SUMMARY:

• Over 7 years Experience with full Project/QA Life cycle (SDLC) from Requirement analysis to User Acceptance Testing (UAT).
• Extensive knowledge of software development life cycle, methodologies and test processes.
• Involved writing Test Plans, Test Cases, and Developing & Executing of Test Scripts.
• Strong Problem Analysis & Resolution skills and ability to work in Multi Platform Environments like Windows & Unix.
• Experience in software testing (Manual and Automated) and system design and requirement analysis. Well versed with Unit testing, White Box Testing, Black Box Testing, System testing, Integration testing, Functional testing and Load Testing, Regression testing and Multi platform testing.
• Performed Analysis to check if EDI Type trees for transaction sets 834, 837, 835 are HIPAA Complaint.
• Hands on experience working on Trizetto Facets 4.51, 4.61 and 4.71. Participated in 5010 upgrades and ICD10 conversions impact analysis meetings and developed impact analysis document.
• Performed high level analysis of 5010 implementation guides and developed requirement development strategy for 5010 conversion.
• Performed 5010 change analysis pertaining to 837 and 278 files and documented them as gap requirements for the system upgrade.
• Analyzed GEMs files and educated business on ICD 10 codes and their differences with ICD 9 codes.
• Prepared test strategy for the 5010 and ICD 10 conversion requirements and presented to the business and management stakeholders.
• Experience on Healthcare systems for commercial (EDI, X12, web, legacy).
• Coordinator of EDI Technology, Healthcare claims processing and HIPPA
• Extensively worked on Web, Client - Server, and Networks applications.
• Experience with Mercury Automated test tools like Test Director, Win Runner, Load Runner, and Quick Test Pro (QTP).
• Experience with all MS Office Tools like MS Word, MS Excel and MS Access.
• Worked on HIPPA, HL7 standards.
• Experience in Database testing with SQL Commands on Database using Toad.
• Involved in Database Testing which includes writing the UNIX Shell /SQL scripts.
• Expertise in ETL (Data warehouse) testing as well as back-end testing using ETL tools and SQL Queries on RDBMS.
• Developing test plans (Scope Documents), Use Cases based on Business Requirement Document (BRD) and System Requirement Specifications (SRS).
• Ability to adept and master quickly new software technologies.
• Excellent Team Member with good Communication and Interpersonal skills

TECHNICAL SKILLS:

Testing Tools: HP QTP 10, Quality Center 9.5, Test Director 8.0, Win Runner 8.0,Load Runner 9.5, IBM Rational Functional Tester, Clear Quest

Web Development: MS FrontPage, ASP.Net, Java, XML, MOSS 2007

RDBMS: MS SQL, SQL Server, DB2 and MS Access, Oracle

Languages/Scripting: C/C++, VBScript, TSL, JAVA, UNIX Shell scripts, JCL (Mainframes)

GUI: VB.Net, ASP.Net, C# Visual Basic 5.0/6.0

Tools: MS Office, MS Outlook

Operating Systems: Windows 9x/NT/2000, XP, Vista, UNIX, DOS.

PROFESSIONAL EXPERIENCE:

Confidential, Nashville TN

QA Analyst

Roles & Responsibilities:

• Involved in Functional, Integration, Regression, User Acceptance, GUI and Stress Testing.
• Participated in Walk through of Test Plans and Test Cases.
• Tested various Text-Hyperlinks and Image-Hyperlinks of Home page and different pages.
• Written test plans, test scenarios and test cases on Healthcare Enrollment plans and executed them on application.
• Analyzed EDI translation errors that failed in the inbound and re-processed the EDI’s without losing the information.
• Worked extensively on Inbound transaction set 834(Benefit Enrollment & Maintenance) Claims Adjudication EDI (837), Remittance (835), Claims Status (276/277).
• Prepared 5010 GAP documents involved with 837, 835, and 278 transactions in collaboration with other team members.
• Prepared high level mapping between X12 4010 and 5010 highlighting the changes that were to be implemented.
• Prepared high level test scenarios on X12 5010 and ICD 10 based business requirements.
• Validated test data prepared by the test team on 5010 EDI transactions and provided necessary inputs so that all the changes were appropriately addressed in the testing.
• Developed low level test cases for testing ICD 9 code sets rules within HL7 requirements on business approved high level scenarios.
• Interacted with QA team and created test plans, test data in EDI, Flat files.
• Coordinated with the trading partners to resolve Inbound and Outbound EDI errors.
• Recorded various scripts on different scenarios to run test automated.
• Prepared Test Data for Positive Testing used in Data Driven Test.
• Back end testing was done to verify and validate data.
• Worked with the technical development team in configuring the EDI 835
• Involved in testing the account validations online.
• Developed Virtual User Scripts using Virtual User generator for Performance/Load/volume testing using Load Runner.
• Involved in writing and testing complex SQL queries involving more than three table joins & getting explained to verify the SQL performance and extensive use of TOAD.
• Worked closely with developers in reproducing bugs reported.
• Created various Synchronization points Using Win Runner.
• Used Quality Center to store, tracking and reporting bugs.
• Performed end user testing before the Build is released for actual real time implementation.
• Testing the Backend with SQL manipulations on database for data validation.
• Prepared pre-conditioned data for testing of the application.
• Extensively used SQL for interaction with the Oracle Database.
• Interacted with developers & various members of team to discuss and resolve defects and their priorities.
• Summarize test results in formula test analysis reports according to the Documentation standards.

Environment: Environment: JAVA, XML Web Services, HTML, SCRUM, XML, WEB SERVICES, HTTP, AGILE, SQL, Oracle 9i/10g, Toad, QTP 9.0, HP Quality Center 9.0/10.0, MS Excel, MS Word and Windows XP Professional.

BA/QA

Responsibilities:

• Facilitated various JAD sessions to determine actual requirements necessary to do the data mapping from CRS supplemental 834 file specification layout to DIAMOND fields for initial load of 20k CRS population.
• Managed business requirement development process and created business requirement documents for each of the existing interfaces that apply to CRS plan.
• Conducted document walk through among managers, State business users, Plan business users, and the vendors utilizing both teleconferencing and physical meeting environment and get the approval.
• Analyzed state provided reports on member data and cross walk with the existing data and produce the consolidated reports
• Created standard 834 extracts documents for vendors which accepted 834 formats and updated existing mapping custom extracts applicable to vendors that accepted non HIPPA formats of data exchange.
• Wrote test plans and test cases.
• Verified system specification document prepared based on BRDs and provided necessary communication to the developers.
• Drafted UAT test cases and do the walkthrough of the documents with the manager.
• Update test cases and results in Quality Center after client side test confirmation.
• Conducted UAT testing and have the test cases and corresponding test results sign off from users, managers, and the respective vendors.
• Wrote SQL queries against DIAMOND production and testing environment database to assure quality by ensuring that test and production data are produced as per the business requirements.
• Coordinated with multiple developers and ensure that development works are getting done smoothly by clearly articulating business requirements to them.
• Facilitated UAT walkthrough for the vendors after completion of UAT; followed up with outstanding issues and got the final approval from them to start production.
• Interfaced with business SMEs in understanding businesses in different lines of business and drafted UAT scenarios involving various UHG projects and got their sign off.
• Updated Claims workflows based on the new CRS plan integration into APIPA and got document sign off from the business.
• Analyzed error report on ANSI X12 834 transaction failures created by state system during receiving CRS member records sent through UHC out bound interface.
• Corrected data errors and prepared updated 834 files and submitted for processing.
• Assisted claims testers in creating claims test data as per CRS population and participated in claims processing in test environment.
• Performed miscellaneous works such as ad hoc testing, BRD updates, meeting reschedules, vendor coordination as requested by the manager.

Environment:: MS Word, Excel, Quality Center, Oracle, PL/SQL, UML, JAVA, MS Outlook