PROFESSIONAL SUMMARY:

• Over 8 years of experience in Software Analysis and Quality Assurance Testing.
• Extensive background in testing EDI transactions and Facets
• Experience in conducting System, Integration, Functional, User - Acceptance Testing and improvement of QA Process.
• Good understanding of the Software Development Life Cycle and Software Testing Life Cycle.
• Expertise in Problem solving and Bug Reports using Bug Tracking Tools.
• Demonstrated strengths in communicating with all levels within an organization, and possesses excellent interpersonal, written and oral communication skills.
• Strong skills in SQL, PL/SQL with various Databases including Oracle, PostgreSQL and SQLServer.
• Expertise in database concepts (RDBMS), writing complex SQL queries using joins, group by, aggregate functions and PL/SQL statements to check for data integrity.
• Expertise in black box testing with a complete QA cycle - from testing, defect logging and verification of fixed bugs and UAT and production support
• Strong experience in creating test scripts using Excel, Word and HP Quality Center / HP ALM.
• Experience in working with Agile and SDLC methodologies.
• Excellent rapport with Business Analysts, Developers and Testers in the projects and worked in close collaboration with team members to ensure quality of the application.
• Strong inclination to take ownership and responsibility.

TECHNICAL SKILLS:

Tools: Mercury Tools, SQL Server Management Studio, Oracle SQL Developer, Quality Center 10, ALM 11, Ultra Edit, McKesson ClaimsXten 5.1 & Clear Claims Connection, Amisys Advance 6.4.2 & 3.1.2, PowerMHS 7.2, Facets 5.0

Operating System: MVS, UNIX, Windows XP/7

Languages: SQL, PL/SQL

RDBMS: DB2, MS Access, SQL Server 2008 R2, Oracle 9/10/11g

PROFESSIONAL EXPERIENCE:

Confidential, Quincy, MA

Sr. QA Tester

Responsibilities:

• Analyzed the business requirements and use cases to understand best about the application.
• Interacted extensively with stakeholders and developers.
• Developed detailed Test Plan for two iterations and Test Cases by using various techniques (Equivalence Class Partitioning, All-Pairs and Boundary Value Analysis)
• Tested the Web / Mainframes applications involving Non Custodial Parents (NCP), Eligibility Determination, Integrated Eligibility, Child Support Enforcement, TANF, Food Stamps, IVA, IVD programs.
• Created different Providers using Enrollment Process through Health PAS Online Portal to create test data.
• Responsible to verify Web services API request, response data validations in REST.
• Performed Manual testing prior to Automated Testing of the application
• Worked in the Agile QA Process, Defect and Test Management
• Used Selenium IDE to record, playback and debug individual test cases, using Selenium Webdriver provided more flexibility in automating test cases.
• Used automated scripts and performed functionality testing during the various phases of the application development using Selenium IDE.
• Performed Integration and Regression testing to check compatibility of new functionality with the
• Worked extensively on HIPAA 5010A1 X12 transactions -837(P&I), 835-Remitance advice, 276/277-Claims status and response, 270/271-Member eligibility verification, 278 Request and Response- Prior authorization.
• Extensively Tested EDI Transactions (270, 271, 276, 277, 834, 835, 837I, 837P, 837D).
• Participated extensively in the Claims Testing Phases like Online Screens, Adjustment/void functionality / Mass Adjustment functionality and Adjudication Process.
• Extensive experience with Members/Subscribers, Products, Providers, Claims processing and Billing modules.
• Tested and Processed Medicaid and Medicare Claims.
• Involved in validation of HIPAA for 837 and 835 Claims.
• Involved in testing the conversion of Financial Claims.
• Tested the Adjudication of Claims and Migration Process.
• Identified the test cases that are to be automated and those that are to be manually done.
• Managed requirements using Requirement Plan Manager of HP Quality Center / ALM.
• Documented Test Cases corresponding to the business requirements in Test Plan Manager of HP Quality Center / ALM.
• Involved in automating Applications using Load Runner.
• Developed requirements traceability matrix between requirements and test cases to ensure maximum coverage of the requirements.
• Followed Rational Unified Process across Software Development Life Cycle.
• Conducted GUI testing, Functional testing and Smoke Testing, Integration Testing, Performance and User Acceptance testing on the application.
• Responsible for doing System Testing, Regression Testing, Functional Testing, UAT, Integration Testing.
• Executed the batch jobs on Mainframes (JCL).
• Ran Batch Process and Job schedulers in the back-end for applications to create tasks for the end users to work on the applications.
• Experienced in testing Online CICS screens.
• Extensively used SQL and PL/SQL for data integrity testing at the backend.
• Wrote UNIX shell scripts to perform batch tests.
• Extensively worked on Defect Manager of HP Quality Center / ALM for bug reporting/tracking.
• Performed regression testing once the defects are fixed.
• Interacted with programmers to identify and resolve technical issues.
• Participated in Defect review meetings with both the stakeholders and developers.
• Participated in weekly review meetings and GO/NO-GO meetings.
• Developed Defect Summary Report and Test Summary Report once the testing is done.

