SUMMARY:

• 6+ years of experience in Quality Assurance and software testing in Health Care industry.
• Highly experienced in SDLC (software development life cycle) system.
• Experienced in different types of Methodology (Waterfall, Agile, Rup and Scrum).
• Experienced in writing test plan, creating test scenario, writing and executing the test cases and test script
• Expertise in RTM (Requirement Traceability Matrix) and gap analysis.
• Extensive experience in Manual and Automated testing using ALM QC, JIRA and QTP/LR such as load runner, win runner. And create a repots (standard, tabular and test summary) and have knowledge in performing stress, load and volume test.
• Expertise in Bug tracking and reporting using Jira, ALM Quality Center and Rational Clear Quest. And experience of Bug life cycle system.
• Expertise in different types of testing such as black box, sanity, smoke, positive, negative, integration, configuration, and regression testing as well as UAT(User Acceptance Testing).
• Experienced in testing Client - Server and Web-Based Application. Front-end and back-end tests.
• Expertise on back end testing using SQL on oracle, MS SQL server environments running on UNIX or Window platform to verify data integrity. And knowledge of ETL testing.
• Experienced in Selenium automation using Selenium Web Driver, Selenium IDE, Java, Junit.
• Well versed with Automation Frame work developing POM classes using java in Selenium Web Driver.
• Strong Knowledge of HIPAA and their regulation. Knowledge of Medicare and Medicaid.
• Knowledge in HIPAA Implementation. Have been involved in a variety of HIPAA related projects. Medical Claims experience in Process Documentation, Analysis and Implementation in 835/837/834/270/271/277/997 (X12 Standards) processes of Medical Claims Industry from the Provider/Payer side.
• Proficiency in EDI 4010 to EDI 5010. Involved in conversion and mapping HIPAA ICD9 to ICD10. Expert in COB (coordination of benefits).
• Extensive knowledge of health information and health care services regulatory environment including HIPAA, Medicaid/Medicare, and EDI
• Expert in EDI and HIPAA testing privacy with multiple transaction exposure such as new Member enrolment 834 inbound, claim 837 inbound or claim adjudication, response to claim 835 outbound, 276 status inquiry277response, 270 eligibility/271 benefits .Tested accordingly.
• Validates professional, Institutional and dentist claims in FACETS, verify codes with description and requirements verify adjudication process of claim in FACETS.
• Experienced on FACETS 4.5-4.71.and used different modules (application): claim, provider, utility managements, member/subscriber and others.
• Excellent comment skill along with verbal and written.

TECHNICAL SKILLS:

Operating System: Window (2000, Me, XP, Vista, 7), Linux, Sun-Solaris, UNIX and MS-DOS

Databases: Oracle, Toad, Db2, MS SQL Server, My SQL, MS Access

Test Management Tools: ALM Quality Center, JIRA, Rational Clear Case,Test director.

Testing Tools: QTP, Selenium(IDE/Web driver), Load Runner, Team Foundation Server, SOAPUI, Microsoft Test Manager

Bug Tracking Tool: ALM QC, JIRA, Clear Quest, Bugzilla. PVC Tracker.

Programming Languages: C, C++, SQL, PL/SQL, Visual Basic, and Java, Oracle.

Application and Web Servers: Apache, Tomcat, IIS, Web Sphere

Methodology: Waterfall, Agile, Rup, Scrum

Web Methodologies: HTML, XML, XSL, XSLT, JavaScript

Productivity Tools: MS-Word, MS Excel, MS-Project, MS Visio, MS Outlook.

PROFESSIONAL EXPERIENCE:

Confidential, Hartford CT

Sr. Quality Analyst/Tester

Responsibilities:

• Involved in HIPAA/EDI Medical Claims Analysis, Design, Implementation and Documentation
• Involved in HIPPA Complaint X12N837 Transaction testing.
• Developed and implemented EDI applications to process Health Care transactions as per the HIPAA implementation.
• Wrote SQL Queries for Back End Testing.
• Conducted Black Box Testing on the application and validated the dataflow in the application.
• Involved in preparing the Test Scenarios for Health Care Claim Payment/Advice.
• Written multiple Test Cases (System, Integration) for multiple transactions include 837I, 837P, 835, (both inbound and outbound) transactions.
• Performed thorough analysis of the companion guides from each trading partners both Medicaid as well as Commercial clients and identified the changes that specific clients need.
• Determined the requisite ICD10 training for both internal staff and Medicaid provider groups and assisted in the development of training materials.
• Used QTP to perform Regression Testing.
• Reviewing the Use Case Requirement, Functional Design Documents and Technical Specification documents.
• Executed SQL Queries to retrieve data from tables and to perform back end testing.
• Creating Test Cases after analyzing the BRD’s.
• Performing Functional and GUI testing on Facets.
• Prepared test matrices based through defect status in Quality Center.
• Involve in testing of FACETS Implementation, involve in end-to-end testing of FACETS Claims. Processing module, Membership and benefits.
• Analyzed FACETS data model to ensure optimal system performance and tuning.
• Logged defects in Quality Center and interacted with the developers to resolve technical issues.
• Performing Backend Testing extensively by writing validation queries on DB database.
• Worked with Data stage ETL and Cognos reporting.
• Generated detailed Bug Reports and documented Defects using Quality Center.
• Worked on uploading all the Test cases to the Quality Center for the current and prior releases.
• 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.

Environment: Facets, Cognos, Interactive SQL, MS Word, MS Project, MS Excel, Quality Center, QTP.

Confidential, VA Beach, VA 

QA Analyst

Responsibilities:

• Directly involved in download data from production environment to different test environment, defined in Oracle Database.
• Performed Data Analysis to make sure its correctness and completeness in test environment.
• Participated in weekly meetings to keep up to date with issues and business changing elements.
• Conducted regular meetings with the people directly responsible for the business in each State.
• Performed the role of QA Analyst as a core role and also took a lead in resolving problem logs.
• Closely worked with SME’s Business Analyst, System Analyst on every stage of application.
• Used QTP for automated testing, modified VB Scripts to meet requirement.
• Wrote test cases based on user stories in Team Foundation Server (TFS) using Microsoft Test Manager(MTM)
• Maintained Visual SourceSafe for all environments and aided conversion from Visual SourceSafe to Team Foundation Server (TFS)
• Used Claims Test Pro for processing claims.
• Analysis of inbound and outbound interfaces and extensions to Trizetto FACETS Claims Processing system.
• Prepared Test Strategy, test plans and Test Cases, Scenarios as per requirements and executed as and when needed.
• Validated Medical, Hospital and Dental claims in FACETS, verified Codes with description and requirements, verified adjudication process of Claims of FACETS.
• Extensively used Claims processing, Provider, Subscriber/Member, Utilization Management and NetworX Applications in FACETS, verified Co-pays and
• Participated in solving Billing issues from the FACETS Problem Log for Trizetto and Billing Entities. Set claim processing data for different Facets Module.
• Created members through express claim test pro for testing purposes
• Analyzing User and Functional requirements to point out gaps between used SQL queries to extract the data from the database.
• Worked on billing and payments in the provider module in Claim Test Pro of Facets.
• Test Case design and Test execution using HP ALM.
• Executed Functional and Regression testing using application QTP/UFT
• Conducted Functional, Positive/Negative Testing, Integration Testing and System Testing using JIRA for different modules of application.
• Extensively involved in Back-End Testing, database table manipulations of relational database systems by writing complex SQL queries manually.
• Led and managed the User Acceptance Testing (UAT) for the implementation of Facets Extended Enterprise administrative system with emphasis on ensuring that the HIPAA regulations are met across all the modules.
• Involved in Functional, Black Box, Usability and Regression Testing for UAT (User Acceptance Testing) using QTP.
• Developed and executed automated scripts usingQTP/UFT for Functional and Regression testing.
• Created user-defined functions and output values for the content builder and appliance by using QTP/UFT
• Performed checkpoints, parameterization in QTP scripts to check the validity of the data.
• Provided daily status report about problem to project Manager, Business and Systems Analyst.
• Responsible for updating the QA manager on weekly updates regarding the progress of testing efforts and open issues t be resolved.
• Used HP ALM (defects management tool) for defects/bugs tracking.

