SUMMARY

• A result driven, details - oriented, and resourceful professional, with 10+ years of experience in Software Development Life Cycle (SDLC) as a QA Analyst.
• Thorough understanding of different phases of Software Development Life Cycle (SDLC) and Software Testing Life Cycle (STLC) including Agile Methodology and Waterfall.
• Extensive experience in Healthcare domain.
• Diverse work experience on Unit Testing, Integration Testing, Functionality Testing, System Testing, Smoke Testing, GUI Testing, Regression Testing, Sanity Testing, Performance Testing, User acceptance testing (UAT), Compatibility Testing, Product Assurance Testing and Data validation for Web based and Client/Server applications.
• Proficient in writing Test Plans, Test Scripts, Test Scenarios and Test Cases for both Manual and Automated Testing.
• Experience executing manual/automated test cases and doing Ad Hoc testing, Black Box, White Box testing.
• Extensively worked on HP Quality Center, Silk Center to Write Test Cases, Execute Test Cases, Log Defects, Track Defects and Prioritize Defects.
• Experience in testing of healthcare ERP solution like FACETS, QNXT and other claims adjudication systems.
• Familiarity with different aspects of Facets implementation lifecycle.
• Experience with Medicare, Medicaid, and commercial insurances in HIPAA ANSI X12 formats including 270/271, 276/277, 835, 837, 997 and NSF formats for interfaces and images to third party vendor applications.
• Worked in ETL environment involving Informatica/DataStage.
• Worked with various teams and data-architects from QA perspective to come up with processes in dev/qa/prod for extraction, transformation and loading the data into the DataMart’s.
• Hands on experience in Data Manipulation, Defining Components and in writing SQL queries.
• Skilled in validation and testing complex scenarios for the maintenance of quality standards in projects.
• Experience on Backend testing and executed the queries using TOAD tool.
• Highly involved in End to End to SAP business process testing which includes, PSC, RTR, OTC, STP and Interfaces.
• Working experience in a cross-functional team environment/different geographical location team.
• Effective team player, self-motivated, capable of adapting to new technology, strong problem solving and analytical skills, and inter-personal communication skills with a desire to achieve specified goals.

TECHNICAL SKILLS

Testing Tools: Facets, Power MHS, SOAP UI and QTP.

Reporting Tool: HP Quality Center.

Automation Tools: QTP 10.0, Rational Functional Tester8.1.1, Selenium

ETL Tools: Ab Initio, Quality Stage 8.0.1, 7.5, Information Analyzer, Informatica PowerCenter 7.1.4

Database: MS SQL Server 2008, Oracle.

Languages: C, C, VB Script, SQL.

Other Tools: Share Point, Visio, MS office.

Tools: Toad, PL/SQL Developer, SQL Navigator, and SQL PLUS

PROFESSIONAL EXPERIENCE

Confidential - Dayton, OH

QA Analyst

Responsibilities:

• Analyzed and defined testable requirements and implemented according to Test Plans.
• Developed Test Scenario, Test Case and Test Script from business requirement document and functional requirement document and uploaded them in HP Quality Center.
• Performed Functional testing and regression testing using PowerMHS.
• Designed and development of test cases based on functional requirements for Institutional and Professional claims for EDI and HIPAA Transactions 837/835, 834, 276/277, 270/271 testing.
• Worked on HIPPA Transactions and Code Sets Standards according to the test scenarios such as 270/271, 276/277,837/835 transactions.
• Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Medicaid Claims. Validated EDI transactions according to HIPPA compliance.
• Validated Professional and Institutional Claims, Process and Adjudicated Claims according to test scenarios.
• Worked with Claims module CL1031, CL1032, CL1033, CL1035 and CL1034.
• Assisted JAD sessions to identify the business flows and determine whether any current or proposed systems are impacted by the EDI X12 Transaction, Code set and Identifier aspects of HIPAA.
• Created transactions and analyzed outputs for Inbound and Outbound claims.
• Develop scripts using VBScript that include advanced error handling to keep scripts running on Selenium
• Performed System testing and System Integration testing.
• Developed extensive experience in eligibility and benefits calculation for state, federal and local services such as Medicare and Medicaid.
• Analyzed HIPPA 4010 and 5010 standards for 837P EDI X12 transactions related to providers, payers, subscribers, and other related entities.
• Worked on 837 transaction business rules for HIPPA 4010 and 5010 validation for loops, segments, elements, qualifiers, and code sets.
• Automation of Functional Testing for certain modules using Selenium and QTP,
• Participating in processing of requests for medical services and pharmacy services submitted via DDE or HIPAA 837 EDI and NCPDP submissions testing, Integration Testing, System testing, end-to-end testing, and User acceptance testing.
• Performed SQL queries to determine data to be used for testing.
• Maintained Requirement Traceability Matrix RTM to make sure that all the requirements were covered by test cases.
• Extensively used HP Quality Center for defects tracking and reporting tool.
• Communicated with Development team and Business Analyst to ensure testing issues are resolved.
• Enhanced automation tests with reusable actions, User defined functions and Generic functions by using VB Script and automated using Selenium
• Documented the test results and reported the status of assigned test tasks and issues to project QA Lead.
• Generated test execution reports get sign off and uploaded validation documents in share point web site for review.

Confidential - Dublin, OH

QA

Responsibilities:

• Worked closely with software engineers, internal and external customers to gather comprehensive testing criteria and plan requirements to ensure accuracy and timeliness of projects.
• Developed and maintained innovative Test cases based on Functional Requirements, Use Cases, user interface designs, system design documents and domain knowledge
• Involved in preparing the Test Scenarios for Health Care Claim Payment/Advice
• Worked on HIPAA Transactions and Code Sets Standards according to the test scenarios such as 270/271, 276/277,837/835 transactions.
• Enrolled members through online screens and 834 Transactions to Facets.
• Modified the 834 file and then checked if the eligibility enrollment is properly loaded onto Facets.
• 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.
• Worked with Accumulators, Deductibles, Coordination of Benefits and Overrides of the Claim Line detail and used them for testing various claims scenarios in Facets.
• Maintained strong relationships with developers which helped in better execution of test plan.
• Worked extensively using SQL for Back End Testing to validate data in the tables of the database.
• Executed commands in Unix to view the files
• FTP the files to Unix server for processing.
• Analyzed and translated requirements and business design into Test Cases.
• Used Quality Center for bug tracking, reporting and analysis.
• Involved in coordination between the automated testers, manual testers, and system administrator for the precise scheduling of test runs.