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Application Developer/business Analyst/quality Assurance Resume

SUMMARY:

IT Business Analyst/Quality Assurance/ Programmer offering extensive experience in the Confidential and Bill Review system.

CORE STRENGTHS:

  • Quality Assurance
  • Business Analysis
  • System Analysis
  • Program Development
  • Excellent Interpersonal Skills
  • Ability to innovate, adapt and learn.

TECHNICAL SKILLS:

Hardware: - Mid Range IBM system AS/400, HP3000, PC

Environment: s: - AS/400, DB2, HP-3000, Windows.

Languages: - FICO Blaze Advisor Rules Engine, Java 2E, Visual Basic 6, COBOL/400, SYNON2E, AS/400 SQL400, CL400, Query/400, Congo s Powerhouse, Turbo Image Database, Taurus Ware House Script, Super Tool.

Packages Tools: - Microsoft Office (Project, Word, Excel, PowerPoint, and Access), PVCS Tracker, Agile & Waterfall methodologies.

PROFESSIONAL EXPERIENCE:

Confidential, Orange, CA

Application Developer/Business Analyst/Quality Assurance

  • Worked with IT BA and Blaze team to design and implement algorithm logic to handle complicate pricing Inpatient Prospective Payment System (IPPS), Central of Medicare and Medicaid Services (CMS), Outpatient Prospective Payment System (OPPS) on Medicare States like Alaska, Connecticut, Delaware, Main, Montana, North Carolina, Nevada, Ohio, Texas, Tennessee, West Virginia, etc.…
  • Created decision tables, templates, flows, and business logic for the Workers Compensation Medical Bill Review System (BR4) using the FICO Blaze Advisor Rules Engine. Wrote routines to reprice hospital bills, apply multiple procedure rules, apply NDC pricing, and perform many state fee schedule billing edits.
  • Helping to create Blaze Rules Maintenance Application (RMA) which allowed business users to maintain rules logic. This tool facilitates faster and more efficient implementation of code changes.
  • Analyze, gather and clarify requirements.
  • Develop test cases on new functions on all phases (development, quality assurance, user acceptance, production.

Confidential, Irvine, CA

Application Developer/Business Analyst:

  • Developing and maintaining repricing logics of PPO (Provider Preferred Organization) and using Visual Basic 6 software for user interface to the PPO application as they become necessary for the new system.
  • Maintenance and implementation of Bill Review application using Visual Basic 6 software for users and enhancements to the software as they become necessary.
  • Developing and maintaining the QA process for QA team in Worker’s Compensation and PPO Repricing Engine.
  • Conduct analysis of Service Request and meets with end-user staff for clarification and coordination of the design and prototype.
  • Develops appropriate problem solution and develops project plans and schedule for implementation activities
  • Work with IS management to develop and coordinate critical project plans.

Confidential, Irvine, CA

Programmer

  • Developing and maintaining the nationwide Worker’s Compensation and PPO Repricing Engine on the AS/400.
  • Analyzes, recommends and initials programming modification and corrects production program.
  • Create fee schedule program logic based on states regulation, and analyze PPO network to upload data and apply program logic.
  • Developing and maintaining the QA process for QA team in Worker’s Compensation and PPO Repricing Engine on the AS400.
  • Support State Fee Schedule compliance. (State Data Reporting).

Confidential, Irvine, CA

Programmer Entry Level

  • Maintaining, corrects or modifying production programs on the AS/400 platform.
  • System wide trouble shooting.
  • Create reports, invoices.

Business Analyst & Quality Assurance

  • Documenting requirements and delivering them to the development team
  • Gathering requirements, working with developers to design technical specs, user acceptance testing and working with QA Coordinate with Information System department for setting up the user-testing environment.
  • Coordinate user acceptance testing.

Confidential, Santa Ana, CA

Worker Compensation Billing Processing

  • Process Workers Compensation bills for various states.
  • Assist programmer in user testing and make suggestion in system wide.

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