SUMMARY:

• Around 9 Years of experience in Healthcare with hands on experience with in all phases of the STLC.
• Over 5+ years of Experience as Onsite (Test Coordinator) and have experience working on Onsite Offshore model.
• Experience in Establishing QA Procedures to meet QA Standards, proficient in writing Test Plans, Documenting the Testing Procedures and writing in - depth Test Cases to meet the Testing Cycle, In-depth knowledge in the analysis of application’s higher-risk aspects, and determining scope and limitations of tests.
• Detailed knowledge of various phases of Software Testing Life Cycle (STLC) with emphasis on Requirements gathering & Test phases in Waterfall, SCRUM and Agile methods.
• Extensive experience in Claims Processing, System, Integration, User Acceptance (UAT) and Regression Testing, Functional Testing, Application Testing, Accessibility Testing.
• Experience working in different Business Areas - Claims, Billing, Benefits Administration, Group and Provider Administration.
• Knowledge of Hospital Billing, Charge and Revenue Codes (CPT), HCPCS, ICD-9, CMS 1500 professional claim forms and UB-92 Hospital claims.
• Support and implement non-production and HIPAA compliant Test Data Strategy.
• Integrated knowledge of documenting end-to-end realistic Outpatient and Inpatient workflows.
• Industrial experience includes Healthcare (HIPAA and EDI), WGS, NASCO and EBDR Systems.
• Expertise in analyzing Business Specifications, Use Cases, Workflows and develop Test Cases
• Process driven (SOP - Standard operating Procedures) and attention to detail
• Proficient in creating Detail test plan (DTP) and Testing Requirement Traceability Matrix (Test Grid, RTM) as per the business requirements to match the functional requirements.
• Having Hands on Experience and sound Knowledge in Health Care-Payer & Provider Domain.
• Involved in various phases of a project life cycle like Requirement Gathering, Functional Analysis, Test Plan Preparation, System testing and Implementation Support.
• Hands on experience with industry's leading QA tools - HP ALM (Quality Center), IBM- Rational Quality Manager, ReqPro and Clear Quest
• Active participant in the design of Quality Benchmarks document, analysis of project Metrics, and guidelines for productivity improvement.
• Good knowledge of both On-line and Batch Systems on Mainframes.
• Expertise in detail documentation and motivation towards Quality, Experience in Software Quality Assurance Process Models like ISO and CMMI
• Creative self-starter capable of establishing positive and productive working relationships
• Excellent communication - written and spoken and a genuine team player
• Good team player with excellent inter-personal communication, leadership, training and multi-tasking skills.
• Expertise in Requirement Gathering, Peer reviews, Inter group coordination and Training Programs and Involved in JAD Sessions.
• Expertise in Production migration of New releases
• Expertise in Processing Professional, Institutional, Medicare, Medicaid Claims.
• Expertise in accessing Microsoft SQL management studio using SQL Queries.
• Good Working Experience in FDA regulated environment including 21CFR Part II.
• Good Working knowledge of the GXP Standards.
• Good Working Experience on ADA Testing using NVDA.
• Good Working Experience on Testing Applications using Mobile,IPAD,IE11 for different browsers as well
• Good Knowledge on HP ALM (Application Life Cycle Management), TFS (Team Foundation Server) used Urban Turtle to Track Requirements and Track Defects.
• Hands on Experience Testing the Products for EFT(Electronic Fund Transfer).
• Hands on Experience Testing the POS(Point of Sale) Device Mechanism.

