SUMMARY

• Over 6 years of experience in Software Quality Assurance Methodologies and Testing in Healthcare Industry.
• Extensive experience with all phases of SDLC including requirements analysis, detailed design, development, testing, maintenance and deployment of the application along with documentation, estimation, and scheduling and defect prevention.
• Experience with healthcare systems, Medicaid with prime focus on claims adjudication, provider, eligibility and prior authorization.
• Excellent database administration (SQL Server 2005 and Oracle 9i/10g) skills and good med command at writing SQL queries, stored procedures, functions and triggers.
• Good at writing software requirement specifications, technical reports and test documents.
• Experience on working with FACETS for verification and validation of EDI transactions.
• Efficient in MS Project/MS Excel for planning/status reporting/writing test scenarios.
• Experience testing HIPAA EDI Transactions and mainly focused on 276/277, 278, 270/271, 837 and 835
• Experience with developing HIPAA Companion Guides for 834 Enrollments, 270/271 Eligibility Inquiry/Response & 820 - Health Plan premium payments
• Experience with Claims Processing, Guided Benefit Configuration, Medical Plan, Provider, Subscriber/Member, Utilization Management.
• Extensive knowledge of QA Methodologies such as Capability Maturity Model (CMM), Rational Unified Processor ( RUP) and IEE Methodology.
• Experience with writing/executing automated/manual test scripts with the help of QA team.
• Experience in creating manual test cases from requirements, design, specifications and process flow diagrams
• Created test plans and test cases for 5010 transactions.
• Identified the impacts of 4010A to 5010 conversion.
• Experience in performing Back end testing by writing and executing SQL queries.
• Expertise in Bug Reporting, Tracking and Documentation.
• Experience in developing business based functional test scenarios.
• Experience in conducting Requirement Analysis.
• Extensive experience in writing and manual testing scripts for various testing.

TECHNICAL SKILLS

Testing Tools: Quick Test Pro, Win Runner, Load Runner.

Operating Systems: Windows XP/2000/ME/98/NT, UNIX, Linux

Web Languages: VB.Net, HTML, XML

Databases and Query Tools: Oracle, Sybase, MySQL, SQL Server 2008, SQL Server 2005

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

Project Management Tools: MS-Office 2010, Microsoft Visio, Excel, Power Point

Bug Tracking tools: Bugzilla, Quality Center, IBM Clear Quest.

PROFESSIONAL EXPERIENCE

Confidential, Southfield, MI

Responsibilities:

• Identified, defined and organized test ideas, test scenarios and test cases based on technical specifications
• Wrote and implemented Automation Testing Scripts using Selenium.
• Worked on Case Management, Disease Management and Utilization Management BRDs and formulated Test Plan and Test Strategy
• Worked on Testing the Care advance application functionality and all the custom built Assessments and Forms for Case management.
• Worked on testing Member and Provider Letters to come up with Test Plan and Test Cases
• Worked on Testing the Interface between CareAdvance Enterprise, CareAdvance Provider and Facets Applications.
• Reviewed EDI 837 claims and flagged HIPPA non-compliant claims received from the Payer side
• Involved in testing Batch Processes required for Concept and Campaigns in order to trigger Alerts and Automated processes within the application
• Worked on End to End testing of the Care Advance application.
• Coordinated defect resolution with the development team
• Executed SQL Queries to verify the data from Oracle Database using SQL Server 2008.
• Preparing sample Test Data and Test scenarios.
• Creating and consolidating SIT Test Cases and UAT test Cases using MS Excel
• Analyze and Report Test failures using BUG Management Tools.
• Provide support to end users while execution of UAT with proper test scenarios & test data.
• Involved in Production support of CareAdvance Enterprise for BCBSM WCM.
• Involved in post production enhancement of CareAdvance application functionality.

Environment: SQL Server, Trizetto Care Advance Enterprise, Facets, SQL Server 2008, Visio 2003, Sybase 12.5.2, MS Word and MS Excel

Confidential, Philadelphia, PA

QA Tester

Responsibilities:

• Involved in developing Test Scripts as per the business requirements in Quality center
• Created Test Plans by going through the design and functional specifications.
• Experience working on HIPAA 4010 claims
• Extensive knowledge of working on Paper claims and testing the applications based on it.
• Involved in HIPAA/EDI Medical Claims Analysis, Design, Implementation and Documentation.
• Developed various test cases for testing HIPAA 837I/P (4010).
• Worked extensively on Paper claims which are in NSF and UB92 format.
• Performed End to End testing and tracked the claim status in CIS.
• Design, develop Load Runner Vuser Scripts, enhance scripts, parameterize cookies, store dynamic content in Load Runner functions, use client side secure certificates.
• Create scenarios for Concurrent and Sequential users.
• Configure Load Runner Monitors.
• Involved in Change Request process and performed System and UAT as the project is in Production.
• Performed Manual Testing of the entire MAPPO application (E2E testing).
• Identified defects while executing and reported the defects using HP Quality Center. So, used Quality Center as a defect tracking tool.
• Interacted with Business Analysts for UAT (User Acceptance Testing), and tested the possibilities of system failure with UAT.

