SUMMARY:

• Over 6+ Years Professional experience as a QA Analyst/Tester in Healthcare Industry.
• Comprehensive knowledge of SDLC Methodologies, RUP, Waterfall model, RAD and JAD methodologies.
• Experience in managing the changes in requirements by Unified Change Management Tools (UCM) like Rational Clear Quest.
• Good documentation knowledge in maintaining the BRD and FRD using the requirement documentation management tool like Requisite Pro.
• Specialized in system study and testing Health Care, Financial, Insurance and Banking applications developed on various technologies such as Facets, QNXT, J2EE, JSP, Java, SharePoint, VB.Net, Oracle and SQL Server on Windows NT/2000/XP and UNIX environments.
• Familiar with HIPAA EDI transactions such as 835, 837 (P, D, I) 276, 277, 278 etc
• Experience in development methodologies like RUP, SDLC, AGILE, SCRUM and Waterfall
• Ability to manipulate and organize the requirements and defects by Traceability Matrix.
• Efficient in Business Modeling by using UML methodologies like use case diagrams, object diagrams, class diagrams, activity diagrams and sequence diagram.
• Excellent knowledge of HIPAA standards, EDI (Electronic data interchange) Transaction syntax like ANSI X12, Implementation and Knowledge of HIPAA code sets, ICD - 9, ICD-10 coding and HL7.
• Extensive knowledge and hands-on experience in SDLC methodologies (Waterfall model and V-model), Software Testing Life Cycle, Defect Life Cycle and various types of testing like black box testing, regression testing, smoke and sanity testing, and functionality testing(positive & negative).
• Expertise in broad range of technologies, including business process tools such as Microsoft Project, Primavera, MS Access, MS Visio, technical assessment tools, Data Warehousing concepts and web design and development.
• Proficient in analyzing the BRS (Business Requirement spec), SRS (System requirement spec) and FRS (Functional requirement spec) for preparing and documenting the test plans/test rules, test cases and executing the test cases for both manual and automation testing.
• Expertise in using the testing tools such as Mercury Quality Center (QC)/Test Director and Quick Test Pro (QTP).
• Highly efficient in using the change management tools of Version Control System like Document Center/Documentum and IBM Rational Clear Case.
• Strong knowledge and experience in writing and executing SQL queries for database testing.
• Experience in developing QA test cases, test scenario and leading towards UAT and Beta Testing for ensuring the application’s successfulness.

TECHNICAL SKILLS:

Methodologies: SDLC, RUP, UML, Agile, XP, RAD, JAD, Prototype

Tools: MS Visio, MS PowerPoint, MS Word, MS Excel, Rational Clear Quest, Rational Clear Case Remedy, Rational Rose, Requisite Pro, Mercury Quality Centre, Mercury

Database: ORACLE SQL & PL/SQL

Languages: C, C++, JAVA (Sun certified Java Programmer)

Operating System: Windows (95, 98, ME, XP)

PROFESSIONAL EXPERIENCE:

Confidential, MN

QA Tester

Responsibilities:

• Involved in developing test plans, Created test cases and test scripts.
• Executed Test Cases to find defects within the NIW system and tracked the defects in Quality Center
• Defined the test criteria, project schedules and base lined the Test Plan with the help of project meetings and walkthroughs.
• Involved in decision making of converting manual test cases into automated test scripts and analyzing their life time and time required to update the scripts.
• Extensively involved in testing Trizetto's Facets and mainly involved in Enrollment and Eligibility modules.
• Written smoke test cases in Quality Center and modified them when they are automated.
• Involved in environment requirement gathering meetings and giving inputs to the environment teams.
• Implemented HIPAA 4010 and 5010 / ICD 10, version for all EDI transactions.
• Extensively interacted with the stakeholders and the IT Department in finalizing the requirements according to the CMS Compliances/Regulations and HIPAA Regulations.
• Developed QA Test Plan from technical specifications and requirements for this project which deals mainly with three areas i.e. presentation tool, integrated genesis selling tool and catalog API.
• Developed plan for data feeds and data mappings for integration between various systems, including XML, to follow ICD 10 Code set and ANSI X12 5010 formats.
• Expertise in testing Enrollment, Billing and claims processing in FACETS
• Involved in creating sample mappings for the conversion of EDI X12 transactions code sets version and translation of ICD 9 codes into ICD 10 codes.
• Manually tested the whole application before going for the automated testing.
• Involved in testing the conversion of the application into web application using XML web services.
• Developed and verified the request codes, response codes, and reason codes using Distributed Applications Technology using JAVA, JDBC and XML.
• Worked on pre authorization of Claims in FACETS and Knowledge of ICD-9, CPT, REV codes.
• UAT testing performed along with call center managers to make sure that application meets their requirements.
• Designed load tests (Stability, Stress and isolation tests) in different ways to measure the application performance.
• Used Test Director and Mercury Quality Center for updating the status of all the Test Cases & Test Scripts that are executed during testing process.
• Generated Performance strategy, reports, Benchmarking, Analysis and Tuning of the System.
• Responsible for building the frame-Work for the Automation. Successful automation of SAS Management Console, Information MAP studio, SAS ETL, Web report Studio
• Translated Business processes into Informatica Mappings for building Data marts
• Responsible for integrating with Facets (Version 4.41).Designing test scripts for testing of Claims in Development, Integration and production environment.
• Regular interaction with developers, business analyst and Logic Unit Workgroup.
• Prepared documentation for all stages according to company standards.
• Extensively involved in the automation of Regression Test Cases by scripting.
• Used Controller to organize the test scripts, Execute and Report scenarios.
• Performed Data driven testing, Correlation and check point in the scripts.
• Enhanced the scripts and developed various functions to enhance the scripts.
• Extensively worked on Performance Monitoring and analyzed the response time, Memory leaks, hits/sec and throughput graph.
• Involved in development and reporting of quality assurance project metrics.
• Created Data Driven Testing for positive and negative scenarios, by creating and storing data sets in MS Access.
• Experience in Integration, Portability, System and Compatibility testing using Black Box methods (manually).
• Planned & managed user training sessions for Cognos
• All the test scenarios which have been satisfied with the functionality are moved to automation testing using Quick Test Professional.
• Backend testing of the DB by writing PL/SQL queries to test the integrity of the application and Oracle databases using TOAD.
• Used Visio for business analysis.
• Debugging and Troubleshooting Informatica Mappings
• Wrote and modified required UNIX scripts and other SQL validation scripts and writing scripts in SQL to validate the outputs analyzed test results and creating performance evaluation reports.
• Performed Black Box testing of Relational Database (SQL Server) under Client/Server environment for both Windows-95 and Windows NT Operating Systems using different network libraries and communication protocols
• Involved in functional and regression testing of the web-application using the VO extension and tested the software using different browsers to study the browser compatibility.
• Responsible for collecting and analyzing the test metrics and then submitting the reports keeping track of the status and progress of the testing effort.
• On-call Production Support (24x7), monitoring and maintaining multiple Applications in Development and QA and Production Environments.

Environment: Windows 98/2000, Window2003, Window NT, Linux, Solaris IBM Web sphere, Apache Tomcat, COBOL, IS 6.0, Web Logic, Java, .NET, ASP.NET, Quick Test Pro 8.2, Mercury Quality Center, Mainframe, DB2, J2EE, UNIX, XML, Windows OS, SQL, PL/SQL, Oracle9i, Cognos, Quality Center 9.0, QTP, Quick Test.