Environment: HPALM 11.0,.NET Framework 3.5, ASP.NET, VB.NET, ADO.NET, Visual Studio 2010, IIS, IBM Mainframes (JCL, DB2, CICS, COBOL, QMF, File-Aid, TSO/ISPF), Oracle 8I/9i PL/SQL, XML, SOAP, UNIX Shell Scripts, Windows XP.

Confidential, Buffalo-Albany, NY

Sr. QA Tester

Responsibilities:

• Developed Test Plan and Test Cases in HP QLM/QC.
• Worked with Trizetto Facets: Group/Class/Plan/Product, Member/Subscriber, Claims Processing, Customer Service, Provider, Subscriber/Member enrollment.
• Worked with Trizetto Facets System implementation, Claims and Benefits configuration set-up testing, Inbound/Outbound Interfaces and Extensions, Load and extraction programs involving HIPPA 834, 835 and proprietary format files and Reports development.
• Agile Process was followed and testing was done simultaneously.
• Attended daily Scrum Calls and guided QA and Developer regarding the defects, Technical Specification Documents and Mapping Documents.
• Worked on Scrum Master for coordinating meetings and defined testing goals.
• Performed End to End System Testing Manually.
• Performed Functional, Integration, System, Smoke, Backend and Regression Testing.
• Used XML and developed XML files.
• Performed Manual and BPT Testing of .NET application
• Developed EDI X12 files for enrollment and validated the compliance.
• Coordinated the upgrade of Transaction Sets 270, 271, 834, 837 (I, P, D), 835 to HIPAA compliance. Analysis of inbound and outbound interfaces and extensions to Facets claims processing system.
• Worked in Facets Reconfiguration Data Element Definition and Usage (Working) with values and completed configuring Facets Applications like Related Entity, Parent Group, Group, Subgroup.
• Tested the claims data and Billing in Facets.
• Developed Test cases for ICD 09/ ICD 10.
• Tested the Loading of Claims Data and Claims Adjudication in Facets.
• Completed Data Mapping for Group and detail Product analysis and report writing.
• Work closely with EDI to ensure accuracy in data transmissions and shared processes. Transaction sets processed (837 (I, P, D), 997, 835, 271, 834).
• Performed GUI testing, Integration testing, Regression testing, Ad -hoc testing, Negative testing, End to End testing, Load testing, User Acceptance testing.
• Wrote Test Scenarios, Test cases in excel sheet and imported them to Quality Center.
• Logged defects in Quality Center, re-tested defects, analyzed defect with Users and Developers.
• Conducted walkthroughs with the end users and stakeholders to gather the modification requests from the user to upgrade or change the business specification for the product.

Environment: Trizetto FACETS 4.81/5.01, Oracle 10G, MS Word, Windows XP, SQL, PL/SQL, VB.NET, HTML, HP Quality Center, ALM, XML Spy, XML, SOAP, SOAP UI, Web Services.

Confidential, Mountlake Terrace, WA

QA Analyst

Responsibilities:

• Created test cases based on business requirements for the health insurance exchange project.
• Imported test cases from excel to Quality Center.
• Participated in the daily stand up meetings to discuss the testing status.
• Created 834’s for different member enrollment scenarios for the states of OR,WA and AK
• Validated creation of members in Facets.
• Validated the subsidy amounts, plan changes, reenrollments and eligibility of the subscriber in Facets.
• Validated the effectuation services for the states of OR and AK.
• Validated the claims and provider notification letter
• Applied payments and created receipts in Facets.
• Worked closely with Washington health benefit exchange for validation of the 820’s.

Environment: Facets5.0, Quality Center 10.0, Oracle 11g, Microsoft Office.

