SUMMARY:

• A QA Analyst/Tester with considerable experience in the field of application systems analysis, software validation & process re - engineering of web-based and Client-Server applications.
• Expert in Agile-Scrum and Waterfall testing lifecycle Methodologies
• Experience in testing various application related domains like - Healthcare
• Experienced in various Healthcare areas like Enrollment, Benefits, Claims, Medicaid, Medicare, and implementation of HIPAA key EDI (ANSI X12) transactions.
• Experienced to Validate EDI 837 claim billing (professional, institutional and dental claims) &835 (remittance advice or payment) claims adjudications.
• Worked in all phases of Software Testing Life Cycle (STLC).
• Strong in Software Analysis, Planning, Design, Development, Testing, Maintenance and Augmentation for various applications in data warehousing, metadata repositories, data migration, data mining and Enterprise Business Intelligence.
• Experienced in Creating BRD’s, FRD’s, TDD’s, Test Strategy, Test Processes, Test Plans, Test Cases, Test Scripts, Test Scenarios and Test Reports.
• Proficient in XML, HTML, SOA, SOAP and Web services.
• Extensively involved in Black Box Testing with various testing methods like Regression, Functional, Integration, System, Smoke, Usability, and Compatibility, Ad hoc, Performance, Security, Database and GUI testing.
• Experienced in Extraction, Transforming and Loading (ETL) using various tools such as SQL Server Integration Services (SSIS) while transferring the data to target destinations from various sources like Excel, CSV, and Oracle, Flat File, Raw file and XML File.
• Experience working in a FACETS environment, and I have gained extensive knowledge about various modules of a FACETS system such as claims,, etc.
• Expertise in HIPAA 5010, EDI transactions like 820, 834, 837 P, 835, 271 and Medicaid/Medicare Claims and Enrollments.
• Skilled in bug reporting and tracking using HP ALM/ Quality Center & Jira
• Strong in IT research, software analysis and design skills.
• Strong experience of developing, implementing and maintaining application systems under UNIX Operating System using SQL & Oracle database.
• Performed backend database testing by writing SQL scripts to verify data integrity.
• Extensive experience in Backend Testing on distributed databases using SQL queries.
• Experience in Functional Testing, System Integration Testing, Back End Testing, GUI Testing, configuration Testing, User Acceptance Testing.
• Solid understanding of, Claims Processing, Billing, Benefit/Eligibility, Authorization/Referrals, COB, and have experience in HIPAA standards and corresponding EDI transactions.
• Knowledge of Medicaid and Medicare Services.
• Tested different web services using SOAP UI.
• Followed Workgroup for Electronic Data Interchange standards for testing that need to comply with the HIPAA guidelines.
• Experience in SQL and SQL scripting.
• Tested the HIPAA EDI transactions 834, 837/835, 276/277, 270/271 according to the requirement test scenarios.
• Optimum use of documentation to avoid any form of miscommunication or misinterpretation during the entire software development process

T ECHNICAL SKILLS:

Methodologies: Agile-SCRUM, Waterfall

Platforms: Windows

Testing tools: SOAP UI, HP ALM/QC

ETL Tool: SSIS

Office Tools: MS Project, MS Office, MS Visio

Reporting Tool: Tableau

Database: MS SQL Server, MS Access, Oracle

Programming: HTML, XML, SQL Scripts, PL/SQL Scripts

EXPERIENCE:

Confidential, Mason, OH

QA/Facets Tester

Responsibilities:

• Preparing test data and sharing with other team members, executing test cases using HP ALM and attaching test documents to the test cases.
• Ensure that code written is working properly, logging defect and giving suggestion to developer to increase productivity.
• Wrote extensive SQL scripts for data validation, analysis and manipulation, and maintaining the integrity of the database.
• Written several UNIX scripts for invoking data reconciliation.
• Solid Back End Testing experience by writing and executing SQL Queries.
• Creation of test scripts in SQL based on published design documents
• Exported the results through SQL and documented the test results for test cases, suites executed.
• Worked on Various SQL Server procedures for various Bugs, executed queries in test databases using SQL queries.
• Inspected and worked on HTTP web services application and on SOAP APIs.
• Performed SOA / Web Service testing using Soap UI.
• Executed SQL Queries for testing integrity of data in database (Backend Testing).
• Written Test Plan and make sure that the development process is according to the requirements.
• Reviewed the Business requirement, Functional Design Documents and Technical Specification documents.
• Created Test Cases and Test data after analyzing the BRD.
• Responsible for manual testing of both web and stand-alone applications (Agile/Scrum development) - majority testing: System Testing, Function Testing and Integration Testing.
• Performed Functional and GUI testing on Facets Billing, Customer service and Subscriber application under Facets.
• Worked in testing the Professional, Institutional Claims processing and adjudication and validate data with FACETS.
• Worked on Claims Processing and Claims Accumulation and Adjudication in FACETS.
• Worked on different FACETS environments.
• Validated Load Receipt functionality, Cash Receipt functionality, Group Invoice functionality, and Policy Details extract functionality.
• Experienced in writing complex SQL queries for extracting data from multiple tables.
• Testing has been done based on Change Requests and Defect Requests.
• Involved in web services like SOAP and RESTful API testing using SOAP UI and developed and executed test cases using Soap UI tool.
• Identified the test scenarios and performed Web Services functional testing using SOAP UI.
• Perform the web service testing using the SOAP and verified the correct data sending and receiving through SOAP envelop messages in the XML format.
• Preparation of System Test Results after Test case execution.
• Performed Functional, Regression, Data Integrity, System, Compatibility testing
• Written several complex SQL queries for validating Business Object Reports.
• Ensure data stored in data warehouse is accurate by writing SQL check scripts against source data.
• Working on Deploying Database changes and SSIS packages by using MS visual studio in test environment.
• Extensively working on QlikView Dashboards and ensure metrics reported on various dashboards are accurate and consistent.
• Conduct impact analysis on EDM systems when there are source system changes and notify development team of any necessary changes.
• Perform Regression Testing for fixes and Enhancements of the application.
• ETL projects include a new commission system, general subledger, Salesforce integrations, Oracle integrations, and many more.
• QlikView dashboards include reporting for Lab, Customer Service, Billing, Finance, Medical Affairs, Clinical Development, and Sales teams.