Environment: Trizetto FACETS, Oracle, SQL Server, HP ALM, QTP, Mainframe, JCL, COBOL, DB2, Soap UI, MS Office, Windows.

Confidential  Dayton, OH 

QA Analyst

Responsibilities:

• Reviewing the Use Case Requirement, Functional Design Documents and Technical Specification documents.
• Developed Test Cases after analyzing the BRD’s.
• Used ALM QC for writing Test Plans, defining Test Cases, developing and maintaining Test scripts, analyzing the results of scripts, interaction with developers in fixing the errors.
• Conducted Manual Testing for checking the flow of the application functionality in ALM QC.
• Manually tested each module of the application and verify against expected results in ALM QC
• Analyzed user requirements and prepared test approach document.
• Enhanced Test Scripts for Data Driven testing using QTP.
• Performed Functional and Regression testing using automation tool QTP
• Performed black box testing including smoke, regression, integration and functional testing.
• Performed GUI testing manually..
• 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.
• SQL server Integration Service Package Testing
• 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 Backend Testing extensively by using SQL Queries.
• Involved in testing HIPAA Transactions & Code Sets Standards
• Involved in testing HIPAA Database, which incorporates all the HIPAA (Health Insurance Portability and Accountability Act) transaction sets.
• Tested and Quality Center for version control, tracking defect, enhancement request, assign work activities and asses the status of the project.
• Prepared Test Cases based on business requirements and business rules for HIPPA EDI Transaction 834, 276/277, 270/271, 837/835.
• Validate the date from EDI transaction.
• Analyzed HIPAA 5010 standards for 837 EDI X12 transactions, related to providers, payers, subscribers and other related entities.
• Performed UAT manually till user satisfaction.
• Uncovered issues related to the data population in the backend database queried using SQL.
• Participated in requirements, Test Scenarios, and Test Conditions walkthroughs and reviews.
• Participated in the meetings to follow up on Defects/Issues
• Performed UAT manually till user satisfaction.

Environment: ALM QC, QTP, FACETS, SQL, ORACLE, TOAD, EDI, DB2, Windows XP, MS office.

Confidential, Atlanta, GA

QA Tester

Responsibilities:

• Created Test Documentation and Test Plans.
• Involved in HIPAA/EDI Medical Claims Analysis, Design, Implementation and Documentation.
• Entered numerous claims for testing purposes to ensure accurate and quality adjudication and implementation of business and operational requirements.
• Worked on Data Mapping to map Facets data to outbound eligibility extracts.
• Wrote SQL queries to extract and validate the data from the Facets database.
• Designed Activity, Sequence and Process Flow Diagrams using MS Visio to simplify and elaborate certain selection criteria and filter conditions.
• Extensively worked with Member/Subscriber and HIPAA Privacy Facets application groups.
• Used Quality Center to create to create Test Plan, Test cases and test scripts as well as steps for manual and automated implementation of test cases in Quality Center.
• Developed and maintained complex SQL queries for MS SQL Server and MS Visual SourceSafe for extensive back end testing purposes.
• For testing purposes, manipulated Members information in the QA environment through Facets front-end application.
• Web testing utilizing HP Quick Test Professional (QTP), Client/Server application manual testing utilizing Windows XP, Oracle 9i, TOAD, and SQL Server. Clear Quest for defect tracking and test cases repository and maintaining RUP documentation.
• Monitoring the performance of the system on a day-to-day basis.
• Regression testing on weekly builds. Performed weakly Walkthroughs and Inspection meetings.
• Performed Black Box Testing. Performed Positive and Negative testing for the system.
• Conducted Back End Testing to test the connection between Store’s system and the database in order to verify data integrity.
• Documented the dimensional models of ETL system
• Used SQL to test various reports and ETL load jobs in development, QA and production environment
• Monitor and analyzed activity report. Created reports for Server monitoring and Transaction time
• Bug reporting using Quality Center.
• Involved in manually testing the application from the backend to carry out data validation.

Environment: QTP, Quality Center, Clear Quest, Toad, Oracle, ANSI X12, HTML, XML, HIPAA, EDI, MS Office, Windows XP.