Quality Analyst/ Claim Audit Analyst Resume
PA
PROFESSIONAL SUMMARY:
- A dedicated professional More Than 5 years of experience in Software Development as Business/Quality Analyst in Retail, E - Commerce, Finance and Health Care Domain.
- A keen planner with substantial knowledge & experience in developing web projects along with understanding of latest cutting-edge technologies.
- Adept in front end development of website from requirement analysis to system study, designing, documentation and implementation.
- Proven abilities in leading & guiding team members and enabling knowledge sharing among them.
- Worked on analysis of FACETS claims processing system.
- Knowledge of Claim processing for both Medical and Pharmacy benefit plans.
- Processed 837P, 837I and 837D transactions, verified those 837 transactions were converted correctly to XML file format and verified the claims data loaded to FACETS for further processing
- Experience with claims process and adjudication in the Medicare, and Medicaid.
- An effective communicator with excellent leadership, problem solving, analytical, people management & presentation skills.
- Experience in writing Test Plans, Test Cases, Test Scripts developing and maintaining test scripts, creating test data, analyzing bugs, interacting with development team members in fixing issues.
- Sound knowledge in functions like Point-of-Sale (POS), Back office processes Modules like (Cash Summary, Orders) Accounting system in Retail.
- Experience in Agile and Waterfall SDLC methodology.
- Experienced in reviewing and analyzing BRD, FRD, and DD.
- Technically resourceful in different types of testing such as Functional/Positive/ Negative/ Regression / Integration/ System testing / User Acceptance/ End-to-End Testing/PIT (Partner Integration Testing)
- Knowledge in automation tool HP Quality Center/ ALM
- Experience in Defect Tracking Tools using HP ALM (Quality Center) / TFS
- Extensively executed SQL queries with advance skills on Oracle SQL developer, SQL Server.
- Experience in performing end-to-end User Acceptance Testing (UAT).
- Extensively involved in managing defect tracking system like Quality Center.
- Experience in tracking test coverage, status, bugs and providing metrics.
- Maintain Close interaction with developers and Business analyst to solve technical issues.
- Strong team player with excellent communication, multi-tasking and time management skill.
- Extensively worked on Confidential POS, NCR POS 7402, 7403, EXXON POS
- Wrote Automated test scripts using Selenium IDE, WEBDRIVER to cover the testing the base functionality of some products.
- Solid understanding of, Claims Processing, Billing, Benefit/Eligibility, Authorization/Referrals, COB, and have experience in HIPAA standards and corresponding EDI transactions.
- Manually Tested 7Eleven App on different devices with different platforms, and OS.
- Knowledge of Dimensional Modeling, Star and Snowflake Schemas, datawarehouse (DWH) concepts like Facts, Dimensions.
TECHNICAL SKILLS:
SDLC Project Methodologies: Water Fall, AgileChange tracking system: JIRA, Quality Center, TFS, Version one
Operating Systems: Windows NT/2000/10, UNIX, LINUXDatabase Management system: Oracle SQL developer, Microsoft SQL ServerBusiness Applications: Microsoft Office Suite - MS Word, Excel, PowerPoint, Outlook
Technical Languages: JavaScript, HTML, Java Script, VB Script, JAVA, Php, C/C++, .NET, VB 6.0
Brand testing tool: UL Testing tools for transactions. (Version 5.2.1)
PROFESSIONAL EXPERIENCE:
Confidential, PA
Quality Analyst/ Claim Audit Analyst
Responsibilities:
- Reviewed Business requirement Documents and functional requirements.
- Maintained Requirement Traceability Matrix (RTM) to make sure that test plans were written for all the requirements.
- Analyzed system requirements and developed detailed test plan for testing.
- Performed Functionality, GUI, Regression testing.
- Performed Smoke and Sanity Testing manually.
- Performed positive testing and negative testing manually.
- Validated all claims data and drugs validation using different NDC codes in End - to-End and Facets Testing.
