PROFESSIONAL SUMMARY:

• 5+ years of experience in QA. To analyze business needs and lead projects in the healthcare market and as well as Work on Technical Projects inclusive of SAP, EDI, HIPAA, Healthcare, Insurance Market, Software and Systems/Unit validation.
• Experience in creating and maintaining the Requirements definition documents that included Business requirements and Functional requirements.
• Skills in developing Use Case diagrams, Sequence diagrams, State Chart diagrams, and Class diagrams. Performed Automated Testing using QTP, Winrunner, Load runner and Rational Test Suite Expertise in Claims, Subscriber/Member, Plan/Product, Claims, Provider, Commissions and Billing Modules of Facets. Medical Claims experience in Process Documentation, Analysis and Implementation in 835/837/834/270/271/277/997 (X12 Standards) processes of Medical Claims Industry from the Provider/Payer side Knowledge of health information and health care services regulatory environment including HIPAA, Medicaid/Medicare, CCHIT, EDI and XML Strong HIPAA EDI 4010 and 5010 with ICD - 9 and ICD-10, analysis & compliance experience from, payers, providers and exchanges perspective, with primary focus on Coordination of benefits Involved in Facets Output generation, Interface development and Facets Migration Projects. Provided analytical solution to the customers for Facets Production Issues Prepared unit test cases and performed unit testing Good Management, Execution and Documentation skills Experience in Mainframe development using technologies like COBOL, JCL, DB2, VSAM, CICS, IMS, REXX, EXPEDIATOR, ENDEVOR Inserted several checkpoints
• Thorough hand on experience with all levels of testing viz., Integration, Performance Regression, Sanity, Functional and System testing
• Involved in writing and executing test cases using MQC based on the requirements
• Performed Back-End testing
• Good experience in analyzing changes and identifying areas of the application to be regression tested
• Experienced in reporting bugs using Test Director, Quality Center and bugzilla.
• Conducted IP spoofing in Loadrunner
• Test automation for web application (SWAP module) using Cucumber. Familiar with Cucumber, Selenium Web Driver, Selenium commands and x-path. Strong working knowledge of PowerMHS modules
• Involved and tracking the defects using Quality Center
• Strong working experience with HIPPA, STB Transactions
• Good working knowledge of major Operating Systems and tested applications developed in wide variety of environments viz., Windows 98/NT/2000, UNIX Tested aplications belonging to Health Care domain
• Experienced in creating Test Plans. Thorough hands on experience with designing test cases covering all test conditions and eliminating redundancy and duplications
• Good experience in creating, modifying and enhancing both manual Test Scripts and Test Scripts created by Test Automation tools - WinRunner, Quick Test Pro, Rational
• Experience in interacting with business analysts, developers, technical support and help them base line the requirement specifications
• Used MS Excel spread sheet, PowerPoint, MS Visio, MS Projects
• Performed Sanity, Smoke and Usability Testing
• Good knowledge of SQL and experience at conducting backend testing

TECHNICAL SKILLS:

Operating systems: Windows 2003 Server, Windows XP/2000, UNIX

Testing tools: Win Runner, Load Runner, Quick Test Professional,Cucumber

Bug tracking tools: Quality Center, Rational Clear Quest, Test Director

Front-end tools: MS Office, MS Project, SharePoint

Languages: SQL, TSL, PL/SQL

Web technologies: HTML, XML, .NET

Databases: Oracle, MS SQL Server

PROFESSIONAL EXPERIENCE:

Confidential, Downers Grove, IL

Sr.QA Analyst

Responsibilities:

• As a QA Analyst worked with other QA in Unit Testing tasks, Trading Partners for connectivity issues; liaison between customers and corporate staff or between IT and Business Units as well as performing system matrix testing
• Also performed impact analysis. Work with trading partners, clients, management, technical and non - technical personnel to create use cases and system validation artifacts and testing documentation and also performed medical coding testing Worked with providers and Medicare or Medicaid entities to validate EDI transaction sets or Internet portals. This includes HIPAA 4010; 837, 835, 270/271, and others. Provided healthcare provider problem resolution. Work as a medical coding SME, including ICD-9, HCPCS; Procedures and diagnosis testing Created technical documentation, Reviews, analyzes, and evaluated business systems for end user needs, including Companion Guides, business process reengineering, including GAP analysis and documenting requirements, documenting processes, workflows Created test plans and test procedure templates and guidelines to be used by the QA team Also worked on 837 and 835 projects, including syntax and business rules for X12 HIPAA 4010 and 5010 validation for loops, segments, elements, qualifiers and code sets. Create export and XML processes for Lotus Notes Created EDI Export and Import processes and work with EDI Trading Partners, Payers or Vendors. Perform a range of telecommunications processes, including FTP, Dial-up, TCP/IP, Web transfers Performed Load, stress and Performance Testing. Involved in writing test cases using MQC based on the requirements Designed Test cases, test plan creation and Companion Guide development from stage to production, including both internal and external requirements UAT testing for HIPAA 4010 and 5010 projects including legacy testing and HIPAA requirements and compliance mandates Quality Center administrator and used Quality Center for defect tracking and reporting Unit testing documentation developed using Excel. Artifacts were created and listed for UAT validation. Writing/validating Use Case Documents Conducted Back-End Testing and Regression Testing using various phases of the application Managed Financial Processing that served as primary lead for corporate financial systems, including accounting processes for accounts receivable and accounts payable systems. Manage financial spreadsheets and vendor accounts. Spearhead collection processes and manage accounts receivable personnel
• Completed several HIPAA 4010 and 5010 Projects, included Medicaid and Commercial entities. Projects include claims and enrollment testing as well as NPI and medical coding and ICD-9 EDI testing
• Involved in writing and executing test cases using MQC based on the requirements Performed Back-End testing Trading Partner / Vendor Management and managing the requirements and selection for Trading Partners and Vendors Used Quality Center Checker Diagnostic, a tool to test many of the QC components. Schedule conferences, JAD sessions, participate in negotiations, set/create/resolve EDI TP issues and create legal draft points for corporate attorneys Followed Unified Modeling Language (UML) methodology using Reqisite Pro and Rational Rose to create/maintain: Use Cases, Activity Diagrams, Sequence Diagrams, and Collaboration Diagrams Tested and delivered Inbound/Outbound Facets interfaces Use Claredi web-based tool to validate HIPAA EDI files. Document errors and artifacts showing success

Environment: Facets, UML, Quality Center, MS Visio, MS Outlook, JCL, DB2 Mainframe, UNIX

Confidential, Dayton, Ohio

QA Tester

Responsibilities:

• Involved in claims submission and payment (remittance) retrievals by using ASCX12N 820 for the In- bound premium payments; ASC x12N 834 for the Inbound Enrollment and Maintenance; ASCX12 276/277 for the claims status enquiry and response; and ASC X12 835 for the Health care Claim Payments Responsible for attaining HIPAA EDI validation from Medicare, Medicaid and other payers of government carriers. The Claims were processed, co-pay is calculated, and the pricing is calculated using the IBM systems for both Retail and Direct Claims processing flow Was Responsible in finding the eligibility of the members and filing claims for the States Disability Insurance benefits for both short term disability who are not eligible for the Social security benefits and for the Long term disability customers who are qualified under Social security plan for the payment of benefits as a result or injury Performed Functional, regression
• System Integration and User Acceptance Testing for the various applications. Managed multiple priorities, project plans, time frames and trade-offs while ensuring the clinical and administrative staff understood the final results of the projects, sharing detailed vision of cost-benefit analysis Executing System Test, Regression Test, User Acceptance Test (UAT) Created reports to satisfy user requests, data sampling, project analysis, or testing verification Wrote Automated Test scripts using QTP Tested user interface and navigation controls of the application using Quick Test Pro. Involved in writing and executing test cases using MQC based on the requirements Performed Back-End testing
• Used the Rational Unified process methodology for the application development and created Use cases, activity diagrams and drafted UML diagrams using the Rational Rose Responsible for customer interface, requirements definition, general and detailed design, testing, maintenance and programs and managed requirements using Rational Requisite Pro Developed associated project documentation, schedule, design specifications, test plan, test scenarios/scripts, performed gap analysis, and test tracking reporting/monitoring for all phases of testing including B2B user acceptance testing

Environment: Microsoft Visio, Windows XP, IBM systems, Rational Requisite, Rational Rose, Win Runner, Load Runner, QTP, Sybase, CICS, JCL, .NET, Oracle.

