SUMMARY

• Over 7 years of experience as Quality Assurance Engineer.
• Extensively worked as a Quality Assurance and Test Engineer, understanding responsibilities in QA plan formulation, developing project plans, communication plans and implementation.
• Highly motivated, self - starter, team player and leader.
• Strong analytical and problem solving skills.
• Excellent oral and written communication skills. Have written technical and user manuals for computer applications.
• Good understanding of health insurance policies like HMO and PPO and proven experience with HIPAA 4010 EDI transaction codes such as 270/271(inquire/response health care benefits),276/277(Claim status), 834(Benefit enrollment), 835(Payment/remittance advice), 837(Health care claim).
• Strong business knowledge of Healthcare sector and very good knowledge about Faucets, HIX and proven experience with ICD9-ICD10 conversion.
• Good working experience in analyzing changes and identifying areas of applications to be regression tested.
• Expertise in reviewing requirements, functional and design specifications.
• Strong Knowledge on CMM and Six Sigma Methodologies standards.
• Well-versed with all stages of Software Development Life Cycle (SDLC) and Software Testing Life Cycle (STLC).
• Expertise in working with Agile, RUP, SCRUM and Waterfall testing methodologies.
• Well- skilled with various testing methodologies, testing types, testing techniques and Quality Work Products.
• Proficient in formulating test plan and Requirement Traceability Matrix.
• Hands on experience in writing test plans, test cases, developing and maintaining test scripts.
• Generated and executed written test plans, isolated and reported problems and contributed to the evolution of quality assurance processes and procedures.
• Experience in developing Software Test Plans, Test Case Design, Test Scripts, System Integration Testing, Functional, Regression Testing, GUI, and database testing.
• Extensively used Blackbox testing Techniques.
• Excellent Experience in Defects Tracking in the Application.
• Strong experience in working in Windows and UNIX environments.
• Expertise in creating Bug Reports using tools like Quality Center. QTP/UFT
• Hands on experience with Databases Oracle, SQL Server and writing SQL Statements.
• Detailed knowledge in Object Oriented Programming Techniques.
• Good knowledge of Health Insurance Plans (Medicare Part A, B, C and D), managed care concepts (Medicaid and Medicare) and experienced in determining the membership eligibility, billing experience within life and disability in health plans.
• A motivated, sincere, committed, quick learner, detail-oriented team player with good communication, analytical, leadership, interpersonal and problem solving skills
• Knowledge of MMIS (Medicaid Management Information System), MITA ( Medicaid Information Technology Architecture
• Have attended seminars/webinars and gained lot of knowledge on HIX (Health Insurance Exchange), EMR (Electronic Medical Record), EHR (Electronic Health Record) and healthcare reforms like the Patient Protection and Affordable Care Act (PPACA), Emergency Medical Treatment and Active Labor Act (EMTALA)
• Assisted Business Analyst in UAT.
• Conducted extensive review and analysis of existing QA methodologies and development practices and worked on the continuous improvement to yield effective solutions.
• Excellent interpersonal skills and professional communication skills and have worked extensively in a team oriented environment.
• Strong points include attention to details, commitment to work and results oriented.

TECHNICAL SKILLS

Testing Tools: ALM/QTP,UFT, Quality Center, Selenium, RQM, CQ

Databases: Oracle, MS Access, SQL Server

Operating Systems: Windows, UNIX

Languages: C/C++, Java, PL-SQL

Browsers: Internet Explorer, Google Chrome, Mozilla Firefox, Safari

PROFESSIONAL EXPERIENCE

Confidential, CA

QA Test Analyst

Responsibilities:

• Validatedand implemented EDI transactions according to HIPAA compliance.
• Participated in analysis workshops for ICD 9 Procedure and Diagnosis Codes in accordance with ICD 10 CM and ICD 10 PCS Conversion Compliances.
• Validated CPT, HCPC, ICD 9 code sets from Data Flat files to support configured benefit plan building.
• Managed global administration and support of the Documented based Regulatory Electronic Document Information System (EDMS).
• Facilitated Electronic Data Interchange and storage in the ICD-10.
• Worked on HIPPA Transaction Sets 837P and 837I Standards according to the test scenarios.
• Created Test Conditions from business requirement document and functional requirement document
• Developed Test Cases to test the functionality of the system based on the test conditions
• Developed Test Scripts, linked Test Scripts and Requirements from DOORS to Test Cases in the Rational Quality Manager..
• Strong experience in working in QTP/UFT.
• Extensively used Rational Quality Manager to monitor the progress of assignment of testing activities and Reported executed results.
• Logged the defects in Clear Quest tool, assigned the right severity level and managed the defects through it.
• Coordinated System and Regression testing schedules and completed the same.
• Ensured the functionality meets business requirements as defined in test results logged in RQM.
• Accessed Diagnosis Master file and Crosswalk Mapping file to use ICD Diagnosis and Surgical Procedure Codes.
• Performed GAP Analysis to make sure that all requirements were covered by test cases.
• Prepared and submitted weekly test status reports to QA Lead.
• Analyzed the System Impact including MMIS Tables, Windows, Reports and Interfaces on external entities.
• Validated Professional and Institutional Claims, Processed and Adjudicated the Claims according to test scenarios.
• Maintained Requirement Traceability Matrix (RTM) to make sure that all the requirements are covered in test cases.
• Communicated with Development team and Business Analyst s to ensure testing issues are resolved.
• Generated test execution reports and uploaded validation documents in share point web site for review.

