SUMMARY:

• Over 8 years of experiences in Information Technology with prime focus on QA and testing of Client/Server and Web - based applications with effective use of Standard Industry QA practices.
• Experienced in developing/creating/updating System/SIT/UAT/E2E Test Plan based on User/Business Requirement Document, Technical Specifications/Design Document, Use case, User Stories and NOPC.
• Professional experience in writing/updating Test cases/Test Scripts, Test Scenarios, Test Conditions, Test Estimation for functional requirements.
• Experienced in conducting different types of QA testing including Targeted, Smoke, Functional, Integration, Regression, End-to-End and User Acceptance testing both manually and through the automated testing tools.
• Hands-on experience in Post Implementation Testing and Production Support.
• Extremely proficient in Manual(Facets, MITS), Automation(QTP/UFT, Selenium WebDriver, JUnit / TestNG, CTP) and Database testing tools to troubleshoot system, integration, user acceptance, positive and negative, functional and regression specific issues.
• Experienced with SDLC and STLC from Verification to Validation.
• Extensive Knowledge of various phases of different Software Development Life Cycle (SDLC) such as Waterfall and Agile/Scrum methodology.
• Adept at Bug Tracking and Defect Reporting using Confidential Quality Center, JIRA, Bugzilla.
• Expertise in querying and testing using RDBMS tools like Oracle, MS SQL Server, and DB2 for Data integrity.
• Expert-level experience in writing SQL queries using DDL and DML commands like Select, Create, Joins(inner, outer) and sub-queries to extract data from various source tables to perform database testing.
• Experience in ODBC Setup and Stored Procedures and PL/SQL programs.
• Expertise in Healthcare industry with Claim Processing, Enrollment, Provider, Managed Care, Medicaid and Medicare as well as Interface Testing and Data Conversion.
• Extensive knowledge on different modules within Healthcare domain like Membership, Enrolment, Claims, Billing, Capitation, Providers and Coordination of Benefits (COB).
• Expertise in ASO/Self-Funded, Fully Insured Plans and GF/NGF HMO/PPO products.
• Experience with HIPAA compliance (4010 and 5010) and Healthcare systems.
• Conducted Requirement Traceability Matrix (RTM) for requirement to be mapped between the Requirement and Test Case using Confidential ALM.
• Hands on Experience with EDI Transactions like 834 Enrollment, 835 Healthcare Claim Payment/Advice, 837 Claims, 270 Eligibility inquiries, 271 Eligibility Responses, 276 Claim status inquiry and 277 Claim status responses.
• Extensively involved 2016 Product Enhancement projects under like Telemedicine, Childhood Obesity, Non-Transport Ambulance in BCBSLA.
• Worked with TriZetto's Facets Application Groups like Claims Processing + ITS, Medical Plan, Subscriber/Member, Provider, Application Support, Accounting, Billing, Customer Service and Utilization Management.
• Highly skilled in creating Medical Claims and enrolling Members/Subscribers in Facets 4.5.1/4.7.1/5.01.
• Expertise in Bug reporting tools such as Confidential QC/ALM, Microsoft TFS/MTM and ability to write clear and concise bug reports with actionable steps to reproduce.
• Ability to set up various Automation Frameworks like Data-Driven, Keyword-Driven and Hybrid.
• Good knowledge of Object-Oriented Programming Language like Java, Scripting Language like VBScript/JavaScript, text editor like Notepad++ and Integrated Development Environment (IDE) tool like Eclipse.
• Possess good understanding of WSDL, XSD, Schema, DTD, XML documents for Web Services Testing.
• Performed functional web services Testing using SOAPUI.
• Experience in Mobile Apps testing.
• Experience in working collaboratively and with cross-functional teams.
• Ability to determine appropriate action to resolve issues quickly and track deliverables.
• Experienced in T raining and G guiding the junior or new testers/QA analysts .
• Hardworking, Dedicated, Flexible and Versatile to adapt any new environment and work on any project.
• Thorough, Self-motivated, Responsible and a Self-starter.
• Have "C an-do" and "T est-to-break" attitude and great attention to details.
• Possess excellent interpersonal, written, verbal communication skills along with the ability to work independently or as a member of a team.
• Strong leadership ability and Can work and manage multiple projects, give direction to others, and take a lead role in improving organizational processes.