Confidential, Miami, FL

QA Analyst

Responsibilities:

• Created test plan and test cases based on business requirements.
• Participated in the business sign off meetings
• Imported test cases from excel to Application Lifecycle Management (ALM).
• Tracked and reported defects using ALM.
• Participated in the daily triage meetings to discuss defects and testing status.
• Created test data to enter the medical authorizations in Acuity for various lines of business (CHOICE, POS, INDIVIDUAL).
• Validated creation of claims, members and providers in Amisys Advance.
• Validated claims re-pricing, adjudication; provider contracts, networks, reimbursement arrangements and member data; and contract and benefit plan in Amisys Advance.
• Verified back-end processing of the claims between Amisys Advance and McKesson Total Payment Integration system audit tool.
• Validated the editing logic for physician coding in McKesson's Clear Claim Connection.
• Validated the Recommendation, Savings and Clear Claim Connection reports in McKesson’s ClaimsXten.
• Verified the Paid Feed sent to the ClaimsXten history database.
• Validated the claims inbound, claims outbound, member eligibility inbound, member eligibility outbound, encounter claims outbound, encounter claims inbound files for various trading partners.

Environment: Amisys 6.4.2, HP Application Lifecycle Management 11.0, McKesson ClaimsXten 5.1, McKesson Clear Claim Connection, Acuity Advanced Care, Oracle 11g, Microsoft Office.

Confidential, Durham, NC

QA Analyst

Responsibilities:

• Analyzed the test scenarios and identified the test areas based on the business requirements.
• Imported the test cases that were written in excel to quality center.
• Tracked and reported defects using quality center.
• Participated in the daily triage meetings to discuss the defects and in war-room calls.
• Worked closely with the developers to resolve the problems encountered in creating test data.
• Validated the Mobius reports(hipaa audit, ED101E), mainframe files for mapping and mainframe tables for modifiers and hold codes
• Keyed claims in FEPdirect (y-price and n-price) and resolved the deferrals.
• Validated the claims in PMHS and the claim response from DC (dfload).
• Validated the claims posting cycle after the claim response was sent to PMHS.
• Adjusted the claims in FEPdirect (credit memo, voucher deduct and write off).
• Verified the adjustments on the claims side and finance side of PMHS and the Mobius error reports for all the adjustments.
• Verified the checks, explanation of payments.

Environment: PMHS7.2, HP Quality Center 10.0, Ultra Edit, Oracle 10g, Microsoft Office.

Confidential, Minneapolis, MN

QA Analyst

Responsibilities:

• Primarily responsible for developing and maintaining test plans and cases for the UHG's highly visible Member EOB Migration system.
• Responsibilities also included providing requirements analysis for the Coordination of Benefits, Primary Claim Calculation and 835 Bundling projects.
• Performed Business Analysis, Requirements Analysis and Gap Analysis.
• Developed detailed Test Plan, Test Cases and Test Scripts.
• Conducted Black Box, Grey Box and White Box Testing.
• Conducted Functional, Integration, Regression, System, Smoke, UAT and GUI Testing.
• Extensively worked on EDI Transactions 270, 271, 276, 277, 834, 835, 837 and 997
• Extensively worked on EDI 837 and 835 claims used for Professional, Institutional.
• Tested HIPAA Claims processing through the Clearing house.
• Extensively worked on the Provider and Member Explanation of Benefits Migration.
• Involved in Spec Review, Test Case Review and Defect Review Meeting.
• Involved in Test Plan Walk Thru Meeting along with the Business.
• Worked on SQL, PL/SQL Queries.
• Defect Management was done using Quality Center.

Environment: MS Visual Studio 2010, HP Quality Center 10.0, Test Director, Oracle 9.6.1.1,Ultra Edit, Microsoft Office.

Confidential, Indianapolis, IN

QA Analyst

Responsibilities:

• Participated in Business Analysis, Requirements Review and Technical specs inspection.
• Involved in writing test plans and developing test cases from Business Requirements.
• Conducted White Box and Black Box Testing.
• Responsible for doing System Testing, Functional Testing, Integration Testing and UAT.
• Tested the Claims (CL0100/CL0200 etc) in Amisys Advance.
• Tested the (ME1600/ME1700) and Benefits (BE0100) applications in Amisys.
• Tested the batch claims adjustment (BCP0500) in Amisys.
• Resolved Errors for the Invalid statuses of the claims
• Tested the Benefits, Members and claims in Facets 4.51.
• Worked with EDI transactions (270, 271, 837, 835, 276, and 277).
• Participated in testing various interfaces (Inbound and Outbound) of Facets.
• Tested various reports in Facets.
• Developed Test logs and exceptions.
• Wrote SQL statements for backend testing.
• Defect tracking was done using Quality Center.

Environment: Mercury Quality Center 9.0, Amisys Advance, Facets, Blue2 3.1v, EDI, Toad, Oracle, Mainframes (COBOL, DB2, JCL, CICS, TSO, MVS), PVCS, Win NT, Unix.