many different scenarios of 837 HIPAA transactions for all claim types. Followed the EDI procedures for submitting those transactions, and verified the results against the expected outcome.

Confidential

Business Services Analyst/Tester

• Worked closely with BCBSAZ management, area SME's and HP technical team to define and document the requirements for the projectsAs a Business Services Analyst supporting BCBSAZ the goal was to modify the EDS developed adjudication healthcare software, MetaVance, to meet the business needs of the client. To accomplish the task, many projects were created and were released in a software upgrade in release 2.8. The main assignment was to test sub-system functionality areas such as claims, benefits and provider. Test cases were developed to verify HIPAA transactions processed correctly in the 270 and 271 transaction segments using a .NET test harness.
• During this assignment, the following tasks were performed:
• Facilitated the walk-through of requirement documentation
• Served as liaison between client and EDS technical team
• Facilitated test case and test plan walk-throughs
• Analyzed business requirements and detailed designs to create master test plans, detailed test cases, and defect tracking plan using Mercury Quality Center now HP Quality Center
• Used Quality Center to document the root cause of any defects found, and recorded the steps taken to correct the problem
• Coordinated defect resolution
• Acted as point of contact during implementation of code into production
• Worked closely with off-shore developers in India to mentor them in the MetaVance application

Confidential

Business Services Analyst/Tester

• The purpose of this project was to enhance the Payroll Departments Automated Systems by working with management in the Payroll Department to analyze business processes and suggest improvements. 7-Eleven ran on an AS400 platform.
• During this assignment, the following tasks were performed:
• Served as liaison between clients and application support teams to help define new business requirements and helped identify application impact on business.
• Developed business requirements and functional design documents used by application support teams to develop technical specifications for client.
• Quality assurance testing experience, using Test Director, in creating test cases and test plans
• Created test cases for the following types of testing: functional testing, unit testing, integrated testing, regression testing, and security testing. This testing experience is related to Mainframe applications, Web based applications and server applications.
• Verified production readiness by analyzing the technical and functional requirements with the results of the test case outcome.
• Conducted User Acceptance Test walkthroughs with clients/vendors

Confidential

Business Services Analyst

• The purpose of this project was to implement MetaVance, a healthcare adjudication and financial software package developed by EDS, into the Blue Cross/Blue Shield of Arizona IT system with business needs modifications.
• Primary responsibility centered on the coordination of testing defects found prior to the GO-LIVE with the MetaVance product. Mercury Test Director was the tool used to track and document defects.
• During this assignment, the following tasks were performed:
• Facilitated weekly defect status report meetings involving people in various locations around the Continental United States
• Assigned technical resources to resolve defects and assigned resources to test the resolved defects
• Worked with the client to prioritize defects and developed timeline to ensure the project was on schedule
• Coordinated with project teams during implementation of code into production to verify the status of the project plan
• Tested the functional area of Membership and Claims when defects were resolved

Confidential

Information Analyst/Developer

• The BCBSMA's Real Time Membership System RTMS is an IMS database structure application written using Cobol, Pacbase and JCL. The membership system includes group and member enrollment, maintenance and eligibility along with financial billing and account receivable information.
• As a developer, during this assignment, tasks performed included:
• Creation, unit testing and implementation of new system programs
• Creation, unit testing and implementation of modifications to existing system programs required as a result of legislation and identified enhancements to current functionality
• Performed batch cycle production support including job monitoring and Abend resolution
• Determined root cause analysis to identify errors in application code
• Implemented fixes to errors in application code

Confidential

Information Analyst

• The Internal Mainframe Billing System tracks multiple EDS client's usage of media storage, including tape, CPU and DASD and the number of transactions processed on EDS IBM mainframes.
• During this assignment, tasks performed included:
• Provided monthly invoices to all EDS accounts.
• Verified user login ids were set up for appropriate accounts, and if incorrect researched and updated account.
• On-call for batch cycle Abend resolution.
• Provided account managers with reports that were used for forecasting revenue and contract renewal
• Updated JCL to improve run time during cycles
• Reconciled day-to-day transaction activity to the monthly invoices

Confidential

Information Specialist/Special

• This project consolidated the Federal Aviation Administration FAA Data Management Centers and Work Flow processes in Oklahoma City, OK, and Bethesda, MD into a single location which was the EDS Service Management Center in Plano, TX, including storage media and FAA Data Center resources
• During this assignment, the following tasks were performed:
• Established the project plan for the Tape Media Vault
• Drew up new floor plans detailing the layout of the new library
• Documented the processes that the FAA used for completing their batch cycle.
• Moved all media storage from the FAA Centers in Oklahoma City, OK by truck, and from Annapolis, MD by aircraft.