SUMMARY

• 6 years of experience in the field of IT with focus on QA and testing of Client - Server and Web based and web services with effective use of QA practices.
• Proficient experience in Manual and Automated Testing of GUI and functional aspects of the Client-Server and Web based Applications on multiple levels of SDLC and Testing Life Cycle (STLC)
• Knowledge in the ETL (Extract, Transform and Load) of data into a data ware house/date mart and Business Intelligence (BI) tools like Business Objects Modules (Reporter, Supervisor, Designer, and Web Intelligence).
• Extensive experience in writing SQL and PL/SQL scripts to validate the database systems and for backend database testing.
• Having expert level experience with Functional testing in Functional System Integration testing, User Acceptance Testing, End to End Test Management, Running Automation scripts in Regression Suites and Non - functional security testing areas. Hands on experience in Project change control mechanisms, Impact Analysis, Risk Analysis, Defect Management, End to End Testing and Production issues/defects ad-hoc and regression Testing & support Having expert level experience with Functional testing in Functional System Integration testing, User Acceptance Testing, End to End Test Management.
• Extensive Confidential experience in Medical Imaging, EHR/EMR, Mobile Apps, Medicare-Medicaid, HIPPA, HIX on EPIC software applications
• Good knowledge of Health Plans managed care concepts (Medicaid and Medicare) and experienced in determining the membership eligibility, billing experience within life and Disability claims in health plans with thorough understanding of CPT coding, CMS-1500 claim forms and reimbursement forms.
• Extensively used rational tools for UML, tracking and reporting and applied the Rational Unified Process in all areas of a software development life cycle.
• Practical knowledge of FACETS configuration principles and activities, including the FACETS data model
• Experienced in writing and preparing business requirements documents (BRDs), system requirements specifications (SRS), system design specification (SDS), functional specifications, defining project plan and change request.
• In depth knowledge of SDLC and implementation of the Rational Unified Process (RUP) in all four phases of a project: Inception, Elaboration, Construction and Transition.
• Demonstrating technical description of HL7 messages supported the HL7 segments and fields and how the HL7 messages relate to the front-end application and data base.
• Highly experienced in Designing, Implementing, executing, and evaluating database schema testing, database performance testing, trigger testing, data integrity and correctness testing.
• Designed and executed test cases for the black box testing and perform boundary value analysis, decision table analysis for business rules, and state transition verification.

TECHNICAL SKILLS

Defect Tracking Tool: Quality Center, Mainframe.

Programming languages: C, C++, Java, PL/SQL, VB Script, c#, Shell Scripting

Processes: Waterfall, Agile

RDBMS/Data base: ORACLE, SQL, MS Access

Tool: MS project, MS Visio, MS office package, File-Aid.

Operating Systems: Windows 2000/XP/VISTA, LINUX, UNIX

PROFESSIONAL EXPERIENCE

Confidential, Chicago, IL

Quality Analyst

Responsibilities:

• Involved in testing EDI transactions: 270, 271, 834, 835, and 837 (P.I.D) to identify key data set elements for designated record set.
• Verified and validated some of the important attribute such as action code to ensure the category of customer’s status.
• Prepare test data in HIPAA compliance for Confidential EDI transactions (837,835). Tested the transaction 837 (claim and encounters).
• Tested databases and report distributions based on functional area priorities and needs.
• Coordinated with other analysts to document business requirements and system specifications and wrote test plan for the installation, GUI, functional, performance testing
• Experienced in software development life cycle such as Waterfall, Agile-SCRUM methodologies, Business Analysis and Modelling.
• Prepared the Business Requirement Document (BRD) and Functional Requirement Document (FRD) for the enhancement of the existing services.
• Involved extensively in writing Agile User Stories and get them reviewed with Business lead and project manager for Sign Off.
• Coordinated and worked with Project Manager to prepare Project Plan in MS Project for Process Claim Domain.
• Performed the GAP analysis to find the Root Cause of the issues.
• Well-versed with leading industry tools like Jira, Version1, Caliber, MS Visio, MS Word, MS Excel and MS PowerPoint to develop various project deliverables
• Work with CMS business owners to define their target goals and propose alternative business solutions
• Worked on developing the business requirement and use cases for FACETS batch process, automating the billing entities and commission process.
• Involved in various Facets Data models like Gateway, Claims, Membership, Provider, Billing, Capitation, Invoice, Benefits, Product and Plan.
• Gathered information about the organization’s work processes and information flows using sequence diagrams and class diagrams.
• Created and maintained requirement documents for Facets for the different modules like Billing, Member enrolment and Claim adjudication.
• Acted as a primary contact in all the phases of Software Development Life Cycle SDLC, including Quality Assurance Testing, Performance & User Acceptance testing (UAT).
• Worked on EDI transactions: 270, 271, 834, 835, and 837 (P.I.D) to identify key data set elements for designated record set. Interacted with Claims, Payments and Enrollment hence analyzing and documenting related business processes
• Working on Lifecycle, Create and follow up on JIRA tickets for the change requests received from various business partners. Test them in prestige and test to validate and bring them to closure.
• Expertise in the EPIC Medical software application (EMR, EHR) as it relates to hospital workflows and setting up the infrastructure for a software implementation in a clinic environment.
• Involved in FACETS Implementation, involved end-to-end testing of FACETS Billing, Claim Processing and Subscriber/Member module.
• Performed GAP analysis for270/271, 834, and 835 EDI transactions, and performed final review and analysis of the 834 ST files those were sent out to the carriers.
• Involved in creating EDI Specifications and Test plans for the 837 Institutional, 837 Professional, 835, 270/271, 276/277 EDI 5010 transactions with EDIFECS.
• Maintained traceability between Requirements and Test Cases in Confidential ALM/Quality Center.
• Utilized SQL in every step of creating data warehouse including data warehouse design, data warehouse database, and loading data into data warehouse.
• Established Inner Join, Outer Joins and created primary key indexes (paired with foreign keys) for dimension tables whenever necessary.

