SUMMARY

• Business Systems Analyst/EDI Analyst and senior software QA with 4+ experience in Health Care domain and Retail/Manufacturing industry and worked in full software development lifecycle (SDLC) and Software Testing Life Cycle (STLC) experience.
• Expertise in designing and developing Business requirement and Functional Specification documents, work flows, test plans, test scenarios and test cases and test summary report with extensive experience.
• To determine operational objectives by understanding business functions; gathering information; evaluating output requirements and formats.
• Designs new computer programs by analyzing requirements; constructing workflow charts and diagrams; studying system capabilities; writing specifications.
• To recommend controls by identifying problems; writing improved procedures with strong analytical skills. Monitoring project progress by tracking activity; resolving problems; publishing progress reports; recommending actions. Contribute to team effort by accomplishing related results as needed.
• Expertise onRetail E - commerce transactions 850,810,855,856,832,860,820,823,824, 997 & 999. Good Knowledge on EDI transactions such asINVRPT, ORDCHG, requests.
• Good exposure toHIPAAtransactions837I, 837P, 835, 834, 276/277, 270/271, 274, 999.
• Implemented B2B integration usingEDI, FTP, FTPS, SFTPprotocols.
• Translated various formats of files:XML, CSV, flat, positional, applicationto the standard file formats using the mapping tools.
• Worked in different roles in the field of B2B technologies asEDI consultant,EDI AnalystandEDI Production Support.
• Extensive knowledge of Oracle EBS Accounts Receivable (A/R) and General Ledger (GL) setup and configuration.
• Have experience in debugging and problem solving skills with excellent understanding of system development methodologies, techniques and tools.
• Excellent skills in System Analysis, Business process modeling, Application Design, Development and Deployment.
• Hands on experience in performing all technical support & troubleshooting activities.

TECHNICAL SKILLS

• SQA Testing & Methodologies
• Test Plans, Cases & Processes
• Business Analysis
• Functional Requirements
• Scripting & Documentation
• Business Requirement Analysis
• Requirement Gathering
• Fee Schedules/BizTalk Pre-Processor
• BRD & FSD artifacts
• Regression & Negative Testing
• UI & Compatibility Testing
• Data Interface & Migration Testing
• Performance, Load & Stress Testing
• EDI Concepts/ANSI ASC X12
• Desktop Web Application Testing
• Exploratory Testing
• Workflow Design/Flow Chart
• Analytical skills/Business Processes
• Defect & Bug Tracking
• Testing Automation
• Test Strategies & Coverages
• QA & QC Standards
• MS Excel Pivot Tables/Vlookups
• SQL Queries
• Process Re-engineering
• Mobile Testing
• Java/C/C++ language
• Oracle Apps/O2C/OM/AP/AR
• IVR Testing

PROFESSIONAL EXPERIENCE

Confidential — Scotts Valley, CA

BSA II/ /EDI Analyst II/Provider Data Configuration Analyst

Responsibilities:

• Working closely with Business Users and IT representatives to better understand the Business Requirements for HSP (Health Solution Plus) claim adjudication system.
• Analyzing, researching, resolving and update Provider information to expedite claim processing. Mapping/Un mapping of interchanges for different trade partners in HSP systems.
• Reviewing, troubleshooting and resolving basic system errors generated from system use and Analytics Department tools. Run SQL queries and reports as needed
• Implementing new and maintaining existing provider data and contract mapping configurations as required by Alliance contracted agreements with providers for claims adjudication, physician reimbursement, and member linkages;
• To develop a Business Requirement, Functional Specification documents and Workflow design processes.
• Resolving claims pended as a result of provider data discrepancies; Ensuring that business requirements are accurately implemented;
• Analyzing, recommending and implementing policy and operational changes from the Department of Healthcare Services, Department of Managed Healthcare, Centers for Medicare and Medicaid services or other governmental entities;
• To Implement a process for COBA (Co-ordination of Benefits Agreement) Claims and notify the Providers, not in the system.
• To validate healthcare EDI (Electronic Data Interchange) inbound and outbound transactions like 837 I/P (Claim information- Institutional/Professional), 837 EXR (crossover claims), 274 (Provider Directories), 835 (Claim billing information), 270/271 (Member eligibility inquiry/response), 276/277 (Claim status inquiry/response), 834 (Member data) using EDI Editors Notepad++, EDI File Scanner and SOAP UI testing application for real-time transactions.
• To Perform UAT (User Acceptance Testing)/BAT (Business Acceptance Testing) to ensure the business requirements are met. To Perform functional, non-functional, Ad-hoc, Data Integrity and Data Mapping, Regression, Database Validations, and UI testing.
• Review workflows and ATS (Alliance Technology Services) SOPs (Standard Operating Procedures) as needed.
• Supporting end users for areas of system and reporting responsibility;
• Coordinating with cross teams within the organization to ensure the quality of work delivered on time.
• Ability to review EDI errors via EDI 999 file in 837 segment/loop level that came through BizTalk server and troubleshoot the errors using EDI (Electronic Data Interchange) Implementation guides
• Creation of Test Cases in Team Foundation Server (TFS) and execution of test cases/steps, in Microsoft Test Manager.
• Identification and reporting of software defects using defect (Bug) tracking tool TFS and assigning to Development Team. Re-testing defects after the fix and closing the bugs created in Agile Environment.
• Extracting data through the use of reporting tools such as SQL, basic Data Warehouse techniques and Ad Hoc reporting software using standardized data definitions and formulas;
• Analyzing, recommending, and implementing/updating policy and operational changes from the Department of Health Care Services, Department of Managed Health Care, Center for Medicare & Medicaid Services or other governmental entities;

