SUMMARY

• Around 7 years of progressive working experience in Software QA and testing wif diverse Healthcare projects.
• Experience in both Manual and Automated testing, and Analysis.
• Thorough noledge of teh Agile and Waterfall SLDC models and methodologies.
• Good understand business requirements and design test cases, test scenarios for functional and regression testing.
• Involved in testing Web Services and XML wif tool called ‘SOAP UI’.
• Strong HIPAA EDI and compliance experience from, payers, providers and exchanges perspective, wif primary focus on Coordination of benefits.
• Performed Sanity Testing, Smoke Testing, Positive Testing, Negative Testing, Black Box Testing, Unit Testing, Integrated Testing, System Testing, Security Testing and Regression Testing.
• Excellent Functional testing experience, involved in Design, Implementation, Upgrade, Proactive Monitoring and Production Support.
• Profound understanding of insurance policies like HMO and PPO and proven experience wif HIPAA 4010 and 5010 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).
• Analyzed business requirements and design test cases, test scenarios and executed.
• Proficiency in Mercury tools (Quality Center, ALM, and Quick Test Pro).
• Strong Knowledge of all stages of Software Development Life Cycle (SDLC).
• Expertise in Back - end Testing using SQL Queries on Oracle, MS SQL Server environment running on UNIX or Windows platform to verify Data Integrity.
• Experienced in interacting wif Business Analyst, Developers and Technical Support Teams and helped them on baseline requirements specifications and testing status.
• Executed SQL Query and then performed Manual Testing on FACETS to verify claims/Bill.
• Maintained Test Matrix, Requirements Traceability Matrix (RTM), and also performed Gap Analysis.
• Analyzed Modification requests and Enhancement requests.
• Possess excellent organizational, interpersonal, communication and documentation skills wif good process management skills along wif a remarkable ability to gather requirements to bring out quality product.

TECHNICAL SKILLS

Testing Tools: Quick Test Professional, SOAP UI, API

Bug Reporting: Microsoft Test Manager, Team Foundation Server, Rational Clear Quest, HP ALM/ Quality Center JIRA, Zephyr

Programming Languages: SQL, Java, C

Databases: MS-Access, Oracle, SQL, DB2

SDLC: Agile, Scrum, Waterfall

MS Office Tools: MS-Visio, MS-Project, MS-Excel, MS-Word, MS-PowerPoint.

PROFESSIONAL EXPERIENCE

Confidential, Long Beach, CA

Sr. EDI/Lead Quality Analyst

Responsibilities:

• Performing teh QA lead role for various state migration projects and handling multiple projects in parallel as a Test Lead.
• Responsible for attending all PROGRAM meetings like Requirements review, Grooming sessions, Defect call, Pre/Post deployment and Design review.
• Responsible for manually analyzing teh requirements from clients.
• Collaborating wif PM and Stakeholders to prepare test environments.
• Involved in reviewing as well as executing test cases manually.
• Involved in teh review of requirements wif Business, IT and Technical specialists.
• Specification walkthroughs and gathers all teh required information for End to End testing.
• Responsible to identify teh Requirement and Design gaps.
• Involved in preparing teh detailed Test Plan to cover both System & SIT activities.
• Responsible for preparing Test Plans, Risk Assessment and Mitigation Plan.
• Responsible for preparing teh Test Plan.
• Responsible for assigning teh tasks to team members and tracking teh progress regularly through daily Standups.
• Responsible for writing and reviewing teh Test Cases and Test Scenarios based on teh Business requirement document.
• Responsible for scheduling review meetings wif all key business/technical stakeholders and getting approvals for all Test artifacts and Test Results.
• Responsible to ensure 100% requirements coverage and preparing RTM.
• Responsible for aligning Test environment and required Test Data for all teh deliverables.
• Responsible for Integration testing wif downstream vendors.
• Responsible for coordination wif UAT team and helping on Test data setup needs.
• Manipulated EDI X 12 837, 834 files as per HIPAA guidelines.
• Worked on Billing and Accounting deliverables like Invoice generation, Premium Payment Processing and running jobs.
• Responsible for multiple testing cycles involving multiple extracts from to teh providers.
• Responsible to ensure members are getting loaded correctly to QNXT through 834 files.
• Responsible to ensure Invoices, ID cards, Member Packets, Letters, and various other functionalities are working as expected.
• Performed Database integrity testing by executing SQL statements.
• Responsible for defect management and follow-up on defects till closure and also responsible for testing and sign off for various interfaces and sending teh files to vendor.
• Responsible to provided Metrics in teh form of Weekly and Daily Status Reports.
• Responsible to host status calls wif project stake holders.
• Responsible for successful Go Live implementation and providing required warranty support.