Confidential, PA

Quality Analyst

Responsibilities:

• Used the requirement attributes (priority, effort, and risk) as the basis for negotiating the inclusion of the requirement, to manage the scope of the system efficiently.
• Facilitated JAD session to find out the impacted area of functionality of Facets due to upgrade and cooperate with developer to come up with solution.
• Build Platform features, user stories, and maintain backlog with priorities, using Rally and JIRA platforms; Drive HLD, Low Level, and Integration (SOAP, REST, JSON, XML etc).
• Involved in all SDLC stages under Agile process requirement analysis, implementation, testing (functional and use acceptance) and deployment.
• Successfully conducted JAD sessions, which helped synchronize the different stakeholders on their objectives and helped the developers to have a clear-cut picture of the project.
• Used SDLC (System Development Life Cycle) methodologies like the RUP and the waterfall.
• Understand the As Is system and develop the To Be system concept and also prepare the System Process Maps.
• Experience in EDI automated first-pass claim adjudication, requiring thorough understanding of claim processing, both front and backend operations.
• Prepared and documented System Requirements and workflows for the Content Management Application tool.
• 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.
• Explored Mercury Interactive Tools (QTP, Quality Center and Load Runner) and Rational tools (Clear Case, Clear Quest, Test Manager and Functional Tester), JIRA for Client/Server and Web-Based Applications.
• Performed Defect Tracking and Project Tracking using Jira - Change Notification Request (CNR).
• Ability to analyses engineering product support issues described within a bug-tracking system (JIRA) and provide guidance to other Client Services members in an advisory capacity, focusing on the quick resolution of the production issue and using this as a training opportunity for other team members
• Evaluated testing results for each potential release build using Test Director, Quality Center and listing summarized bug information in priority sequence, recommended viability of release for production.
• Worked in an AGILE delivery model involving multiple scrum teams and daily stand-up meetings
• Implemented and tested the application with Agile Methodology for overall software test strategy and approach, project schedules, issue management, estimations and risk assessment.
• Participated in meetings to discuss the alignment between the two different software development processes used by Amex (waterfall model) and NAN (agile method).
• Created business plans for integration of front end applications to communication with the back end mainframe.
• Helped in writing Training manuals and helped business with the Training on a one to one sessions.
• Employed Rational Clear Quest for effective Change Management (Requirements Creep) and bug tracking during the testing lifecycle.
• Developing Test Cases and Test Scripts for testing the different formats of data loaded on to the Web Services.
• Developed test scripts using VB Script in scenarios where recording using QTP was not possible.
• Performed manual testing on different modules of the application to verify for the load and usability/environmental issues.
• Regular review, clean-up, management and configuration of JIRA accounts and work closely with the different teams like LDAP, Network, and Infrastructure.
• Security testing was also performed due to the sensitivity of the data entering the databases. Involved in developing test cases for the scenarios where there can be breaches in the Security system.
• 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.
• Performed backend testing using SQL and PL/SQL to validate the data entering the fields.
• Involved in User Acceptance Test(UAT) activities like creation of manuals and helping users in testing etc.,
• Recorded all the bugs detected or suggestions made by the users during UAT. Recorded them in Bugzilla or other defect tracking device and escalated them to the Team Lead and worked with the developers for the release of the bug-free application.

