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Sr. Edi Qa Tester Resume

Richmond, VA


  • I have over 8+ years of diverse experience in Information Technology with an emphasis on Software Quality Assurance.
  • My ambition is to take up a challenging position in the area of Software Quality Assurance and Testing in a progressive, fast - paced dynamic environment that will allow me to align my skills in the organization in the most efficient manner.


  • Extensive knowledge of various phases of different Software Development Life Cycle (SDLC); models like Waterfall, Agile, SCRUM, RUP, etc
  • Adequate knowledge in Health Administration - Claims processing (auto adjudication), COB, EOB/Drafts, Claims pricing and testing, HIPAA, enrollment, EDI, Medicare, Medicaid, CDHP (consumer driven health plans)
  • Actively involve with major Clearing Houses to support their EDI transactions
  • Experienced in Full life cycle Manual and Automated Testing in a Web-based Applications (JAVA, .NET etc), Client/Server Applications, and mainframe applications in Multi-Tier environments
  • Expertise in problem solving and bug tracking using Mercury tools like Quality Center, Doors, Rational Clear Quest and Test Director
  • Expertise in querying and testing using RDBMS tools like Oracle, MS SQL server, PL/SQL, DB2, QMF, TOAD, and MS Access for Data integrity
  • Thorough understanding of Software Development with various programming languages such as, C, C++, Java, .Net, HTML, XML, etc
  • Well versed in the Internet technologies and Object Oriented Programs
  • Huger exposure to various banking, health, retail and data warehouse modules
  • Expertise working in Healthcare industry with Insurance, Loans, Claim Processing, etc. Medicaid and Medicare modules as well as Interface Testing and Data Conversion
  • Worked with ANSI X12 5010 as well as ANSI X12 4010 including medical transactions such as 837 (medical claims), 835 (medical claim payments), 270 (eligibility inquiry), 271 (eligibility response), 276 (claim status), 277 (claims status response) and 278.
  • Strong knowledge of managed claims management process. Knowledge of Medicaid and Medicare services.CMS Health Assessment System, HL7 standards, HIPAA, PPACA(Patient Protection and Affordable Care Act), Compliance issues, LO INC and SNOMED Mapping, HL7 Message Validation, ICD9, Electronic Health Records (EHR), Electronic Medical Record(EMR).
  • Strong experience withSOAarchitecture which includeSoapWeb ServiceandRestFul Web ServiceTesting
  • Extensive knowledge of gap between HIPAA 4010 and 5010.
  • Fluency in web services standards, technologies and tools (e.g. XML,RESTful, etc).
  • Excellent knowledge of HIPAA standards, EDI (Electronic data interchange), transaction syntax like ANSI X12, Implementation and Knowledge of HIPAA code sets, ICD-9, ICD-10 coding and HL7
  • Involved in various HIPAA and HL7 testing and validation for EDI transactions using 820, 834, 835, 837, 270/271, 267/277, 278
  • Expert in analyzing system and functional specifications used cases, Business Requirements and business rules to prepare Test Plans and design Test Cases from business requirements
  • Excellent understanding of Expertise in ETL process, Rational Unified Process (RUP), Unified Modeling Languages (UML) diagrams including Use Case-diagrams, Activity Diagrams, State Diagrams, Sequence Diagrams, Physical Diagram, etc
  • Strong working experience in the data analysis, design and development, implementation and testing of data warehousing using data conversions, extraction, transformation and loading (ETL), Informatica, Business Objects, MS SQL server and Oracle


Testing Tool: WinRunner, LoadRunner, Quick Test Pro, Rational Team Test

Test Reporting Tool: Quality Center, Test Director, Rational Clear Quest, DOORS

Operating System: Windows 98/2000/XP/NT, UNIX, LINUX

Database: Oracle, MS SQL Server 2005/2008, MS Access, DB2, TOAD, QMF

Testing Language: TSL, SQA Basic, VB Scripting

Programming Language: C, C++, SQL, Java/J2EE

Web Technology: JSP, ASP, XML, HTML, .Net

Other: MS Office (Word, Excel, PowerPoint), IBM AS/400, Business Objects, Infomatica, Cybermation, Tortoise SVN, HIPAA, EDI, HL7, MMIS (Medicaid Management Information System), Trizetto Facets, UNIX Nile Server, Networking protocols and fundamentals