Confidential

QA Test Analyst

Responsibilities:

• I have been involved in Preparingdetailed test plans explainingthetestscope,testingenvironment,test system hierarchy or file system, test naming conventions, testability issues, and test system data, procedural steps describing test procedure and expected results. Clarifying requirements, understanding design requirements and creating Test Strategies / Plans/ scenarios/scripts etc., Evaluate the testing steps in the form of test scripts and related test cases Preparing & executing detailed test plans and test scripts for both System integration testing as well as User acceptance testing which are of high quality Validating test results Preparing test scenarios and test cases of high quality and avoiding leakage of defects to production from User acceptance testing Logging test results and triaging issues with testing independently. Have received several compliments from the business team for identifying potential issues even before the testing phase started. Provided feedback to Analysts and Developers on test results Organizing and storing information about tests and test cycles in Rational Clear Quest. Requirements from the Requirements Traceability Matrix (RTM), were traced to test cases.
• Requirements are managed through Rational Requisite Pro. Effective defect tracking through Rational Manual Tester. Interacting with Business for getting the requirements for User acceptance testing and have a good rapport with Client partners. Assigning the testing tasks toother team members/offshore resources and track the status. Ability to write Complex SQL queries withstrong knowledge of DB2. Reviewed and provided feedback on Test scenarios, case/scripts, and data to offshore resources as well as onshore team members. Effective planning and working with multiple client vendors. Lead and coordinated all testing efforts with vendors and other testing areas, as needed Worked on ANSI EDI 834, 997 formats for enrolment as well as Agent Commissions system ( & Billing area) Worked on Various web portals like Connecture (IBU enrolments), Agent and group portal
• Benefit focus e-Billing Portal Performance testing, Cross-functional testing and End-to-End testing including external systems. Preparing Test strategy document as part of test data preparation process to make sure that the data is unique for each and every functional area. Identifying and securing unique/appropriate test data for the test scripts Data set up for System Test, Integration Test, Performance Test, Enterprise Test and Regression Test. Creating test data with Automation of Rational Robot and VB Script. As a part of value addition to the project, I took initiatives like “Regression test bed”, Preparing understanding documents on each of the project modules, proposal forautomating the functionalities, etc. Developing few tools using REXX to minimize the routine/redundant activities

Environment: Rational Clear Quest, Rational Manual Tester, Rational Requisite Pro, MQ Series, Webservices, XML validations, COBOL, JCL, DB2, IMS,REXX, Endevor, FTP, NDM.

Confidential, Chicago, IL

QA Tester

Responsibilities:

• DevelopedTest Planand overallTest Strategyfor the program usingTest Manager DevelopedTest CasesandTest ScriptsforSystemandUAT Testing. Involved in analyzing the requirements and understanding production volumes ofClaims Processing. Check the transformation of data inETLprocess fromODStoCDW.
• Performsmoke Testfor theInterfacesandmanagement reports. Performed the data driven test by pumping different sets of data. ValidatedHospital and Medical claimsprocessing. Validated the reports and files according toHIPPA and HL7enforced standards. Automatedthe major functionality of Member module usingRational Robot.
• Testingwork flow integrationof various modules. Querying data base by writingSQL queries using Toad. Tested theclaimsand validated the claims on mainframes. Tested various reports runs on theDatawharehouse and Datamining. Worked withJCLJobs onmainframes and data validation and verification. Validated the batch production of documents andtransaction-driven documents. Performedvolume testingby transmittingbatch filesand validating them. Recommending continuousprocess improvement, maintainQA standardsand artifacts. Developed Test scripts inRational Functional Tester (RFT). In RFT worked with share and privatedata pool,sharedObject mapsetc.
• Automated the tasks usingUnix Shell scripts (Ksh) DevelopedTest Summary Reportsand participated inGO / NO-GOmeetings. Tracked defects usingClear Quest& Conducted Bug-Review meetings. Coordinated with Business, Providers, Project Managers and Developers

Environment: HIPAA Gateway, Mainframes (COBOL, DB2, JCL, TSO/ISPF, CICS, MVS), Java, J2EE, EJB, XML, Oracle 8i, Data stage, Toad,Rational Test Manager, Rational Robot,Rational Clear Quest,Bugzilla, Windows NT,UNIX, Microsoft office suit.