Objective

• Seeking a challenging position as a Quality Analyst in a fast - paced industry, where I can utilize my Interpersonal, Analytical, Technical, and Documentation skills, abilities and my diversified experience in software quality assurance to ensure sustained growth and continued success of the company.

SUMMARY

• 6+ years of experience in IT industry with specialization in Quality Assurance/Software Testing in various domains.
• Experience in both manual and automation testing and analysis.
• Maintaining knowledge of Medicare and Medicaid rules and regulations pertaining to the FACETS configuration and evaluating the impact of proposed changes in rules and regulations.
• Proficiency in HIPAA 4010 to HIPAA 5010 and Involved in conversion and mapping ICD9 to ICD10.
• Hands on experience with partitioning and pairwise analysis.
• Expertise in validating and testing Client-Server and Web-based applications in different environments.
• Sound knowledge of all phases of Software Development Life Cycle (SDLC).
• Experience in different methodologies of SDLC: Agile-Scrum, Rational Unified Process and Waterfall methodology.
• Experience in developing Test Plans, Test Cases and Test Reports based upon the business requirements.
• Strong understanding of EDI Claims, member enrollment, and billing transactions.
• Excellent knowledge of Medicare (Part A, B, C and D) and Medicaid Health Insurance Policies and reimbursement forms.
• Experience in different types of testing like Integration, System, Regression, Functional, Black Box, Positive and Negative Testing.
• Profound knowledge and experience in reporting bugs using Bug tracking tools such as Bugzilla, Jira, TFS, HP Quality Center/ALM.
• Proficient in Manual and Automated testing on Windows and UNIX platforms.
• Knowledge of production release and project success verification.
• Proficient in writing and executing SQL queries to define, manipulate, and control data on the databases running on windows or UNIX platforms.
• Strong Knowledge of Electronic Health Record (EHR), EDI transactions, ASC X12 transactions like 270/271, 276/277, 834, 835, 837I and 837P.
• Excellent knowledge and working experience in writing Test cases, Bug Tracking and Test Summary Reports.
• Documented and uploaded the testing processes across the Facets, including weekly Status Reports, Test and Defect Metrics Report, Requirement Traceability Matrix, Master Test Plan, Test Evaluation Summary Document.
• Extensive knowledge of writing complex SQL queries for doing backend testing.
• Extensive hands on experience in using databases like MS-SQL Server.
• Ability to work independently as well as in a team; experience in working with offshore teams in different geographic locations using emails and video conferences.
• Excellent communication, documentation, interpersonal and presentation skills with an ability to adapt to new environment quickly.

PROFESSIONAL EXPERIENCE

Confidential, Tampa, FL

QA Tester

Responsibilities:

• Prepared Test Plans based on the of analysis the use cases, Business process specification documents and UI documents.
• Worked with business team to revise Business Requirement document (BRD) and Functional Requirement Document (FRD) using the Scope and Interview with stakeholders.
• Wrote manual Test Cases in Excel sheets and then exported them to HP ALM (new version of Quality Center).
• Worked on Claims, Customer services, Members, Enrolment, Billing interfaces and extensions for FACETS as a part of FACETS implementation team
• Attended review meetings and walkthroughs to discuss the status of the work.
• Prepared Test Cases and detailed test procedures using JIRA for testing the application under test.
• Developed Facets Trizetto Benefit configuration for client healthcare products (Commercial, Medicare, and Medicaid).
• Involved in FACETS Configuration planning for ICD with SMEs, Trizetto Team and Third party vendor.
• Used Rational Quality Manager to create test cases and test plans that included functionality testing, destructive testing, error testing, negative testing, and any additional tests for management of the test scripts.
• Performed manual and automation testing.
• By using Execution Grid, run all manual and automated test cases in JIRA.
• Experience with documenting Claims processing lifecycle and got good exposure of X12 834 transactions for HIPAA.
• Experienced handlingHIPAA ANSI X12, formats including(270(Eligibility)/271(Benefit Inquiry and Information Response), 820(Premium Payment), 834(Member Enrollment), 835(Adjudication system), 837(IPD claims), 276(Claim Status)/277(Claim Response) Etc.
• Conducted End-to-End and Black box testing.
• Worked with Medicare, Medicaid, and commercial insurances in HIPAA ANSI X12 formats including EDI transactions such as 270/271,834,835 formats for interfaces and images to third party vendor application.
• Testing Data warehouse ETL components by Executing SQL Queries.
• Bug Reporting and Tracking using Mercury Quality Center(ALM).
• Derived UAT test cases using different white box, black box, and experienced based techniques.
• Work closely with Business to development of business process and technology to support Claims/encounters,CareManagementand Risk Adjustment for Medicare & Medicaid and CMS rules.
• Worked with Claims, enrollment, eligibility verification for members and providers, benefits setup and backend payment cycle based on Fee Schedules in FACETS.
• Tracked to resolution all UAT environment and data test issues before code is released for test.
• Involved in executing SQL queries for back-end testing.
• Created manual Test Cases in HP ALM for various User Stories based on Sprint Plan.
• Tested the Members, Claims, Providers, and Services in Facets.
• Involved in logging and tracking defects in JIRA with proper severity and priority.
• Involved in re- engineering of the EDI Gateway to assist in the development of HIPAA repository to process HIPAA claims.