Confidential, North Richland Hills, TX

QA Analyst

Responsibilities:

• Designed and development of test cases based on functional requirements for Institutional and Professional claims for EDI and HIPAA Transactions 837/835, 834, 276/277, 270/271 testing.
• Discussed with SMEs across different business units to gain solid knowledge of the existing Derivatives Exchange Systems and assisted in preparing an advanced Derivatives Valuation and Risk Management.
• Assisted in GAP Analysis; identified and documented improving area to meet the end state requirements.
• Designed and developed Use Cases through visually modeled UML diagrams to both management and development teams to ensure uniform understanding of the business scope, and detailed business and functional requirements.
• Understood the business process that included Sales processes, Rating methodology, different Products, Group Renewals and Enrollment process in Facets.
• Experience in EDI automated first-pass claim adjudication, requiring thorough understanding of claim processing, both front and backend operations.
• Developed HIPAA EDI Transmissions. Work includes complete business cycle management and hands-on production as well. Create EDI Testing process, documentation, and performance matrices.
• Technical Specification Creation for EDI. Schedule meetings with technical personnel to determine technical parameters for EDI and other related processes, including communication, security, and privacy.
• Collaborated with the development team to enforce the implementation of requirements throughout the entire coding cycle and managed change request using Rational Clear Quest.
• Developed test plans with QA team and helped to develop test scenarios for system testing, integration testing and performance testing.
• Extensively involved in testing Facets Member/Subscriber, Billing, Medical Plan, Dental Plan modules.
• Involved in testing Facets for Group Information, Enrolling Subscribers, adding members, Related Entities, Class/Plan definition, Premium Rate Tables and all.
• Interpreted and calculated the option issues like Option Premium, Strike Price, and Option Intrinsic Value for America/Euro Options in the user manual.
• Conducted Functional Testing, Joint Functional Testing and UAT, documented and reported user feedbacks to management team.
• Developed plan for data feeds and data mappings for integration between various systems, including XML, to follow ICD 10 Code set and ANSI X12 5010 formats.
• Used Quality Center/Test Director for requirement management, test planning, scheduling, executing test cases, managing and tracking defects.
• Utilized corporation developed Agile SDLC methodology. Used Scrum Work Pro and Microsoft Office software to perform required job functions.
• Automation of test scripts was done using QTP for test re-usability of different online transaction modules.
• Performed Defect Tracking and Change Control Procedures using Rational Clear Quest and Configuration Management and Version Control using Rational Clear Case.
• Responsible for the User Interface, including screen presentation and reports.
• Involved in Regression testing of each build during the various phases of the application using QTP.
• Coding of QTP automation scripts was done by using VB Script.
• Performed sub-system integration test, system test, functionality test (positive and negative), and re-test and regression test.
• Assisted JAD sessions to identify the business flows and determine whether any current or proposed systems are impacted by the EDI X12 Transaction, Code set and Identifier aspects of HIPAA.
• Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Medicaid Claims.
• Worked on EDI transactions: 270, 271, 834, 835, and 837 (P.I.D) to identify key data set elements for designated record set. Interacted with Claims, Payments and Enrollment hence analyzing and documenting related business processes.

Environment: Load Runner, ASP.NET, Java, Oracle, XMLSPY, TOAD, Windows NT /2000, SQL Server 2005, Microsoft Word, Project, Excel, PowerPoint, Ms-Visio, GIS Tools, Cognos, BI, Sybase, MS Project

Confidential, Nashville, TN

QA Analyst/ Tester

Responsibilities:

• Validated the following: 837 (Health Care Claims or Encounters), 835 (Health Care Claims payment/ Remittance), 270/271 (Eligibility request/Response), 834 (Enrollment/Dis-enrollment to a health plan)
• Designed and developed all use cases and UML models using Microsoft Visio;
• Implemented the entire Rational Unified Process (RUP) methodology of application development with its various workflows, artifacts and activities;
• Maintained and kept track of stakeholders requests for enhancements and changes using Rational Clear Quest
• Gained understanding of Medicaid policy and billing requirements and documented needed changes to policies and billing manuals related to ICD10 through facilitation with internal program areas.
• Documented business needs for ICD10 resulting from the HIPAA 5010 gap analysis.
• Worked on the ICD9 to ICD10 crosswalk and coordinated the development of the crosswalk solution.
• Determined the requisite ICD10 training for both internal staff and Medicaid provider groups and assisted in the development of training materials.
• Wrote Test Cases in Mercury Quality center that would test various Test scenarios.
• Used UML notations for Object Oriented Design and Documentation.
• Interfaced with the development team utilizing ASP, JavaScript and Visual Basic and produced detailed user-interface prototypes and performed usability testing.
• Wrote Test plan and Test cases for the Integration testing and system testing.
• Did Integration Testing, GUI testing, Smoke and Sanity Testing, and Acceptance testing in the new builds for Basic Functionality Checking.
• Provide implementation assessment, strategy, and mentoring services for Rational Rose, UML and RUP.
• Analyzed and optimized the process, Prepared Business Requirement Document (BRD) and then converted the business requirements into Functional Requirements Specification and Technical Specification using Rational Requisite pro.
• HIPAA EDI transactions such as 835, 837 (P, D, I) 276, 277, 278.
• Assisted JAD sessions to identify the business flows and determine whether any current or proposed systems are impacted by the EDI X12 Transaction, Code set and Identifier aspects of HIPAA.
• Verifying Healthcare Eligibility, Claim, Benefit and Service using ANSI ASI X12 Standards.
• Rational Clear Case was used to manage all the changes and change requests in the projects. Worked with QA team with the aid of Clear Quest for the bug tracking and Mercury Test Director for Test Case Management.
• Establish documentation for Agile methodology for implementation with a very water-fall-centric development team.
• Designed and implemented SQL queries for QA testing;
• Assisted the PM in setting realistic project expectations and in evaluating the impact of changes on the project, and conducted project related presentations;
• Prepared user manual and performed user acceptance testing;
• Played a key role in the planning and testing the system enhancements and conversions.

Environment: Load Runner, Toad, Windows NT /2000, SQL Server 2005, Sybase, MS Word, MS Excel, MS PowerPoint, Ms-Visio, XML, XML Spy, Cognos BI, MS Project, Primavera, PowerBuilder, Clear-Quest, Rational Test Manager, GIS Tools

Confidential, Philadelphia, PA

QA Analyst/ Business Analyst

Responsibilities:

• Worked for Version document with SME. Primary Liaison between Business User and Development Team.
• Conducted GUI and functionality testing using QTP.
• Conducted data driven testing using QTP to conduct backend testing.
• Deep understanding the Business Flow of Investment Banking, and extensively involved in Portfolio management and analysis, Mutual Funds, Securities trading
• Deep understanding of Structured System Development Methodologies
• Assisted Project Manager and User managers to conduct Market Research and Feasibility Studies, and to develop Scope/Vision Documents.
• Assisted Project Manager in development and documentation of Project Plan
• Closely worked with SMEs and Identified, researched, analyzed, and defined key issues of the Business flow.
• Responsible for attaining HIPAA EDI validation from Medicare, Medicaid and other payers of government carriers.
• Created use-case scenarios and storyboards in MS Word and MS PowerPoint for better visualization of the application and managed them using Rational Requisite Pro.
• Worked on Documentum for Version Controlling, to maintain up to date changes in the Documents.
• Verifying Healthcare Eligibility, Claim, Benefit and Service using ANSI ASI X12 Standards.
• Monitored the compliance mapping of transactions to the EDI transactions standards ANSI -X12.
• Performed White Box testing by using Expediter tool and updated some of the PROCs, JCLs and SAS programs in the Test region. Submitted batch JCLs in order to create output datasets for verification.
• Analyzed and Documented Business Requirement Document (BRD), Functional Specification Documentation, and System Requirement Documentation, using UML methodologies
• Designed and developed Use Cases using UML and Business Process Modeling.
• Developed QA Test Plan, test conditions and test cases, as well as assisted with QA team in System Testing using Mercury Test Director
• Involved in creating reports for the end users using Crystal reports from the gathered requirements.
• Developed User Manual and Provided User Training.
• Conducted User Acceptance Testing

Environment: RUP, UAT, UNIX, Java, SharePoint, Sybase, Microsoft Word, Project, Excel, PowerPoint, GAD (Gap Analysis Document), HTML, XML, PowerBuilder, ASP. File Net, SQL, GIS Tools, MS Visio