SUMMARY

• Highly motivated and accomplished engineer with 9.8 years of professional IT experience in healthcare domain testing in Facets, NASCO, Mainframe testing, functional testing, automation, and web service testing.
• Proven track record effectively leading teams through all phases of every project while maximizing resources and increasing productivity.
• Determined to fully engage with every client, team member, and external stakeholders to effectively collaborate, complete projects, and meet organizational objectives.

TECHNICAL SKILLS

Technical Testing: Facets Testing, NASCO claim engine, Mainframe testing, Functional Testing, Web services Testing, Automation Testing using SeleniumHealthcare Testing Claims, Membership management, EDI (837/835/27x), Provider management, ITS, FEP, Medicare enrollment, Accums inbound/outbound, NASCO adjudication system.

Programming Languages: CICS, Core Java, SQL, PL/SQL, VB, JCL

Databases: Oracle, DB2, Access DB

Database Tools: SQL Developer, Advanced Query Tool, Toad

Test Tools: Jira, ALM, Grid, RxExpress, Pega, Edifecs, Insomnia, SOAP UI.

PROFESSIONAL EXPERIENCE

Confidential, Folsom, CA

Technical Test Lead

Responsibilities:

• Effectively coordinate and mentor team during all phases of every project by regularly checking - in and providing constructive feedback and guidance as needed.
• Good working knowledge on Facets claims engine and Facets data model, Mainframe testing.
• Good working knowledge on Federal Employee Program systems in Healthcare Domain
• Sound Domain and Technical skills in Healthcare Processing - Payer, Provider, Medicare, Capitation and Claim Processing
• Rich experience in Health Care and Pharmacy Benefit Management domains.
• Proficient in preparing Test Plan, Test Cases, Test data management, Test Execution, Test Results Reporting, and Test Closure activities.
• Strong skills in communications, problem-solving, project management.
• Good knowledge of InterPlan Teleprocessing systems in the Healthcare Domain
• Good knowledge of claim processing engines FACETS, STAR, NASCO.
• Worked on all Testing Life Cycle Phases for Functional Testing
• Good experience in Web Services testing using SOAP UI, XML, & WSDL. Providing required input data to request XML & get the required data from response XML & use the response data from other request XML using SOAP UI.
• Build End to End automation framework for applications.
• Create a knowledge base for better reuse of code helping maximize resources and available technology.
• Analyze and gather requirements to develop appropriate estimates for every new project in healthcare.
• Develop strategies, test plans, test cases, defect reports, and developing test scripts, traceability matrices, test environments, and automation scripts for End to End testing.
• Prepare defect report, defect logging, retest, and defect tracking till closure.
• Understand requirements, pose questions, and get the requirements clarified from Onsite counterparts.
• Plan, schedule and prioritize project-related activities to effectively delegate assignments daily and meet deadlines.

Confidential

Technical Test Lead

Responsibilities:

• Delivered Medicare end to end system testing during HICN to MBI migration
• Delivered Capitation business process system testing
• Delivered multiple mandate projects with high test quality and received client appreciations
• Mentor for freshers in providing healthcare knowledge
• Created automation STT flow for commercial and ITS claims
• Lead QA in initial Real time claim and Real time accums implementation with various Accum vendors
• Acted as primary point-of-contact for claims and medicare tracks
• Worked on proposals for new projects with clear test strategy to client
• Coordinated tasks and resources across multiple simultaneous projects. Leads development and execution of configuration plan including estimates
• Demonstrate knowledge on Facets claim engine, Facets data model, and Automation experience.
• Ensure Quality Assurance Life Cycle aspects by developing and implementing appropriate Tests.
• Oversee and lead Defect management, including Defect creation, modification, tracking, reporting using tools like ALM, JIRA.

Confidential

Test Analyst

Responsibilities:

• Provided QA services for implementation and maintenance of claim adjudication system RxExpress, web services, and claim processing mechanism, process consultancy for setting up QA processes, test data management, master data management, and Data Warehouse.
• Created Automation scripts for End to End testing and prepared & developed test plans for the project.
• Developed Functional Test cases for planned release and Test Data setup for Execution.
• Managed Defect report preparation, Defect logging, retest, and Defect tracking till closure.
• Performed planning, scheduling, prioritizing, and coordinating day to day project-related activities.
• Effectively communicated with the team to report any problems and offer solutions proactively.
• Supported team with any tasks on the day-to-day assignments to ensure deadlines are promptly met.
• Initiated communication with the team to request additional feedback or guidance, resulting in increasing workflow.

Confidential

Test Engineer

Responsibilities:

• Worked on the claim processing portfolio in Steady-state projects for Blue Cross and Blue Shield of Minnesota, a leading health insurance organization.
• Maintained and enhanced the claim adjudication system to comply with the healthcare mandates/ rules.
• The enhanced system resulted in Defect-free work, optimized effort, and on-time project delivery, reduced cost of Project implementation, Automation of Manual process by tools.
• Designed Test Plan for Consumer Engagement Operation and Transactional Track in this Project.
• Automated Mainframe online regions using Hiperstation scripting.
• Verified the Test Data in the Database by using mainframe commands.
• Coordinated with the Business and Development team in resolving complex issues.
• Managed End to end responsibility of deliverables from Offshore.
• Assessed automation feasibility for the applications and provide a report.