SUMMARY

• 8+ years of IT & QA experience
• Strong experience in developing Test Plans, Test Cases, Test Procedures and Test Scripts from Requirements and Use Cases.
• Expertise in performing integration, system, end - to-end, regression, performance, UAT and cross-platform testing.
• Involved in Complete Software Development Lifecycle (SDLC), Quality Assurance Lifecycle (QALC) from Requirement Analysis, Business Analysis to Development, Testing, Deployment and Documentation.
• Capable of working as an individual and also as a part of team.
• Strong application knowledge, inter personal skills, good verbal and written communication capabilities.
• Strong knowledge QA Methodologies like CMM, Agile and RUP.
• Proven communication, presentation skills and leadership qualities.
• Experience in Test Planning, Test case development and Test Execution.
• Experience wif Manual and Automation testing.

TECHNICAL SKILLS

Languages: Oracle, Sybase, PLSQL/ SQL 9.2, SQL Developer Programming, Unix - Shell Scripting, PERL scripting, JavaScripts, HTML, DHTML (JavaScript / vbscript)

Databases: Oracle (8i, 9i & 10g) versions 9.2 & 10.2, Sybase (12.5 and 15.1)

Operating Systems: Windows95/ 98/ NT/ XP/ 2000/ 2007

Tools: /Software/App Server: HP QC, SQL Developer for Oracle, Autosys, SQL developer, Unix and Perl scripting

PROFESSIONAL EXPERIENCE

Confidential, Baton Rouge, LA

Sr. Quality Analyst

Responsibilities:

• Involved in testing all teh HIPAA EDI Transactions- Eligibility, Claim Status and Service Review Transactions.
• Involved in writing teh Test cases for teh Eligibility, Claim Status and Service Review Transactions.
• Responsible for writing a Test strategy, Test Cases and Test Scripts for all phases of QALC.
• Working on hospital, medical claims.
• Developed repeatable process for Test Plan and Project Plan of teh project
• Conducted weekly Status meetings wif Test team. Developers and Business Users.
• Performed all phases of end-to-end testing which includes User Acceptance testing, Functionality testing, Regression Testing, API Testing, Web Testing, Backend Testing, GUI Testing and system testing of teh Facets, ITS, ICD9, ICD10 and Blue2 Application, its interfaces and Client-Server Utilities.
• Tested and Analyzed inbound and outbound interfaces and extensions of Facets claim processing system.
• Developed Test Cases and Test Scripts for Validating ICD9 and ICD10 Codes.
• Tested and Analyzed ICD 9 and 10 codes
• Involved in ICD 10 Implementation and validated ICD 9 and ICD 10 reports
• Worked in Facets Reconfiguration Data Element Definition and Usage (Working) wif values and completed configuring Facets Applications like Related Entity, Parent Group, Group, Subgroup.
• Tested teh claims data and Billing applications in Facets.
• Tested teh Loading of Claims Data and Claims Adjudication in Facets.
• Tested Member Enrollment, Eligibility Enquiry, Eligibility Response, Claim Status Enquiry, Claim Status Response and Financial Claims in Facets
• Completed Data Mapping for Group and detail Product analysis and report writing.
• Developed test plans based on teh business requirements in teh Quality Center.
• Developed Base line scripts for testing teh future releases of teh application.
• Tested teh XML files and SOA web services / SOAP Messaging using SOAP Scope.
• Extensively worked on ANSI X12 EDI 5010 Transactions (270, 271, 276, 277, 835, 837 and 997).
• Involved in validation of ANSI X12 5010 for 837 and 835 claims used for Professional, Institutional and Dental Claims by Writing Test cases, Test Plans.
• Created Claims in Medical Claims/Hospital and Dental Processing application
• Performed Smoke test for each New Environment and New build in Facets and Middleware Applications
• Validated all enhancements for ITS Release wif Partner Plans in Facets and FDB (Plan Connexion)
• Validating teh claims by using Facets and MS Access.
• Working on HP QC for testing teh claims.
• Extensively involved in all teh transactions in 83X (REG, FEP, ITS, Medicare and Medicaid)
• Proposed test practices to halp overcome teh data limitation in testing 835

