SUMMARY

• 6+ years of experience in Quality Assurance and Software Testing using FACETS in Healthcare
• Excellent skills in writing Test Plans and Test Cases
• Extensive experience in testing Client/Server and Web - based Applications.
• Expertise in Automated testing tools such as WinRunner and QTP
• Expertise in Bug reporting tools such as Test Director and Quality Center.
• Proficient in manual and automated testing of applications on Windows and Unix environment
• Very good experience in Back-End Testing using SQL on UNIX and Windows platform to validate the consistency of data
• Experienced working with x12 version 5010 transactions changes analysis, design and migration strategy.
• Have good knowledge of HIPPA versions. Experience with International Classification of Disease (ICD).
• Experience working in a FACETS environment and I have gained extensive knowledge about various modules of a FACETS system such as claim,membership and pre pricing etc.
• Knowledge and Implementation experience in Eligibility System, Facets Data model, Configuration Implementation of FACETS module.
• Involved in using FACETS for various health insurance areas such as products, enrollment, members and other modules related to FACETS.
• Profound understanding of insurance policies like HMO and PPO and proven experience with HIPPA 4010 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).
• Maintained Test Matrix and Requirement Traceability Matrix.
• Performed Gap Analysis.
• Strong Knowledge on MS Office suite, MS Visio, MS Project, and MS Access.
• Proficient knowledge in various types of Software Testing such as Unit testing, Integrated testing, System Testing, Black box testing, Positive Testing, Negative testing, Performance Testing, Stress Testing, Load Testing, Volume Testing, Data Driven Testing, Back end Testing and Regression Testing.
• Good working knowledge of major Operating Systems such as Windows 98, 2000, XP, Vista, 7 and UNIX.
• Extensive knowledge of SDLC.
• SOLID understanding of ANSI X12 5010 version 837/835
• Working Knowledge of HIPAA
• Excellent communication and writing skills with the ability to adapt to new and dynamic environments
• Good team leader, Player and can work alone with minimal or no supervision
• Ability to multi-task, prioritize and work with time constraintswhile paying attention to details
• Good problem-solving, judgment, and decision-making skill
• Experience in designing, developing and normalizing database and conducting Backend testing by executing SQL queries, also performed database migration from MS Access to MS SQL Server.
• Excellent Project planning, designing and management skills also proficiency in developing project schedule and Milestone Reports using MS Project. Effective Time management skills and consistent ability to meet client deadline.
• Excellent interpersonal, communication and presentation skills with an attitude to bridge the gap between team members and the client.
• Sound knowledge of Designing Computer networks and network administration, Hardware and software Maintenance.

TECHNICAL SKILLS

Testing Tools: Win Runner, QTP (Quick Test Pro), Rational Team Test, Load Runner

Bug Reporting: Quality Center, Rational Clear Quest, Test Director.

Operating Systems: Windows 95/98/XP/2000/2003/Vista/7, UNIX/LINUX

Programming Language: C, C++, C#, SQL, VB Script, Java Script, TSL (Test Scripting Language), UNIX Shell Scripting.

Database: MS SQL Server, My SQL, Oracle 8.0/8i/9i, MS Access, DB2.

Applications: Visual Studio, MS Project, MS Visio, MS Office, Adobe Photoshop, Dreamweaver, Lotus Notes.

Web Technologies: HTML, PHP, XML, SOA, SAP, J2EE, .NET, UML, ASP.NET, Web Services, TCP/IP, SQL PLUS, Visual Studio 2005 Team Foundation Server, Visual Web Developer 2005 Express Edition, ERP, PMRS (Production Monitoring and Reporting System), IIS Server, Apache tomcat.

Process Improvement Methodologies: Process Modeling (MS EXCEL, Web), Total Quality Management (TQM), Root Cause Analysis

PROFESSIONAL EXPERIENCE

Confidential, Minneapolis, MN

QA Tester

Responsibilities:

• Analyzed the business requirements, functional specification and use case documents.
• Developed test plans, test cases using requirements, use cases, wire frames and design documents.
• Performed GUI and Functionality testing, Integration Testing and System Testing.
• Performed extensive manual testing of each module.
• Performed Manual Testing prior to automate testing on the application.
• Experiences working in ANSI x12 EDI Transaction.
• Involved In Testing the EDIs according to HIPPA code set 834 enrolment and disenrollment in a health plan using QTP
• Involved in testing EDIs according to code set X12 835 Claim Payment & Remittance Advice Claims processing and 837 Claim transactions.
• 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.
• Involved in FACETS Implementation, involved end to end testing of FACETS Billing, Claim Processing and Subscriber/Member module.
• Set claim processing data for different Facets Module.
• Generated and Edited the scripts using VB Script in QTP for Automation
• Conducting validations using check points and transactions in QTP to perform System Testing
• Designed the Recovery Scenarios using External Function calls.
• Inserted Checkpoints to check for broken links, Text and standard properties of an object using QTP.
• Performed Class mapping.
• Developed automated test scripts to conduct Regression testing on the application using QTP
• Actively participated in walkthroughs and enhancement meetings
• Customized Mercury Quality Center to suit the requirements of testing effort
• Monitored the Defect Tracking Process and generated customized graphs and reports for the client using MQC

