OBJECTIVE:

Analyst with over 7 years of diverse experience in Information Technology with an emphasis on Software Quality Assurance in Healthcare and Insurance domain. My ambition is to take up a challenging position in the area of Software Quality Assurance and Testing in a progressive, fast - paced dynamic environment that will allow me to align my skills in the organization in the most efficient manner.

SUMMARY:

• Expert in testing ETL processes for Enterprise Data Warehouse (EDW) applications using SQL queries and DBMS tools.
• Utilized ETL Tools like Informatica Power center, Autosys Scheduler and SAS.
• Expert in retrieving database information writing SQL Queries and transforming data to reports.
• Experienced testing ETL Process and Reports using MSBI Suite - SSAS, SSIS, SSRS
• Proven experience with HIPPA EDI transaction sets such as 837 - Healthcare claims transactions, 270/271 - Healthcare Benefit Inquire/Response, 276/277 - Claim Status Inquire/Response, 834 Enrollment, 835 - Payment and Remittance for both HIPAA 4010 and HIPAA 5010 version.
• Experience with ON Exchange 834 Enrollment process.
• Experience with EDI Tools such as Edifecs Transaction Manger, Edifecs Specbuilder and WinSCP.
• Proficient in Agile Methodology approach of Software Development.
• Experience in testing Web services to combine component based development and Internet standard protocols that includes HTTP, XML, SOAP and Web services Description language.
• Experience in both Manual and Automation testing using QTP.
• Excellent understanding of insurance policies like HMO and PPO.
• Strong knowledge of Medicare and Medicaid state benefit plans.
• Experience with testing of OPL, COB, Healthcare Claim Pricing, Healthcare Claim Benefits, End to End Claims Processing.
• Solid understanding of ANSI X12 5010 version SNIP EDITS.
• Excellent understanding of HIPAA version 5010 changes as well as ICD9 and ICD10 version codes.
• Experience with claims processing/adjudication system in Medicare, Medicaid and Private Insurance sectors like MMIS.
• Experience with FACETS Subscriber, Provider, Claims and Rating modules.
• Excellent Understanding of Xcelys (Diamond) Claim Processing system and its version - Xcelys 8.1.
• Excellent understanding of healthcare Inbound and Outbound process.
• Strong knowledge of outbound regulatory and not regulatory reporting process for state and vendor reporting.
• Experience with SAS reporting tool that utilizes Unix server (win32) for generating reports.
• Expertise in testing various report and files such as Flat file, CSV file, EDI files etc.
• Excellent understanding of Healthcare Encounter Process and System.
• Good experience in tracking bugs and generating reports using Quality Center 10.0 / ALM 11.5.
• Experience with creating and organizing test plans / test cases, executing test and tracking bug using Microsoft Test Manager (MTM) tool.
• Expert in writing and executing test scripts (including test data creation) for Functional, Integration, Regression, Smoke, Unit, Volume and Stress testing.
• Expert in Defect tracking and setting priorities and severities of test cases developed.
• Proficient in documenting Test Results using MS office tools.
• Proficient in writing and executing SQL queries for backend testing.
• Proficient in testing data completeness, data transformation, data quality, ETL performance using Technical Design document and Source to Target mapping document for Enterprise Data Warehouse (EDW) Project.
• Experience creating test strategy for application that requires smoke, sanity, regression and integration testing using Business Requirement document.
• Tested ETL process for transition of HEDIS application from Oracle EDW database to Big Data (Greenplum).
• Highly Motivated, able to work independently as well as in a Team Environment.
• Excellent interaction with Business Analyst, Developers and Technical support teams and worked towards the successful completion and execution of a project.
• Expertise in analyzing system and functional specifications used cases, Business Requirements and business rules to prepare Test Plans and design Test Cases.
• Skillful in Enhancing and Editing Test Scripts.
• Experienced with batch processing system for claims electronic transaction.
• Well known with front end processing for the Claims, Subscriber/Family and with Providers.
• Excellent Communication, presentation and interpersonal skills.
• Exceptional inquisitiveness and ability to learn new concepts.
• Effective Time Management skills and the consistent ability to meet client deadline.