Environment: Main frame/CICS/DB2 (Client Server Applications), Edifecs Spec Builder, IBM Rational Quality Manager, QTP, UFT Rational Clear Quest, Share Point, MS SQL Server.

Confidential, Sacramento, CA

QA Analyst

Responsibilities

• Preparation of Requirements traceability matrix for each legacy systems to ensure the data migration is achieved with accuracy.
• Preparation of Requirements traceability matrix for HIPAA compliance, various business rules depending on the state and ensuring the MetaVance functionalities are in compliance.
• Responsible for validating and testing clear ICD-9 to ICD-10 conversion.
• Developed test cases and test documents used for configuring software to meet needs of ICD-10 readiness.
• Knowledge of 837, 835, 276,277, 270, 271, 834, HIPAA EDI and X12 transactions.
• Writing system test plans, test scripts, check lists and its review.
• Extensively performed Manual testing process to ensure the quality of the software.
• Involved in Manual testing using Quality Center to develop test cases, test scripts, executing the scripts and logging the defects.
• Develop scripts and test cases for Integration Testing, Regression Testing and Stress Testing.
• Designed data for interpreting negative/positive results.
• Extensively used SQL scripts/queries for data verification at the backend.
• Interaction with the legacy SME, business, IT team and HP for technical clarifications.
• Interaction with the QA Team, Business Analyst and Delta IT team for status reporting and tracking.
• Work with Release Management Team to ensure that the correct version of code is pulled from SCCS for the respective testing cycles.
• Familiar with SCCS and was involved in code review with the development team in certain cases to help facilitate troubleshooting and identify the root cause of the bugs reported.
• Worked closely with the legacy team and HP to ensure adequacy of testing through clear understanding of Design aspects and business requirement.
• The areas of online application testing I covered were Membership, Benefits, Claims processing and Billing.
• The Batch testing covered the membership, benefits validation, claims adjudication and processing, payment processing and billing batch jobs. This also covered the legacy data load for each of the functional areas.
• Prepared Robust Regression Test scripts to test each new release provided by MetaVance team.
• Conduct Critical performance tests for the claims adjudication and payment processing systems.

Environment: Oracle, PL/SQL, SQL Developer, UNIX, Windows XP, HP Quality Center, MS-Office, ALM/QTP.

Confidential, Madison, WI

QA Analyst

Responsibilities

• Analyzed use-case document and functional requirement specification document.
• Prepared and maintained the Requirement Traceability Matrix to ensure completeness.
• Created test cases and test data from the functional requirement specifications.
• Primarily responsible for reviewing the approved Change in Requirements and analyzing and identifying the impact to existing test cases and scripts.
• Primarily responsible for reviewing the approved Change in Requirements and identifying and preparing the new test cases and test scripts.
• Involved in Black box, Manual Testing and prepared Test Suite for all the Test Cases.
• Created different document and matrices like test log, test incident report, test coverage matrix, tractability matrix etc.
• Generated test reports and test cases using QC.
• Strong experience in working in Selenium.
• Tested the system to verify the compliance with HIPAA in terms of privacy, security and standards
• Involved in detailed Functional and GUI testing and User acceptance testing (UAT).
• Involved in writing SQL queries for Backend data verification, retrieving data from related tables and Testing.
• Conducted End-to-End testing of the system manually.
• Detected bugs and reviewed them with business and developers and classified them based on the severity.
• Generated various Reports for PMO including Weekly Status Report and Open Defect Report using Excel.
• Conducted the Regression tests for already reported Bugs and change requests to test whether fix has been applied or not and to test and ensure the fix does not cause a new problem or break existing functionality.

Environment: Windows XP, HP Quality Center, UNIX, Oracle, Java, MS-Office, Selenium

Confidential, Concord, CA

QA Analyst

Responsibilities

• Participated in full SDLC cycle from initiation to deployment with regards to testing (Requirements Gathering, Test Planning, Test Cases, Test Data Preparation, Test Script Development, Test Execution, Test Reporting, Test Result Analysis and Review, Defect Retesting).
• Involved in Initial Test Walkthroughs (ITA's) for business requirements and test plans.
• Analyzed the BRD (Business Requirement Documents), FRD (Functional Requirement Document) and HLD (High Level Design).
• Attended JAD Sessions with Business Analysts, SME’s and the Development Team Manager.
• Designed and Developed Test Cases and Test Scripts from FRDs, BRDs and documented them in Quality Center.
• Tested the system to verify the HIPAA compliance in terms of Privacy, Security and Standards.
• Tested whether EDI Transactions is in compliance with the HIPAA 5010 changes.
• Worked on HIPAA EDI 835, 837, 271/272, 278 use cases and collaboration templates according business requirements in Claims Process.
• Expert understanding of the business process and verified the functional aspect as per the Business Process and validated the interfaces with the other systems and data conversion from the legacy system.
• Developed and modified the testing related documents such as Test Plan, Test Case, Test Scenarios and Test Scripts throughout the project.
• Wrote several basic and complex SQL scripts to validate the data integrity in the application.
• Worked closely with the Business Analyst to perform UAT and to prepare test scenarios and test data.
• Used Quality Center to create, track and follow up to closure on defects, during various builds.
• Coordinate with the team and QA manager to generate the status report and test matrix for each release.

Environment: Windows XP, HP Quality Center, UNIX, SQL Developer, MS-Office Suite.