Confidential, Vienna, VA

QA/Facets Tester

Responsibilities:

• Worked with Business Analyst and QA Lead in reviewing and analyzing the business requirements Documents and functional requirements.
• Troubleshoot any problems found within FACETS and when testing the SQL data database while validating the business rule.
• Prepared Test Cases based on business requirements and business rules for HIPPA EDI Transaction 834, 837, 835.
• ICD 9- ICD 10 conversion project - worked in the analysis of the ICD 9-10 codes conversion Project Expertise in GEM processed and concepts.
• Excellent understanding of HIPPA 5010 rules as well as ICD 9 and ICD 10.
• Tested HIPAA EDI Transactions and Code Sets Standards such as 837/835, 270/271, 276/277 transactions.
• Tested 837/ 835, 270/271, 276/277 transactions.
• Authored and executed Test cases for Claims and Customer Service Workflow by manually.
• Entering Claims and Customer Service Tasks into the FACETS.
• Responsible for Back-End Testing Using SQL Commands.
• Documented the test results and reported the status of assigned test tasks and issues to project QA Lead.
• Conducted Back-End Testing Using SQL Commands.
• Extensively used SQL statements to query the Oracle Database for Data Validation and Data Integrity.
• Responsible for Performing Integration Testing, UAT testing.
• Actively participated in walkthroughs and enhancement meetings
• Maintained Test Matrix and Requirement Traceability Matrix.
• Performed Gap Analysis.

Environment: Oracle, SQL, UNIX, HIPPA EDI, XML, Rational Test Manager, Facets, Rational Functional Tester, Rational Clear Quest

Confidential, Chantilly, VA

Facets Tester

Responsibilities:

• Gathered business requirements and studied the applications
• Analyzed HIPAA 4010 and 5010 standards for 837P EDI X12 transactions, related to providers, payers, subscribers and other related entities.
• Formulated detailed Test Plan using Rational Test Manager after analyzing business rationale and software requirements
• Worked on developing the business requirement and use cases for FACETS batch process, automating the billing entities and commission process
• Involved in testing HIPAA Database which incorporated all the HIPAA transaction sets
• Used Rational Test Manager to create and maintain test requirements
• Created repository using Rational Administrator
• Generated and recorded test scripts that provided extensive application coverage using Rational Robot
• Conducted Usability testing, Positive testing and Negative testing
• Used Rational log view to analyze the result of test
• Performed GUI testing using Rational Robot
• Used several types of verification points to check the functionality of the application using Rational Robot
• Performed Back-End testing manually for database integrity using SQL statements on UNIX platform
• Used Rational Clear Quest to track defects, version control, enhancement request and assessed the real status of the project
• Performed Regression Testing to ensure that bugs fixed did not generate new defects
• Actively involved in verification process using check lists
• Participated in various meetings and discussed modification requests and enhancement request issues
• Gained Knowledge of Health Insurance Portability and Accountability Act (HIPAA) for testing effort

Environment: Rational Team Test, Clear Quest, Oracle, Facets, UNIX, Apache

Confidential, Minneapolis, MN

QA Tester

Responsibilities:

• Worked with Business Analyst and QA Lead in reviewing and analyzing the business requirements Documents and functional requirements.
• Importedpreexisting Microsoft Word and Excel-basedrequirements and testsfor analysis in MQC.
• 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.
• Involved in FACETS Implementation, involved end to end testing of FACETS Billing, Enrollment Claim Processing and Subscriber/Member module.
• Set claim processing data for different Facets Module.
• Performed Positive and Negative Testing Manually
• Actively participated in walkthroughs and enhancement meetings
• Maintained Test Matrix and Requirement Traceability Matrix
• Performed Gap Analysis
• Performed Security Testing on the application
• Tested user interface and navigation controls of the application using QTP.
• Experiences working in ANSI x12 EDI Transaction.
• Validate the date from ED5010 I transaction.
• Tested the HIPPA EDI 834, 270/271, 276/277, 837/835 transactions according to test scenarios and verify the data on different modules.
• Authored test case scenarios in Excel spread sheet and export them into Mercury Quality Center.
• Documented the test results and reported the status of assigned test tasks and issues to project QA Lead.
• Conducted Back-End Testing Using SQL Commands.
• Extensively used SQL statements to query the Oracle Database for Data Validation and Data Integrity.
• Executed test cases found errors reported defects, determined repair priorities, did regression testing and closed by using Mercury Quality Center.
• Responsible for Performing Integration Testing, UAT testing.
• Customized Quality Center to suit the requirements of testing effort
• Monitored the Defect Tracking Process and generated customized graphs and reports for the client using QC.

Environment: Oracle, HIPPA, EDI 5010, XML, QTP, Facets, Mercury Quality Center.