- Worked on end-to-end testing, Facets testing which includes the data verification and validations in different Confidential UI s like Coverage Code Manager (CCM), Case Installation Tool (CIT) and Rx Nova (DST).
- Validated pharmacy benefits and cost shares were applied correctly in all tiers of drugs (Tier1, Tier2, and Tier3 & Tier4).
- Validated accumulators and penalty were applied correctly on All Tiers of drugs as per state mandate and PPACA rules.
- Experienced In using Claims Auditing Tool DST.
- Used Rational Clear Quest for bug reporting and communicating between developers and test team members.
- Performed configuration/ compatibility and user interface testing manually.
- Documented the test results and reported the status of assigned test tasks and issues to project manager.
- Coordinated with developers and Project Manager.
Environment: Facets, HIPAA, EDI, XML, Window, MS Office, Oracle, DST, Client Installation Tool (CIT), CCM (Coverage Code Manager), Vista, Rx Nova DST, Confidential Host Emulation
Confidential, Cherry Hill, NJ
Business/ Quality Analyst
Responsibilities:
- Interact with the Senior business analysts and respective developers, wrote the test requirements for all the modules from the approved business requirements.
- Used Microsoft Excel to write the Test Plans and Test Cases.
- Captured the screen shot for the defects which not reproducible immediately, so that the developer understands the defect.
- Attended the weekly meeting with the developers and coordinated with them, explained them and take priorities from the leads, coordinated with our team to prioritize them.
- This application is developed using Web Services.
- Execution of Test Plans and Test cases on builds and new features, if any. Reporting the bugs found into Project Tracking System.
- Knowledge of Business Intelligence (BI) analytical reports using Oracle BI.
- Good knowledge of OBIEE RPD Modeling layers.
- Interacted with Business analyst/System analyst to understand the workflow of various functionalities.
- Mapped requirements with Test cases using the ALM.
- Involved in writing UAT test scenarios for all production issues.
- Interacted with several Investment banks to support UAT testing for them.
- Involved in the development and execution of test plans independently and in collaboration with internal and external teams.
- Performed Cross Browser Functionality testing across different browsers such as Internet Explorer, Chrome, Firefox and Safari in different Operating Systems.
- Maintained data sheet based on the test scenarios and implemented them during the testing.
- Involved in Bug Triage meetings to discuss about the Open defects, status reports and track issues with the development team for the resolution.
- Performed Table, GUI, Database, XML Check Points in Quick test pro scripts to check the validity of data.
Environment: QTP, Oracle, Java, SQL, Agile, Microsoft Visio, MS Access, Mercury Quality Center
Confidential, TX
Business Quality Analyst
Responsibilities:
- Participated in Production Releases and project launch and attended Client and internal meeting.
- Managing all phases of testing for assigned components ensuring test plans and test cases are completed and met business requirements.
- Tested in different Card types like EMV , Mag stripe , SV cards and EBT cards at POS and CRIND (ICR) using VeriFone MX915 and Ingenico ISC350 Pin pads.
- Used to verify System configurations and Network configurations in ISP back office for testing prospective .
- Used to generate Network Reports and validated Database tables and EDHTM, G - tracer logs.
- Execute, Analyze and document test results for Smoke test and the regression test.
- Getting contact with HPS via email for Store setup like ON test, OFF test, Partial approval and hard declines.
- Validated Network reports and Cash summery. Developed SQL queries for defining and developing test data for testing.
- Handled all alone Payment Card testing, closely worked with the HPS (Heartland Payment system) for the Brand Mastercard, Visa, Discover, and Amex.
- Participated in the status meetings that included vendors HPS, Gilbarco, and CTS.
- Performed database queries, validated data and verified table updates.
- Assisted 7-11 with UAT testing, communicate any discrepancies in the system. Explain if discrepancies are a defect or not a defect and if it is an existing functionality of the system.