Environment: XML, HIPAA, EDI, ClearCase, HTML, JavaScript, Oracle, DB2, SQL, WinNT, Java.

Confidential, Blue Bell, PA

Quality Analyst

Responsibilities:

• Worked with Trizetto Facets System implementation, Claims and Benefits configuration set-up testing, Inbound/Outbound Interfaces and Extensions, Load and extraction programs involving HIPPA 834, 835 and proprietary format files and Reports development.
• Assisted in building a business analysis process model using Rational Rose and Visio. Produced Visual models for the application using Rational Rose and created Use Cases, State diagrams, Sequence Diagrams and Activity Diagrams..
• Performed Code Testing, Migration and Validation per SDLC standards.
• Created Test Scripts, Test Plans, Validation Plans and Testing Metrics Reports.
• Performed Functional, Integration and Regression Testing.
• Coordinated the upgrade of Transaction Sets 270, 271, 837 (I, P, D), 835 to HIPAA compliance.
• Work closely with EDI to ensure accuracy in data transmissions and shared processes. Transaction sets processed (837 (I, P, D), 997, 835, 271, 834) .
• Performed GUI testing, Integration testing, Regression testing, Ad -hoc testing, Negative testing, End to End testing, Load testing, User Acceptance testing.
• Wrote Test Scenarios, Test cases in excel sheet and imported them toTest Director
• Logged defects in Test Director, re-tested defects, analyzed defect with Users and Developers.
• Involved in both automated and manual testing
• Involved in writing the positive and negative test cases.
• Played a key role in the planning, testing, and implementation of system enhancements and conversions.
• Worked with a cross functional and diverse team of business users and developers to enable accurate communication of requirements and ensure consensus.
• Analyzed the requirements corresponding to coding the insurance rules in various processes.
• Facilitated weekly meetings with the review teams to continuously improve the QA process for the application development.
• Conducted walkthroughs with the end users and stakeholders to gather the modification requests from the user to upgrade or change the business specification for the product.
• Followed a structured approach to organize requirements into logical groupings of essential business process, business rules and information needs.
• Assisted with product evaluation, product customization and system integration.

Environment: FACETS, Sybase, C, SQL, Mercator 5.0/6.5, Data stage, Stored Procedures, Unix, Java, IBM RS6000, NT

Confidential, Arlington Heights, IL

QA Tester

Responsibilities:

• Analyzed the System Requirements, Functional requirements and Business Requirement Documents.
• Define product-testing approach with the assistance from development and technical architecture teams.
• Gather test environment requirements from development teams, various Design Documents and facilitate product testing.
• Gathered the system requirements by interacting with the business users.
• Involved in business user and design review meetings to sign off the system design
• Involved in the development and implementation of Test plans, Test cases, Test data and Test scripts according to requirements in the Use Case and Requirement documentation and Test execution on both Test Environment as well Production Environment.
• Prepared the test plan and test cases for unit and system integrated testing.
• Manage end-to-end testing per functional product test plan and verify the results based on business requirements.
• Verify the test results from successfully executed test cases from both manual, automated test scripts and document them using Quality Center.
• Involved in the validation of retirement services, annuities, life insurance, employee benefits.
• Developed test data depends on the Test Scenarios as per the functionality of the application.
• As a Quality Analyst responsible to plan and priorities of daily and weekly deliverables and status update to QA Manager and Project manager and actively participate in team meetings, status meetings and work progress meetings.
• Involved in Back-End testing for Oracle as a part of Parallel Test and written SQL queries to extract and validate the data.
• Performed Functional Testing, Regression Testing, System Testing, Sanity Testing, Database Testing/Back-end testing, Black-box testing and User Acceptance Testing.
• Executed SQL queries to validate the Data tables, which hold the customer information using TOAD Tool.

Environment: WindowsNT, Oracle 10.x/9.x VB, ASP, SQL Server 2005/2000, Visual Source Safe, XML, Internet Explorer, Netscape, AOL