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Qa Tester Resume

Cranston, RI


  • Highly skilled Benefit configuration business Analyst and Software QA Analyst with 6+ years of progressively responsible project experience, seeks business analyst position to drive through business and bring improvements in the process.
  • Experience in coding and testing of health care application involving Client benefit changes, claims processing, coverage determination, appeal processing for Medicare, Medicaid and other commercial health programs.
  • Strong domain knowledge in Health Care, Banking and Insurance, Claims Adjudication System, Pharmacy Benefit management (PBM) system, Benefit Configuration, Membership, Provider and Billing related application .
  • Expertise in Software Development Life Cycle (SDLC), Software Testing Life cycle (STLC), Methodologies and Test processes, Business analysis and documentation.
  • Proficient in GUI testing of Web based and Client - Server applications
  • Experienced in Develop Test Scenarios and execution of Test plan, Defect tracking and Reporting
  • Good knowledge in diverse industries such as e-commerce, Insurance, Finance, Retail, mobile application
  • Good knowledge in Analyzing and developing Requirement Document and preparing Traceability matrix
  • Knowledge in working with Web Services using SOAP UI, JMeter tool to validate XML request and response using different methods.
  • Experienced with testing tools such as HP Quality Center, ALM, Quick Test Pro(QTP) and UFT, Load Runner testing client/server and web based applications
  • Good experience in Automated testing Tools UFT, QTP, Load Runner, Quality Center, JIRA.
  • Knowledge in regression testing, data driven testing, UAT (User acceptance testing), Integration testing, Unit Testing, Smoke testing, Functional testing, Performance Testing etc.
  • Good knowledge in back end testing of Oracle & SQL Server databases to check the Integrity of data
  • Knowledge in Validation Source and Target database in ETL process
  • Working experience in Mobile application testing
  • Experienced working on an Agile team environments
  • Knowledge in UNIX / Linux, FTP ( file transfer protocol ), Executing shell scripts
  • Proven ability to support multiple projects under Tight Deadlines often with competing priorities and complexities
  • Excellent verbal and written communication skills and highly effective in interfacing across business and technical groups.
  • Experienced in working in onshore/offshore model and teams located across different geographical locations.


Tools: & Languages: Quality Center, JIRA, Load Runner, UFT, QTP, ALM, EZ Query++,EZTest, Soap UI, As-400, File-Aid, Toad Data point, JMeter, Putty, Selenium Visual Basic, JAVA, Testing Script Language (TSL), VB Script, SQL, PL/SQL, (T-SQL)

Data Base: SQL Server, MS Access, Oracle via Toad Data point

Business Area: Claims, PBM, HIPAA 5010, Membership, Provider, Benefit Configuration, EDI ICD-10 code, HCPCS and CPT codes, Utilization Management, Member Pricing, Patient Pay system.

Business Applications: Salesforce, AS-400,MS Word, Excel, Outlook, PowerPoint, Visio, Lotus Notes, MedHOK, Clinical Authorization System (CAS,) Enterprise Systems, Pharmacy Online Processing Systems (POPS), Citrix, SAP

Operating Systems: Windows 98/NT, Windows 2007& 2010 Windows XP, Mainframes and UNIX, VMware

Web Services: SOAP, RESTFul, SaopUI Tool, XML


Confidential, Cranston, RI

QA Tester


  • Create to test scenarios, test plan, and Test cases.
  • Performed Functional, Regression, Smoke testing
  • Validated and test by crosschecking data in backend
  • Execute test cases in Jama and track the defect in Jira.
  • Working as a UAT(alfa testing) tester in preproduction
  • UAT (beta testing)in production environment with stake holder
  • Translation testing in both Spanish and Portuguese in CRM software
  • Intersystem / External Interface testing
  • Involve to find out bad (invalid) data in DHS data base and clear them from production environment.
  • Communicate among different stake holders and member to release application to the production
  • Involve to create daily status report to the client on day-to-day basis.

Environment: JAMA/JIRA,IBM CICS ADABAS, COBOL and Natural programming languages on an MVS/ZOS platform, Excel, Access, MS Outlook, Oracle

Confidential, Lincoln, RI



  • Worked in Agile environment, attended daily stand up meetings, SCRUM meetings.
  • Business requirements development and reviews(User Stories) with Account manager, Team lead, and coder
  • Developed test scenarios/test cases based on user stories
  • Written test scenarios, test cases, testbed generation and raise defects
  • Performed Smoke testing, Functional, Regression, Sanity testing, Smoke Testing and User Acceptance Testing.
  • Performed Functional on AS-400 system to check the real life Adjudication at pharmacy working as per SLA
  • Performed system testing for pharmacy requirement
  • Validated tests by crosschecking data in backend
  • Performed Regression testing
  • Communicated with Pharmacist team to resolve the issues about drugs(NDC,GPI, UM etc)through SFDC
  • Participated in defect management activities through identifying, logging and re-testing using Salesforce
  • Participated defect triage meetings and assigned severity and priority to defects based on risk assessment and worked with developers to resolve issues.
  • Coordinated and work with offshore team to provide them information as per their requirements and activities

Environment: As-400, Excel, Access, MS Outlook, Windows, Salesforce (SFDC), EZ Query++

Confidential, Shrewsbury, MA

QA Tester


  • Worked on preparing test strategy, test plan, and Test cases.
  • Involved in system requirement analysis phase to ensure requirements adequately cover users prospective.
  • Involved in Functional, Regression, Sanity Testing, Smoke Testing, Integration testing and User Acceptance Testing.
  • Involved in writing automated test scripts using UFT to support regression testing and functionality of the application
  • Learned application business requirements, technical specification and installation guidelines.
  • Developed test scripts to automate process of testing in Soap UI.
  • Participate and executed test cases for major program modules.
  • Performance and Load testing of web applications using Load Runner.
  • Performed usability, GUI, Functionality and regression testing of the new builds.
  • Identified application defects to minimize number of steps to reproduce the problem.
  • Performed browser (IE, Firefox, Chrome, Safari) and platform (Windows 7/Vista/ XP) compatibility testing in virtual machine environment.
  • Worked on HP ALM to write manual test cases, executed them and Logged defect on both ALM and JIRA.
  • Involved in Understanding user stories in each sprint and creating scenarios in each sprint.
  • Providing daily status report to client on day-to-day basis.
  • Worked in Agile based environment working from sprint to sprint.

Environment: JIRA, HP ALM, UFT, Soap UI, Load Runner, SQL Server, Visual studio 2010, Oracle, PL/SQL, C++, Java, VB, VB Script, UNIX, Excel macros, and Windows NT/2000

Confidential, Lincoln, RI

Appeals Representative


  • Reviewed incoming requests and determined the nature of the appeal for Medicare part D member.
  • Channeled misdirected requests to the appropriate department.
  • Researched in member benefits and check claim history in different systems (MedHOK, PeopleSafe, CAS & As400) to validate the incoming appeal request.
  • Processed member appeals and initiated claims overrides as necessary following CMS guidelines.
  • Maintained internal provider database updates Atena for billing and mailing addresses based on correct NPI numbers during provider letter generation process.
  • Communicated with physicians, pharmacists or other external agency to complete appeal review process

Confidential, Lincoln, RI

Prior Authorization Representative


  • Received inbound Prior Authorization requests via phone/fax from members, providers and pharmacies to review and respond.
  • Communicated with providers and pharmacies to clarify details and resolve issues and complete member coverage determination.
  • Followed CMS guidelines using CAS and AS 400 system to process Medicare part D prescription drug requests.
  • Processed claims in PBM system and ensured authorizations are accepted on critical cases to meet SLA.

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