- Assist customers in UAT defect analysis and logging with enough evidence for the further analysis with the partners as well as Confidential .
- Extensively worked on the Back-Office Cash Management Reporting for Cash, Credit Card, Debit Card, Pre-Paid Phone Card, Stored Value Card, Money Order, and Lottery sales transactions.
- Worked on different modules of Cash management like Cash Summary, Order Management, Product Assortment, and Gas Module.
- Validated the Network Reports, Card load Reports, Paid In/Paid Out Reports, POS Audit Report, Money Order reports. Safe Reports, Coupon Sale Reports, Gas Reports, Coupons sales Reports etc.
- Tested the product with different peripherals ISP, GOT, and Scanner, POS.
Environment : Oracle SQL developer, TFS, Point of Sale (POS) Confidential and NCR, ISP Back office, CRIND (ICR), EMV , Mag stripe, VeriFone MX915 , Ingenico ISC350 , SharePoint., Window server 2008, HP/ALM 12, MS Visio.
Confidential, New York, NY
QA Tester
Responsibilities:
- Worked on the enhancement of E-Commerce Web Application and linked systems such as Commerce Manager, Databases.
- Maintained strong relationships with developers which helped in better execution of test plans.
- Functionality testing during the various phases of the development of the Point of Sale (POS) System.
- Developed and executed Test Cases and Test Scripts based on the requirement and managed it using JIRA.
- Used HP Quality Center/ ALM for bug tracking, reporting and analysis.
- Responsible for creating the daily status report.
- Used HP Quality Center/ ALM to create and Maintain Test requirements.
- Actively interacted with the development team to fix critical bugs.
- Executed PHP scripts on Putty server
- Executed test cases and Reporting and Tracking the defects.
- Coordinated and controlled testing through the entire Software Waterfall Development Life Cycle (SDLC).
- Analyzed BR and design document to write test cases to cover overall quality assurance testing using Quality Center.
- Worked on test planning document and test strategy document. Wrote SQL join queries to extract data from the database.
- Worked on Mobile app and web-based testing with Android, iOS, windows.
- Worked closely with the development staff with regards to system functionality and bug fixing.
- Used Quality Center to track the defects and making pass-fail reports.
- Responsible for entering, tracking defects in QC and assigning these defects to the developers for Change Request.
Environment: Windows, Oracle, HP - ALM/ Quality Center, MS Visio 2007, MS SQL Server, SharePoint Rational Requisite Pro, Crystal Reports, Agile, Linux, Putty
Confidential
Business /Quality Analyst
Responsibilities:
- Drives the requirements management process across the software development lifecycle
- Evaluates simple and complex business requirements; performs process analysis of customer activities to determine alternative business solutions or process improvement opportunities.
- Develops and maintains comprehensive documentation of complex business requirements
- Resolves ambiguities and conflicting business and technical requirements. Proactively identify issues concerning technical limitations and key product requirements.
- Develops business client testing strategies, plans cases and conditions; tests and monitors testing efforts; reviews and approves new system behavior to ensure alignment with business requirements and objectives
- Coordinates upgrades and rollouts across multiple business units and regions including specific duties related to of end users
- Engages and partners with 3rd party vendors, internal development, and other parties as needed.
- Leads problem resolution as needed to ensure that internal and external customers receive prompt, efficient service in accordance with company policies.
Environment: PHP, Cakephp Framework, Mysql, OS (Ubuntu 13.10), TFS, MS Visio, Selenium IDE, Java API, UIDAI API JAVA, Smart Git
Confidential
Tester / Mentor/ Assocciate
Responsibilities:
- Created Test cases and Test design based on the functional requirements and system requirements.
- Developed SQL queries for defining and developing test data for testing.
- Handling End to End Testing
- Create and deliver opportunities
- Working closely with the stakeholders, from taking the requirements till delivery
- Maintaining all Essential documents regarding the development process.
Environment: Php, Apache, HP/ALM, Linux, CSS5, HTML, MySql