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Sr. Edi Qa Analyst Resume

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Oakland, CA


  • 8 years of extensive experience in Sr. EDI QA Analyst, manual and automation testing of web and client server applications based on HTML, XML environment.
  • Proficient in all stages of software testing i.e. System testing, Functional testing, Integration testing, Regression testing, GUI testing, Black Box testing, Front end testing, Backend testing, Database Testing, UAT testing, mobile application testing
  • Experience in healthcare industry and has good knowledge of HL7, EDI standards and HIPAA.
  • Experience includes the testing of Client/Server, ETL, SOA and WEB applications using Manual and automated testing tools like Quality center, Rational Suite, Load Runner, Win Runner and Quick Test Professional.
  • Knowledge of Health Insurance Portability and Accountability Act (HIPAA) transaction sets
  • Experience in Different Software development methodologies like Waterfall Model-V model and Agile Methodology.
  • Projects including requirements gathering & analysis, test planning, execution and defect tracking and reporting.
  • Extensive working knowledge of Front end GUI, End To End, Back-End and ETL Testing.
  • Assisted, co-ordinate with component team, testing team, delivery management team and was part of the release management team to ensure environment readiness in accordance with established timelines.
  • Adhered to all policies and procedures concerning all confidential information including but not limited to internal use and restricted information, including Protected Consumer Information (PCI)
  • Proficient in Microsoft Office Suite-Word, Excel, Outlook and Power Point
  • Practical implementation of TOAD client tool (related to database testing)
  • Experience in defects logging and tracking in test management tool like Quality Center(QC), JIRA
  • Good understanding and work with FACETS core tables and update in batch mode or on a specialty basis.
  • Excellent oral, written communication and interpersonal skills and a self-starter able to multi task and prioritize.
  • Experience in preparing Test Strategy, developing Test Plan, Detailed Test Cases, writing Test Scripts by decomposing Business Requirements, and developing Test Scenarios to support quality deliverables.
  • Experience in Automation using Mercury Interactive Tools such as Win Runner, QTP, Load Runner and Test Director. Experience in using Bugzilla, Test Director and HP Quality Center for Bug Tracking and Defect Reporting.
  • Closely working with Software Development team in resolving Defects, presenting the Defect Status reports, resolving requirement, and observed design inconsistencies.
  • Expertise in querying and testing RDBMS such as Oracle, MS SQL Server using SQL, PL/SQL for data integrity.


Testing Tools: QTP, Win runner

Source Control Tools: Microsoft Visual Source Safe and PVCS

Claims software tools: FACETS, QNXT and NASCO

Test Management Tools: Rational Test Manager and HP ALM

Data bases: SQL Server, Oracle and MS Access

Languages: C, TSL, Shell Scripts, Visual Basic, .Net, Java Script

Web Technologies: HTML, XML, ASP, .Net, Java Script

GUI Tools: Visual Basic and Oracle developer 2000

Operating Systems: MS DOS, Windows 9 xs and Windows NT/2000/XP, UNIX, IBM-Mainframes

Methodologies: Software development Life cycle (SDLC), RUP, Waterfall, Agile, Scrum