TECHNICAL EXPERTISE:

Methodologies: Waterfall, V-Model, Iterative, RUP, Agile/ScrumOS: Windows 7, Vista, XP, NT/2000, MS-DOS, Sun OS/UNIX, LINUX, iOS, Android

Languages: Java, JavaScript, VBScript, PL/SQL

Health Care Tools: TRIZETTO Facets 4.6, 4.71, 5.0; TRIZETTO HIPAA Gateway, Edifecs (Transaction Management), MITS, BizTalk

Test Management Tools: QC/ALM, JIRA, Team Foundation Server(TFS), MTM, SharePoint

Defect Tracking Tools: Confidential QC 8/9/10/11(ALM), JIRA, Clear Quest

Databases: MS-SQL Server, Oracle, MySQL and MS-Access

Web Technology: Web Services, SoapUI, HTTP, SMTP, HTML, XML, EDI, SOA.

Automation Tools: Quick Test Pro/UFT, Selenium WebDriver, CTP

Application: MS Office, MS Lync, Eclipse, Notepad++, Visual Studio, Virtual PC, VM Ware, iTRACE, Work Tracking Tool, ServiceNow, Planview, iLinkBlue

EXPERIENCES:

Confidential, Baton Rouge, LA                                                              

Quality Assurance Engineer

Responsibilities:

• Reviewed minutely Front-end claims validation related Business Requirement Documents ( BRD ), Notice of Plan Changes ( NOPC ), Use Cases, facets Medical Plan and Facets Application Support application Groups for writing test cases/test scripts.
• Heavily involved in writing Claims related Test Scenarios/Test Cases for GF/NGF ASO/BBS and Fully Insured Products to be executed in Facets.
• Effectively communicated and reported defects, and experienced in defects logging and tracking with test management tools including Confidential ALM/Quality Center (QC).
• Broad Knowledge in reviewing Test Procedures, creating Test plans and detailed test plans for UAT, Test scenario, defining Test cases, both System & Integration and executed many test cases
• Performed peer review on test cases written by other testers/QA Analysts.
• Uploading Test cases from Excel Sheet to QC/ALM Test Plan module and next export them from Test Plan to Test Lab in QC/ALM for execution.
• Create Test Data like membership and upload them in SharePoint so that testers can use them during test execution.
• Review and updated defects using JIRA
• Proficient in using test management tool Confidential ALM/Quality Center (QC) which includes creating Test Plans, preparing and maintaining Test Cases, executing Test Scripts, analyzing the results, reporting the defects and preparing Status Reports.
• Project management experience in developing requirement and testing strategies based on functional and technical goals
• Pulled Product specific providers' list from database using SQL queries and send them to the testers for using during test execution.
• Validated front end claims in Facets 5.01 for FEP, OGB, ASO/BBS, Fully Insured and BCBSLA Regular Plans' Claims in NRS1 or ICD10 or SPC1 environment...
• Logged defects in QC/ALM and retest when the defects are fixed. If retesting passed, close the defect, otherwise reopen the defect.
• Reported outstanding bugs, followed up bug fixes, conducted review of existing test scenarios and assessed the need for their enhancement using Quality Center/ALM.
• Track and update BET Configuration Work Tracking Tool after each phase of testing including formal completion of successful testing.
• Set up ODBC for newly hired Resources and teach them how to use Company's Databases through ODBC.
• Performed Back-End testing to ensure Proper validation of the claims into the Database by executing SQL queries.
• Responsible for developing test plan for some products of Product Enhancement 2016 in line with Master Test Plan .
• Analyzed and Business and Technical Requirements and help Test lead to estimate Level of Efforts (LOE) for different products of Product Enhancement 2016 project.
• . Conducted validations of functionalities in Facets 5.01 for different applications of Claims Processing, Provider, Subscriber/Member, Application Support, Medical Plan Application Group.
• Worked closely with business analysts and SMEs to understand and document overall work flow for enrolling subscribers in BCBSLA health plans through Health Insurance Exchange(HIX).
• Closely involved in writing test cases for enrolling members with different metallic tiers, benefit packages and business levels.
• Assisted managers with project management tools like MS-project for status reporting and planning work breakdown schedule (WBS), network diagramming projecting task duration, resources requirements.
• Participated in different walkthrough meetings with Developers and Testers and answered their questions with respect to different systems.
• Following Agile/Scrum process, participated in daily scrums and analyzed stories. 
• Developed Test Cases, Test Conditions and Test Scripts for each sprint.
• Created automation test script in Eclipse using Java and Selenium WebDriver for BCBSLA CRM project .
• Performing UAT, functional and Regression testing for all features and sprints of the Application according to the Acceptance criteria in MobileApp project.
• Managed UAT, Integration testing. Developed the test cases, test scenarios and strategies for the same.
• Performing Mobile App Testing in all iOS (iPhone, iPad) and Android devices.
• Using iPhone (6,6+,6S,6s+,5,5S,4,4S), iPad (iPad Air, iPad Mini) with iOS (9.1, 8.1, 7) and Android devices Samsung Galaxy (S6,S5, S2), Google Nexus 4,7 with OS (5, 4.4,4.3, 4.2, 4.0) for perform all UAT, functional and regression testing.
• Involved in extensive Regression Testing after every new build and verified the results using Selenium WebDriver for CRM project
• Performed Web Services testing and Validated XML request/response data using SOAPUI especially in ICD 10 project...
• Involved and assisted the system users in User Acceptance Testing .
• Extensively performed Back End Testing using SQL Server
• Validating and documenting Post Implementation Break Fix Activities in production.
• Responsible for retesting and updating the Service Desk Tickets.

