Summary

• Over Five years of experience as a Business Analysis, Quality Assurance Analysis and User Acceptance Testing of application system coupled with strong database knowledge in Client/Server and Web database environments.
• Strong leadership ability, can work and manage multiple projects, give direction to others and take a lead role in improving organizational processes.
• Managed BA activities of Software Development Life Cycle for insurance and healthcare clients.
• Proven track record of getting Deliverables delivered in highly chaotic and fast-pace environments.
• Detail-oriented and outstanding communication, organizational and leadership skills.
• Experienced with HL7, HIPPA 4010, 5010 EDI transaction codes 270/271, 276/277, 834, 835 and 837.
• Experienced in EDI Testing, Mainframe Testing, with great knowledge of QA methodologies.
• Involved in testing Batch and Real Time updates of HIPPA-4010-mandated ANSI 270 Eligibility and Benefit Request and the ANSI 271 Eligibility and Benefit Response .
• Working knowledge in ICD 9 Health codes in the claims environment.
• Worked with Claims, enrollment, eligibility verification for members and providers, benefits setup and backend payment cycle in Facets.
• Good knowledge of Health Insurance Plans Medicare Part A, B, C D , managed care concepts Medicaid Medicare and experienced in determining the membership eligibility, billing experience within life and disability in health plans with thorough understanding of CPT coding.
• Hands-on experience working on Medicare/Medicaid public insurance programs.
• Understood the impact of ICD 9 to ICD 10 conversion.
• Involved in preparing and executing Batch Tests to improve testing efficiency.
• Experienced in performing User Acceptance Testing UAT and keeping testing logs cycles to add to Software Testing Artifacts.
• Developed Test Plan, UAT test strategy, Test Scenarios, Test Scripts, UAT Test Scripts and Test Reports.
• Excellent Negotiating/Presentation Skills, Well Written and Oral Communication Skills to work with the business users for UAT Testing.
• Extensive experience in working with Agile and RUP.
• Experienced in using Test Director for requirements management, Planning, Scheduling, running tests, defect tracking and defect management.
• Integrated QTP with Quality Center to store and execute automation scripts and log execution reports.
• Strong Problem Analysis and Resolution skills and ability to work in Multi-Platform Environments like Windows 2000/XP, UNIX.
• Expertise in Analyzing Business Specifications and writing Test Cases, develop Test Scripts and execute them.
• Experience of the full Software Development Life Cycle SDLC Methodologies and Validations to ensure the Quality Assurance Control.
• Extensive experience in Functional, Integration, Regression, User Acceptance UAT , System, Load and Stress testing, Black Box Testing and white box testing.
• Maintaining the Requirements Traceability Matrix RTM across deliverables of a project.
• Experience working with SQL scripting, managed version control software and defect tracking systems.
• Strong Analytical skills, excellent communication and interpersonal skills, team player and self-Starter.
• Liaison between the Project Manager, QA Manager and testing team. Created Data Mapping documents to migrate the data from existing system to the new system.

Technical Skills

• Methodologies: Rational Unified Process RUP , Waterfall, Agile
• Languages: C, C , SQL, PL SQL, HTML, XML
• Database Tools: SQL Developer, TOAD
• Project Management: MS Project 2000/2003
• Other Tools: Rational Requisite Pro, Clear Case, MS-Office Suite, Edifecs X-engine, Specbuilder, Biztalk
• Data Modeling Tools: Rational Rose, Visio, ERWIN
• Operating Systems: Windows 98/NT/XP, UNIX
• Databases: MS SQL Server 2000, MS Access, Oracle, DB2
• Testing Tools: Mercury Quality Center, QTP, Win Runner, Clear Quest

Professional Experience:

Confidential

Business Process Analyst

Responsibilities:

• Analyzed the available artifacts such as BRDs, both functional and nonfunctional, Use cases and Data Flow Diagrams.
• Documented the scope of the project and built a project plan.
• Conducted daily meetings with the development team to communicate the requirements and make sure they were mapped according to the requirements document.
• Gathered requirements, prepared Process Flow and Diagrams for the manual to automated conversion project.
• Performed GAP analysis and created requirements traceability matrix of business rules, business and system process flow, user administration and requirements.
• Identified the scenarios based on business requirements.
• Created specifications documents and mapping documents.
• Created and maintained quality system documents and records, e.g. flowcharts, procedures, forms, templates, spreadsheets and presentations.
• Experienced in UAT testing activities. Interacting with the Business Users, Execution of UAT Test Cases and Retested UAT Defects.
• Mapped UAT Test Cases with the Business Use Cases.
• Involved in preparing the RTM.
• Worked with the QA lead as a team.
• Expert in using formulas, concatenations and Pivot Tables in Microsoft Excel.
• Worked extensively with MS Excel to automate UHG's testing process.
• Tested the data received from UHG clients in MS Excel using formulas, concatenations and Pivot Tables.
• Used Macros to automate the testing process.
• Attended meetings with the QA lead about automation.
• Was responsible for three of UHG's clients.
• Helped build new Control Points for the testing process.
• Involved in writing testing directions for the Control Points.