Confidential, Oakland, CA

Sr. EDI QA Analyst


  • Analyzed the business requirement documents, Functional specification documents to prepare Test cases and effort estimation.
  • Worked on different EDI transactions for submitting claims, 835 for payments, 834 for benefit enrollment etc.
  • Developed test scripts for providers and Claims modules of FACETS.
  • Conducted automation and manual regression analysis of the Test Scripts
  • Knowledge on QNXT, FACETS, NETWORX PRICER, ANSI X12 5010 version,837 X12 and NCPDP formats, ICD9 to ICD 10 conversion
  • Involved in Database testing by writing & executing SQL queries by using SQL
  • Generated detailed reports that include graphs and tables for various performance object counters and Application transaction times.
  • Responsible for compliance testing of EDI X12 5010 level 1 and level 2 messages.
  • Involved in executing manual and automated test scripts using Rational Manual Tester and Rational Functional Tester
  • Extensively involved in Member, Provider and claims testing in QNXT application
  • Performed impact analysis on applications for deadliness of ICD-10 conversion.
  • Developed and executed manual test scripts using test plan and test lab sections of Quality Center for System testing, Integration testing and Regression testing of the application.
  • Created transaction sets and mappings in various ANSI X12 EDI formats
  • Involved in member enrolment process by creating the membership enrolment files for different vendors.
  • Created SQL scripts to change data and validate service response.
  • Captured all HIPAA-related EDI data in the repository using FACETS.
  • Experience with QNXT, Facets, Inbound & Outbound interfaces, EDI.
  • Coordinated UAT, Regression and Integration testing schedules and completed the same.
  • Validated automated test scripts using Quick test pro ( QTP) to ensure that all test scenarios are complete and operating in all test environments
  • Involved in analyzing the functional acknowledgement and claims acknowledgement (277CA) files.
  • Maintenance and updates of various files and documentation using Word, Excel and Access.

Environment: Quality Center, Manual testing, VSTS, SOAP UI, Facets, ICD-9 & ICD-10, Agile, QNXT, Java, J2EE, IBM WebSphere, Spring, Hibernate, Web services, XML, XML schema, Oracle 10g, SQL, TOAD, EDI X12, MS Office 2007, UNIX and Windows XP.

Confidential, Los Angeles, CA

EDI QA Tester


  • Developed Test scenarios, Test Scripts and Test cases based on Requirements, and performed GAP Analysis.
  • Involved in coordinating with SME to discuss different scenarios at the time of scripting Test Cases.
  • Identified the test cases to be automated and performed data driven testing and GUI Check
  • Involved in testing QNXT Member, Provider, Claims Processing, Utilization Management, Accumulators, Contracts and Benefits
  • Created various test sets for different test cycles and assigned them to team of testers for test execution purposes.
  • Worked on different EDI transactions like 837 for submitting claims, 835 for payments, 834 for benefit enrollment etc.
  • Captured all HIPAA-related EDI data in the repository using FACETS.
  • Validated and implemented EDI transactions according to HIPAA compliance.
  • Facets support systems were used to enable inbound/outbound HIPAA EDI transaction in support of HIPAA transactions.
  • Validate the sequence of web service invocations to fulfill a required business process using soapUI.
  • Participated in JAD sessions for requirement gathering, analysis and design.
  • Back-End Database verification manually and using QTP to automatically verify database with the Values entered during automated testing by inserting Database Checkpoints.
  • Involved in level data mapping, prepared detailed data mapping sheet.
  • Accepted inbound transactions from multiple sources using FACETS.
  • Extensively involved in System testing, Functional, Integrating Testing, Manual Testing, UAT testing and DR Environment testing.
  • Wrote SQL queries, generating reports to ensure data integrity and validating business rules.
  • Involved extensive unit testing of mappings and investigated the source and target data to ensure sound data integration.
  • Supported integrated EDI batch processing and real-time EDI using FACETS.
  • Extensively used SQL queries to retrieve data from the databases.
  • Involved in Unit Testing, Integration, and User Acceptance Testing (UAT) of Mappings.
  • Extensively involved in writing the SQL queries to verify the data in the QNXT and online portal databases.
  • Bugs that would enhance the usability of the application were logged using Quality Center.
  • Used MS TFS as source control tool to store all code, as well as a record of all changes and current check-outs in a SQL Server database.
  • Maintenance and updates of various files and documentation using Word, Excel and Access.