Environment: Oracle, SQL, Facets, Windows, Slack, HPALM, Trizetto, MS Office Suite (Word, Excel, PowerPoint, Access, Outlook), UAT

Confidential, Newark, NJ

QA Analyst/Tester

Responsibilities:

• Design and develop Test Scenarios and Test Cases using HP ALM tool based on BRD, Use Cases, CRs and Enhancements.
• Review Test Cases scripted by QA Team, prioritize them and assign them for execution.
• Prepare Test Data and share with QA team members including BAs.
• Execute Test Cases using HP ALM manually and attached test document to the Test Cases.
• Performed Functional Testing, System Testing, Ad-hoc Testing, Integration Testing, End to End Testing, Regression Testing, Exploratory Testing and User Acceptance Testing (UAT).
• Log and track Marketplace defects using HP ALM/QC to resolve the issues.
• Inspected and worked on HTTP web services application and on SOAP APIs. Perform testing on XML for WSDL documents to validate SOAP messages.
• Tested performance of web application and read, validate and trouble shoot XML’s generated by SOAP.
• Used HP ALM to track and report system defects.
• Tested the Web Services (SOA applications) and tested the XML/SOAP/HTTP/WSDL applications as part of SOA test using SOAP UI.
• Written several complex SQL scripts for validating Reports.
• Involved in Facets implementation, end-to-end testing of Facets applications like Claims Processing, Provider, Subscriber/ Member, Utilization Management, etc.
• Documented Functional Specifications for Enrollment (834), Customer Service Interface, Claim (837) including Encounter Claim and Capitation Payment (820) and Authorized Representative for Medicaid Members.
• Extensively worked on Backend using SQL Queries to validate the data in the database.
• Performed Functional, Regression, and system testing of various Facets modules involved in claims processing, members and providers.
• Used SQL to extract data from different relational database management.
• Used HP ALM to report defects, maintain requirements and traceability matrix.
• Perform Header and Body Testing as a part of Regression Test using SOAP UI.
• Inspected and worked on HTTP web services application and on SOAP APIs.
• Compared and validated Reports Generation with Query Outputs using SQL Scripts and Tableau.
• Tested whether the reports developed in Tableau Reports as per company standards.
• Performed backend database testing by writing SQL scripts to verify data integrity.
• Executed SQL Scripts to retrieve test groups and manipulate date for testing purpose.
• Log and track bugs using HP ALM/QC, categorize them based on the severity and interacted with developers in resolving critical and high defects.
• Participate in Daily Testing Call with vendor, Weekly Status Report and Defect Triage Meetings to provide updates and input.
• Assisted in conducting User Acceptance Testing (UAT).

Environment: HP ALM/QC, SOAP UI, SQL, SharePoint, Facets, ETL, Windows, EDI, Oracle, XML, HTML.

Confidential, TN

QA Analyst

Responsibilities:

• Keep track of the new user stories from the Project.
• Preparing Test Plans.
• Identifying High-level Test scenarios.
• Monitoring EDI X12 transactions.
• Followed NCPDP rules to adjudicate and process the Medicare prescription drug claims.
• Preparing Test Cases.
• Responsible for Medicaid Claims Resolution/Reimbursement for state healthcare plan using MMIS.
• Creating Test cycles in JIRA and adding the test cases.
• Validated XML schema for system data documentation including the data requirement document.
• Execution and bug tracking through JIRA.
• Was involved in the project of modernizing the Medicaid and the Children’s Health Insurance Program (CHIP) eligibility systems to comply with Affordable Care Act (ACA).
• Performed web services data validations, input parameter validations, security constraints, xml, WSDL configurations.
• Writing functional, GUI scenario based test cases & executing them.
• Ensure efficient day-to-day management of all customer service queues across multiple facilities in order to effectively meet various client performance expectation metrics, along with optimizing staffing levels
• Planning and assigning daily tasks to team members.
• Generated the test defects report and reported it to the development team for Bug fixing.
• Actively attend Monthly/weekly/daily meetings with the team and other groups.
• Actively attend daily client calls.
• Providing KT sessions to the team members and the fresher’s.
• Prepared Test Cases based on business requirements and business rules for HIPPA EDI Transaction 834, 276/277, 270/271, 837/835.
• Tested all HIPAA transactions for multi-version support and validating the database to file elements.
• Defect Identified in testing environment where communicated to the developers using defect tracking tools like JIRA
• Updated the test cases using Jira
• Reported the defects in Jira and assign the SA or Developer for fixing defects, etc.
• Performed Back end Testing-using SQL queries, generating reports to ensure data integrity and validate the inserted and updated data
• Analyzed the responses of the web service using SOAP UI and validating the data in backend.
• Involved in System and Regression testing for 278, 837 and 835 files for Medical and Institutional claims.
• Tested and Validated Request and Response of XML using SOAP UI.

Environment: Windows XP, MS Office Suite, Jira, SQL Server, Oracle, UAT, HTML, XML .

Confidential, Dublin OH

QA Analyst

Responsibilities:

• Worked on Business Requirements (BRD) and functional requirements (FRD) that were implemented and analysis through JAD session.
• Developed elaborate Functional Test Plan and Test Strategy for the project.
• Involved in development of Test cases from functional requirements, technical specification and Use Cases.
• Developed test scripts to perform functional tests as part of black box testing.
• Working as part of Agile Scrum Development Team, conducting and effectively participating in sprint planning, task estimates, task sequencing, task assignments, sprint reviews and retrospectives.
• Created test cases for white box testing for ETL Data flows and Mappings.
• Followed Scrum/Agile Methodology in the process of the project management based on SDLC.
• Worked with Developer teams to verify the Business requirement document and Vendor logic.
• Developed and Maintained Test plans and Test cases using JIRA.
• Also participated in defining scope of project, gathering business requirements and documenting them.
• Wrote extensive SQL queries for data validation, analysis and manipulation, and maintaining the integrity of the database.
• Developed mappings for policy, claims dimension tables.
• Worked on various EDI X12 transaction sets such as 270/271, 276/277, 835, 837 etc.
• Working with database connections, SQL joins, aliases, views, aggregate conditions, parsing of objects and hierarchies.
• Submit, modify, and track change requests in Jira.
• Worked on different modules of Facets such as Members/subscriber, commissions, provider, billing.
• Worked on Facets Claims Screens and Facets Tables.
• Wrote SQL queries extensively to retrieved data from the database
• Used Pivot tables, formulas and relational tools to show the relation between the tables in Excel for the upload purposes.
• /enrollment and billing-entered information on Facets to ensure correct eligibility, etc
• Involved in Managed Care applications, Healthcare claims, ITS, HIPAA / EDI (837/835/276/277 , 270/271, 278,), NPI, Provider portals and Claims Processing applications.
• Involved in end-to-end testing of FACETS Billing, Claim Processing and Subscriber/Member module.
• Validated the translated HIPAA files with the proprietary Common Claim Record implementations.
• Create maps to transform data from EDI to standard XML business documents, provided assessment of business and technical needs.
• Created and executed test cases based on test strategy and test plans based on business requirement documents.
• Wrote Test Cases for Manual Testing and created Traceability Matrix.
• Extracted, Transformed and Loaded (ETL) data from various sources into Data Warehouses.
• Involved in writing SQL Queries to check for the data validation.
• Generated reports using document generator of Jira.
• Provided Efforts Estimate and coordinated the schedule using Agile testing method UAT phase.
• Involved in the peer review of Test Plans, Test Cases with the BA/QA team to verify implementation of new features and enhancements on QA and Production Environments.
• Used MS SQL server for data extraction, transformation, and loading (ETL) and related system business transactions.
• Designed ETL Process using Informatica to load data from Flat Files, and Excel Files to target Data Warehouse database.
• Performed the Back-End integration testing to ensure data consistency on front-end by writing and executing SQL statements on the Database.
• Involved in Back End testing using SQL Queries
• Created SQL queries within UNIX environment to automate the back-end testing.
• Develop, design & implement department plan to configure new Facets integrated processing system, to include but not limited to, workflow, management oversight and performance analysis.
• Worked on Data Mapping to map Facets data to outbound eligibility extracts.
• Wrote different types of SQL queries like Select, update, where, delete, insert into to write and retrieve data from database and also different types of Join and Union statements to compare and combine data among tables.

Environment: Agile/Scrum, JIRA, Facets, SQL, XML, SQL Server, SOAP UI, ETL, UAT, UNIX, MS Office Suite (Word, Excel, PowerPoint, Visio), Windows.