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Facets Qa Tester Resume


  • Six plus years of diversified experience in Quality Assurance and Software testing in Healthcare/Insurance Services, Information Technology, etc.
  • Experienced in every phase of Quality Assurance Life Cycle (QALC) and Software Development Life Cycle (SDLC)
  • Performed planning and development of Test Plans, Test Strategies, Test Cases and Test Scenario to meet product’s business requirements.
  • Strong knowledge of software development methodologies including the Agile methodology, Waterfall, and V - Model and SOA Methodology.
  • Strong experience of developing, implementing and maintaining application systems under UNIX Operating System using SQL, PL/SQL, Oracle 10g/11g database
  • Performed backend database testing by writing SQL and PL/SQL scripts to verify data integrity.
  • Extensive experience in Backend Testing on distributed databases using SQL queries.
  • Solid understanding of Membership, 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.
  • Experience in performing functional testing using Quick Test Pro.
  • Expertise in Claims, Subscriber/Member, Plan/Product, Claims, Provider and Billing Modules of Facets.
  • Thorough understanding and hands-on working experience with standards for medical transactions like 820 (enrollment), 834 (premium payments), 835 (medical claims payments), 837 (medical claims), 270 (eligibility inquiry), 271 (eligibility response), 276 (claim status), and 277 (claim status response).
  • Proficient in working with FACETS, claim processing systems.
  • Experience on Web services to combine component based development and Internet standards and protocols that include HTTP, XML, SOAP and Web services Description language.
  • Proficient in Black Box testing, QA Methodologies and Integration Testing, System Testing and User Acceptance Testing.
  • Specifically used SQL for Backend testing to validate the data.
  • Have good knowledge of SQL, Triggers, Stored Procedures and database connectivity for Back-end testing


Methodologies: SDLC, RUP, Agile, Waterfall, Hybrid.

Platforms: Windows, Linux

Testing tools: SOAPUI, WinRunner, LoadRunner, Quick Test Professional, Jira, QA Complete

Change Management Tools: Rational ClearQuest, TestDirector, HP Mercury Quality

Office Tools: MS Project, MS Office, MS Visio

Database: MS SQL Server, Oracle SQL pro, MS Access, Oracle, Toad

Programming: Java, C++, JavaScript, HTML, XML, Ruby on Rai



Facets QA Tester


  • Identified the requirements for accommodating HIPAA 5010 standards for 837P transactions and captured these requirements to develop new GUI for the internet based application.
  • Participated in setting up testing environment
  • Involved in preparing Test Cases based on business requirements
  • EDI Conversion from 4010 to 5010.
  • Tested HIPAA Transactions and Code Sets Standards such as 837/835/834, 270/271, 276/277 transactions
  • Tested 837/ 835, 270/271, 276/277 transactions with File Aid.
  • Authored and executed Test cases for Claims and Customer Service Workflow by manually.
  • Responsible for writing the Test Cases and Test Scenarios based on the Functional Specification and technical Specification and documented in Quality Center.
  • Executed Automated Test scripts using QTP.
  • Performing Functional and GUI testing on Facets. .
  • Involve in testing of FACETS Implementation, involve in end to end testing of FACETS Claims Processing module, Membership and benefits.
  • Recorded scripts in Quick Test Pro to perform Functionality testing.
  • Worked with providers and Medicare or Medicaid entities to validate EDI transaction sets or Internet portals. This includes HIPAA 4010; 837, 835, 270/271, and others.
  • Responsible for Back-End Testing Using SQL Commands using TOAD.
  • Working with others on 820 for Premium Payment Processing
  • Perform functional, exception and scenario testing.
  • UAT testing for HIPAA 4010 and 5010 projects including legacy testing and HIPAA requirements and compliance mandates.
  • Logged the errors, reported defects, determined repair priorities and tracked the defects until resolution using Quality Center.
  • Extensive experience in writing SQL and PL/SQL scripts to validate the database systems and for backend database testing.
  • Extensively used SQL statements to query the Oracle Database for Data Validation and Data Integrity.
  • Responsible for performing System and integration testing for release.
  • Created and maintained Test Matrix and Requirement Traceability Matrix and performed GAP Analysis.
  • Performed User Acceptance Testing (UAT).

Environment: MS SQL Server, Quality Center, XML, Windows, DB2, MS Office, EDI, TOAD, PL/SQL, Manual Testing.


