Objective

• Looking for an opportunity in a challenging environment of Software Quality Assurance and Testing that would best utilize my technical, interpersonal, analytical and documentation skills and benefit from my background in the field of Information Technology.

SUMMARY

• 5 years experienced IT Professional with diverse experience in Software Quality Assurance.
• Extensive experience in all phases of SDLC processes and methodologies.
• Strong in Analyzing Business specifications and expertise in developing Test Plan, Test Scenarios and Test Cases.
• Participated in Walkthrough and inspection with the test lead and Development team.
• Involved in developing and maintaining Requirement Traceability Matrix and performing GAP analysis.
• Tested software application including Client - Server Web based application.
• Experienced in Data Driven Testing, Batch Testing, Functionality Testing GUI Testing, Regression Testing, Backend testing, Positive Testing, Negative Testing, Integrating Testing, Black box testing.
• Experience in documenting Test schedules, Test objectives, Test Scenarios, Test Strategies, Test Plan, Test Cases, Test summary report, defect tracking documents.
• Expertise in Claims, Subscriber/Member, Plan/Product, Claims, Provider, Commissions and Billing Modules of FACETS.
• Strong HIPAA EDI 4010 and 5010 with ICD 9 and ICD 10, analysis & compliance experience from, payers, providers and exchanges perspective, with primary focus on Coordination of benefits.
• Experienced in running SQL queries for data validation and comparison to perform back end testing.
• Involved in FACETS Implementation, involved end to end analysis of FACETS Billing, Claim Processing and Subscriber/Member module.
• Strong knowledge and working experience on ICD-9 and ICD-10 conversion and expertise in forward and backward mapping using GEM.
• Worked on applications that used Claims Processing system and also have understanding of Medicare, Medicaid services and Enrollment system.

TECHNICAL SKILLS

Operating System: Windows (7, 8, 8.1, 10), UNIX, Android, iOSx

Test Reporting Tools: HP ALM, HP QC, JIRA

Testing Languages: SQL PLUS, SQL Server

Databases: Oracle, MS SQL, MS Access

Methodologies: Agile, Waterfall

Packages: MS Office suite, Share Point, MS Visio

PROFESSIONAL EXPERIENCE

Confidential

QA Analyst

Responsibilities:

• Developed QA Test Plan, test conditions and test cases, as well as assisted with QA team in System Testing using Quality Center.
• Responsible for attaining HIPAA EDI validation from Medicare, Medicaid and other payers of government carriers.
• Determine the amount of coverage a customer should receive for Medical claim or Hospital claim according the procedure done and the coverage on the account.
• Managed and executed the test process, using Agile Methodology.
• Performing Backend Testing by writing validation queries on DB2 database using SQL
• Performed extensive Backend Testing of data validation of applications using SQL queries.
• Prepared Test Cases based on business requirements and business rules for HIPPA EDI Transaction 834 & 820.
• Stay in constant contact with medical facilities providing service to determine accuracy of Medical claims being made.
• Verifying Healthcare Eligibility, Claims, Benefit and Service using ANSI ASI X12 Standards.
• Monitored the compliance mapping of transactions to the EDI transactions standards ANSI -X12.

Confidential, Boise, ID

QA Analayst

Responsibilities:

• Testing both inbound and outbound, and XML files converted by Biz Talk that were in EDI format and prepare analysis document with various results
• Participated in development of Functional test plans, test cases, test strategy and estimation of test duration.
• Involved in the testing of web portal of NewMMISsystem
• Worked on Web Services and Tested XML data for validity as part of Web Testing used SoapUI for verifying Request-Response data.
• Performed backend testing for data validation using SQL Queries, used SQL PLUS Queries to find out test data and validation through Oracle 11g.
• Experience in the Backend Testing by running the SQL Queries in Oracle Database.
• Ongoing membership maintenance load programs, input files being both Proprietary and HIPAA 834 file formats.
• Vendor outbound extract programs, files being in both Proprietary and HIPAA 834 formats.
• Used SQL queries to validate the data between the backend and the front end.
• Used Process log browser to view different types of log history files to figure out issues with 834 transactions.
• Analyzed 824 and BRR reports to find the issues with 837 I and P, 834, and 820 transactions.
• Co-ordination of front-end changes in multiple development and testing environments.
• Reviewed Test Strategy and Test Plans to ensure that they reflect and include all functional, Performance, Usability and Security requirements.

Confidential, UT

QA Analyst

Responsibilities:

• Coordinated with different teams and prepared Test Plans and Test Strategy documents and helped other QA members with Business Requirements.
• Extensively worked with 837 I and 837 P Claim files.
• Reviewing Test plans, Test conditions, Test cases, and Test results.
• Translated Use Cases into Test Cases and Test procedures and actively participated in brainstorming and walkthrough sessions.
• Supporting Team members in Preparation of Test Plan, Scenarios and the Testing procedures.
• Prepared Traceability Matrix and mapping Requirements and Test cases
• Performed regression, integration and functional testing on the builds of the application
• Conducted Backend test using SQL queries to verify the Integrity of the Database.
• Expertise in Claims, Subscriber/Member, Plan/Product, Claims, Provider, Commissions and Billing Modules of FACETS.
• Implementation and knowledge of HIPAA code set ICD-9, ICD-10.
• Ensured that EDI files were in compliance with ICD-10 standards.
• Performed analysis of ICD 9 Procedure and Diagnosis Codes in accordance with ICD 10 CM and ICD 10 PCS conversion compliances.

Confidential, CA

QA Tester

Responsibilities:

• Reviewing the Business requirement, Functional Design Documents, Technical Specification documents and Playbooks to create Test Cases and Test data after analyzing the BRD and Playbooks.
• Monitoring ETL batch jobs on batch servers and reviewing Log, Error and Output files.
• Performing Functional and GUI testing on Facets Billing, Customer service and Subscriber application under Facets.
• Logging of defects in JIRA to maintain Test requirements and to communicate the bugs with the Developers.
• Performing Backend testing validation queries in SQL Server 2008 against the database.
• Responsible for running ETL jobs in batch server and validating mapping rules.
• Analyzed and tested all the ICD 10 codes based on standards.