SUMMARY

• Over 7 plus years of experience in SDLC, QA Lifecycle, testing of Web applications, Health Care Applications, Data Warehousing and Business Intelligence (BI) applications, Medical and client - server applications
• Over 5 Years of Experience in testing of Health Insurance and Healthcare Applications.
• Thorough experience of HIPPA compliance like 837, 834, 835, 270, 271,276,277&278 etc and extensive knowledge of ICD 9, ICD 10 as well as conversion of .
• Experience in All modules of Facets 4.31, Facets 4.51 and Facets 4.71, Facets 5.01.
• Extensive experience in testing Facets all modules and also involved in testing Federal Employment Program(FEP) and Affordable care Act(ACA) claim processing, Membership, Provider, Eligibility and Enrollment modules.
• Extensive experience in testing Extract, Transform and Load (ETL) processes and Reports
• Strong technical skill in ETL tools DataStage, and Oracle Warehouse Builder
• Experience in testing reports generated by the OLAP tools (Crystal Reports,, Microstrategy reporting tools,Business Objects, Cognos)
• Demonstrated experience in using RBDMS like Teradata, DB2, SQL Server and Oracle
• Experience in Client/Server Technologies like C, C++, Java, J2EE, EJB, JSP, JDBC, Servlets, XML, Middleware like Message broker.
• Experience in developing Automation framework using QTP
• Experience in creating, modifying and enhancing both Manual testing and Test Scripts created by Test Automation tools - Win Runner, Quick Test Pro and Load Runner
• Sound knowledge and exposure in working with the various relational databases like PostgreSQl, Oracle, SQL Server etc.
• Experience with QA Methodology and QA Validations to ensure the Quality.
• Experience in data ware house tools like Informatica, Datastage, Data Integrator, Message Broker.
• Extensive working knowledge in UNIX/Linux operating systems.
• Good knowledge in DBMS and RDBMS concepts for large oracle databases.
• Good knowledge in Unix and Shell Scripting
• Solid Back-end testing experience in writing and executing SQL Queries.
• Extensive working knowledge in Linux and WINDOWS platforms
• Extensive experience with database languages such as SQL and PL/SQL.
• Performed the Database testing by writing and executing SQL queries on the database.
• Experience in using TOAD, SQL Query Analyzer tool for ORACLE.
• Experience in working Offshore-Onshore model.
• Expertise in ISO/CMM levels, RUP and Agile
• Accustomed to work in a team environment with tight schedules and capable of working efficiently under pressure

TECHNICAL SKILLS

Testing Tools: HP Tools / Mercury Tools (Quality Center, Test Director, QTP, Win Runner and Load Runner), JIRA, Rally, Rational Tools (Requisite Pro, Test Manager, Clear Quest and Clear Case)

ETL Tools: Informatica, Datastage, Oracle Warehouse Builder

Reporting Tools: Crystal Reports, Business Objects, Cognos, Microstrategy

Configuration management: Rational Clear CaseRDBMS Oracle 9i/8i/7.x, Teradata, DB2/UDB, SQL Server

ERP Packages: Siebel, Oracle ERP

Languages: C, C++, Java, JSP, JDBC, XML, EJB, Web services, JavaScript and HTML.

Operating Systems: Windows XP/NT/2000/98, Unix and Linux.

Data Architect: Erwin Data Modeler, UML

Servers: Web Sphere, Web Logic, TM, AIX

Mainframes: CICS, JCL, MVS, VSAM, File-Aid, QMF, SPUFI, TSO and Endeavor

Packages: MS Office.