Confidential, Snellville, GA

Quality Analyst

Responsibilities:

• Worked in fast paced Agile Methodology and release-based sprint level testing
• Attended various BRD, GAP analysis meetings with BA, developers and stakeholders.
• Attended UAT scenario review meetings and attended various walk through meeting for the proper understanding of the BRDs.
• Prepared test cases, test scenarios, RTM documents.
• Imported WSDL from SOAP UI and submitted requests to specified end point URL and verified the results.
• Responsible to work on Medicaid Management Information System which includes two divisions: HIPAA compliance and Maintenance units division and Claim processing division.
• Worked on claim processing module which involved Receipt, Enrolment (834), Verification of Claims Form (837) and Claims Adjudication, Health Claim Payment/Advice (835) as per HIPAA guidelines.
• Verified the Order flow in XML files by using SOAP UI and added new requests.
• Validated EDI Claim Process according to HIPAA compliance. Tested HIPAA regulations.
• Created BRD and FRD for Medicaid managed care requirements and documenting them.
• Performed Smoke, IST, Régression testing.
• Developed and maintained QA test plans based on functional requirements, use cases, user interface designs, system design documents and domain related documents
• Test planning, documentation, coordination and execution and work with other QA engineers to coordinate testing.
• Conducted Functionality testing during the various phases of the development of the application.
• Created and maintained the Requirements Traceability Matrix (RTM).
• Generated reports and graphs to assist in analyzing testing requirements test planning data, test results and progress of defect fixes in ALM.
• Involved in Review, Analysis, and Testing of System and business Requirements.
• Used SQL to perform Back End testing on Database.
• Supported Regression team on monthly upgrade release by submitting claims for different claim types with new ICD codes with range of testing scenarios (positive & negative) and made necessary changes to ensure that claims are getting paid as expected.
• Compared and analyzed actual to expected results and reported all bugs in ALM.
• Executed test cases manually ALM that were developed in pre testing phase.
• Developed and executed scripts to test data migration using SQL and UNIX Shell Scripting.
• Involved in documentation as to how to maintain and run scripts for future enhancements.
• Actively interacted with the development team to fix critical bugs.
• Tracked and reported defects using JIRA.
• Tracked defects and Communicated through HP ALM.
• Interacted with developers, business analysts and discussed technical problems and reported bugs.
• Performed data Integrity testing to mitigate undetected loss of data and sanity testing to verify the encryption of the data to protect PHI (Protected Health Information).

Confidential, Lee Summit, MO

Facets Tester/QA

Responsibilities:

• Prepared Test plan and Test cases based on the functional specifications.
• Involved in all phases of Software Development Life Cycle (SDLC) achieving usingAgile,
• Performed Positive and Negative Testing manually.
• Validated existing Provider, Prior Authorization, Benefit Plans, Claim andEligibilityinformation using ProviderEnrollmentSystem.
• Processed for integration and configuration ofJIRAbug tracking system and Confluence
• Responsible for creating user stories inJIRA(Agilemethodology) from the high-level business requirements delivered by the SMEs.
• Involved in FACETS Implementation Testing, involved end to end testing of FACETS Billing, Claim Processing and Subscriber/Member module.
• Performed integration testing of enrolment and benefits with FACETS
• InvolvedinUAT for ProviderEnrollment, Prior Authorization, Benefits Administration, Encounter, Claims and Encounters,EligibilitySubsystem.
• InvolvedinTestingIn-Bound Transactions (837,276,834) submitted through Data-Exchange gateway.
• Tested Claims and Benefits on FACETS and verified the output.
• Handling and testing the data in FACETS application
• Checked the transactions especially EDI 837, 270 and 276 and verified the responses on the FACETS database and front end.
• Performed Backend Testing by writing SQL statements
• Integrated ALM with external sources such as Excel, Requisite Pro, Word, etc.
• Provided the required test data for the developers in order to fix the defects.

Confidential, Madison, WI

Facets Test Analyst

Responsibilities:

• Thoroughly analyzed the business requirement documents and created test cases according to it.
• Implemented Standardized and Unified process throughout the Software Development Life Cycle(SDLC).
• Actively participated in all the phases of the testing Life cycle (Planning, Designing, Development and Reporting and Results).
• Developed standardized FACETS testing, implementation and QA processes, and performed Integration testing, system testing
• Used SQL in order to retrieve data from the database by writing Stored Procedures, views, triggers etc.
• Used Complex SQL queries using joins and sub-queries to test the reports generated by the different modules as a part of back-end testing
• Designed, updated and reviewed the Test Cases for member’s information, Providers according to HIPAA
• Membership/enrollment and billing-entered information on Trizetto Facets to ensure correct eligibility, etc.
• Worked on Data Mapping to map Trizetto Facets data to outbound eligibility extracts.
• Extensively worked with ANSI X12 HIPAA EDI Transactions 270, 271, 276, 277, 837, 835 and 999.
• Tested the Web interfaces and Web Service Applications.
• Worked with ANSI X12 (835, 837, 834) EDI Transaction.
• Developed and maintained the test scripts, test data and test cases.
• Involved with other team members to set up testing tools, implementation and other testing Environments.
• Performed various types of testing, such as functional, regression, user acceptance testing manually.
• Created the test scripts for both positive and negative testing.
• Defect Identification and created defect tracking reports till the close of the defect.
• Prepared Test Metrics using Quality Center/ALM.
• Attended various Functional Walkthroughs and writing high level testing scenarios.