TECHNICAL SKILLS:

• HIPAA Trained
• Medical Insurances
• Strong Multi - Tasker
• ICD-10-CM
• Medical Software
• Excellent Interpersonal Skills
• ICD-9
• Electronic Claim Submission
• Excellent Phone Skills
• CPT/HCPCS
• Paper Claim Submission
• High Level of Accuracy
• Medical Terminology
• Attention to Detail
• Work Well Under Pressure
• Problem Solving
• Analytical
• Data Analysis
• Working Knowledge of Oracle Database using SQL/SQL+
• Working Knowledge of Unix/NT server
• Quality Center Reporting and Analysis
• Microsoft Applications and Window Versions
• Proprietary Software testing tools.
• Quality Center and Testing Studio
• Keyboard 51 WPM
• Proprietary Billing Software
• Medical Software

PROFESSIONAL EXPERIENCE:

Confidential, Sacramento, CA

Quality Assurance Analyst

• Prepare documentation of executed test cases from design requirements and functional specifications.
• Document defect/issues in tracking system, including relevant brief descriptions of the issue with detailed steps to replicate.
• Follow quality procedures and testing standards, execute manual and automated tests for multiple software builds within scheduled release cycles.
• Engage in functional, integration, regression, UAT and performance/stress testing for client/server and relational database environments.
• Proactively troubleshoot with Business Analyst, Development and QA peers to replicate/identify and resolve issues.
• Proactively alert QA team and Development team of issues and updates, providing regular progress reports as needed.
• Research and diagnose complex software problems, recommend solutions and determine when program requirements have been met.
• Engaged with Relationship Managers during their UAT process.

Eligibility Representative II

Confidential - Rancho Cordova, CA

• Assists Processing team in manual entry of daily Eligibility Reject and EIP reports during critical processing for Open Enrollments.
• Allocate payments and reconcile and audit assigned individual and employer group accounts.
• Reviews work with Supervisor or Lead Rep once an audit is performed.
• Applies payments and reconciles balances monthly to maintain client account financial integrity.
• Handles internal and external inquiries concerning billings, rates and members.
• Provide guidance and assistance to Eligibility Representative Staff with shared accounts.

Confidential - El Dorado Hills, CA

Functional Test Engineer

• Executed functional test cases, to find and correct defects in the billing software.
• Ensured test environment was error-free and operating efficiently for accuracy in program testing outcomes.
• Minimized downtime and improved overall operations via ensuring test environments preparedness.
• Improved billing processes and reduced errors by initiating Sanity and Smoke testing in 3 test environments.
• Performed defect management using Quality Center to resolve and close defects.
• “Go-To Advisor” for chat room database tool questions, query needs, and database query writing.

Confidential

Senior Quality Assurance Analyst

• Performed component, functional, and enterprise testing ensuring consistency with all related processes to maintain smooth work flow and increased productivity.
• Increased customer understanding and prevented billing payment delays by validating accuracy via end-to-end testing: from inception to final outcomes of billing software projects.
• Reduced errors and eliminated defects to guarantee on-time delivery and meet customer needs by reviewing software requirements and designs to test, measure accuracy, and maximize performance.

Confidential, Sacramento, CA

Billing Analyst

• Reviewed and processed rate increases, area builds/rebuilds, agent transfers and marketing promotions to grow business and ensure profitability.
• Guaranteed project’s needs maintained compliance with state and federal laws and regulations.
• Recognized as a mentor to peers and customer service representatives regarding change requests, promotions and planning details.