Confidential

UAT Analyst

Responsibilities:

• Working on various subsystems related to Pharmacy, Drug rebate systems and Finance. Their file exchanges between Medicaid Information Technology System MITS , ACS and providers.
• Served as a liaison for Business and IT/QA/UAT on both business functional requirements.
• Involved in Gap Analysis of ICD 9 to ICD 10 code sets.
• Participated in Impact Analysis of ICD9 to ICD10 code sets.
• Involved in drafting high level test scenarios based on GAP documents and high level x12 5010 and ICD10 based business requirements.
• Extensively used Lotus Notes for database across and for mails.
• Worked on Data mapping for 4010 to 5010 conversion.
• Extensive experience in testing EDI 4010 and MITS.
• Prepared Test Cased based on Use Case documents and high level X12 5010 based business requirements.
• Assisted the client during the UAT phase by researching any issue, helping clients in testing and acting as the point of contact for researching issues.
• Created test plans and test cases for user acceptance testing UAT
• Ensured that the MMIS upgrades are able to handle the new HIPPA transaction.
• Participated in National Provider Identifier NPI crosswalk for 5010.
• Developed Test Plans and Test cases for 5010 transactions.
• Created workflow for HIPPA inbounds 837 Institutional, Professional and Dental Claims.
• Developed EDI X12 based implementation guides and ODJFDS's application file formats.
• Work on developing logical mapping for new trading partners, develop cross reference and store inbound and outbound data files.
• Reviewed approved functional test plans and worked with UAT for acceptance testing.
• Used Clarity for status reporting.
• Involved in User Acceptance Testing and also perform testing with the trading partners to accomplish project deadlines.
• Used Quality Center for logging and tracking defects.
• Developed and executed SQL queries on claim records to validate reporting data.
• Extensively worked on Managed Care Plans MCP , actively involved in the file exchanges of MITS architecture.
• Verified the file layouts which are inbound and outbound from MITS to various sources.

Environment: MS Visio, Microsoft Office, Microsoft Sharepoint, Clarity, Lotus Notes, HP Quality Center, QTP, Project Workbench, SQL, TOAD

Confidential

QA Analyst/UAT Tester

Responsibilities:

• Executed Test Plans and Test Cases manually and automatically to verify the functionality of the application against the expected results.
• Reviewed the requirements and the use case diagrams to write Test Cases/Test Plans that would test various scenarios.
• Developed and implemented test plans for System, validation, UAT, Performance and Regression Testing for various Facets 4.71 modules such as Billing, Claims Processing, Providers, Subscriber/Member and Customer Service.
• Worked on designing processes sub-processes confirming it against the functional requirements.
• Prepared Test Cases and Test strategies for 5010 transactions.
• Worked on upgrading HIPPA X12 4010 to HIPPA X12 5010.
• Validate to make sure that all the test cases created for Facets are processed successfully.
• Responsible for developing the test cases for Non Electronic Submissions, Provider services,
• Recipient and Call Center build teams.
• Experienced in UAT Testing Activities. Interacting with the Business Users, Executon of UAT Test cases and Retested UAT Defects.
• Worked on both Oracle database for creating, modifying and deleting queries and also for creating PL/SQL procedures and functions for validating various test data for Functional testing.
• Experience in creating the Medicaid Incentive Payments System MIPS . Built test cases for matching and validation of attestation processes in Health Information Technology MIPS.
• Tested the Claims, Members, Subscriber and Providers in Facets 4.7.1.
• Assisted the clients during the UAT phase by researching any issues, helping clients in testing and acting as the point of contact for researching issues.
• Extensively created requirements using Quality Center and generated traceability Matrices to ensure that all the requirements are covered by the test cases.
• Used Quality Center for writing test cases and logging defects.
• Logging defects with detail information, screenshots and related documents in Quality Center.
• Planned, designed and generated scripts for the manual test cases.
• Regression testing for Facets 4.71 is conducted to ensure that newly added functionality did not break any of the previously tested functionality.
• Wrote SQL queries to validate data in database and Facets 4.7.1.

Environment: MS Office Suite, Windows XP Professional, Quality Center10.0, Facets 4.71, SQL Server 2005

Confidential

BA/QA Analyst

Responsibilities:

• Participated in user meetings, gathered Business requirements specifications.
• Established a business Analysis methodology around the SDLC, helped to develop use cases, project plan and manage scope.
• Involved in the meeting with Business Process Owners, SME Subject Matter Experts and store users for Requirement gathering in Definition Stage.
• Manage Scope and change throughout the SDLC process of the product.
• Analyzed User and Functional Requirements Specifications.
• Involved in preparing the Functional test cases according to functional specifications.
• Worked with the business/functional unit to assist in the development, documentation and analysis of functional and technical requirements.
• Coordinates test execution for UAT.
• Developed and implemented test case mapping to requirements, Project Status reports, Issue defect matrices, UAT test plans and User Training documents.
• Prepared regression test plan for feature enhancements.
• Participated in functionality and regression testing.
• Created Functional and Regression test folders in Quality Center.
• Exposure and knowledge to 834 benefits claims files testing in enrollment and plan merger projects.
• Worked extensively on inbound transaction set 834 Benefit Enrollment Maintenance Claims Adjudication EDI 837 , Remittance 835 and Claims Status 276/277 .
• Performed Analysis to check if EDI Type trees for transaction sets 834, 837, 835 are HIPPA Complaint.
• Involved with backend testing of the SQL database and verified the EDI data transactions in the database.
• Extensively used Mercury Quality Center for Test Plan Documenting, Test Case design, Executing test in test lab, requirement gathering and reporting.
• Executed test cases manually as well as automation and developed test reports.
• Reporting the bugs using Quality Center and tracking them to closure.
• Conducted Security Checking by restricted privileges and roles to the users.
• Preparations of defect report and logging the defects in Quality Center.
• Interacted with Developers and Business Owners.
• Documented and resolved errors and provided feedback on testing activity through weekly reports.

Environment: Quality Center, Oracle, SQL, PL/SQL, MS Office, MS Project, MS Visio, Java, QTP and Windows