SUMMARY

• Possess 7 years of testing experience in web and client/server based applications.
• Proficient in Manual as well as understanding of Automation testing.
• Complete understanding of HIPAA rules and regulations and implementation guides for the Healthcare Industry.
• Strong HIPAA EDI 4010 and 5010 with ICD - 9 and ICD-10, analysis & compliance experience from payers, providers and exchanges perspective.
• Strong knowledge and hands on experience of claim adjudication process.
• Worked on Medicare and Medicaid as well.
• Extensive uses of tools like Clear Quest, Quality Center, ALM, and Quick Test Professional. Used those tools to log defects and recognize the defects according to priority and severity. Vast knowledge of the Defect Life Cycle.
• Experienced in creating System Test Plans. Thorough hands on experience with defining test cases covering all test conditions and eliminating redundancy and duplications.
• Experienced in analyzing and evaluating X-12 and XML files.
• Proficient in using SOAP-UI for web services testing.
• Experience creating and maintaining Requirements Traceability Matrix and performing Gap Analysis.
• Performed UAT testing alongside the client.
• Thorough understanding and hands-on working experience with standards for medical transactions like 820 (enrollment), 834 (premium payments), 835 (medical claims payments), 837 (medical claims), 270 (eligibility inquiry), 271 (eligibility response), 276 (claim status), and 277 (claim status response).
• Good knowledge of relational databases (Oracle, MS-SQL server).
• Experience in Sanity, Smoke, Integration, Positive, Negative, Front-end, Back-end, Usability, Data Driven, GUI and Regression Testing.
• Experience writing SQL queries and SQL statements to query the Oracle Database for Data Validation and Data Integrity.

TECHNICAL SKILLS

Testing Tools: Quality Center, ALM, ClearQest, JIRA, and TFS

Languages: SQL

Database: Oracle, SQL Server and MS SQL

Operating Systems: Windows XP/7, basic UNIX

Business Application: Biztalk, Filezilla, Business Objects, Cognos

Other Tools: MS Office Suite, MS Project Plan, IBM ReqPro

PROFESSIONAL EXPERIENCE

Confidential, Boston, MA

MAR Analyst

Responsibilities:

• Analyze business rules and DSD’s to create/modify existing test packages in order to get sign-off from SOA for the 92 EMAR reports.
• Work alongside management in figuring out and trying to solve production defects brought up by the client.
• Created and managed defects through the defects management module in ALM.
• Involved in triage calls with the technical team as well as the users.
• Extensively involved in the discussion with Confidential and the SOA about the data load process.
• Worked along with business partners to figure out their needs and helped them out in UAT testing as well.
• Created test plan documents to plan out the testing aspect of the project at hand.
• Maintained Requirements Traceability Matrix using HP ALM.
• Used the Test Plan module in ALM to create testcases and executed them in the Test Lab module.
• Used the reporting module of ALM to generate reports relating to the status of the testing phase etc.
• Documented defects clearly and concisely in order to avoid wastage of resources.
• Involved in troubleshooting reports to figure out the root cause of the problems. Involved in triage calls with the development and test teams.
• Extensively involved with the creation of the EMAR Manual. Worked on creating the operations manual document for end-users.
• Co-ordinated efforts between Confidential and internal Cognizant and Xerox team members to get the tasks done inorder to meet deadlines.
• Set up meetings with Certification team members and discuss to find a solution to fix the reports crucial for certification.

Environment: HP ALM 11.52, IBMClearCase, IBM Cognos, Enterprise, Oracle SQL Developer, MS Sharepoint, MS Office, MS Project

Confidential, Boston, MA

QA Analyst

Responsibilities:

• Performed functional, data-driven, regression, integration, web-services testing of the MA-HIX website in the UAT environment.
• Worked with both Manual and Automation testing team in understanding/writing test cases or scripts.
• Experienced in FPL calculations, APTC, Plan Management, Program Determination testing.
• Experienced in CMS/Federal Hub integration testing.
• Used HP ALM to write testcases, execute testcases, perfrom RTM as well as track defects.
• Worked on multiple projects at the same time, very good time management skills.
• Worked with the UAT team in the understanding of requirements and previously reported bugs.
• Worked alongside the BA’s and SME’s to breakdown and understand the rules document.
• Worked with the BA’s to develop the RTM.
• Developed Test Scenarios and Test Cases based on the business requirements provided by the BA’s.
• Developed basic SQL scripts to pull the data from the existing database based on the business rules.
• Documented defects clearly and concisely in order to avoid wastage of resources.
• Used IBM Doors for requirements tracking as well as ALM for the same purpose.
• Helped the BA team develop the RTM document.
• Experience using JIRA as a defect-tracking tool.
• Extensively involved in the Triage process.
• Involved in writing the initial test plan document.
• Worked closely with business to gain understanding of the various phases/processes within the framework of HIX.
• Ran numerous test cases for Program Determination, Blueprint and Notices testing.
• Improved issue tracking by configuring JIRA, an issue tracking tool and helped business prioritize the list of open issues periodically.
• This allowed the business users to efficiently use time by identifying what is required of IS in the next release prior to deployment of the current release.