Confidential, Richmond, VA

Sr. EDI QA Tester


  • Translation of the requirements into functional design
  • 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.
  • Have proven business insight and the technical know-how to implement large-scale EMR and EHR engagements
  • Design EDI Dashboard for encounter data to identify and report errors in terms of graphical representation for accepted and rejected claims.
  • Used SQL statements to check data integrity and data validation
  • Created Text area Checkpoints to test the properties of the text in the application using Quick test pro.
  • Analyzed HIPAA 4010 and 5010 standards for 837P EDI X12 transactions, related to providers, payers, subscribers and other related entities.
  • Working on the complete end-to-end processing of the 837 claims testing also helping debug and recommend change in EDI guidelines for 837 claims processing in Ramp Manager.
  • Experience with Medicare and Medicaid: Claims processing, Medicaid billing, Membership, and Eligibility Verification and Care management.
  • Managed the configuration and modification of the EHR (Electronic Health Record)for the clinical validation to meet regulatory requirements and organizational best practices
  • Conducted and performed analysis of EDI transactions, document and produced metric reports.
  • Responsible for defect tracking and bug reporting using Quality Center; interacted with developers and Business Analysts to discuss and resolve defects
  • Developed and prepared EDI documentation for 834 (Benefit & Enrollment Maintenance) for client processing the 834 transaction.
  • Exposed to using ICD 9/ICD 10/HL7 coding standards in Medicare and Medicaid domains of the healthcare systems and industry for both inpatients, outpatients, reimbursement methodology.
  • Involved reporting and tracking the defects using Quality Center.
  • Involved in testing Web services andXMLusing SOAP UI. Verified the response received by updating the requestXML.
  • Conducted and performed analysis of EDI transactions, document and produced metric reports.
  • Used Quality Center to run manual and automated tests, report execution results.
  • Worked with Development and DBA team as well as System Integration Testing team to collaborate results analysis on Conversion User Acceptance Testing and related issues
  • Involved in testing the functionalities of the application and validated against the requirements using Test result analysis and Database testing by performing SQL Queries and Commands
  • Create and executed complex SQL scripts for Data conversion validation using Source to Target Database mapping details.
  • Created High Level Test Scenarios, Test Cases and Test Scripts for Data Hub requirements as described in RSD (Requirement Specification Documents) and DSD (Design Specification Documents) as well as HIPAA and HL7 regulations like 834, 835, 837, etc
  • Developed and wrote new Customer Implementation Procedures to be used for EDI Implementations.
  • UsedXMLfor building and parsing of Application Configuration file.
  • Automated Regression Test cases using QTP and Writing API and Web Service Test Cases usingSoap UI.
  • Worked withXMLvalidation java with web services
  • Participates in the QA process to review Test Cases

Environment: QTP, Quality Center, VB, Windows XP, Oracle, HL7, HIPPA, ICD, EDI, SQL, PL/SQL, Cognos, MMIS, EMR, EHR, QC, HP ALM, XML, EDI, SOAP UI, UNIX

Confidential, WA

QA Tester


  • Created Use Case diagrams using UML and Business Process Models using MS-Visio.
  • Facilitated Joint Application Development (JAD) Sessions for communicating and managing expectations and to discuss the different ways and means for the integration of Rational tools with the current system using an "adoption through execution" strategy.
  • Participated in providing implementation assessment for Rational Requisite Pro, Rational Clear Quest using Unified Modeling Language (UML) and Rational Unified Process (RUP).
  • Developed the strategy for developing and implementing new EDI (HL7 and EDI X12) interfaces and converting historical clinical and data.
  • Developed Use Cases, Sequence Diagrams, Activity Diagrams and Class Diagrams.
  • Analyzed HIPAA 5010 standards for 837P transactions, related to providers, payers, subscribers and other related entities
  • Identified the requirements for accommodating HIPAA 5010 standards for 837P transactions and captured these requirements to develop new GUI for the internet based application
  • Involved in FACETS Implementation, involved end to end testing of FACETS Billing, Claim Processing and Subscriber/Member module.
  • Developed and prepared EDI documentation for 834 (Benefit & Enrollment Maintenance) for client processing the 834 transaction.
  • Involved in creating requirements that comply with HIPAA, HL7, and ANSI X12 format regulations to protect the privacy of the employee insured under any policy.
  • Facilitated development of required needs analysis, and develops functional integration specifications withbusinessoperations and across other EHR application teams
  • TestRestfulWeb Servicewith manual and automation process.
  • Developing Test Scripts usingSOAP UIand SOA Test Automation tools.
  • Set claim processing data for different Facets Module.
  • Involved in testing the functionalities of the application and validated against the requirements using Test result analysis and Database testing by performing SQL Queries and Commands
  • Worked on EDI request transactions (270, 276, 278) and response transactions (271, 277)
  • Worked as the primary liaison between the business user and the developers throughout the project cycle.
  • Worked with various Business Intelligence tools for reporting and decision making.
  • Performed Gap Analysis to identify the deficiencies of the current system and to identify the requirements for the change in the proposed system.
  • Knowledge of Patient Protection and Affordable Care Act(PPACA), Electronic medical records (EMRs) and Electronic health records (EHRs).
  • Analyzed and worked with HIPAA specific EDI transactions for claims, member enrollment, benefit enrollment, claims processing, and billing transactions. Worked specifically with 270/271,276/277,837, 834/835.
  • Handled changes at each stage of project development.
  • Used clinical analyst and business analyst skills to document EMR system requirements, work flow and hardware assessments in the physician practice and clinic setting.
  • Conduct complex documentation and user needs analysis. Interface with team and staff to develop HL7 integration.
  • Documented Requirement Traceability Matrix in Requisite Pro for traceability of requirements.
  • Provided technical assistance in identifying, evaluating, and developing systems and procedures that were cost effective and met business requirements.

