SUMMARY:

• 7+ years of experience in both in Facets/QA Tester in Healthcare domain.
• Strong working exposure in AGILE, SCRUM and Waterfall SDLC methodologies.
• Proficient in analyzing and creating User Stories and Story Boards.
• Knowledge on HIPAA Compliance EDI Transaction Sets 834, 837 and Good understanding of the EDI transaction sets 834, 837.
• Excellent analytical skills for understanding the business requirements, business rules, business process and detailed design of the application.
• Expertise in EDI and HIPAA Testing Privacy with multiple transactions exposure such as Inbound Claims 834 - Membership Enrollment, 837-Institutional, 837-Professional, 835-Claim Payment/Remittance Advise, 270/271-Eligibility Benefit Inquiry/Response, 276/277-Claim Status Inquiry/Response Transactions and testing in Client Server systems and Mainframe Applications.
• Extensive experience in Backend Testing on distributed databases using SQL queries.
• Proficient experience with project management tools like MS-Project, JIRA for status reporting, planning and error tracking and correcting
• Developed and executed overall UAT testing process including coordination between UAT, business, and technology.
• Analyzed the FACETS Requirements and conducted gap analysis.
• Extensive experience in writing Business requirements documents, test strategy, test plans, test cases, test execution, Risk assessment, and test matrix for upper management, test environment setup, bug reports, & traceability matrix for web based application.
• Worked closely on 834 transaction code for Benefit Enrollment and was involved in Validation of HIPAA.
• Expertise in EDI files transferred to Trading Partners in HIPAA standards
• Experienced in troubleshooting and resolving errors in 834 and 820 transactions for health insurance exchanges and performing root cause analysis.
• Extensive knowledge of Facets Billing, Enrollment and Claims processing.
• Used Facets support systems to enable inbound/outbound HIPAA EDI transaction in support of HIPAA 834 transactions.
• Experienced on Web Services to combine component-based development and internet standards and protocols that include HTTP, XML, SOAP and Web Services description language
• Developed Test Scenarios and Test cases for Data Conversion, Functional, Integration, Security and UAT testing.
• Performed Black Box Testing, Regression Testing, Integration Testing, Sanity Testing, Smoke Testing, of Web-Based applications and Data warehouse testing.
• In depth knowledge of Medicare/Medicaid Claims processes.
• Maintaining knowledge of Medicare and Medicaid rules and regulations pertaining to the Facets and evaluating the impact of proposed changes in rules and regulations.
• In-depth knowledge of creating use cases, functional design specifications, activity diagrams, logical, component and deployment views to extract business process flow.
• Facilitated as UAT (User Acceptance Testing) lead and worked closely with users and supported in test execution and defect management during UAT.
• Strong understanding of project life cycle and SDLC methodologies Waterfall and Agile.
• Worked in close co-ordination with the testing team in developing test plan and test cases from functional and business requirements.
• Highly motivated team player with excellent communication, presentation and interpersonal skills, always willing to work in challenging and cross-platform environment.

TECHNICALSKILLS

Testing Tool: Quick Test Professional

Bug Reporting Tools: Test Director, Quality Center/ALM, JIRA

Databases: Oracle, MS Access, MS SQL Server

Project Management Tools: MS Office, MS Project, Excel, Confluence

Operating Systems: UNIX, Windows

WORK EXPERIENCE:

Confidential, Virginia Beach, VA

Facets/ QA Tester

Responsibilities:

• Worked with Business Analyst and QA Lead in reviewing and analyzing the business requirements Documents and functional requirements.
• Developed detail Test Plans for different benefit packages according to Business requirements documentation.
• Perform testing of software applications and other types of applications based on defined requirements.
• Manually created members in Facets in different environments using GCP document as well the requests raised by other teams.
• Perform front-end and back-end analysis of applications without detailed instruction.
• Contribute actively in technical and functional requirement review meetings.
• Extensively used Agile Methodology in the process of the project management based on SDLC.
• Analyze requirements and create/update test cases.
• Interacted with the technical team for the 837 claims transactions design.
• Claims processing and 837 Claim transactions.
• Tested 837/ 835, 820, 270/271, 276/277 transactions with File Aid.
• Use SQL queries skills to perform test data preparation and data verification. Use SQL to extract data about claims, providers, members, subscribers and others.
• Acting as liaison between end user and Facets for user problems, outstanding issues, training needs and new software releases.
• Evaluated and imported projects to look up EDR and DER in Soap UI and ran SQL query in TOAD to determine the eligibility.
• Preparing the 837 I&P Claims and validated these in Facet System.
• Created T-SQL statements and procedures for data mining related to 837 transactions.
• Set claim processing data for different Facets Module.
• Log and review defects with developers and other project team members to assist with resolution.
• Provide status to test leads/managers.
• Provided overall project management to multiple projects successfully completing them on-schedule and on-budget.
• Perform test case peer reviews.
• Apply QA and Testing processes and best practices to projects.
• Actively participated in walkthroughs and enhancement meetings.