TECHNICAL SKILLS:

Testing Tools: Quick Test Pro (QTP), Soap UI, Edifecs TM, Edifecs Specbuilder

Defect Tracking Tools: Quality Center 10 / ALM 11.5, Test Director, Rational Clear Quest, Microsoft Test Manager (MTM)

Languages/Scripting: SQL, PL/SQL, MySQL, Interactive SQL, HTML, UNIX Shell

Databases: Oracle, DB2, MS-SQL Server, and MS-Access

Web Technologies: JSP, ASP, Asp.Net, VB Script, CGI, HTTP/HTML, XML

Operating Systems: Windows XP/2000/NT/98, UNIX

Other Tools: MS Project, SQL Navigator, Visual Source Safe, TOAD, Adobe Acrobat, PVCS, Change Management Tools, MS Visio, MS-Excel, Knowledge of TCP/IP, Version Control, Autosys Scheduler, Beyond Compare, MS Visual Basic TFS, Ultra Edit, Citrix, MSBI Suite - SSAS, SSIS, SSRS, Informatica power center.

PROFESSIONAL EXPERIENCE:

Confidential,Tampa,FL

Sr. QA Test Analyst

• Reviewing and analyzing business requirement, design document for completeness and testability.
• Collaborate with the development and QAEM team for deployments into the test environments.
• Involved in walkthrough with the state to better understand the requirement document and also provide input from testing prospective and timelines.
• Utilize HP ALM to log and track all defects identified during testing
• Processed both EDI 834 X12 and XML Enrollment files and communicated the testing effort and result appropriately.
• Worked with both State and Carrier for ON Exchange Enrollment Testing.
• Worked very closely with cross carrier team for impact analysis and solution.
• Processed standard Enrollment transactions and provided Out Bound files for carrier feed testing.
• Referred to Implementation/Companion guide and XSD Mapping document to validate the realtime EDI 834 Files and Conversion Enrollment XML’s.
• Worked on various modules build in both Java and mainframe platform.
• Tested ETL Process for loading the Carrier (UHC) Conversion XML in to Mainframe and DB2 tables.
• Tested the reports generated by OBIEE and verified and validated the reports using SQL.
• Extensively tested several OBIEE reports for data quality
• Created and communicated Daily Open Enrollment reports to Stakeholder.
• Validated Daily production Outbound Files before carrier and FFM submission.
• Validated ETL Process and Reports using MSBI Suite - SSAS, SSIS, SSRS
• Tested IMS Tickets as a part of production support for Wellmark carrier.
• Tracked and communicated all Tickets for agile releases in Daily AIMS Agile meeting.
• Tested web services and web application such as ExchangeLink, ServiceLink, Member Portal, EMC and Admin tools utilizing SOAP UI and RESTful.
• Tested the Outbound EDI 834 Process for SBM - State Based Marketplace for UHC.
• Validated various Carrier Deliverable report such as Baseline report, Balance Forward report, Rate mismatch Report, Past - Due Report.
• Parsed and converted raw inbound XML data into MS Excel and MS Access to perform validation.
• Tested ETL Process, DB2 tables and reports as a part of On Exchange CMS compliance reporting.
• Created process flow documents to assist the testing team using Microsoft VISIO.
• Assisted Team in creating mass EDI 834 Test file by utilizing tools such as Notepad++, Ultra Edit and Microsoft Excel VBA.
• Extensively used EDIFEC Specbuilder to create EDI 834 Test file from scratch per requirement.

Environment: Mainframe, EDI - ExchangeLink Admin tool, WTX, OBIEE, Quality Center 11.5 (ALM), IBM DB2, XML, LINUX, MS-Office, Windows 2007 Server, Informatica, MSBI Suite - SSAS, SSIS, SSRS, SOAP UI, IBM Data Studio, Notepad++, Ultra Edit, EDI Notepad, Specbuilder, WINSCP

