SUMMARY

• 7 years of diversified experience in the field of IT, EDI Quality Analyst and Software Testing specific to Health Care Insurance, Finance industry.
• Followed the RUP based methods using UML to create Use Cases, Activity Diagrams, State Chart Diagram, Sequence Diagram etc.
• Extensive experience to gather requirements and categorized them into FURPS (Functionality, Usability, Reliability, Performance and Supportability).
• Expertise to design Business Requirement Specification (BRD), System Requirement Specification (SRS), User Requirement Specification (URS), Use Cases Document, Work Breakdown Document (WBD), and Requirement Traceability Matrix (RTM).
• Expertise in Rational tools for Requirement Management, Business Process Modeling and defect tracking like Rational Req Pro, Rational Rose, Rational Clear Case, Rational Clear Quest.
• Expertise in Claims, Subscriber/Member, Plan/Product, Claims, Provider, Commissions and Billing Modules of Facets
• Used requirement elicitation techniques like Interviewing, Brainstorming, Joint Application Development (JAD), and Rapid Application Development (RAD) sessions.
• Expertise in Test Automation Tools Parasoft - SOATest, Mercury/HP Quick Test Professional (QTP), Quality Center, Test Director, Requisite Pro, Test Manager, Clear Quest, Clear Case.
• Proficient in creating Use Case diagrams, Sequence diagrams, Activity diagrams, Class diagrams, E-R diagrams, and Data modeling using MS Visio and Rational Rose.
• Can effectively use Erwin tool for creation of a basic Data Model and Database Schema.
• Expertise to design mock up for UI solution using Photoshop, HTML, DHTML and XHTML.
• Worked on analysis of FACETS membership enrollment system and to gathered requirements to comply with HIPAA requirements.
• Familiarity with current industry standards such as HIPPA guidelines (4010 & 5010) and EDI Transaction. Extensive experience in EDI implementations (Real and Batch Processing).Excellent experience in EDI transaction like 270, 271, 276, 835, 837
• Involved in design and maintain of Test Plans, Test Cases and Test Scripts using Test Director, Test Manager.
• Involved in Providing the FRD / Specification Document Review Clarifications to detect the Defects in the Early Stage. Also lead the creation, preparation, and conduct of QUALITY ASSURANCE/verification reviews of software development artifact
• Experience in FACETS. claims Adjudication system.
• Involved Unit Testing, System Integration Testing, System/Black Box Testing, and Regression Testing with QA team.
• Excellent working knowledge on test design, test development and implementation of test procedures for Web based, Client/Server (Internet & Intranet) using Java, J2EE, VB, ASP,Net BPM applications on Windows, UNIX and CICS screens for Mainframe systems.
• Extensively used Clear Quest for bug tracking and Clear Case for Requirements traceability and document version control.
• Experience in testing Business Intelligence reports generated by various BI Tools like Cognos and Business Objects.
• Strong experience in conducting User Acceptance Testing (UAT).
• Strong knowledge of project management skills like time estimation, task identification and scope management.

TECHNICAL SKILLS

Methodologies: Waterfall, RUP, Agile, UML

Modeling Tools: Rational Rose, MS Visio, Case Trakker

Requirement Management Tool: Rational Requisite Pro

Testing and defect tracking Tools: Rational Robot, Rational Clear Quest, Rational Clear Case, Quality Center, Win Runner, Load Runner, and Quick Test Pro (QTP)

Project Management Tool: MS Project, Business objects, Cognos.

Operating System: Windows Vista/XP/2000/98/95, Dos, Unix

Integration/ Middleware Tools: TIBCO, STERLING-GIS, PERVASSIVE

Languages: JAVA, JAVA Script, .Net, VB, COBOL, C, C++

DBMS: MS SQL Server 2005/2000, Oracle, MS Access 7.x, PL/SQL

Web Technologies: ASP, .CSS, HTML, DHTML, XML

PROFESSIONAL EXPERIENCE

Confidential, Saint Louis MO

QA Tester

Responsibilities:

• Analyze the Business Requirement Document and Functional Specs for ICD 10 and Dental on Facets for writing the test scenarios.
• Developed Test Data for ICD 10 and Dental on Facets
• Wrote test scenarios and then test cases
• Worked on Waterfall methodology for testing and have used HP Mercury Quality Center
• Involved in testing HIPAA EDI Transactions and mainly focused on PA and
• Hands on experience in testing the claims Adjudication Process using Facets.4.71
• Performed System and Regression testing
• Logged defects in Quality Center and communicated that to the development team during daily defect status call
• Involved in testing HIPAA EDI Transactions and mainly focused Eligibility Transactions.
• Worked extensively with Quality Center for requirements, Preparing Test cases, Executing, Bug reporting.
• Mercury Quality center is used to document the test requirements, Test cases, test cases execution bug reporting and bug tracking.
• Executing post build verification tests using QuickTest Professional Test Automation Tool. Creating new test scripts, Capturing new GUI’s for window validation during QTP scripts execution
• Extensively worked on HP Quality Center, Test Director, Quick Test Pro, Load Runner and Rational Suite.
• Involved in loading the flat files into Oracle Database and involved in writing Complex SQL Queries.
• Loaded individuals and Providers in Facets for testing
• Have been actively involved in monthly team meetings to discuss the project status and bottlenecks

Environment: EDI X12N 4010HP Mercury Quick Test Pro, Quality Center, FACETS, 4.71/5.01 MS Outlook, MS Office, Oracle, Mainframes Windows 7

Confidential, Louisville, KY

QA Analyst

Responsibilities:

• Involved in writing Test plans, Test cases and responsible for executing the Test Scripts.
• Responsible for designing, developing test plans use cases and executing test scripts.
• Performed Smoke, Integration, functional, Regression, and system testing.
• Interacted with Business users and Technical team in providing clear solutions to requirements.
• Involved in testing HIPAA EDI Transactions and mainly focused Eligibility Transactions.
• Transactions focused on were 270,271,276,278,834, 835, and 837.
• Worked Extensively with Inbound 837 I and 837 P, 835s(Out bounds) claims processing systems
• Used FACETS Analytics for fast and easy retrieval, display and grouping of information for performing queries and generating reports.
• Configured FACETS.4.71to adhere to customers work flow for claims processing, claims automation and group administration
• Used FACETS to provide seamless transactions between the provider, members and the plan and used FACETS Workflow to route the claims according to the priority.
• Worked on Value added routines in Facets and provider and subscriber modules.
• Worked extensively with CPT/ ICD Codes. ICD-9 and ICD-10
• Extensively used the MVS utilities like File-Aid, QMF and DB2 Load for scheduling the jobs.
• Extensively tested Security on Web logic Servers and I-Frame portlets for Web Applications used Internal and External.
• Involved in setting up Permissions and Restrictions for Users within and out of Community.
• Tested the changes for the front-end screens in Trizetto FACETS,4.71related to following modules, test the Trizetto FACETS (membership, Billing, Provider, etc).
• Expertise in running Oracle Abstraction calls to load the data from the Web Services into the Data Mart/ Relational DB is accordance to the mapping requirements.
• Used IBM Mainframes- Incremental Scripts for adding, updating and modifying Datasets and fields in back-end to be populated in front-end.
• Used Quality Center for preparing the test plans and manual test scripts.
• Involved in executing ETL Informatica scripts to load data into Oracle DB and HP9000 systems.
• Generated the Cognos reports involving complex queries, sub queries
• Writing test scripts from functional specifications in test plan within Mercury quality center.
• Involved in loading the flat files into Oracle Database and involved in writing Complex SQL Queries.
• Involved in generating Reports using Oracle Report Builder and testing the reports using Oracle Run Time.
• Involved in writing Complex SQL Queries using TOAD to validate the loads
• Involved in executing Maestro Schedules in UNIX Environment.

Environment: EDI X12N 4010, FACETS 4.71 HIPAA Toolkit, DB2, LDAP, OLAP server, TSO/ISPF, JCL, Visual Basic, ASP, XML, SQL, MS Access, UNIX, Mainframe (IBM CICS), Oracle Run Time, Cognos, DB2.Windows95/98/NT/2000/XP Mercury Quality Center, SQL, MS Office.

Confidential, Eagan, MN

QA Analyst

Responsibilities:

• Responsible for decomposition of the requirements based on the functional specifications, design, development, coding, testing, debugging and documentation of applications to satisfy requirements.
• Involved in FACETS Implementation, involved end to end testing of FACETS Billing, Claim Processing and Subscriber/Member module.
• Involved in the testing of claims module and claims adjudication process ofFACETS.
• Set claim processing data for different Facets Module.
• Created Use Cases / Activity Diagrams thus defining the Data Process Model and Business Process Model.
• Creating Test Cases after analyzing the BRD’s.
• Responsible for GAP analysis of ICD9-ICD10.
• Performed manual back-end testing using PL/SQL to connect to an Oracle 9i database on a UNIX server.
• Assisted EDI team with the testing of maps for HIPAA transactions 835 and 837.
• Performing Functional and GUI testing on Facets.
• Prepared test matrices based through defect status in Quality Center.
• Executed test cases manually as well as using Automation tool Quick Test Pro.
• Logged defects in Quality Center and interacted with the developers to resolve technical issues.
• Involved in loading the flat files into Oracle Database and involved in writing Complex SQL Queries.
• Worked on ETL transformations implementation and Cognos reports validation.
• Used Quick Test Pro for creating inquiries from E-Leads, Online Application and Internal Referral form.
• Performing Backend Testing extensively by writing validation queries on DB database.
• Validating member’s benefits against the benefits matrix.
• Analyzed and tested data on claims manually and writing queries on DB database for validating data.
• Involved in HIPAA/EDI Medical Claims Analysis, Design, Implementation and Documentation.
• Experience on Data Migration Testing From Mainframe to Java Application.
• Involved in writing extensive SQL Queries for back end testing oracle database.
• Designed and implemented HIPAA 835 Payment Advice Transaction, 837 Health Care Claim Transaction.
• Set claim processing data for different Facets Module.
• Involved in User Acceptance Testing and training of end users.
• Worked with the Quality Management team to ensure that requirements documentation can be easily translated into test plans, and ensure that the proper testing plans have been completed.

Environment: Rational Unified Process, EDI X12N Quality Center 10,Rational Rose, Visio 2003, Oracle, Reflection, IBM Mainframe Office 2003,MS Project 2002, ETL, Informatica, Cognos Ms FrontPage, Windows XP, Quick Test Professional Facets 4.0.

Confidential, Richardson, TX

QA Tester

Responsibilities:

• As a tester Analyzing the Business Requirements, Functional Specification Documents to prepare Test Plans.
• Participated in project planning activities to determine testing scope.
• Worked on GAP’s for migrating from RxAmerica to Confidential System.
• Expertized in PBM and claim adjudication (AETNA) process.
• Created Eligibility, plans, Pricing schedules and adjucating claims by submitting claims to prepare Test data.
• Extracting claims on daily extracts and creating CET’s for different clients.
• Reviewing Test plans, Test conditions, Test scripts, and Test results.
• Involved in both black box and white box testing
• Providing Test Case walkthrough with Business and obtaining business approvals.
• Planning and delivering project Deliverables on time and delegating work to team members.
• Providing Test Results walkthrough with Business and obtaining business approvals.
• Supporting Team members in Preparation of Test Plan, Scenarios and the Testing procedures.
• Advising team members in resolving Data Setup and Execution issues.
• Executed test cases on each build of the application and verified the actual results against requirements using Mercury Quality Center.
• Prepared Traceability Matrix and mapped Requirements and Test cases
• Performed regression, integration and functional testing on the builds of the application
• Conducted Backend test using SQL queries to verify the Integrity of the Database.
• Involved in preparation of Traceability Metrics, software metrics.
• Involved in all phases of Data Load activities such as Segregation, Pre-Load and Load to load in the system.
• Analyzed the Data Load Activities and made the changes to the program whenever required.
• 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: PBM, OS/390, VS COBOL, DBU, DB2, WRKMBRPDM, IBM Utilities, SQL Assistant, ROBO, and Quality Center

Confidential, Tulsa, OK

Software Tester

Responsibilities:

• Interacted with Business partners to perform thorough analysis of business requirements, functional requirements and helped the team develop robust test conditions
• Involved in reviewing Use Cases and Requirements.
• Created test cases and test-case templates for manual testing and performance automation testing.
• Performed System testing, Regression testing and User Acceptance Testing and tested all aspects of products and thoroughly reported issues in bug tracking systems.
• Performing data manipulation in excel and HP QC.
• Did scripting, executed it, and got defects in Load runner.
• Performing automated testing of the web Services and applications using QC.
• Performing Load, Stress, Volume, and AD-Hoc Testing of the application using Load Runner.
• Executed SQL Queries using the simple and complicated join.
• Worked very closely with client side managers and developers.
• Tested on QA environment while performing functional tests.
• Initially performed end-to-end manual testing on the billing systems.
• Participated in regular project status meetings related to testing.
• Maintained documentation of test results to assist in debugging and modification of software.
• Analyzed test results to ensure existing functionality and recommends corrective action.

Environment: Microsoft .NET, SQL Server 2000 and Window XP, Agile Methodology