Confidential, Middleton, WI

Facets Tester

Responsibilities:

• Responsible for gathering, analyzing and digesting the requirements and the critical areas of the application to setup and execute baseline tests
• Participate in Agile SDLC using the Scrum process
• XML stub creation for GUI test execution
• Coordinated and initiated Agile Scrum meetings with the Project Managers, QA, BA and Dev Teams
• Extensively participate in weekly status meeting with Test Team to discuss the current and future issues for testing plan as well as testing procedures
• Executed test scripts to verify the expected results based on the system requirements maintained in Quality Center.
• Validated Claims process using Facets.
• Involved in business analysis and project management, coordinating between the team members according to the business requirements.
• Involved in FACETS Implementation, involved end to end testing of FACETS Billing, Claim Processing and Subscriber/Member module.
• Involved in writing test cases using ALM based on the requirements.
• Expert in writing complex SQL queries in order to extract the data from multiple tables and perform data validations in the process of back-end testing.
• Defect tracking using ALM.
• Extensively performed manual testing and defect reporting using TFS.
• Performed back-end testing and verified the data between GUI and database are reflected correctly.
• Conducted smoke testing of different Applications using SOAP UI.
• Executing the SQL statements to extract data from tables and verify the output data with ref to user inputs from browser page.
• Drafted test strategies, test cases and test plan based on functional specifications
• Developed test cases for manual testing
• Establish test data for testing the application
• Wrote Test Scenarios, Test cases in excel sheet and imported them to Quality Center and also used to track the bug.

Confidential, Downers Grove, IL

QA Tester

Responsibilities:

• Conducted GAP analysis and filling gap according to the format set by HIPAA.
• Involved in FACETS Implementation, involved end to end testing of FACETS Billing, Claim Processing and Subscriber/Member module.
• Involved in validation of the data in 837 transactions in accordance to companion guide.
• Responsible for customer interface, requirements definition, general and detailed design, testing, maintenance and training programs and managed requirements using Rational Requisite Pro.
• Involved in FACETS Implementation, involved end to end testing of FACETS Billing, Claim Processing and Subscriber/Member module.
• Performed Back-End testing manually for database integrity using SQL statements on UNIX platform.
• Used the Rational Unified process methodology for the application development and created Use cases, activity diagrams and drafted UML diagrams using MS Visio
• Tested HIPAA regulations in FACETS HIPAA privacy module.
• Validated Claims process using Facets
• Performed Back-End Testing to check database integrity by writing SQL queries.
• Performed Back-End testing
• Set Claim processing data for different FACETS Module.
• Assisted the development team during the second and third iteration using the RUP model
• Developed design Specification writing Test report s and documenting Test results
• Used RUP to create use cases, activity, class diagrams and workflow process diagrams
• Analyzed the FACETS Requirements and conducted gap analysis.
• Conducted interviews and workshops for soliciting customer requirements
• Performed Test execution and wrote and executed Test scenarios/Test Scripts
• Defect Tracking and Bug Reporting was performed using Quality Center

Confidential, Dublin, OH

QA Tester

Responsibilities:

• Prepared Test Plans for each release, written Test Cases and executed them as part of Functional Testing.
• Analyzed and test configuration changes in FACETS
• Performed Black Box testing and conducted Functionality and Regression testing on various phases of the Management software.
• Support UAT testing and created defect guidelines documents for users using MTM.
• Performed User Acceptance Testing (UAT) & Regression testing.
• Gained Knowledge of EDI transaction code sets including, 276/277, 834, 835, 837.
• Reviewed Software and Functional Specification documents for Test Planning.
• Worked with medical Payment/billing system which kept track of various payment and bills issued to authorized medical care providers.
• Extensively used Scrum/Agile Methodology in the process of the project management based on SDLC.
• Involved in testing of Facets Implementation, Tested end to end testing of FACETS Membership and benefits module
• Work in the Agile testing environment with frequently changing requirements and features set.
• Executed SQL queries to validate the backend data using SQL Developer.
• Conducted Smoke Testing of the new ICD UAT region and recorded testing results in RTM.
• Generated the test defects report and reported it to the development team for Bug fixing through Microsoft Test manager (MTM)
• Performed Testing on Web Services, SOAP and Rest API Testing using data transfer and SoapUI.
• Developed and executed test cases for XML/SOAP services using SOAPUI tool.
• Involved in setting up different configuration environment for compatibility testing and manual testing.
• Upgraded the existing Test Scripts and created new scripts for client application to be able to work for new versions and patches, which improved product quality.
• Worked effectively on Member/Subscriber Benefit in Facets and functionality of new features, new enrollment, enhancements and Data validation in Facet
• Created SQL Queries using Oracle, SQL Server and DB2 in validating data into Data Warehouse applications.
• Involve in preparing Trace Matrix to design test cases