Environment: AIS, HSP, Team Foundation Server, Microsoft Test Manager, EDI file scanner, EDI Quick, DnGrep, Toad, Oracle SQL Developer, File Zella, Notepad++, SOAP UI, EDI Implementation guides, BizTalk Pre-Processor, NPPES, Tax Port Check, Tableau, Provider Data/Member Data Configurations into systems, SharePoint, bmc footprints, ANSI ASC X12 Transactions, X12 837 transaction version 5010, Paper Claims/Trizetto, Provider/System Configurations, Fee Schedules/Benefit Plans, Group Contracts, EDI Transactions 837/999, 270/271, 276/277, 835, 274, MS Office Suite - Word, Excel - Pivot Tables/Vlook ups, PowerPoint, Visio, etc.

Confidential — Scotts Valley, CA

Sr. QA Analyst/EDI Tester

Responsibilities:

• To analysis the requirements, acceptance criteria and the technical specifications for the tasks assigned to validate
• Walkthrough with the developers including Business Analyst, Project manager, QA Manager
• Build a Test Plan, Test scenarios and Test Cases in Team Foundation Server (TFS) and get the internal and external review done
• To Create Test Suite in Microsoft Test Manager (MTM) to consolidate all the test cases. Testing the applications which are developed in Java Scripts
• Performing functional, non-functional testing, Ad-hoc testing, Data Integrity, UI testing, Data Mapping, and Database level testing
• Execution of Test Case and to find defects/issues using defect (Bug) tracking tool TFS and to assign a concerned developer
• Re-testing defects after the fix and closing the bugs created and sending out Test Summary Report at the closure of the testing cycle
• Testing EDI Transactions like inbound and outbound 837P/I, 999, 835's, 270/271, 276/277transactions
• To identify the EDI 999 errors at segment/loop levels for the claims that came through Biz Talk Pre-Processor
• To develop a Test Summary Report, once validation is done and to send to all the stakeholders within the project
• Validation of functionalities of the requirement in User Acceptance Testing environment
• Experience in defining and using appropriate test data sets for the requirements/tasks assigned
• Experience testing in Third Party software verification, integration and data mapping
• Expert at writing SQL queries using TOAD/SQL Developer to get test data ready for testing
• Ability to perform testing requests through SOAP UI for Real-Time Transactions
• Have exposure working in Agile methodology in two-week sprint iteration

Environment: AIS, HSP, Team Foundation Server, Microsoft Test Manager, EDI file scanner, EDI Quick, DnGrep, Toad, Oracle SQL Developer, File Zella, Notepad++, SOAP UI, EDI Implementation guides, BizTalk Pre-Processor, MS Office Suite - Word, Excel - Pivot Tables/Vlook ups, PowerPoint, Visio, EDI Transactions 837/999, 270/271, 276/277, 835, 274, BizTalk Pre-Processor etc.

Confidential, San Jose CA

QA/BA Analyst

Responsibilities:

• Provided reviews, support and developed Business Requirement Document (BRD) and Functional Specifications Documents (FSDs).
• Created and documented the Test plan, Test scenario and Test case from functional requirements documents
• Utilized Quality Center test plan module for writing Test Cases and test lab module for executing them.
• Responsible for writing SQL queries to find out if the data is correctly populated in each field for price comparison.
• Designed and executed test cases for different mobile operating systems and browsers using Unix/Linux environments
• Used UML models such as Use Case Diagram to create tests for each module and functionality.
• Performed Functional testing for the search function, ensuring that each filter is working as designed.
• Performed Functional testing for the price comparison application, ensured that customers can compare up to four items and the prices are correctly listed.
• Performed the Backend testing by writing and executing theSQLQueries using SQL management studio
• Performed Database testing, POS integration testing and End to End UAT testing
• Maintained the test logs, test reports and defect reports using Quality Center.
• Assisted Production Support team and provided walkthrough from functionality perspective of the application.
• Involved in writing SQL queries to do backend testing.
• Created a Test Plan, that defines the test environment, phases of testing, entrance and exit criteria into different phases of testing and resources required.
• Worked on Warehousing transactionsets940,943,944,945 & 947. Expertise onRetail E - commerce transactions 850,810,855,856,832,860,820,823,824, 997 & 999.
• Configuring the 3PL trading partners into the Oracle systems after performing validations.
• Expert atonboarding trading partnersand transferring files from test to production for secure exchange of electronic data.
• Have good experience in developing translation maps for both inbound and outbound transactions
• Analyzed requirements, Functional requirements and Design documents. Troubleshooting
• Performed the Smoke testing, Functional Testing, System Testing, Regression testing, and UAT Testing.
• Database validation (SQL) to check the updated data in the Database using SQL Server.
• Validated the data on web screens against the data points and database.
• Testing and Reporting the Bugs in product releases and performed the Root Cause Analysis for the Defects raised. Defects are tracked and reported using Quality Center (ALM).
• Coordinated test execution efforts such as test data and support team provision, defect tracking and management, ensuring resolution of testing issues.

Environment: MS Office suite, Quality Center, SQL Server Management, Toad, Java, Java scripts, 850, 855, 856, 810, 999 ORDERS, ORDRSP, DESADV, INVOIC, Notepad++, EDI Quick, EDI File Scanner, Warehouse Management Systems, EDI Communications, EDI Trading Partners, SDLC, EDI Troubleshooting, Functional Acknowledgements, 3PLs, etc.Education