Environment: Facets 4.7, ITS 10.2, UNIX, Oracle 10G, TOAD, EDIFECS, Mainframes, XMLHP Quality Center 11.0, MS-Project, MS-Office

Confidential, Fargo, ND

Sr. Quality Analyst

Responsibilities:

• Writing test plans and executing System Test cases in Microsoft Test Manager these test cases / test scripts were developed after reviewing teh business requirements document and technical specifications document.
• Conducted all Testing activities throughout teh QALC.
• Involved In Processing 834EDI Files for HIX 834 Enrollment Project and Validating 999 and TA1 EDI Transactions.
• Involved in identifying Error Logs for Pickup and Drop Locations for 834 EDI Files using Web services enable/disable services.
• Involve in Direct Enrollment Project for open enrollment testing CMS Registering/Logging through BCBSND and validating plans and member details.
• Involved in End-to-End Integration Testing and worked closely wif Development Team.
• Involved in Identify risks, dependencies, roles and responsibilities, tools, defect management and schedule.
• Involved in Functional, Regression, API, UAT, GUI and Integration testing.
• Developed various Automated test cases using Soap UI and Rest API.
• Involved in Life Ray Applications (Managed Care applications), Healthcare claims, HIPAA / EDI (834/837), Medical management portals and Claims Processing applications.
• Developed Test Plans, Test Cases, Test Data, Traceability Matrix and Test Summary Reports and followed Agile/Scrum process.
• Involved in Web portal Confidential Application projects and validating teh results as per Business requirements.
• Involved in requirements gathering, business analysis and requirement analysis.
• Involved in integration tests for Different modules including Member Enrollment, BCBSnd.com, Off exchange, JE part A/B Testing,
• Test Case management and Execution status in Test Manager and defect tracking using TFS.
• Tested Confidential Web Portal application and validating eligibility, claim information for different Line of Business.
• Coordinated wif PM, BA’s, Developers and functional teams and coordinated meetings.
• Developed SQL queries/Unix Shell Scripts / XML Schemas/ Files / SOAP web services and VB C# Scripts.

Environment: Life Ray Web Portal Applications, SQL Server, XML, TFS (Team Foundation Server) Windows NT, MS-Word, MS-Excel, QA Wizard, VB C# 4.0

Confidential, MD

Sr. Quality Analyst

Responsibilities:

• Reviewing teh business requirements and working wif business and requirements team for gaps found during teh review
• Conducted Functional, Integration, Regression, Web, API, Backend, System, GUI and UAT Testing.
• Working on CGW support team (Production support EDI team)
• Working on Production issues and providing test results to business for their approval
• Working on ICD-10 and ICD-9 Pre-processing edits validation
• Processed claims wif ICD-10 Diagnose codes and procedure codes
• Processed claims wif ICD-9 Diagnose codes and procedure codes
• Worked on CGW HIPAA 5010 implementation
• Create test artifacts for various Confidential projects (837, 835, 834, 270/271 and 276/277 EDI’s)
• Writing teh test scenarios based on business requirements and Business use cases
• Worked on Facets Medical Customer Service Application Implementation
• Worked Pipeline FEPThin implementation (Patient Match process and Claims process)
• Worked on Pipeline NASCO implementation. (837, 270, 276 and 835).
• Worked web services by using Para soft tool or SOAP UI.
• Analyzed different EDI X12 transactions (837, 270, 271, 276, 277, 835, 834, 997 and TA1’s) based on teh requirements.
• As part of HCR(Health Care Reform), validate teh Lite UW logic, waiting period rules, Medical underwriting rateup functionality during Open EnrollmentPeriodfor child only apps and Multy party app where U19 child exists
• As part of HCR, validated teh medical underwriting flow for healthy people for discounted premiums using 6 rating factors for Healthy Blue apps
• As part of HCR, validated teh grand fathered plans wif respect to teh new benefit standard plans in teh areas of life time limits and extend to teh dependants coverage up to 26 years of age
• As part of HCR, Validated teh guarantee issue flows for O65Medigap apps
• Validated teh member group, subgroup, class codes and billing entity information in Facets application
• Validated Limits, Deductible, Billing functionality in Facets customer service application
• Validated teh Subscriber/Member Family Eligibility and Benefits Summary information in Facets applications
• Processed teh Medical and Hospital Claims in Facets Medical/Hospital Claims Processing applications
• Validated teh Medical/Hospital Claims data on Medical Claim page and Claims Inquiry applications
• Worked on Subscriber/Family application and Created and updated Groups, Subgroups, Subscribers and Members in test environment
• Validating CGW claims validation process (Compliance, UMM, Routing, NPIXWalk, PPE, UPM)
• Verifying teh data in TIBCO Admin tool for TIBCO BC logs.
• Supervising teh other QA’s and providing teh support to team
• Involved in Status calls, Business and Technical design meetings
• Attended Defect review board(DRB) calls and Team meetings
• Identify teh Regression Test Scripts and automate them using QTP.
• Created test data and generated reports for Facets, NASCO and FEP application
• Prepare defect report and test summary report and present it to customer for every project release
• Performed Acceptance integration, System, Regression and end-to-end testing of teh application
• For Requirements, Test cases and defect reporting using HP Quality Center/ALM

