SUMMARY:

• 8+ years of extensive experience in the IT field with emphasis on Quality Assurance. Worked on testing client/server and web - based applications. Experience in Healthcare projects, good team player with excellent communication skills and ability to work independently along with strong problem solving, learning and interpersonal skills.
• Extensive knowledge of SDLC (Software Development Life Cycle) methodologies.
• Good working knowledge of the insurance industries.
• Performed Testing on Windows and UNIX platform.
• Experience in writing Test Plans, defining Test Cases, developing and maintaining Test Scripts and Documenting all phases of the QA process.
• Experienced in RUP Software Development Life Cycles (SDLC), Agile processes, Use Cases, UML, Interaction Diagrams, Sequence Diagrams and Activity Diagrams.
• Experience in reporting bugs using Bug tracking tools such as HP ALM and JIRA. Review Requirements in Requisite Pro and develop Test Cases/Test Scripts, execute tests and log results in Rational Test Manager.
• Extensive experience with EDI X12 (Knowledge of most of the segments and loops).
• Excellent knowledge on MMIS (Medicaid Management Information System) and MEDS (Medicaid Eligibility Determination System) and its operation, MMIS is an automated claims processing and information retrieval system that helps State government administer the Medicaid program.
• Worked on Data migration, Facets version upgrades, Reports Implementation, letters, Inbound/outbound Interfaces and Facets Extensions. Implemented EDI transactions 835, 270/271, 276/277 and 834 in Agile Methodology.
• Extensive Knowledge and Experience in Service Testing (Web Portal Services).
• Expertise working in Healthcare industry with Insurance, Loans, Claim Processing, etc. Medicaid and Medicare modules as well as Interface Testing and Data Conversion. This includes HIPAA 4010, 5010; 837, 835,834, 270/271,276, 277 and 278.
• Proficient knowledge in various Medicare products (Medicare part A, B and D).
• Expert in analyzing system and functional specifications used cases, Business Requirements and business rules to prepare Test Plans and design Test Cases from business requirements.
• Good knowledge on different modules within healthcare (Membership, billing, enrollment, Claims, capitation, providers).
• Experience with HIPAA compliance (4010 & 5010) and Healthcare systems.
• Experienced in GUI, Regression, and Functionality Testing.
• Performed Back End testing by executing SQL queries.
• Involved in Black Box, Positive, Negative, Unit, System and Integrated Testing.
• Experience in Stress, Load, Performance and Volume Testing.
• Performed Sanity and Smoke testing.
• Manually performed User Acceptance Testing (UAT). Involved in maintaining Test Matrix and Traceability Matrix and performing Gap Analysis.
• Good Team player with the ability to lead, manage and work independently in a time sensitive environment

TECHNICAL SKILLS:

Testing Tools: HP ALM, Rational Team Test, Microsoft Test Manager, Soap UI

Bug Reporting: Microsoft Test Manager, Team Foundation Server, Test Director, Rational Clear Quest, Quality Center, JIRA

Programming Languages: SQL, Java, XML

Databases: MS-Access, Oracle, TOAD, Microsoft SQL SERVER

Operating System: Windows, Unix

MS Office Tool: Word, Excel, PowerPoint, Visio

PROFESSIONAL EXPERIENCE:

Confidential, Dallas, TX

QA Tester

Environment: Web Portal, SQL, EDI, Agile, Windows, Quality Center, MMIS

Responsibilities:

• Analyzed user/business requirements and developed System Test Plan and Test cases.
• Done testing of consumer web portal for the enrollment of Medicare members
• Automated test scripts to carry out Regression Testing and Backend Testing.
• Expert in Medicaid/Medicare claim processing
• Conducted Requirement Traceability Matrix (RTM)for requirement to be mapped with Test scenario
• Supported documentation across extending testing team as directed by UAT Manager, and SIT Manager
• Responsible for testing of claims adjudication process for the New MMIS system.
• Provided the test summary report to the QA lead and coordinated with the fellow QA lead to plane test execution by using JIRA.
• Performed full User Acceptance Testing (UAT) on multiple portals & modules in order to know that the product is designed/ working as per the business standards.
• Performed Web Portal Service testing as functional testing.
• Worked with providers and Medicare or Medicaid entities to validate EDI transaction sets,
• Developed Test Cases for the Back-End Testing, integrating the SQL queries to be used in running the test cases
• Developed Test Cases/Test Scripts, execute tests and log results.
• Manually tested the web internet portal application to ensure the flow of the application functionality.
• Involved in the testing of web portal of New MMIS system.
• Managed and executed the test process, using Agile Methodology.
• Created new UAT scripts based on requirements.
• Designed, Communicated, and enhanced QA testing plan for the application
• Prepared and executed test cases manually for different modules
• Used JIRA & Quality Center, and as the bug-reporting tool and testing tool.

