SUMMARY:

• 7 + years of experience in Quality Assurance and Software Testing in Healthcare
• IT Professional with experience as a Testing Analyst using the iterative Software Development Life Cycle (SDLC) methodologies like Waterfall and Agile.
• Experienced in documenting and writing Test Plan, Test Objectives, Test Strategies, Test Scripts, Test Scenarios and Test Cases.
• Extensive experience in testing Client/Server and Web - based Applications
• Expertise in tracking defects and generating detailed reports using Defect Tracking tool(s); Rational Clear Quest & Quality Center
• Experienced working with X12 version 5010 transactions changes analysis, design and migration strategy.
• Having good experience working with transaction codes such as 270/271(inquire/response healthcare benefit), 276/277(Claim status), 834(Benefit enrollment), 835(Payment/remittance advice), 837(Health care claim).
• Experience in Medicare and Medicaid.
• Experience on HIPAA standards, ICD9/ICD10 conversion, EDI transactions & 4010/5010 versions.
• Adept in using automation tools like Quick Test Pro (QTP).
• Maintained Test Matrix and Requirement Traceability Matrix.
• Strong Knowledge on MS Office suite, MS Visio, MS Project, and MS Access.
• Proficient knowledge in various types of Software Testing such as Integrated testing, System Testing, Black box testing, Positive Testing, Negative testing, Data Driven Testing, Regression Testing, User Acceptance Testing and Back-End Testing using SQL.
• Active team player with good passion, positive attitude, communication, decision making with an attitude to bridge the gap between team members and the client.
• Ability to multi-task, prioritize and work with time constraints while paying attention to details.

TECHNICAL SKILLS:

Testing Tools: Trizetto QNXT, Facets, Rational Team Test, QTP, SOAPUI

Defect Tracking Tools: Quality Center, Rational Clear Quest

Operating Systems: Windows 95/98/XP/2000/2003/Vista

Database: MS SQL Server, My SQL, Oracle

Business Applications: Microsoft Office Suite, MS VISIO, MS Project

PROFESSIONAL EXPERIENCE:

Confidential

QA Analyst

• Analyzed system specifications and involved in the development of Business Specification, Requirement Specification and Design Specification Documents.
• Involved in reviewing the Requirements and Use Cases
• Develop System, Regression UAT Test cases based on requirements, business designs and business scenarios where necessary.
• Involved in Walkthroughs, Defect Report meetings & Audits during various phases of SDLC.
• Validate EDI Claim Process according to HIPAA compliance via QNXT.
• Reviewed the HIPAA 4010A1 & 5010 documentation and prepared the Test plan and Test cases for 5010 HIPAA transactions 837I/837P/837D, 276/277,270/271, and 835.
• Verified and validated HIPAA compliant X12 format for both inbound and outbound healthcare EDI transactions as per HIPAA 5010.
• Implementation of ICD9 to ICD10 codes transition and also verifying the fields in the internal systems are aligned to meet the new structure.
• Involved in testing the code sets as per ICD-9 and their conversion as per ICD-10.
• Prepared test cases and executed scenarios of the Affordable Care Act (ACA) project for upgrade of Process Manager and Provider Revalidation.
• Got training for SME roles in the system configuration to handle the work related to the Contracts and Rate Settings.
• Validated the SQL server data against the QNXT.
• Conduct backend testing by querying databases to synchronize testing databases and check for data integrity and proper routing based on specifications.
• Database Validation (SQL) to check the updated data in the Database using SQL Server
• Involved in performing functional, application, integration, system, regression and User Acceptance Testing.
• Performed Sanity and Smoke Testing of the application manually after each build
• Performed IVR (Interactive Voice Response) Testing.
• Exhaustively retested Health Claims with Production Issues & succeeded in achieving customer satisfaction
• Created reports (daily Status reports and weekly reports) and creating testing metrics as requested by Project Owners/Management.
• Participated in discussion with the Policy writer, Provider Relation team and Provider Integrity team for the new change in the sections of Policy.
• Actively involved in validating the results that impact the configuration related to the topic i.e. in terms of contracts and rate settings.
• Involved in identifying gaps in system functionality to business requirements with developers and coding team.
• Recorded test scripts and customized them for Functionality testing using QTP.
• Executed QTP scripts for Regression Tests using Object repository.
• Performed regression testing by automating the manual test cases into QTP.
• Worked closely with users to ensure the project meets business needs.
• Involved in refining and determining feasibility, correctness, and completeness of end-user's requirement.
• Attended project status and issue meetings along with the Test Lead Manager.