Environment: Facets 5.01, 4.71, 4.51, NASCO, ALM 11.09, SQL Developer, SOA Tool (Para soft and SOAP UI), Java, J2EE, JSP, SQL Server, MS-Office, Windows XP, Mainframes.

Confidential, NH

Senior QA Tester

Responsibilities:

• Extensively coordinated wif Business Users, Developers and BA throughout teh project.
• Developed Test Cases, Test Conditions and Test Scripts for eachsprint.
• Developed Test Cases and Test Scripts for System and UAT Testing.
• Performed Business Analysis, Requirement Analysis and Data Analysis.
• Used HP QC for test cases and defect tracking
• Tested teh Interfaces and management reports.
• Validated teh reports and files according to HIPPA X12 enforced standards
• Worked on different 5010 HIPAA EDI transactions and code sets including 278 (Referrals), 834 (Enrollment), 270/271 (Eligibility), 276/277 (Claim status), 837 (Claims) 835 (Claims Payment) Batch and real-time (wif MQ series used for real-time). Also worked on Medicare Claims.
• Developed a test plan, test cases and test scenarios for Facets patches and Reports.
• Validated teh integration of Client letter application wif Facets, which manages teh customer service, claims, membership, care facilitation and appeals.
• Tested teh loading of Claims data into Facets.
• Tested teh Adjudication of Claims in Facets.
• Tested Facets Interfaces (Inbound and Outbound).
• Used SOAPUI Pro 3.6.1 for web services testing
• Involved in testing Web Services and XML wif tool called ‘SOAP UI’.
• Tested teh User interfaces for teh Health care web application
• Attend Daily Scrum’s calls & Sprint Planning sections (Every 2 weeks)
• Created test data requests for 5010 and conducted happy path/Negative testing.
• Used EDIFECS (Spec Builder) for 4010/5010 test data validation.
• Validated teh data by using SQL extensively.
• Developed Test Summary Reports and participated in GO / NO-GO meetings.
• Tracked defects using QC & Clear Quest & Conducted Bug-Review meetings.
• Coordinated wif Business, Providers, Project Managers and Developers
• Tested teh CICS (Mainframe) Screens.
• Worked wif JCL extensively to schedule and execute teh jobs.
• Extensive use of SQL queries to perform transaction testing.
• Maintained Test Logs, Test Summary reports and participated in defect review / Status / GO-NOGO Meetings.

Environment: Facets 4.71, HP QC 10.0, Trizetto HIPAA Gateway, Pega, Mainframes, File-AID, JCL/Proc, QMF, Java, Java script, HTML, Oracle 8i, TOAD, 7.0, Clear Quest, UltraEdit, EDIFECS(Spec Builder), Rally, Windows 7, Ms-Project, SoapUI Pro 3.6.1, Visio, Microsoft Visual Studio Test Suite 2008,MS-Word, MS-Excel.