Confidential,Virginia Beach,VA

Sr. Quality Assurance Analyst

• Experienced in using all module of HP ALM for loading functional requirement, creating test cases, executing test cases, logging defects and tracking them and uploading the test result documentation.
• Utilized agile scrum methodology as a SDLC process.
• Prepared test strategy and test plan document based on business and Functional requirement document.
• Prepared test cases in both Excel sheet and HP ALM using Technical Specification document.
• Created test data by updating tables based on Source to Target mapping document for Data Warehouse ETL process.
• Reviewed Business Requirement documents and the Technical Specifications document and participated in all kind of requirement review meetings.
• Participated in Agile Scrum meetings, Defect Meeting, Standup and status meetings.
• Involved in ETL testing of Data Warehouse Remediation Project for State Reporting VA APAC.
• Referred Companion Guide and Implementation guides for preparing test data for EDI transactions set 837 and 834 using EDIFECS Specbuilder tool.
• Manually compared and converted ICD9 version 837 claims to ICD10 version using Ultra Edit and Notepad++.
• Tested several complex reports generated by Cognos including Dashboard, Summary
• Reports, Master Detailed, Drill Down and Score Cards
• Extensively tested several Cognos reports for data quality, fonts, headers & cosmetic
• Validated SNIP edits for EDI 837 claims using Edifecs TM and Business provided crosswalk table.
• Tested EDI 834 outbound process for Vendor and State Reporting.
• Tested various module of Facets and ODS Data source and compared and validated ETL Process and Report for VA APAC Regulatory reporting project.
• Performed various data validation for ETL application such as: data completeness, data quality, data transformation, performance, duplicate check, Business Logic implementation etc.
• Provided support to business user for User Acceptance Testing in walkthrough meetings.
• Performed various testing like black box testing, white box testing, integration testing, regression testing, smoke testing and functional testing.
• Prepared Test results document as per the company standards after the completion of each Work Item Ticket.
• Used Microsoft TFS for general SDLC Process.
• Expert user of ETL tools like Informatica power center and CA Automation Load tools for Data Warehouse project.
• Expert in writing SQL queries for any ETL Testing and Backend testing.

Environment: Xengine, Edifecs TM, IBM Cognos 10.2/10.2.1/10.2.2, Edifecs Specbuilder, Informatica, CA Automation Load, MS Office, Windows 2007, MS TFS, HP ALM, Oracle, MS SQL Server, Ultra Edit, Notepad ++, Beyond Compare.

Confidential,Tampa,FL

Sr. Quality Assurance Analyst

• Manually created several test scripts in ALM and documented the results using MS-Office tools.
• Prepared the Test Plan and Test Scenario based on functional specifications document.
• Created and maintained SQL queries to extract data from the database for Backend Testing.
• Experience using with Quality Center 11.5 ALM for test management and defect tracking.
• Reviewed Business Requirement documents and the Technical Specifications.
• Involved in ETL testing of Claim Load Process and Vendor Extract process for Data Warehouse Remediation Project.
• Referred Companion Guide, Implementation guides to validate the data element and Loop for Testing the EDI’s 837 Inbound and Outbound transaction for ICD-10 changes.
• Manually tested 837 transactions SNIP Edits for HIPAA DB Upgrade 8.0.11.
• Tested the EDI 834 Enrollment Xcelys Load and Premium Recon process.
• Involved in testing Real-time 270-271 and 276-277 transaction using SOAP UI tools.
• Experience with HIPAA 4010 and 5010 transactions sets.
• Expertise of testing Web Application. Tested both front end (GUI) and Backend server for various web application such as appeal and grievances, Web DDE, real-time EDI Transaction such as 270-271 and 276 and 277.
• Tested Xcelys 8.1 patch for Access and Template changes.
• Performed testing Data Warehouse ETL processes that used Informatica and Autosys Scheduler tool to extract and load data from Oracle, MS SQL Server and Excel spreadsheet into the target Enterprise Data Warehouse (EDW) database.
• Participated in Agile scrum and Defect meeting with various IT team for the resolution of issues.
• Prepare test plan, test cases, test estimates for each sprint in Agile Methodology Environment.
• Prepared test data and performed Member, Provider for Claim Intake System (CIS) application.
• Compared ICD-9 and ICD-10 coded claims using beyond compare tool.
• Tested Web application WCToolBox - Appeal and Grievances for ICD-10 changes and tracked backend Database to see if Application is syncing correct data from Database.
• Tested batching process for iHealth Application and validated the recommendation XML file using the database to XML mapping documentation.
• Tested SAS application using Unix server (win32) for generating regulatory reports.
• Tested outbound Encounter files and Outbound Encounter Processing System (EPS).
• Compared and performed data validation like data completeness, data quality, duplicate etc. between Oracle EDW database and Big data Greenplum database for HEDIS Big Data transition project.