Confidential, CA

Quality Analyst

Responsibilities:

• Reviewing and analyzing the BRD, FRD and Detail design documents, and understanding the SDLC methodology of the organization.
• Tested various transactions (Enrollment (834), Payment (835) and Medical Data (837)) for their compliance with the HIPAA regulations
• Prepared test plan & test cases based on requirements given by Health Business group and matched them to HIPAA specifications.
• Conducted review meetings with the development team to set a hard-freeze date and gather input for creating the Test Plans and Test Specifications.
• Security testing was also performed due to the sensitivity of the data entering the databases. Involved in developing test cases for the scenarios where there can be breaches in the Security system.
• Tested the portal application to make sure the claims, members are loading to Facets & QNXT and Providers can check the member eligibility and claim status.
• Create complex JIRA workflows including project workflows, field configurations, screen schemes, permission schemes and notification schemes.
• Team of Business Analysts for creation of Business and Functional Requirements for the creation of Electronic Health Records (EHR).
• Gathered requirements for making changes to the existing Electronic Medical Records (EMR), Electronic Health Records(EHR) and Ambulatory Services for the existing Epic Interfaces.
• Involved in development of the system for data exchange from EMR, EHR to Electronic Lab Reporting Systems.
• Provided business and mapping expertise during a transition of the EDI applications from the GXS Application Integrator (AI) to GIS
• Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Medicaid Claims. Worked on EDI transactions: 270, 271, 834, 835, and 837 (P.I.D) to identify key data set elements for designated record set. Interacted with Claims, Payments and Enrollment hence analyzing and documenting related business processes.
• Worked on AGILE Environment with daily scrum meetings, grooming sessions, planning and sprint cycles.
• Good understanding of SDLC and STLC methodologies including Waterfall, Iterative, Agile and Scrum methodologies.
• Involved in creating business processes and modeling diagrams using Rational Unified Process (RUP).
• Created use case scenarios and documented work flow and business process using Rational Rose
• Documented requirements, associated change requests with requirements and connected requirements with Use cases.
• Incorporated Rational Unified Process (RUP) to create Requirement Document Specifications using Visible Analyst.
• Performed extensive data modelling to differentiate between the OLTP and Data Warehouse data models
• Identified/documented data sources and transformation rules required populating and maintaining data warehouse content.
• Effective with the creation of artifacts and management of various roles specified by Rational Unified Process (RUP), Agile Methodology, RAD, Workflow Processes and Waterfall cycle method.
• Responsible for creating test scenarios, scripting test cases using testing tool and defect management for Policy Management Systems, Payables/Receivables and Claims processing.
• Involved with all the phases of Software Development Life Cycle (SDLC) methodologies throughout the project life cycle.
• QTP - test, image, bitmap, table, XML, and database checkpoints. Data Driven testing (data from database and integrated data tables).Building object repositories
• Extensively used QC for defect tracking and prioritizing defects and enhancement requests after base lining the requirements.

Confidential, KY

Quality Analyst

Responsibilities:

• Involved in creating performance test plan and performance test strategy, by reviewing functional and non-functional requirements.
• Planned the load by analyzing Task distribution diagram, Transaction Profile and User profile and executed Performance Testing using Load Runner.
• Created performance benchmark matrix that included the priority transactions and their expected response time behaviors.
• Analyzed Business Requirements and segregated them into high level and low level Use Cases, Activity Diagrams / State Chart Diagrams using Rational Rose according to UML methodology thus defining the Data Process Models.
• Understand the As Is system and develop the To Be system concept and also prepare the System Process Maps.
• Interacted with the developers to report and track bugs using Test Director.
• Take the overall responsibility for the Jira configuration and be the go-to person for any Jira issues, enhancements or best practice question.
• To function as the coordinator for the project involving the conversion/sell over of members from legacy system to Facets.
• Test data entry into FACETS 4.7 application in the test environment for creating groups, subscribers and family members.
• Worked on the Patient Management System (integrated version of Patient Information System with EMR/EHR)) is intended to remotely communicate with a compatible pulse generator from BSC CRM and transfer data to a central database (HIT EHR).Performed extensive requirement analysis including Data analysis and Gap analysis.
• Defined Functional Test Cases, documented, Executed test script in Facets system.
• Proficiency with Confidential Office applications (Word, Excel, PowerPoint, and Visio and Project Management Software), and Atlassian (JIRA, and Confluence)
• Implemented and tested the application with Agile Methodology for overall software test strategy and approach, project schedules, issue management, estimations and risk assessment.
• Created Process Flow diagrams, Use Case Diagrams, Class Diagrams and Interaction Diagrams using Confidential Visio and Rational Rose.
• Wrote Test Cases and performed User Acceptance Testing, documented the in detail defects using the Defect Tracking report.
• Used Test Case distribution and development reports to track the progress of test case planning, implementation and execution results.