Environment: Windows 10, Unix, MySQL, QNXT, JIRA, SharePoint, Optum, MSOffice365, SOAP UI, EDI, HP ALM (Quality Center), Remote desktop connection, and Cisco Any Client Secure Mobility Client VPN. Windows, Waterfall and AGILE Methodology, Business Objects.

Confidential, Lombard, IL

Sr. Quality Analyst

Responsibilities:

• Proactively monitoring availability and performance of APIs, Mobile, Web applications and UI flows using AlertSite (tool for monitoring from SmartBear) from 23 different locations around teh globe.
• Recorded complex user/web transactions and scripts in staging and production environment using DejaClick and uploading to AlertSite for monitoring.
• Medical Claims experience in Process Documentation, Analysis and Implementation in 835/837/834/270/271/277/997 (X12Standards) processes of Medical Claims Industry from teh Provider/Payer side.
• Updated and re-recorded monitoring scripts when needed after every program increment/deployment.
• Used SOAP UI for testing and validating Rest and SOAP web services.
• Extensively involved in communication wif business and technical stakeholders for reporting availability and performance issues in case of failures.
• Coordinated wif teh developers and IT architects to design teh interface of teh new system according to teh X12 (270, 276, 278, 834, 835, 837 (me, P, D) and 820) standards.
• Created availability and performance reports after every sprint.
• Provided plan support (Member Tier level 2) for Digital eXperience related incidents/inquires for fepblue.org (MyBlue portal) issues submitted in Service Now.
• Took appropriate steps to assist these incidents as mentioned in teh Standard of Procedure (SOP) and drive to closure.
• Re-engineered and captured EDI transactions wif legacy systems Enrollment -834, Eligibility Transaction (270/271), Claims (837), Claim Status Request and Response (276/277), Remittance (835) .
• Validated teh HIPAA/EDI transactions, tested teh claims processing and Adjudication (EDI 810 & EDI 835).
• Experienced working in ANSI x12 EDI Transaction.
• Tested teh HIPAA EDI 820,834, 837/835 transactions according to test scenarios and verify teh data wif FACETS on different modules.
• Escalated teh production defects/issues to business/product owners and created user story for tracking teh same in Rally.
• Created/updated standard operating procedure (SOP) as needed by teh program for triage and escalations of teh alerts after every program increment/deployment.
• Created Plan Support documents for training.
• Participated in ongoing enhancements and developments meetings for teh Production Environment to stay updated.
• Coordinated and attended defect call, pre-production and post-production issue meetings and daily stand up calls.
• Involved in designing and executing test cases and test scenarios for LIT and SIT after reviewing and understanding business requirement documents in HP ALM.
• Participated in testing and validating XL Release in Rally for planning, tracking and executing release plans to avoid release delays and failures.
• Generated daily reports using SQL Server 2014 Management Studio for monthly statistics report for MyBlue portal.
• Generated daily reports using WinSCP and Putty to collect metrics for hidden, blank, non-medical and corrupt claims files which are submitted at production servers every day.
• Created various metrics and reports as per teh requirement from business owners or partners.

Environment: SQL, SOAP UI, Rally, EDI, HP ALM (Quality Center) and IBM Rational ClearQuest, AlertSite, DejaClick, WinSCP, Putty, Remote desktop connection, and Cisco Any Client Secure Mobility Client VPN. Windows, Waterfall and AGILE Methodology, Business Objects.

Confidential, Nashville, TN

Quality Analyst

Responsibilities:

• Understand business requirements and design test cases, test scenarios for SIT, UAT, and regression testing.
• Executed test across multiple testing phases, including SIT, UAT, and Regression.
• Extensively involved in creating Test plans/ script, and identifying defects, execution of Test cases and Test scenarios to meet teh product’s business requirements.
• Experienced wif FACETS support systems to enable inbound/outbound HIPAA EDI transaction in support of HIPAA 834, 835, 837, 270/271 transactions.
• Involved in requirement analysis and creating test strategy.
• Analyzed and worked wif HIPAA specific EDI transactions for claims, member enrollment, billing transactions. Worked specifically wif 837, 835, 834, and 270/271.
• Prepared Test plan and test case for EDI 834, 835, 837.
• Analyzed and worked wif HIPAA specific EDI transactions for claims, membership enrollment, billing transactions.
• Created Regression Test cases Suite in HP ALM/Quality Center and performed regression testing to make sure their were no broken functionalities.
• Involved in testing Web services and XML wif tool called SOAP UI and using dis tool to locate WSDL file on internet, create Test cases and run them.
• Conformed to HIPAA for Claims processing during Electronic Data Interchange (EDI) me.e. 834 (Benefit Enrollment), 835 (Claims Payment) and 837 (Claims Encounters).
• Set claim processing data to test different Prior Authorization to use in teh claims.
• Participates in Peer Reviews to ensure teh completeness of all Test Assets created.
• Identify teh test data and create and review teh test cases.
• Good understanding and follows all applicable SDLC and testing processes.
• Identifies, reports, and reviews defects in assessing application quality.
• Experienced working in ANSI x12 EDI Transaction.
• Used Agile testing methodology for achieving deadlines in UAT.
• Tested Web Services using web services client generated using SOAP UI, response SOAP Messages.
• Tested teh HIPPA EDI 834, 270/271, 276/277, 837/835 transactions according to test scenarios and verify teh data on different modules.
• Worked wif developers to resolve Issues and Production Incidents using HP ALM/Quality Center.
• Developed teh reports using HP ALM/Quality Center.
• Mapped teh test cases to teh Requirements in HP ALM/Quality Center and executed teh test cases in HP ALM/ Quality Center in Test Environment.
• Excellent communication skills, will have to work wif cross-functional teams involving subject-matter and technical experts to gather workflows.
• Enhanced Test Scripts using various utilities provided in Quick Test Pro (QTP) like check points.
• Production Support: Smoke testing on all production update in various environments
• Good Team player wif teh ability to lead, manage and work independently in a time sensitive environment.
• Extensively used SQL statements to query teh Oracle Database for Data Validation and Data Integrity.
• Responsible for performing System and integration testing for release.
• Used ALM defects management tool for defects/bugs tracking.

Environment: Web Services, SOAP, XML, ALM/Quality Center, EDI, HIPAA, Claims, SQL, TOAD, Claim Test Pro, ALM, Oracle, Windows, Waterfall and AGILE Methodology, Business Objects.

Confidential, Murray, UT

Quality Analyst

Responsibilities:

• Review Requirement Design Documents, Requirement Analysis document for maintenance and enhancement of TennCare eligibility and enrollment subsystem.
• Reviewed business requirements and design test cases, test scenarios for SIT, UAT, and regression testing.
• Worked on Implementation of providing eligibility to teh individuals after verifying their inconsistencies in income and citizen ship status.
• Used SOAP UI tool to test Web services using SOAP services and REST API.
• Worked wif business SME’s to translate business requirements and processes into test cases according to FACETS requirements and subsequent effective configuration.
• Involved in FACETS in depth testing of Care management intake, Screen, Enroll, Assessment and Subscriber/Member insurance modules.
• Tested teh UI of teh end product on mobile, PC, tablets, Android and Apple platforms to ensure dat language translation and currency conversions were displaying as required.
• Implemented open source web test tool Selenium WebDriver for cross browser and cross platform web testing.
• Used Selenium WebDriver to test teh online member and provider portal functions.
• Very good exposure of testing applications on wide range of Mobile handset of different vendors which includes Android, Windows Mobile, HTC, LG, iPhone and many more.
• Worked on resolving production issues related to eligibility jobs being abend due to compliance failure, changes to teh User interface for accepting eligibility and eligibility failure for ROP (Reasonable opportunity period) recipients.
• Involved in system analysis to ensure dat teh fixes to teh production issues are not impacting any of teh current process.
• Performed backend testing wif extensive use of SQL queries and to check teh validity of ETL process.
• Used SQL and queried teh database for teh Proper validation of teh claims into teh Database.
• Performed Data Analysis and Data validation and report validation by writing SQL queries.
• Prepared Test Strategy, test plans and Test Cases, Scenarios as per requirements and executed as and when needed.
• Designed and maintained test schedules, test plan, test strategy, test assignment documents for various testing activities using SharePoint and HP ALM/Quality Center.
• Created various test reports such as Test Execution Status, Defect Status, and Defect Injection Rate through Reports and Graphs feature of HP ALM/Quality Center and publish them on as needed basis on teh SharePoint site.
• Excellent communication skills, will have to work wif cross-functional teams involving subject-matter and technical experts to gather workflows
• Good Team player wif teh ability to lead, manage and work independently in a time sensitive environment.

Environment: Java, XML, HP Mercury ALM/Quality Center, FACETS, Oracle Application Server, SQL, TOAD, Waterfall and AGILE Methodology.