PROFESSIONAL EXPERIENCE

Confidential, MI

QA Analyst

Responsibilities:

• Involved in testing Claim processing, Membership Enrollment, Eligibility Inquiry, Billing Entity and Payment and Provider modules in FACETS application.
• Involved in preparing Test Plan and Test Cases based on business requirements.
• Wrote Test Cases in Excel based on Technical Specifications, Functional Specifications and Business rules for online application system. Performed positive testing and negative testing manually.
• Executed Configuration Testing to check if the application was compatible in different environment for each module of the application
• Performed Functionality, GUI, Regression, Security testing, System testing, Smoke testing and User Acceptance Testing and reported defects using Clear Quest.
• Identifying Test Cases to be run for Regression Testing and conducting Regression testing as and when new builds and Server Upgrades were made.
• Performed backend testing by creating and executing SQL scripts on MS SQL Server database.
• Involved in ETL Mapping Design and Performance tuning to Load mapping process.
• Experienced in writing complex SQL queries for extracting data from multiple tables.
• Generated various Test Reports such as Test completion, Test execution, Defect reports, and Requirements traceability matrix.
• Played a lead role in developing Test Cases in a spreadsheet and uploaded them to Quality Center Test Plan module and executed them in QC/ALM test lab for various source systems.
• Conducted result analysis and interacted with the developers to resolve the issues.
• Interacted with developers and business analysts and discussed technical problems and reported bugs.
• Automated the tasks usingUnix Shell scripts (Ksh)
• Performedvolume testingby transmittingbatch filesand validating them.
• Maintained test logs and test summary reports. PerformedXMLdocument validation and developedUNIX Shell scripts.
• Tested web services, XML, WSDL using SOAPUI tool. Modified end points when we worked on different servers and different versions of Web Services.
• Tested Web Services, providing required input data to request XML and validated response XML.
• Validated Web Services request and response xml using SOAPUI tool.

ENVIRONMENT: Java/J2EE, Facets 5.10 R7, Clear Quest, WebLogic application server, UNIX, MS Office, Oracle, WebServices, SoapUI, SQL Advantage, SQLDbx, .

Confidential, MO

QA Analyst

Responsibilities:

• Reviewed Business Requirements with Project Manager and Lead Developer to learn the functionality of the application.
• Involved in testing Claim processing, Membership Enrollment, Eligibility Inquiry, Billing Entity and Payment and Provider modules in FACETS application.
• Extensive experience in testing claim processing, Membership and COB benefit validation for Federal Employment Program(FEP) and Affordable Care Act (ACA).
• Involved in preparing Test Plan and Test Cases based on business requirements.
• Wrote Test Cases in Excel based on Technical Specifications, Functional Specifications and Business rules for online application system. Performed positive testing and negative testing manually.
• Executed Configuration Testing to check if the application was compatible in different environment for each module of the application
• Performed Functionality, GUI, Regression, Security testing, System testing and User Acceptance Testing and reported defects using Daptive.
• Identifying Test Cases to be run for Regression Testing and conducting Regression testing as and when new builds and Server Upgrades were made.
• Involved in Claims Adjudication, Claims Payment, and Coordination of Benefits (COB), dental implementation, membership and UAT.
• Expert in ICD 9 - 10 Conversion Analysis. Full knowledge of the Diagnosis and Procedural Code changes for Healthcare Entities like Payers, Employer Groups, and Providers. Worked on ICD 9 codes and gathered future requirements based on ICD 10 codes. Managed creation of sample mappings for the conversion of EDI X12 transactions code sets version and translation of ICD 9 codes into ICD 10 codes.
• Updated EDI transactions like EDI 837(Institutional, Professional and Dental Claims, 835 (Remittance), 834 (Enrollment to a health plan), 820 (Premium Payment for enrolled health plan members ) and 27x with the HIPPA 5010 changes.
• Involved in forward mapping of ICD 9 to ICD 10 and backward mapping of ICD 10 to ICD 9 using CDMA tool.
• Authored Test cases for HIPAA EDI Transactions 270/271, 276/277,837/835. Tested HIPAA Transactions and Code Sets Standards according to the test scenarios such as 270/271, 276/277,837/835 transactions.
• Executed Test cases manually by composing 270, 276,837 EDI files and dropped inbound and check response 271,277,835 using interleaves and outbound.
• Performed backend testing by creating and executing SQL scripts on MS SQL Server database.
• Involved in ETL Mapping Design and Performance tuning to Load mapping process.
• Experienced in writing complex SQL queries for extracting data from multiple tables.
• Generated various Test Reports such as Test completion, Test execution, Defect reports, and Requirements traceability matrix.
• Conducted regression testing on various crystal reports such as Daily claims reports, billing age reports ect.. in SAP Business objects view.
• Conducted result analysis and interacted with the developers to resolve the issues.
• Interacted with developers and business analysts and discussed technical problems and reported bugs.