Environment: TRIZETTO Facets 5.01, CTP, Confidential ALM/ Quality Center, MS TFS and MTM, JIRA, UAT,EDIFECS, SOAPUI, BizTalk, UNIX, Putty, MS SQL server, MS Access, MS Office 2007, MS Office 2010, IPD Ultera, iOS7-iOS9, Android OS 4 - OS 5,Text pad, XML Notepad++, Work Tracking Tool, Service Desk Manager.

Confidential, El Paso, TX

Senior Quality Assurance Analyst

Responsibilities:

• Reviewed the Business Requirements Document, Functional Design Documents and Technical Specification Documents
• Created/Updated Test Cases and Test data after analyzing the BRD/Co..
• Developed Test Data like membership for different Groups .
• Validate EDI Claim Process according to HIPAA compliance
• Worked on HIPPA Transactions and such as 270/271, 276/277, 837/835, 820/834 transactions.
• Extensively worked on Primary Managed Care Provider(PMP), Enrollment and PMP Assignment history.
• Worked with Managed Care Recipient Enrollment & potential MC Recipients .
• Performed daily smoke testing/UAT and updated comments using Manual Testing.
• Report the bugs by using Excel Sheet and JIRA Bug Reporting Tool.
• Used Confidential ALM Quality Center
• Created test plans and test cases for Managed Care Capitation Transaction Processing and PMP Capitation History.
• Conducted and attended meetings and discussions with the developers and the clients in deciding the agile methodology testing at the end of every sprint (bi-weekly), enhancing and reoriented based on the completed work.
• Worked with Recipient MC Special Conditions and Recipient PMP Lockout
• Actively participated in the UAT transition, retested UAT defects and updated comments in JIRA on client feedbacks
• Hands on experience working on Managed Care Daily and Monthly Enrollment Roster Process
• Worked with external interfaces such as " MITS Eligibility and Demographics to MCEC" for various Job Runs.
• Created reports that included a general overview, open bugs and enhancement requests.
• Maintained Test Matrix and Requirements Traceability.
• Prepared/updated test scripts for automated testing using QTP.
• Performed Functional and Regression Testing using QTP
• Performed Data Driven Testing Using manually to check the behavior of the application using both Positive and Negative data.
• Wrote SQL queries for data validation.
• Used Quality Center to enter and report defects.
• Interacted with Business Analysts and developers regarding Requirements, COs and CCRBs.