DOMAIN AND TECHNICAL EXPERIANCE:

• HIPAA (HIPAA-Health Insurance Portability and Accountability Act) and Insurance Domains.
• Validation, Pricing, Adjudication of Electronic Claims (837-I) and Paper Claims (SRCP)
• Medicare & Medicaid - ICD9/ICD10
• Extensive knowledge & Experience in following EDI HIPAA (4010-5010) Transactions (837(P), 837(I)).
• Rational Tools (RQM, Requisite Pro and Clear Quest), eFDE, PRO 32,Anthem Tool
• HP ALM (Quality Center)
• Database Testing using SQL queries using TOAD Database Analyzer, SPUFI and QMF.
• Good Knowledge on Running Queries for Identifying cases using SQL Sybase.
• Basic knowledge on testing Using SOAP UI Tool.
• Hands on Experience in Mainframes (JCL,COBOL,DB2,CICS).
• Hands on Experience Working on FDA Related Projects (21 CFR Part 11)

PROFESSIONAL EXPERIANCE:

Confidential, WI

System: Java, Asp.Net

Tools: QC(ALM),SQL Server 2008, SOAP UI, SharePoint, REST, Selenium, Rapid SQL 8.5,JIRA

QA Analyst(Onsite Coordinator-Lead)

Responsibilities:

• Understanding Business requirements (FDD)
• Involved in identifying test conditions, designing test cases, reviewing test cases and executing test cases.
• Analyzed business requirements and software requirements, specification documents.
• Communicate and document test results
• Perform quality control on behalf of business before changes are deployed
• Performed Regression testing as and when there was a new build or version
• Identified data requirements for different scenarios.
• Daily and Weekly status reporting
• Involved in System IntegrationTesting (SIT).
• Reporting and tracking defects through JIRA.
• Prepared Test Analysis Report (TAR)

Confidential, Milwaukee, WI

System: Java, Asp.Net, Host Server Mainframe DB2

Tools: QC(ALM),SQL Server 2008, NVDA, REST, SOAP UI,TFS(UT), SharePoint, Rapid SQL 8.5

QA Analyst(Onsite Coordinator-Lead)

Responsibilities:

• Understanding Business requirements by attending Scrum meeting
• Involved in identifying test conditions, designing test cases, reviewing test cases and executing test cases.
• Analyzed business requirements and software requirements, specification documents.
• Communicate and document test results
• Perform quality control on behalf of business before changes are deployed
• Performed Regression testing as and when there was a new build or version
• Identified data requirements for different scenarios.
• Daily and Weekly status reporting
• Understanding Business requirements by attending Scrum meeting
• Searching the policy from database using Rapid SQL and use the policy for test data.
• Testing NMC website using different Browsers IE, Chrome, Firefox, Good Browser and using different devices like Ipad, Iphone, Andriod Phone.
• Testing the Products for EFT(Electronic Fund Transfer).
• Testing NMC Applications using VM IE11.
• Testing NMC Applications as per ADA Standards.
• Involved in System Testing.
• Reporting and tracking defects through ALM.
• Daily Standup: Where we discussed on the PBI’s in current sprint in addition to the work done previous day, planned work for Today and any impediments
• Backlog refinement (for future PBI’s (Product Backlog Items))
• Sprint Review: Each scrum team demoed their work that was done in current sprint in front of the stake holders, who would provide us any improvements or suggestions and where we would explain them about the work done and the reason behind it to be done in the current manner
• Team Retrospective: The scrum team met to discuss what went well in the sprint, what could have been done better. Also each person takes an better if item to be worked in coming sprint
• Group Retrospective: All the different scrum team of the project meet and discuss went well and better if’s.
• Sprint Planning: Team plans for the current sprint and pulls in the PBI’s based on the load and velocity of the scrum team for the sprint

Confidential, Detroit, MI

System: Mainframe Emulator, IBM DB2, SQL Server2008, Visual Studio, Oracle web logic XML, COBOL,MS Office, MS Visual Studio 2008, Adobe Reader

Tools: QC(ALM)

QA Tester(Onsite Lead)

Responsibilities:

• Involved in identifying test conditions, designing test cases, reviewing test cases and executing test cases.
• Analyzed business requirements and software requirements, specification documents.
• Develop Test Cases based on Business Requirements and Technical Specifications. Identified and documented test cases for different scenarios.
• Design and execute test scripts for testing of MA Bonus Payments
• Communicate and document test results
• Perform quality control on behalf of business before changes are deployed
• Performed Regression testing as and when there was a new build or version
• Identified data requirements for different scenarios.
• Daily and Weekly status reporting