Environment: EDI, HIPAA, FACETS, soapUI, Quality Center, QNXT, Agile, C#, ASP.Net, ADO.Net, XML, Web Services, TFS, VSTS, SQL Server 2005, T-SQL, IIS and Windows

Confidential, Salt Lake City, UT

QA Test Analyst


  • Preparing test plan and test cases in Quality Center.
  • Converting test plan and test cases of test Director into ( Electronic Document) in order to share test
  • Worked extensively on inbound transaction set 834 (Benefit Enrollment & maintenance) claim.
  • Adjudication EDI ( 837), Remittance (835) and Claim status
  • Experience in using Diamond tool and automation tools HP tools Quality Center& QTP,TFS, Rational Tools and RUP
  • Wrote SQL queries for each Test case and automated standard reusable test cases like audit control and balancing
  • Involve in weekly status updates with the Manager and Project Leader.
  • Created the Regression Test cases and automated them for the purpose of regression Testing.
  • Coordinated UAT, Regression and Integration testing schedules and completed the same.
  • Used TOAD GUI tool for querying oracle database.
  • Executed tests for Rehabilitation visits for members using ICD codes as well as CPT codes.
  • Analyzed the QNXT (claims engine) data and discussed with the Business team regarding the Requirement.
  • Involved in the reporting analysis and configuration in Trizetto QNXT System
  • Ensured functionality met business requirements as recorded in test results logged in Quality Center
  • Defined structured testing methodology and standard testing procedures
  • Created Test plan, Test Design and responsible for implementation of Test cases as automated test scripts.
  • Validated CPT, HCPC, ICD 9 code sets from Data Flat files to support configured benefit plan building.
  • Created and maintained templates such as: Quality Strategy, Test Plans, Requirements. Traceability Matrix, Test Scripts, Test Calendars, Testing Issues, Project Sign-off and Test Reports
  • Created Functional and Integration Test Folders in Quality Center
  • Managed and coordinated testing process with in-house testers and outside testing resources

Environment: Windows XP, UNIX, Perl, QTP, VB Script, Quality Center, QNXT, .NET, XML, SQL, QNXT, Oracle, HTML, MS Excel, MS Office

Confidential, San Francisco, CA

QA Tester


  • Defined the test criteria, project schedules and base lined the Test Plan with the help of project meetings and walkthroughs.
  • As a part of transaction testing, extensively used SQL queries to verify database table in the backend using SQL Developer.
  • Conducted Functional, System Integration (SIT), Regression, UAT, Smoke and System Testing.
  • Developed and maintained automated test scripts to support regression testing and participated actively in system testing and regression testing.
  • Completed 5010 Gap Analysis and Impact Assessments on Business process, Application and EDI Transaction process for upgrade from 4010A1 to new 5010 HIPAA EDI X12 electronic formats.
  • Maintenance of the automation scripts for enhancements and modifications to the product.
  • Analyzed 4010 and 5010 gaps and impacts across all transactions, system interfaces, applications and business processes.
  • Provided an integrated system which included, Requisite Pro, Clear Quest, Clear Case, Functional Tester, Rational Quality manager.
  • Developed an implementation guide for Partners for EDI X12 transactions
  • Work on Logical Data Requirements and Physical Data Mapping for the Forward Data Cache a new Data Model designed for EDI transactions
  • Developed Test Cases and Test Design using Rational Test Manager.
  • Worked with Rational tool suite integration including Rational Team Concert (RTC).
  • Experience of manual testing process and in creating automation environment using Rational Suite, and Test Director and Quality Center.
  • Adhered data transition of the enrollment process, COB, Claim Status and Eligibility as per the EDI standard
  • Worked with EDI transactions 837 - Claims and 835 Remittances and validated the claims.
  • Set up Rational Team Concert to accept cross domain requests from Rational Quality Manager.
  • Worked with X12 /EDI transactions and validated the specifications/mapping for 837 transactions for Institutional and professional claims and 835 responses.
  • Tested the Data warehouse (ETL) applications using ETL tool Informatica.
  • All the test scenarios which have been satisfied with the functionality are moved to automation testing using QTP.
  • Backend testing of the DB by writing PL/SQL queries to test the integrity of the application and Oracle databases using TOAD.
  • Responsible for collecting and analyzing the test metrics and then submitting the reports keeping track of the status and progress of the testing effort.

Environment: SharePoint, ASP.NET, VB.NET, EDIFECS Transaction Manager, EDI, ETL, Cognos, Informatica, Quick HP Quality Center, ALM, Rational Suite, UNIX, XML, SQL, PL/SQL, Oracle.

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