Environment: Windows, Oracle, SQL, RUP, SQL, DB2, HIPPA, EDI, ICD, HL7, ETL, PL/SQL, Java, MS Office, MS-Project, MS Visio, Quality Center.

Confidential, Topeka, KS

QA Analyst


  • Translation of the requirements into functional design
  • Defined the change management approval procedures to control the scope of the order management system (OMS) requirements.
  • Worked on projects which used Agile and Waterfall methodologies.
  • Developed Test Plan and reviewed and wrote test cases, data creation to perform SIT & UAT testing tasks.
  • Analyzed the system for the effectiveness of the E- commerce operations Involved in testing the conversion of the application into web application using XML web services.
  • Involved in managing and updating Object Repository which stores objects in the AUT in QuickTest Pro.
  • Created User Defined Functions in VBScript library files and used these functions in various test scripts using QuickTest Pro.
  • Extensively Performed Back-End testing by writing and executing SQL queries on the database.
  • Got involved in the User acceptance Testing (UAT) and SIT and documented the test scenarios and outcomes.
  • Gathered requirements for the integration of Point-Of-Sale (POS) system with the supply chain system.
  • Tested the Web-services of theSOAusingSOAP-UI.
  • Developed Automation Test Scripts to perform Functionality, Security, UAT and Regression Testing using Quick Test Pro
  • Defect tracking and bug reporting using Quality Center
  • Interacted with developers, business analysts and discussed technical problems and reported bugs

Environment: Windows XP, VB, SQL, UNIX Shell scripts, XML, SOAP UI, Quick Test Pro, Quality Center.

Confidential, Columbus, OH

Quality Assurance


  • Generated Test Cases and Test steps in Quality Center
  • Created and tested business processes testing UAT and Integration testing) and supported end users in execution of test scripts.
  • Generated test results from HP Quality Center and documented the detailed Test Exit report.
  • Managed changes to the POS system and worked in POS integrations.
  • Worked onXMLtools with various documents for further processing and worked onXMLAPI's.
  • Created both Automated and Manual test cases with the help of QTP and HPQC.
  • Expertise in manual Testing and Automated testing using Mercury Interactive test tools like QTP, Silk Test Pro and HP Quality Center.
  • Strong experience in conducting User Acceptance Testing (UAT) and documentation of Test Cases. Expertise in designing and developing Test Plans and Test Scripts.
  • Active participation in regular project status meetings related to testing.
  • Integrated POS with Ingenico devices to accept payment and capture customer information.
  • Participated in daily meetings to discuss defects, issues and risks of project
  • Involved in the documentation process of program evaluation.
  • Responsible for creating and uploading the project artifacts in Share point site and providing release support.

Environment: COBOL, DBU, DB2, IBM Utilities, SQL Assistant, Quality Center

Confidential, Memphis, TN

QA Analyst


  • Review database design and other related documents for better understanding of the application
  • Worked on Agile SCRUM approach implementation for the whole testing life cycle for Performance Test
  • Fully engaged and mentored the development and management teams in the Agile/Scrum process
  • Assist clients in the computer systems usage best practices to avoid non-compliance. Also helped in the documentation for the same
  • Created templates to be used in assessments of the system
  • Conducted Back-End Testing manually for the purpose of Database Integrity
  • Wrote complex SQL queries in TOAD (Relational DB) to perform Back-End testing. Participated in data analysis for verification purposes using SQL queries, views and procedures
  • Written and maintained SQL scripts to accelerate the testing process
  • Interacted with programmers to identify and resolve technical issues
  • Initiate meetings concerning different clients at regular intervals to update them on the progress of the project
  • Performed User Acceptance Testing (UAT) with all business users and interacted with developers for any bugs found while UAT
  • Participated in various meetings, which are done for Enhancement Request and Modification Request of applications, following the client requirements
  • Participated in walkthroughs with the management team and developer team
  • Trained the team members, presented demos in team meetings and participation in business requirement meetings
  • Coordinated with developers to fix the bugs and maintained bug status up-to-date in Test Director

Environment: Windows XP, Oracle on UNIX Nile Server, SQL, UNIX scripting, TOAD, Test Director,

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