SUMMARY:

• 7 years of IT experience in the Analysis, design, development and testing of different software applications with Manual and Automated Testing methodologies and principles.
• Experience in the Quality Assurance Life Cycle (QALC) aspects such as creating Test Plans, Test Cases, Test Scripts to perform different types of testing and validation.
• Experience in Manual testing and Automation testing. Sound Knowledge of Software Testing Life Cycle (STLC) and Bug Life Cycle.
• Extensively worked with all phases of testing including creation of Test plans, Test Strategy, Test case specifications, Traceability Matrix, Test execution, Defect tracking, Resolution, Documenting and Reporting.
• Good understanding and exposure in Software Development Life Cycle (SDLC) aspects such as Requirements Analysis, Design, Development, Testing and Deployment.
• Good knowledge of different software development models like Waterfall and Agile.
• Experience in working with projects delivered through Agile and Experience in working with Scrum Methodology.
• Experience in testing HIPAA and business rules during file transmission for Claim EDI transactions on ICD09 and ICD10 related inquires to enforce HIPAA guidelines.
• Experience on designing and developing the testing solution for Healthcare System, Medicare, and Medicaid and with prime focus on Member enrollment, claims adjudication, provider, eligibility and prior authorization into Trizetto Facets and EDI.
• Experience in troubleshoot file transmission problems and business rules with all healthcare EDI transactions like Enrollment 834, 824 Claims transactions 837, 835, 276, 277, Eligibility transactions 270, 271 related inquires and enforce HIPAA guidelines with ANSI X12 Version 4010, 5010.
• Experience in Requirement Analysis, Test Planning, Test Case preparation, and Test Data preparation, Test Case Execution, Defect Reporting and Documentation.
• Experience in System and Integration testing, User Acceptance testing, Ad - hoc Testing, Smoke Testing, Sanity testing, GUI testing, and Black-box Testing, Compatibility Testing and Regression testing.
• Good knowledge of SQL and experience at conducting Backend Testing by writing and executing SQL Queries for Oracle database.
• Knowledge of Automation Frameworks and hands on experience at identifying processes/areas to be automated.
• Excellent Communication skills, Documentation Skills, Problem solving ability, analytical and quality conscious.
• Ability to self-manage. Capable of working under tight timelines. Understands various communication channels and escalates appropriately.

TECHNICAL SKILLS:

Testing Tools: HP QTP 9/10/11, HP Quality Center 9/10, Test Director, Bugzilla, Clear Quest, Win Runner 7.5

Programming Languages: Visual Basic, HTML, XML, SQL, Java, J2EE.

Scripting Languages: VB Script, XML, HTML, and JavaScript.

Databases: MS Access, SQL Server, Oracle, DB2.

Web Technologies: HTML, XML, and VB Script, Apache, Web Logic

Operating Systems: UNIX, Linux, Windows 95/98/NT/2000/XP

Other Tools: SQL, PL/SQL, Toad, MS Office

EDI Standard: EDI X12(ANSI), HIPAA

Transaction Sets: 837,835,270,271,276,271,278,820,ICD9,ICD10

PROFESSIONAL EXPERIENCE:

Confidential, Tampa, FL

QA Tester

Responsibilities:

• Analyzed System requirements to develop the Test Plan. Mapping Test cases to requirements in order to ensure that all the functional requirements have been covered in the Test plan.
• Performed Functional, Black Box, System, Integration, Smoke and Regression Testing.
• Creating Test Cases in Quality Center as per Functional Requirements.
• Prepared Test data to enable the software to be quality checked.
• Created Test Scenarios for Both ICD-9 and ICD-10 Codes with the Cut Off Dates for ICD-9
• Checked the basic functionality by manual testing. Pro-actively involved in automating some of the manual test cases using QuickTest Professional (QTP).
• Involved in the automation of test cases from the scratch and developed a full regression suite for the entire project.
• Developed smoke testing and regression testing suite using QTP.
• Worked on HIPAA Standard Transaction Forms X12-837 for Equivalent Encounter Information, X-12-835 Claims Payment and Remittance Advice, X12-Health Care Claim status request and response, X12-270/271 Eligibility for a Health Plan and X12-820 Premium Payments.
• Handled requests for proposals, making presentations to customers, and negotiating project timelines and deliverables.
• Provided Support services for Centers for Medicare and Medicaid Services (CMS).
• Sent claims files as batch to CMS (Medicare Services).
• Worked on Rejections from CMS and Send Data to CMS/Palmetto using Sterling Connect Direct.
• Performed Smoke Testing, Functional Testing, and System Integration testing on EDI Health care transaction 834.
• Worked on Managed care programs like HMO and PPO.
• Involved in creating test cases for EDI 837 Claims (I & P) Transactions.
• Designed and implemented Mainframe EDI system utilizing ANSI X12 standards.
• Processed claims for the Batch adjudication system and validated the full payment cycle process.
• Reported software defects in Quality Center and interacted with the developers to resolve technical issues.
• Generated SQL queries to validate various reports, loads and extract processes.
• Tested for content, comprehensiveness, layout and functionality and involved in positive and negative testing of the application.
• Working with Scrum Team and daily stand up to discuss about all possible tasks and technical issues with Business System Analyst and Developer
• Used Quality Center for bug tracking and reporting.
• Extensive Backend testing by writing Complex SQL Queries.
• Responsible for conducting the defect review meetings with the development and business teams on a daily basis to report and discuss the validity of defects opened by the testing team.

Environment: Facets, Quality Center 10.0, QuickTest Professional 10.0/11.0, Oracle 11i, Java/J2EE, Agile Model (Scrum Methodology), VB Script, SharePoint, XML, TSO/ISPF,QMF,Oracle11i, DB2, SQL, MS Access, Web logic, Windows95/98/NT/2000/XP, Internet Explorer.