Confidential, Menominee Falls, WI

System: Mainframe Emulator, IBM DB2, SQL Server2012, Visual Studio, Oracle web logic XML, MS Office, MS Visual Studio 2008, Adobe Reader

Tools: Quality Center 10.00

QA UAT Tester(Onsite Lead)

Responsibilities:

• Involved in identifying test conditions, designing test cases, reviewing test cases and executing test cases.
• Analyzed business requirements and software requirements, specification documents.
• Develop Test Cases based on Business Requirements and Technical Specifications. Identified and documented test cases for different scenarios.
• Design and execute test scripts for user acceptance testing of Credit systems code changes
• Communicate and document test results
• Perform quality control on behalf of business before changes are deployed
• Ensure quality and integrity of system implementations from a user perspective relative to the project requirements. Investigate, document and escalate issues related to all systems used in Credit.
• Performed Regression testing as and when there was a new build or version
• Identified data requirements for different scenarios.
• Daily and Weekly status reporting
• Test the POS(Point of Sale) Device

Confidential, Ashburn, VA

System: SQL Server 2008, Web Portal (Java), SQL Server Database, Medical Devices(Printers)

Tools: Quality Center 10.00

QA Tester(UAT)

Responsibilities:

• Performed System testing on Master and Client PCs.
• Imported data from Microsoft SQL server data by running Import packages provided by MAK dev Team.
• Developed new test procedures and included in the STCP document and executed to verify the CRs and SPRs
• Perform regression coverage with an end-to-end flow and confirming the extraction process.
• Prepared Test Coverage Estimations.
• Prepared RTM (Requirement Traceability Matrix) mapping all the Requirements to the Test Coverage.
• Executed Test cases related to Collection of Blood Donation Process.
• Validated different fields related to donation records.
• Executed simple SQL queries accessing the donor records using Microsoft SQL server Visual Studio (R2).
• Active Participation for the Interface Testing from eBDR to Eprogesa System CD staging using Extract CD data process.
• Documented the observations identified during system test in the System Test Analysis Report (TAR).
• Observations to open an SPR or CR, the defects will be added into Configuration Management Tool Integration (CMTI) (Quality Centre).
• Created and Executed Test Cases for UAT.
• Wrote documents for all aspects of the computer systems validation lifecycle, accordance with FDA regulations in compliance with cGMP, particularly 21 CFR Part 11, including validation plan and protocol.

Confidential

System: WGS(CA&OHMainframes),EDIScripts(837(P),835), SourceCorp(COBOL,JCL,VSAM), Nasco, Facets

Tools: Anthem tool, File Manager, RQM(Rational Quality Manager),Clear Quest, SharePoint, Microsoft Excel, Reqpro

QA Tester(Onsite Lead)

Responsibilities:

• Gathering requirements, Preparation Functional Specification document.
• Implemented whole life cycle of testing Methodologies starting from planning, creating, executing, reporting and tracking the defects.
• Co-ordinate testing tasks in RQM.
• Executed for the claims Adjudicate ICD10 claims with rules that look at historical claims coded in ICD9.
• Created XML Files and validated in the Anthem tool
• Testing of various ProvidersTesting of various Rules Testing of Different Types of ICD10 codes as for Different Combinations of Rules Editing Paper Claims using File Manager and create File with Claims having ICD10 codes and different combinations of Providers to validate for Different Rules
• Regular business interaction to discuss issues, queries, requirements and project status.
• Involved in creation of Test cases/Test Scripts and execution.
• Performed Functional, Integration and UAT Testing.
• Projecting Weekly metrics/status on QA activities to higher level.
• Bug tracking using Bug tracking Tools like Clear Quest Tracker.
• Created and Executed the Test cases for UAT
• Identification of Regression cases for Automation.
• Prepared Test data for Automation and Executed the ready Scripts

