SUMMARY

• Over 7+ years of diverse experience as a Business/Quality Assurance in Healthcare Domain.
• Proven skills in Business analysis, Planning, Process Management, Software development.
• Thorough understanding of HIPAA versions, X12 format, ICD codes, EDI and Siebel systems.
• Participated in the Software Development Life cycle. Expertise include development of testing methodologies, testing cycle analysis, designing test case scenarios and validating application software in a time critical web and client - server applications environment.
• Strong Knowledge of SDLC: AGILE, RUP methodology and project life cycle.
• Work Experience as Quality Assurance Black Box Tester, extensively involved in test designing, Test Plans, test automation and test execution of Client/Server, and Web applications.
• Proficient in Manual Testing and Automated Testing; Adept in using Testing Tools Quality Center, and QTP. Developed excellent professional skills by working as a team member to prepare test scripts and test cases for manual/automated testing.
• Worked on Team Foundation Server.
• Hands on experience on Guide wire Billing Center.
• Knowledge of Healthcare Products and Guidelines. Can work individual and in a team.
• Experience in working on various EDI transaction sets in all phases of medical claims including defining Membership Eligibility and Enrollment and Claims submissions and adjudicating.

TECHNICAL SKILLS

Languages: Unified Modeling Language (UML), Structured Query Language (SQL), XML, JAVA.

Management and Software tools: Rational Requisite Pro, MS Visio, MS Project, MS PowerPoint, MS Excel, EDI transaction support and reporting tool, Claims Inventory system, MS Visio, Clear-case (RQM)

Software Development Methodologies: Traditional Software Development Life Cycle (SDLC), Agile Methodology

Databases: MS Access, Oracle, SQL server.

Testing Tools: Quick Test Professional (QTP), Quality Center (QC), Quick Test Case (QTC)

Environment: s: MS DOS, Windows 95/98/2000/XP/Vista/7, Unix

PROFESSIONAL EXPERIENCE

Confidential, Basking Ridge, NJ

Business Analyst

Responsibilities:

• Worked with MA State for Health insurance and exchange.
• Documented high level requirements by writing migration BRD, prepared Provider Migration BRD.
• Extensively involved in assisting mapping the requirement in ALM requirement tree.
• Drive several modules in state based health insurance application.
• Assured that all Artifacts are in compliance with corporate SDLC Policies and guidelines.
• Scheduled meeting with state SMEs, documented requirements, created BRDs.
• Prepared end to end test scenarios and given a demo to business team.
• Updated and modified business requirements after reviewing with state SMEs and project leads.
• Worked on healthcare.gov application for UIUX and Verification modules.
• Conducted walkthrough meetings with BA and SMEs for application defects of particular releases.
• Coordinated and prioritized outstanding defects and enhancement/system requests based on business requirements, allowing sufficient time frame to ensure accuracy and consider deadlines.
• Core responsibility involved extensive Manual and Automated testing of the application under test.
• Worked on waterfall and agile methodology and joined daily meetings.
• Given live session to state on various issues, scope planning and test reports.
• Involved in Business/State meetings and planning sessions. Provided weekly status of the team and performance monitor report to manager.
• Worked as Plan management and shopping overhaul lead with managing 7 resources onsite and off-shore.
• Worked on several tracks like Accounts, RIDP, FPL, APTC, PD, PA, CMS data, BO, CSR, notices, MMIS Medicaid and many more.
• Worked on TRIAGE the live data feed with OE and customer enrollments with state. Used graphical presentations and live feed from web portal.
• Used Jasper reports to review the logs and stack trace for FMS errored out reports using SQL report queries.
• Worked on the enhancement and modifications of existing functionality of the service application.
• Worked on several tools such as HP ALM 11 and 12.01 version, Utility tools and SQL data extracts.
• Assisted enrollment and billing team with XMLs and responses through SOAP UI
• Analyzed bugs using JIRA and Quality Center and reported those bugs to the development team
• Linked defects to requirements including, tests, test sets, test instances, runs, run steps, and other defects to determine the status of defect using Quality Center.
• Worked on Web service testing, XMLs request and response validation using SOAP UI and SQL back end validations.
• Validated REST, request and response, XMLs in SOAP UI for web service calls.
• Executed and maintain UFT script (QTP), validated result files and retested the failed results manually and updated ALM.
• Validated and performed Smoke testing, Functional testing, back end testing and Regression testing.
• Worked on several web based enrollment applications under agile environment.
• Performed Gap analysis of business rules, business and system flow,user administration to be used for new migration platform.

Confidential, Jacksonville, FL

Sr. QA Tester

Responsibilities:

• Reviewed business requirements and modified the use cases and wrote use case specifications
• Extensively involved in assisting mapping/crosswalk documents for Siebel financial and services
• Created test plan and test cases for user acceptance testing (UAT)
• Assured that all Artifacts are in compliance with corporate SDLC Policies and guidelines.
• Prepared end to end test scenarios and given a demo to business team.
• Coordinated and prioritized outstanding defects and enhancement/system requests based on business requirements, allowing sufficient time frame to ensure accuracy and consider deadlines.
• Core responsibility involved extensive Manual and Automated testing of the application under test.
• Prepared Test Plan and Test Cases based on Business Requirements Document
• Involved in writing Test Summary Report.
• Worked on the enhancement and modifications of existing functionality of the service application using TRIAGE support on live data analysis and validations.
• Worked on Health Insurance, Delinquency, Billing and Group enrollment projects. Performed integration testing, system testing and data validations.
• Involved in HIPAA /EDI Medical Claims Analysis, Design, Implementation and data validation SQL Testing.
• Worked on the HPS new enrollment members Service Request and ID card changes for the health insurance web applications. Validated REST JAVA error logs for request and response failure or errored out records.
• Validated data in the mainframe system and have used SQL queries to retrieve and verify the data.
• Played a substantial role in documentation process for EDI codes (837) Health care claims, (275) patient information and (835) Health care claim payment testing.
• Worked on ALM 11 for test scenario, execution of the test plans; translate user stories and defects in AGILE environment. Worked on several Siebel scope items including the workflow management and process.
• Analyzed bugs using Quality Center and reported those bugs to the development team
• Linked defects to requirements including, tests, test sets, test instances, runs, run steps, and other defects to determine the status of defect using Quality Center.
• Worked on Web service testing projects using SOAP UI tool. Validated request and response, XMLs in SOAP UI.
• Validated exception and work queue including the XMLs in EAS. (Enterprise Audit Services) and Siebel Performed Smoke testing, Functional testing, Mainframe testing and Regression testing
• Worked on several web based enrollment applications under agile environment. Also used SQL complex queries to validate the backend data. Executed UFT scripts for customer data update.
• Used selenium IDE free tool to records and generate basic scripts and small group test cases.
• Involved in extensive testing of Client-Server and Web based application.(enrollment insurance for Small Group)

Confidential, Nashville, TN

Sr. QA Tester/Business Analyst

Responsibilities:

• Reviewed business requirements and modified the use cases and wrote use case specifications
• Extensively involved in assisting mapping/crosswalk documents for ICD 9 to ICD 10 conversion.
• Created test plan and test cases for user acceptance testing (UAT). Provided a walkthrough for Mobile applications testing projects.
• Updated test artifacts BRD and FRDs as per business requirements.
• Assured that all Artifacts are in compliance with corporate SDLC Policies and guidelines.
• Coordinated and prioritized outstanding defects and enhancement/system requests based on business requirements, allowing sufficient time frame to ensure accuracy and consider deadlines.
• Core responsibility involved extensive Manual and Automated testing of the application in AGILE environment.
• Prepared Test Plan and Test Cases based on Business Requirements Document
• Involved in writing Test Summary Report.
• Enhanced the Test Cases by analyzing the Specification Documents worked with EDI applications to process Health Care transactions as per the HIPAA implementation guidelines
• Tested the EDI 834, 835 and 837 interfaces, developed test cases and test scripts for all 835, 837 Institutional and Professional HIPPA Transactions
• Participated in the batch processing of the mainframe data from DB2 used SQL statements. Supported CICS team for the client letter and inquiry project using SOAP UI.
• Manually tested the Extensions in the application like Claims Entry, Claims Provider Cross-Reference, Clean Claim Date, Explanation Codes and Claims down Pay.
• Performed Smoke testing, Functional testing and Regression testing.
• Performed different testing phases using Quality Center. Worked closely with SQL developers for resolving issues.
• Analyzed bugs using Quality Center and reported those bugs to the development team
• Linked defects to requirements including, tests, test sets, test instances, runs, run steps, and other defects to determine the status of defect using Quality Center.
• Performed the test manually as well as using Quality Test Pro (QTP) to verify that the results appeared correctly and in the appropriate fields. Tested mainframe backend data.
• Used Quality Center for defect tracking and maintained defect repository and followed Bug life cycle until the issue was closed.
• Uploaded requirement document and tag the requirements in QC traceability documents

Confidential, NY

QA Analyst

Responsibilities:

• Formulated detailed Test Plan, Test Cases and Testing Procedures which included Test Cases/Scripts, capturing Test Results and capturing and resolving Test Anomalies.
• Was extensively involved in user acceptance testing (UAT) and ensuring it meets the client requirements
• Used Boundary values analysis strategies for developing test cases for the client server application.
• Linked requirements to tests and tests to defects, providing traceability throughout the software development lifecycle using Quality Center.
• Involved in testing the n-tier application wherein the graphical user interface acted as the front end of the client server application, the business logic was stored in the central server and the test data was stored in the server which managed the database.
• Wrote Test Cases in Test Plan Module of Quality Center for the client server and web based application.
• Involved in Test Execution, Tracking and Defect logging in Quality Center.
• Analyzed reports and logs using jasper reports for the applied customer data.
• Parameterized the Test script for data driven testing. Checked heavily on Equivalence Class Data.
• Testing each release to ensure no adverse impact on customers and systems.
• Report and maintain the defects database and track the defects until resolved.
• Discuss status of all open issues facing the test team and describes actions taken to mitigate such issues.
• The project was initially implemented using the Waterfall Methodology but due to changing requirements and time constrains Agile methodology was implemented and daily Scrum meetings were carried out in order to meet the deadlines.
• Tested the application to check if the patient information was anonymized in order to comply with the HIPAA standard.
• Involved in performing backend testing and wrote several SQL queries in order to retrieve the data from the database.
• Wrote SQL queries in order to perform joins and to join multiple tables in order to test the data.
• Worked closely with developers to troubleshoot and isolate complex problem.
• Identified QTP and Quality Center environment issues and working with technical support to resolve the issues.
• Performed Regression Testing using Quick Test Professional and generated scripts for testing functional, acceptance and limit validations.
• Experience in good document practices and validation documentation.
• Executed SQL queries to perform testing on Database connectivity applications.