Environment: s: HP ALM 11.52, SOAP UI, Windows, JIRA, Off-exchange, Oracle DB, IBM Doors

Confidential, Columbus, OH

QA Analyst

Responsibilities:

• Formulated detailed Test Scenarios after analyzing business rationale and software requirement artifacts.
• Analyzed user/business requirements and developed System Test cases.
• Conducted Web Service Testing in MMIS.
• Tested both XML and X-12 responses for various EDI transactions.
• Used SAP Business Objects for data warehousing to generate reports by using the Business Objects GUI and also by modifying the SQL within Business Objects to obtain desired results to test the requirements stipulated by the business.
• Wrote test cases for 834/837/270/271/277 EDI’s.
• Used SOAP UI to test web-services and 834/837/270/271/277 EDI’s.
• Executed numerous Test Cases written by me or written by a team member for different modules.
• Conducted Functionality, GUI, End-to-End, Security, Information, Extract, Regression, and UAT testing during the various phases of the development of the application.
• Experience in Provider Information, Recipient Information, Reference Information, Security, and Financial Information.
• Involved in Automation Testing, scripting of manual test cases.
• Conducted Work Product Reviews with the technical team and Business Analysts to make sure that the Test Scenarios covered all the requirements being tested and the dependencies to generate the required test data were covered as well.
• Expert in Medicaid/Medicare claim processing.
• Experience submitting various types of Fee for Service and Encounter healthcare claims within the Interchange system using a Web Portal.
• Conducted Requirement Traceability Matrix (RTM) for requirement to be mapped between the Requirement and Test Case using HP ALM.
• Supported testing various sub-systems/testing teams as instructed by the SIT Manager or UAT Manager
• Worked with the billing team to resolve billing and claims payment issue.
• Provided feedback to the Management to streamline the testing process.
• Used HP ALM Quality Center 11.0 and as the bug-reporting and testing tool.

Environment: s: HP ALM 11.52, HP Quality Center 9 & 10, MMIS, SOAP UI, Windows, SAP Business Objects

Confidential, Greenwood Village, CO

QA Analyst

Responsibilities:

• Worked with the business team and team lead for analyzing the test document and involved in creation of test plan and wrote test cases.
• Tested / 834/270/271/276/277 EDI transactions following the HIPAA compliance EDI standard X12 format.
• Reported issues during testing using Quality Center (QC) and entered defects using correct terminologies and standards. Attended defect management meetings as well.
• End - End testing of claim processing of HMO, MEDICARE, MEDICAL claims in IDX.
• Ran new EDI files, extracted results, compared the results to baseline validation files, identified discrepancies and updated Quality Center.
• Administered problem management process, including monitoring and reporting problem resolutions.
• Worked with ICD-9 end-to-end testing.
• Created the test strategy, test plan, test cases, and test scenarios according to the Business Requirements Documents.
• Participated in requirements design document reviews.
• Used Quality Center to create and execute test cases. Defects were logged using Quality Center as well.
• Conducted business validations, covered the deliverables like FACETS Providers, Facets Claims and Facets.

Environment: FACETS, Payer Solutions, EAI/TIBCO Servers, HP Gateway, Toad for Oracle, and HP Quality Center, IBM Doors

Confidential, Camp Hill, PA

QA Tester

Responsibilities:

• Worked in claims processing in the projects during corporate/ Non- Corporate Releases and Regression testing for corporate and Non- Corporate Releases. I also participated in ICD-9 and ICD-10 projects.
• Developed Test Strategies, Test Plans, Test Cases, Scripts and have logged Defects.
• Created Test Cases by analyzing and compiling data that is specific to the scope of the test and also created the requirements traceability matrix document.
• Reported issues during testing using Quality Center (QC) and entered defects using correct terminologies and standards. Attended defect management meetings as well.
• Performed backend integration testing to ensure data consistency on the front-end by writing and executing SQL Queries.
• Ran queries and reports under personal queries for each Testing Release using Rational Clear Quest.
• Involved in professional, Institutional and ITS claims adjudication.
• Validated the Home and Host claims for the ITS transactions.
• Supported various levels of testing, such as functional, parallel testing, Regression Testing for RENO subsystems.
• Analyzed and Researched test results based on defined specifications to ensure all functionality, requirements, and business values were met.

Environment: ORACLE, SQL, OSCAR Mainframe, RENO, IBM Rational (IBM Rational test Manager, IBM Rational Requisite Pro, IBM rational Clear Quest for windows Client,) IBM Rational Manual Tester

Confidential, Minneapolis, MN

QA Analyst

Responsibilities:

• Analyzed and performed capacity testing of production database from time to time
• Interacting with developers to resolve application defects and for configuration management.
• Performed both Manual and Automated testing of the applications.
• Used Mercury Interactive MQC for Test Planning, Test Designing, Test Analysis, Test Execution, Defect Tracking and Test Evaluation and defect logging.
• Participated in testing POS (point of sale) software.
• Performed manual testing to check the functionality of the POS.
• Communicated with developers to resolve POS software issues.
• Performed Regression testing using QTP.
• Created Test Cases, Test Scripts, Test Plan and Test Procedures and implement compliance of quality standards.

Environment: Oracle, SQL Server, MS SQL, HTML, QTP, MQC