Confidential, Camp Hill, PA

QA Analyst

Environment: Oracle, UNIX, Windows XP, MMIS, Microsoft Test Manager, Web Portal, Team Foundation Server, Soap UI

Responsibilities:

• Formulated detailed Test Plan after analyzing business rationale and software requirement artifacts
• Analyzed user/business requirements and developed System Test Plan and Test cases.
• Conducted Functionality, GUI, End to End, Security, Performance, and Stress Testing during the various phases of the development of the application
• Performed Security Testing, System Testing, Positive and Negative Testing
• Done testing of consumer web portal for the enrollment of Medicare members
• Automated test scripts to carry out Regression Testing and Backend Testing.
• Expert in Medicaid/Medicare claim processing
• Performed Parameterization for running multiple iterations of the script using different sets of data Black Box, Integration and Security Tests
• Performed Smoke Testing.
• Extensively Used Soap UI as open source for web testing, and functional testing
• Conducted Requirement Traceability Matrix (RTM)for requirement to be mapped with Test scenario
• Supported documentation across extending testing team as directed by UAT Manager, and SIT Manager.
• Excellent knowledge on MMIS (Medicaid Management Information System) and MEDS (Medicaid Eligibility Determination System) and its operation, MMIS is an automated claims processing and information retrieval system that helps State government administer the Medicaid program.
• Provided Efforts Estimate and coordinated the test schedule using Agile testing methodology in UAT phase.
• Detecting, Tracking and Reporting defects to developing team lead using JIRA and QC following up the status of defects.
• Performed SOA / Web Portal Service testing using Soap UI
• Worked with providers and Medicare or Medicaid entities to validate EDI transaction sets or Internet web portals. This includes HIPAA 4010, 5010; 837, 835, 270/271, and others.
• Developed Test Cases for the Back-End Testing, integrating the SQL queries to be used in running the test cases
• Developed Test Cases/Test Scripts, execute tests and log results.
• Implemented the whole life cycle of QA methodology starting from planning, capturing, creating, executing, reporting and tracking the defects using QC
• Manually tested the web internet portal application to ensure the flow of the application functionality.
• Designed, Communicated, and enhanced QA testing plan for the application
• Prepared and executed test cases manually for different modules
• Used Microsoft Test Manager and Team Foundation Server as the bug-reporting tool.

Confidential, Durham, NC

QA Analyst

Environment: SQL, Oracle, SOAP UI, EDI, Quality center

Responsibilities:

• Created Test Cases by analyzing and compiling data specific to the scope of the test and performed traceability matrix.
• Supported various levels of testing, such as functional, parallel testing, Regression Testing for RENO subsystem.
• Worked with EDI and verify if received, translated, and posted Institutional/Professional ERA output to Stratus.
• Worked on Claims adjudication, Membership, Eligibility, Prior Authorization
• Involved in professional, Institutional and ITS claims adjudication.
• Documented and communicated test results and status to the appropriate Analyst.
• Utilized project management methodologies to develop project deliverables.
• Reported defects during testing by using defect tracking tool Clear Quest database with correct terminology/standards and attended defect meetings.
• Initiated with a comparison report of migration of 4010 to 5010. 270Eligibility, Coverage or Benefit Inquiry, 278 Prior Authorizations
• Performed the Backend integration testing to ensure data consistency on front-end by writing and executing SQL queries.
• Documented defects in JIRA General Access (JRA) and helped DIA team & developers to identify the performance issues and modules to be fixed.
• Worked on creating templates for UAT test execution.
• Performed Data validation, Functional, UI, Database, Smoke, Ad-hoc, Integration, Regression & UAT Testing.
• Analyzed and Researched test results based on the defined specifications to ensure all functionality, requirements, and business values are met.
• Run queries and reports under personal queries for each Testing Releases in Rational Clear Quest.
• Checked all Professional, Institutional 835 ERA Out of Balance Reports and Files.
• Created and run a Radar report from Production OSCAR Claims and copying from production to Test region.