Confidential

Technology: Windows,DB2,Unix,MS-DOS,Citrix

System: CA&OH Mainframe, EDI(835,837), SOURCE CORP, NASCO, Facets

Tools: Anthem tool, EFDE, File Manager, QC, SharePoint, Microsoft Excel, Reqpro

QA Tester(Onsite Lead)

Responsibilities:

• Responsible for testing complete claims processing workflows as per business requirements
• Understating requirement documents & getting acquainted with new tools.
• Involved in creation of Test Plan/Test cases/Test Scripts and execution
• Validated the XML Files in the Anthem validator tool.
• Interacted with EDI Drop team to get the claims loaded.
• Created Claims with ICD9 and ICD10 using eFDE Tool.
• Interacted with development team & various members to discuss and resolve defects based on priorities.
• Worked with Team Lead for prioritizing bugs and addressing various execution related issues.
• Re-testing of the fixed defects.
• Performed Functional, Integration and Regression Testing.
• Projecting Weekly metrics/status on QA activities to higher level
• Performing Estimations for Testing requirements.
• Developed and Maintained Test Schedule for Quality assurance deliverables.

Confidential

Technology: Windows,DB2,Unix,MS-DOS,Citrix,Jazz

System: EDI (835,837)CA&OH Mainframes

Tools: Pro32 Tool, Anthem Tool, RQM, Clear Quest, SharePoint, Microsoft Excel

QA Tester

Responsibilities:

• Involved in creation of Test Plan/Test cases/Test Scripts and execution
• Generated X12 Files using Pro32 Tool.
• Validation of X12 Files using Anthem Tool.
• Follow up with the Dev Team to drop XML Files.
• Validation of the X12 File to the Claim loaded in to the mainframes.
• Validation of the entire Provider related Fields from X12 File to the Claims.
• Validation of the entire Member related Fields from X12 File to the Claims.
• Validation of the COB and Medicare Fields from X12 File to the Claims.
• Validation of the increased number of DX codes ICD9 from X12 File to the Claims.
• Tested integration of Claims data flow from different Systems.
• Regular interaction with development team and Business Teams to discuss issues, queries, requirements.
• Prepared Requirement Traceability Matrix.
• Logged the Potential issues as defects in Rational Clear Quest.
• Re-testing of the fixed defects.
• Performed Functional, Integration and Regression Testing.
• Projecting Weekly metrics/status on QA activities to higher level.

Confidential

Technology: Trizetto Software, Windows, Mainframes(CICS Screens), DB2, MS-DOS, Citrix

System: CA & OH Mainframes, Facets, NASCO

Tools: eFDE, RQM, Clear Quest, Sharepoint,X12

QA Facets Tester

Responsibilities:

• Testing Claims in Two Different Facets environments.
• Testing for Valid Facets Members in Facets environments.
• Testing the Plan Profiles for different subscribers according to the business.
• Creating Claims using Facets Members in DDC Screens.
• Creating Claims using eFDE for Nasco System.
• Capturing Facets Claim ID for Facets Claims in TSO session Mainframes TSO PRIM.
• Viewing Mainframes SAR Reports.
• Ran Few Report Jobs in Mainframes IMSL Region to generate few SYSIN Reports.
• Generate .DAT Files and send for OWEN Request for Loading Claims in to Facets System.
• Track the Claim for Fields and Finalization in Facets System.
• Regular interaction with development team to discuss issues, queries, requirements.
• Involved in creation of Test cases/Test Scripts and execution.
• Created Defects and tracked the defects using Quality Centre.
• Interacted with development team. & various members to discuss and resolve defects based on priorities
• Re-testing of the fixed defects.
• Identified Test Cases for Regression.
• Performed Functional, Integration and Regression Testing.
• Created and Executed Test cases for UAT