QA Analyst


  • Developed Test Cases bases on Requirement Specifications and Design Documents.
  • Responsible for modification and executing of the Test Scripts.
  • Prepared test cases, according to the business specification and wrote scripts according to the test case.
  • Analyzed requirements and design/tech-specs for testability.
  • Coordinated feedback from testability reviews to PM from the QA team.
  • The project has subscriber Payment Data extract and Eligibility Data extract. Validation completed for both extracts.
  • Worked on a commission adjustment extension of Facets Core Apps and tested successfully on time.
  • Assisted UAT Business Leads with set up in tools and tool training as needed.
  • Performed Functional, Regression, System and User Acceptance Testing (UAT) in Web and Mainframe application.
  • Worked on Members, Providers, Claims, Configuration and Payment Modules of FACETS.
  • Recommend on implementation of HIPAA 5010 (EDI X12 837,834, 820, 278,270,999) in the new System.
  • Analyzed the FACETS Requirements/BRD’s/Gap analysis, then prepared test scenarios and test cases.
  • Conducted Validations for different FACETS modules Providers, Claims and Membership.
  • Involved in System and Regression testing for 278, 837 and 835 files for Medical and Institutional Claims.
  • Member and Provider Conversion, Created Keyword and EDI File and Modify the Member Data as per the Business Requirement Document and as per the test case.
  • Prepared Test Cases based on business requirements and business rules for HIPPA EDI Transaction 834, 276/277, 270/271, 278 and 837/835.
  • Wrote complex SQL, PL/SQL Testing scripts for Backend Testing of the data warehouse application.
  • System Integration testing for Facets core modules with external systems.
  • Created and maintained SQL Scripts to perform back-end testing on the oracle database.
  • Developed and executed test cases test Scenarios and followed-up defects using Quality center.
  • ICD 9- ICD 10 conversion analysis - Worked in the analysis of the ICD 9 - ICD10 codes.
  • Arranged weekly team meeting to assign testing tasks and acquisition of status reports from individual team members.
  • Conducted Bug review meeting to discuss resolution of issues.

Environment: Facets, Batch Servers, JIRA, TOAD for Oracle, MS Word, MS Project, MS Excel, PL/SQL, Reporting Portal, SQL, Quality Center.

Confidential, OH

QA Analyst


  • Analyzed and defined testable requirements created and implemented test plans.
  • Developed Test Cases/Conditions for manual and Automation testing of the above Applications and Reports.
  • Gathered requirements from the users and analyzed the requirements.
  • Involved in performing functional, application, integration, system, and regression Testing.
  • Developed the Test Data for different Groups
  • Communicated with development team to ensure testing issues are resolved
  • Performed Screen Navigation Test to ensure that the links are established as per the documentation provided.
  • Prepared and executed different SQL Queries against the Oracle and Sybase Database.
  • Entering Claims and Customer Service Tasks into the FACETS.
  • Recommend on implementation of HIPAA 5010 (EDI X12 837,834, 820, 278,270,999) in the new System.
  • Verified and Validated the Rates Calculations and Rate Renewal Calculations for different Products and Validate EDI Claim Process according to HIPAA compliance.
  • Used Facets Analytics for fast and easy retrieval, display and grouping of information for performing queries and generating reports.
  • Analyzed forms and successfully crosswalk details to corresponding ANSI X12 formats.
  • Tested the changes for the front-end screens in Facets related to following modules, test the Facets batches (membership, Billing, Provider, etc).
  • Worked on HIPAA Transactions and Code Sets Standards according to the test scenarios such as 270/271, 276/277,837/835/834 transactions.
  • Created reports that included a general overview, open bugs, new bugs and enhancement requests. Entered new bugs and maintained the current status of those bugs.
  • Responsible to work on Medicaid Management Information System which includes two divisions: HIPAA compliance and Maintenance units division and Claim processing division
  • Maintained Test Matrix and Requirements Traceability Matrix. Performed Gap Analysis on the same
  • Performed System testing, Integration testing and Usability testing in Quick Test Pro by inserting various check points necessary for HIPAA and Medicaid standards.
  • Involved in testing web testing with automated tool SOAPUI.
  • Performed backend database testing by writing SQL and PL/SQL scripts to verify data integrity.
  • Used Quality Center to enter and Report defects for Rate Quote Remediation
  • Prepared Application Testing Metrics Reports using MS Project.
  • Prepared and submit the weekly test status reports to QA Lead and Manager
  • Followed and Implemented the SDLC to improve the Testing Process and Efforts.
  • Coordinated with the Business users, BA’s and Testers in order to perform UAT Testing.
  • Involved in Weekly Testing Status meetings with Testing Team and Weekly Rate Quote Task force meeting with Business Users and Developers.

Environment: HIPPA, EDI, Rate Quote System, Rate Quote Remediation, Mass Transfer, Quality Center, QTP, UNIX, Shell Scripts, Java, J2EE, Web sphere, Web Logic, TIBCO, MQ Series, PowerBuilder, Visual Basic, MS-Windows, MS Project 2003, Sybase, Oracle, SQL Plus, PL/SQL, Access, SOAP UI, XML, SQL, .NET

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