Environment: Xcelys, Transaction Manager(TM), Quality Center 11.5 (ALM), Oracle SQL Server, MS-SQL Server, XML, UNIX, MS-Office, PL/SQL, Windows XP, Informatica, Autosys Scheduler, SOAP UI, EDIFECS Specbuilder, MS Visual Basic TFS, Greenplum (Big Data

Confidential,Owing Mills,MD

Quality Analyst

• Developed Test Plans/Cases for Testing at various stages of the development cycle, resource/time estimates.
• Worked on Agile SDLC approach implementation for the whole testing life cycle.
• Created Requirement Traceability Matrix (RTM) for tracking requirements and Test cases.
• Wrote and executed Test cases using Mercury Quality Center.
• Followed SDLC methodology and STLC for testing.
• Involved in end-to-end testing of FACETS Billing, Claim Processing and Subscriber module.
• Referred Companion Guide, Implementation guides to validate the data element and Loop for Testing the EDI’s 835, 837, 270s
• Did a comparison of all the EDI Transaction (837,834,835,820) between 4010 and 5010 HIPAA Version.
• Involved in testing Batch and Real Time updates of HIPAA-5010-mandated rules.
• Experience with conversions of 5010.
• Performed various validations such as record count, duplicate checks, referential integrity, error and exception logic, incremental and historic process for Enterprise Data Warehouse (EDW) implementation.
• Involved in preparation of Test strategy document that defines the Test environment, phases of Testing, entrance and exit criteria into different phases of Testing and resources required conducting the effort
• Prepared detailed Test execution schedule, including data setup and batch execution dependencies.
• Involved in the Review of Requirements Specification with functional manager and technical specialists of the application
• Tested various phases in ETL processes that used Informatica tool to load data from Oracle, MS Access and Excel spreadsheet into the target SQL Server database for EDW Reporting project.
• Done data mapping and data analysis to identify the data sources and data fields to be selected
• Created and maintained SQL Scripts to perform back-end Testing on the oracle database.
• Worked on various BizTalk errors on the outbound 837 transactions.
• Retrieved records from multiple tables from Oracle Database by using SQL QUERIES.
• Experienced in Testing XML web services using Soap protocol.
• Extensively wrote SQL queries to do the data integrity Testing.
• Used Quality Center as a Test management for tracking and managing the defects.

Environment: FACETS, WINDOWS NT/2000/XP, ASP.NET, Visual Studio.NET, Oracle SQL Server, Informatica, Quality Center 10.0, Informatics, SOAP and Cogno

Confidential, Newark, NJ

Quality Assurance Analyst

• Involved in gathering Business, System and Functional requirements for the application.
• Involved In developing Test Strategy, Test Plan, Test Scenarios, Test Cases and detailed test cases in Mercury Quality center.
• Created test plan, executed them and tracked defect using Microsoft Test Manager (MTM) as test management tool.
• Wrote SQL extensively for testing various database such as Operational Database System (ODS), Source database (Facets) and Enterprise Data Warehouse (EDW) database.
• Followed the Agile methodology for the entire SDLC
• Developed user defined functions to support automated scripts.
• Interacted with Business users and Technical team in providing clear solutions to requirements.
• Involved in testing HIPAA EDI Transactions.
• Transactions focused on 837/997,835,270/271,276/277.
• Worked Extensively on Inbound Interfaces 837/997, 835 and make sure the provider claims get processed in the new system.
• Created transaction sets and mappings in various ANSI X12 EDI formats like X12 837, X12 835, X12 270/271, X12 276, X12 277/275 and X12 278.
• Trained in SQL Server to verify and validate all the test cases run.
• Extensively used SQL for Back end testing on Oracle database.
• Created and maintained SQL Scripts to perform back-end testing on the oracle database
• Involved with business user and stakeholders and performed UAT.
• Preparation of Organic data for different Claim file formats.
• Created Host Claims in Medical Claim Processing (camps) and Hospital Claim
• Processing (ITS) Performed Functional, User Interface, End-to-End, Cross Browser, Application, System, Integration, Regression, UAT and Back End Testing.
• As a Defect Coordinator participated in defect reviews with the developers, managers and business people and presented the Defect reports in the defect review Meetings
• Participated in Production rollouts and provided end-to-end support and post-implementation support to the customer community resolving production related issues.
• Performed Data Driven Tests to validate the same scenario with different test data using Quick Test Professional.

Environment:: Quality Center, Data stage, Java, TOAD, XML, UNIX, HTML, Oracle, PL/SQL, Windows XP