Environment: IBMDB2 tools, Trizetto Facets 4.71, 5.01, Message broker tools, Unix Shell Scripts, MS Access 2000, Microsoft Excel, Rational Test Manager, Rational Clear Quest, RUP, Windows XP, Interactive SQL, Informatica, oracle 10g,MS SQL server 2008,Sybase Advantage 11.5,Daptive, Spec Builder 6.8, Transaction Manager™, EDIFECS, BlueDriect, Blue Exchange, FEP DIRECT, SnagIt tool, Crystal Reports, SAP Business Objects.

Confidential, NY

QA Analyst

Responsibilities:

• Analyzed the requirements for Inpatient, Outpatient, Ancillary, and Physician contract and Agreements and developed test plans.
• Developed Test Cases/Conditions for manual and Automation testing for Inpatient, Outpatient, Ancillary, and Physicians Agreements and Claims
• Involved in performing functional, application and regression Testing.
• Created Test Data for different Inpatient, Outpatient, Ancillary, and Physicians Claims with relevant agreements in FACETS 4.71
• Verified the different Product Benefit Configuration for different Members.
• Created the different services like Physical Therapy, Speech Therapy etc.
• Created the Test Claims for Different Service diagnosis and procedures in IFacets.
• Verify the Active member benefits updates in IFACETS
• Verify and Validate the Pricing in Production for different Claims of outpatient, inpatient, Physicians
• Created the Test Claims and Adjudicated them to determine the members payment in the IFacets.
• Verified the Enrollment Files loaded from External Vendors.
• Verified the VF File for Enrollment with Subscriber Id’s.
• Verified the Eligibility information in Facets and Backend for Every Load.
• Developed the different Test Billing Entities.
• Developed the Billing Test Data for different Invoice Cycles.
• Verified Enhanced Agreements for different Provider Contracts in NetworX Modeler Verified the Enhanced Pricing for Service Procedures in NetworX Pricer.
• Verify and Validated the Provider and Provider Group.
• Verified the user-defined warning messages for Subscriber/Family application for use in Claims processing and Customer Service. Used ProClaim for Claims Validation in the Legacy Environment.
• Verified the user-defined Error Messages Incorrectly Entered Claims
• Used Quality Center for Defect Reporting and Tracking.
• Communicated with SME’s to develop different Test Scenarios in Benefit and claims processing.
• Used Third Party Citrix Web to use and access the IFACETS and Rational Testing Tools.
• Used Rational Robot for Functional and Regression Testing.
• Used BOS Ticket System for Production Claims Processing and Pricing Issues
• Interacted with Business users and BA’s and Benefit Coders regarding the Requirement Issues.

Environment: Facets 4.51, 4.71, SQL Query Tools (Ex: PL/SQL Developer 8.0, TOAD 10.6), Screen Shot Capture tool(Ex: Snag IT, Paint), Rational Test Manager, Clear Quest, Oracle 11gR2, XEngine, SpecBuilder6.5,Team Foundation Server, QA pipeline, SQL Loader, Windows NT

Confidential, Hartford, CT

QA Tester

Responsibilities:

• Actively participated in creating requirements traceability matrices, Test Scenarios, Test plans and also performed inspection of the Test scripts for Healthcare application.
• Involved in the design, analysis and testing of the application.
• Demonstrated knowledge of the business functions. (i.e. finance, accounting, billing, claims, provider contracting, enrollment, underwriting, etc.
• Performed black-box testing of the Healthcare application (FACETS) and identified the different test cases for regression testing.
• Experience with output management (print interfaces, ID Cards, Bills, EOB/EOP's, etc.) and Developed processes for System Integration Testing.
• Analyzed and translated the business requirement documents into test scenarios.
• Created Test Cases and modifying existing test cases, in Rational Manual Tester and Rational Performance Tester.
• Authored and Executed Test Cases for Billing, Commissions, Capitation and Client letter applications.
• Authored and Executed Test Cases for the Operational Data Store (ODS) and Enterprise Data Warehouse (EDW) in both Facets 4.31 and Legacy Systems.
• Used Test Director as a bug-tracking tool to track the Defects, for writing the Test cases and for Requirements and for the Reports Involved in User Acceptance Testing of the application.
• Wrote PL/SQL scripts to verify the database updates, inserts and deletes of the records.
• Tested the Data Consistency, Data Integration and Data Validation.
• Participated in Defect Triage and used Rational Clear Quest for Defect Management
• Attending meetings with QA Team, Development Team and Project Management Team.
• Actively participated in all phases of testing lifecycle (Design, Planning, Development and Results).
• Created large volumes of test data viz. Claims, Member/Subscribers, EDI’s etc.

Environment: Facets 2.96, 4.31, JAVA, CONTROL-M, UNIX, ONYX-CRM, BOE, ASPECT (CTI), Sybase, Oracle, Rational Clear Quest, Test Manager.

Confidential, Dublin, OH

QA Tester

Responsibilities:

• Documented and prepared Test Plans.
• Prepared test requirements and test cases.
• Assisted data entry and verification during Manual Test execution to reduce human error.
• Performed extensive manual testing on critical functionalities of the application.
• Created and tested scenarios using positive and negative test data.
• Modified and maintained Test cases with changes in application interface and navigation flow.
• Interacted with developers and team members for verification and validation aspects.
• Conducted Integration test for the application.
• Involved in writing complex SQL queries to check the data integrity
• Ensure that products and changes are fully documented.
• Analyzing User and Functional requirements to point out gaps between used SQL queries to extract the data from the database.
• Performed Smoke and Sanity testing manually.
• Performed Positive and Negative Testing manually.
• Performed Security testing and Backend testing manually.
• Extensive Regression Testing at Unit and Integration environments manually.
• Participated in conducting System testing and End to End testing manually.
• Performed Usability and Integration testing manually.
• Used Quality Center (Test Director) for bug tracking and reporting, also followed up with development team to verify bug fixes, and update bug status.
• Documented bugs found out during the process of testing

Environment: HTML, IE, UNIX, Oracle, Quality Center, SQL, TOAD, QTP, TEST DIRECTOR

Confidential, Montville, NJ

QA Engineer

Responsibilities:

• Involved in preparing the Test scenario’s, Test cases for complete application Testing
• Drafted Analyzed functional specifications and provided structured to all phases of testing by setting test priorities
• Test plan and developed Automated Test scripts and Test cases using Win Runner
• Done debugging interface and checked SQL code line-by-line using TOAD
• Defined test procedures that in corporate multiple tests of the entire system.
• Conducted Smoke, Security testing and Functional testing of the application.
• Conducted regression and integration testing
• Interacted with developers and other QA engineers to address quality problems.
• Reported bugs using defect-tracking system.
• Involved in White Box Testing of the GUI application.
• Identified software errors and interacted with developers to resolve technical issues
• Prepared pre-conditioned data for testing the application
• Responsible for weekly status updates showing progress of testing
• Designed data for interpreting negative/positive results
• Tested functional, GUI and performance requirements of the application

Environment: Java, Java Script, IE, Mainframe, UNIX, Oracle, Test Director, SQL, TOAD.