Environment: QNXT, QTP, SOAP UI, Clear case, Clear Quest, Quality Center, Java, MS Office, Quality center, Biztalk server, Agile/Scrum project methodologies, SQL Server, Oracle

Confidential

QA / EDI Tester

• Worked with Business Analyst and QA Lead in reviewing and analyzing the business requirements Documents and functional requirements.
• Involved in the testing and performing GAP Analysis for HIPAA 4010 and 5010 transactions and utilized EDI tools to verify mapping to X12 format
• Reviewed the HIPAA 4010A1 & 5010 documentation and prepared the Test plan and Test cases for 5010 HIPAA transactions 837I/837P/837D, 276/277,270/271, and 835.
• Tested all HIPAA transactions for multi version support (4010 and 5010) and validating the database to file elements.
• Involved in Up-gradation of HIPAA X12 4010 transactions to HIPAA X12 5010.
• Tested all edits for Facets for Claims.
• Performed Positive and Negative Testing Manually
• Performed Security testing on the application.
• Used SOAPUI to test web service messages that are travelling though frontend to backend.
• Documented the test results and reported the status of assigned test tasks and issues to project QA Lead.
• Conducted Back-End Testing Using SQL Commands.
• Extensively used SQL statements to query the Oracle Database for Data Validation and Data Integrity.
• Made sure that the systems complied with the rules of HIPAA.
• Involved in writing and executing test cases using QC based on the requirements
• Helped in project testing efforts for doing integration tests, regression tests and user acceptance tests.
• Worked on Data mapping, logical data modeling and used SQL queries to filter data within the Oracle database tables
• Responsible for Performing Integration Testing and UAT testing.
• Actively participated in walkthroughs and enhancement meetings
• Maintained Test Matrix and Requirement Traceability Matrix.
• Created Status and Test Summary Reports on Weekly basis.

Environment: Facets, Oracle, SQL, UNIX, HIPPA EDI, XML, Rational Tools, Quality Center

Confidential

Human Resource (Intern)

• Maintained the human resource records of an organization’s employee’s information such as name, address, job titles and earnings.
• Make agenda, data entry, file and answer and maintain employee’s information.
• Updating/reminding the managers of their meetings, meeting room reservation, helping them in developing meeting presentations, take down dictations and supervise the overall administrative functioning of the office.
• New hire on boarding: compiling all new hire material for orientation. Ensuring all paperwork is received and processed for payroll, collecting all legally required documents for the completion of I-9 forms.
• Support hourly recruiting, hiring and payroll process.
• Develop purchase orders, handle computer generated reports, make travel arrangements, tracking information regarding office budgets, receiving phone calls, taking appointments, arranging conferences, meetings and dealing with company visitors.
• Maintain the confidential records and files, records of decisions taken, research and help in preparing the motions, policies and office procedures.
• Data entry in PeopleSoft and other HRIS systems for new hires, terminations, etc.
• Support benefits administration with both answering questions and resolving associate issues.
• Designed new employee orientation package and established and facilitated all new employee activities and sessions, which provides continuity in the company and benefit information presented verbally and in writing for the first time.
• Boosted consumer division operating margin to 7.2% from original 5.6% by working in a team.
• Strengthened leadership team effectiveness and set foundation for changes necessary to sustain competitiveness in a fluctuating business market.

Environment: MS Office Suite, Windows XP, Internet.