Confidential, Washington, DC

QA Tester

Responsibilities:

• Test business requirements (user story), performed Quality Analysis for UHG business requirements and validate system workflows for Clearing House project.
• Troubleshoot EDI file transmission problems and business rules related inquiries which enforced HIPAA guidelines in the X12 Version 4010, 5010 Transactions Implementation guides with FTP/SFTP Servers by STOMP UI, SOAP, HTML and Healthy-E-Network applications.
• Validate EDI transactions 837, 270, 271, 276, and 277 related inquires for UHG and NON UHG payers along with ICD 9 and ICD 10.
• Involved in Scrum call during pre-planning meeting to help the estimation process for the user stories based on the complexity.
• Worked as a proactive member of Quality engineering team for projects like IEDI , STOMP and ICD10 .
• Helped manual testing team to setup and run automation scripts in Quality Center.
• Prepared automation user guides that will help manual team run scripts from Quality Center.
• Worked on different kind of Claim, Claim status and Eligibility files format like in X12, Print Image, CMS GUI and XML for quality testing.
• Developed QE test plan , test conditions and test cases in using Application Life Management and update testing tables for automation testing on regression suite during testing Functional , Regression and UAT on different environments.
• Creation and execution of QE and testing processes on Clearing House project applications like Healthy-E-Network, ACE, CM, CLAREDI and BYPASS.
• If needed organized meetings like walkthrough and DRB calls to discuss business requirements and outstanding issues with BA and Developers.
• Experience with Data selection, testing and handling to write complex SQL queries for testing Databases of Clearing House project.
• Created test data for helping team to get real time scenarios for quality engineering work.
• Writing SQL queries to retrieve required testing data from SQL server 11g in TOAD for the purpose of quality testing.

Environment: TOAD, MS Office, Agile Methodology, Scrum and Sprint environment, HP Quality Center, SOAP, STOMP UI, ACE, HP ALM, QTP, HIPAA X 12 4010/5010, Oracle 11g, SQL, HP ALM, QTP, Rally, X12, Print Image, XML, Ortelius.

Confidential, Washington, DC

QA Analyst

Responsibilities:

• Test business requirements, performed Gap Analysis for Confidential business requirements and generated system workflows in TriZetto Facets.
• Creation and execution of QA and testing processes on Automated Enrollment project for test planning, test case writing, test case execution, Log defects, bug documentation and issues investigation for TriZetto Facets application.
• Worked and tested different web applications like TPM, Error Handling GUI, Startup, Business Object, and BAM Dashboard.
• Extensively used HP Quality Center 9.2 for Test management and execution of test cases.
• Involved in front end GUI testing, Backend SQL Server database validations testing and Validating TIBCO response with the Flex output.
• Test cases are maintained in Quality Center.
• Experienced in validating more than 500 TIBCO and PEGA business rules for Automated Enrollment EDI 834 transaction in Facets for Group and IMD business which related to 15 submitters.
• Troubleshoot file transmission problems in enrollment related inquiries by EDI and enforced HIPAA guidelines in the X12 Version 4010/5010 Implementation guides (834, TA1, 997, 824).
• Analyzing experience with Data Conversion, testing and handling to write complex SQL queries for testing Databases of TriZetto Facets, TPM, TDB, AE.
• Using FTP and SFT environments to dropping transaction file to test the complete enrollment process of the organization.
• Experience on testing system upgrades in TriZetto Facets 4.3 to 4.5 and 4.5 to 4.7, TIBCO, PEGA and Automated Enrollment systems.
• Worked on Vendor Extracts, Extensions, Enrollments, Startup, Mass Transfer, CJA, Confidential Letters, TIBCO, PEGA and AE2 Applications (TPM, BAM, Error Handling, Broker Express and eHealth) for TriZetto Facets, Mainframe.
• If needed organized meetings to discuss outstanding issues with BA and Developers like Walkthrough and DRB.
• Worked on Integration, Functional, Regression and UAT testing along with updating automation tables for regression suite.
• Involved in testing the Business Objects Reports as a part of Integration, Regression Testing.

Environment: Pega PRPC and TIBCO rules, SFT, FTP, TriZetto Facets 4.3, 4.5, 4.7, HP ALM Quality Centre, SOAP GUI, HP Output Server, 4010/5050 X12 Format, COBOL, MS Office 2007/10, Lotus Notes, Mainframe 3270, SQL, SQLDBX, TRMS, HPX, Oracle Developer, EDI, Business Objects 6.5,DB2.

Confidential - Iselin, NJ

QA Tester

Responsibilities:

• Responsible for analyzing system requirements and developing a test plan for the project based on SDLC.
• Writing and executing Test cases and Test Scripts after reviewing the business requirement document and technical specifications.
• Developed and maintained automated test scripts.
• Conducted Regression Testing before and after the code conversion using QTP and manually.
• Validated the reports and files according to HIPPA X12 enforced standards
• Involved in testing the Medical and Hospital claims in Facets based on Service, Agreement and Pricing Id’s.
• Tested the EDI interfaces and EDI transactions (270, 271, 835, and 837).
• Performed Black box testing, Integration testing, System testing, data validation testing, end-to-end testing of the application and involved in white box testing.
• Interacted with Business Analysts, Developers and QA team members in different defect raising situations.
• Reporting the bugs using Quality Center
• Performed Screen Navigation Test to ensure that the links are established as per the documentation provided.
• Presentation of the QA Status report and the Defect Status reports in the weekly meeting.

Environment: FACETS, QTP, Quality Center, HTML, XML, DB2, SQL, UNIX and Windows NT