Environment : HIPAA EDI, UAT, Quality Center, QuickTest Pro , iTRACE, JIRA,MS Visio, Clear Quest, .NET, Oracle, Mainframe, Windows, UNIX.

Confidential, Seattle, WA

QA Analyst

Responsibilities:

• Reviewed Test Strategy and Test Plans to ensure that they reflect and include all functional, Performance, Usability and Security requirements.
• System Integration testing for Facets core modules with external systems.
• Data mocking for different Claim file formats.
• Conducted HIPAA Gateway Testing.
• Tested Subscribers/Providers and claims in Facets.
• Retested Defects using Manual Testing, and update the defects using JIRA.
• Participated in developing and implementing End2 End testing.
• Tested the GUI / User Interface of the Web applications.
• Participation in requirement / Use Case analysis, risk analysis and configuration management.
• Tested the Membership and claims files (XML) in Facets.
• Transactions focused on were 270,271,276,278,834, 835, and 837.
• Validated the reports and files according to HIPAA X12 enforced standards.
• Tested the Members, Claims, Providers and Services in Facets.
• Extensively Used Claims Test Pro (CTP) for processing claims. 
• Used TFS, MTM and Quality center for test cases, defect logging and defect tracing.
• Involved in testing HIPAA EDI Transactions and mainly focused on Eligibility Transactions.
• Tested the subscriber and Member enrollment in association with class, plan and product.
• Tested the Registration process of common practitioner in Facets and validated the fields (Medicare or Medicaid billing number, License and DEA number).
• Worked on Claims Test Pro (CTP) Facets for project tracking and for reporting progress. 
• Identifying Test Scenarios, prepare Test Specification document and Test cases in MTM
• Performed Manual Testing using Quality Center (QC) and User Acceptance Testing (UAT).
• Performed UAT Testing Manually in coordination with UAT group to ensure correct business logic.
• Tested and validated the database tables using SQL queries and performed Data Validation and Data Integration
• Responsible to work on Healthcare Management Information System which includes two divisions: HIPAA compliance and Maintenance units division and Claim processing division.
• Monitored workflow of the Resolution/Adjustment Unit, delegate tasks accordingly, and ensure that quality, quantity, and efficiency standards are met or exceeded.
• Worked under HIPAA compliance standards.
• Created and maintained SQL Queries for back-end testing.
• Performed SOA / Web Service testing using SoapUI.
• Updating daily tasks and storing the automation code in Visual Studio TFS
• Created Data for XML Requests in SoapUI.
• Maintained Test Matrix which gives overview of the Testing Effort.
• Tested Claims intake/Logged claims/Failed claims data from Pulse tables to Oracle Financials.
• Monitoring the defect life cycle, generating customized graphs and reports for the client, using Quality Center.
• Used Quality Center to record documenting information useful in debugging process, evaluating test data.
• Used Quality Center for reporting and tracking bug and generating reports.
• Extensively used SQL statements to query the Oracle Database for Data Validation and Data Integrity.

Environment: ICD, Agile, FACETS, Mercury Quality Center, JIRA,UAT,ANSI X12,TFS, MTM, Claims Test Pro (CTP), JavaScript, HTML, XML, HIPAA, EDI, UML, MS Office, Windows XP/,Java/J2EE.

Confidential, MD

Quality Assurance 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.
• Developed the Test Data for different Inpatient, Outpatient, Ancillary, and Physicians Claims with relevant agreements in FACETS 4.51
• Created the Test Claims for Different Service diagnosis and procedures in Facets.
• Used Networx Modeler for Verify the updated Agreements Contracts.
• Used Networx Pricer for Verify the updated Pricing for Service Procedures.
• Used Main Frame Topps for Verify the Pricing for different quarters for different Services.
• Verify and Validated the Provider and Provider Group.
• Verify the Active member benefits updates in FACETS
• Verify and Validate the Pricing in Production for different Claims of outpatient, inpatient, Physicians
• Developed the Test Claims and adjudicated them to determine the members’ payment in the Facets.
• Verified the user-defined warning messages for Subscriber/Family application for use in Claims processing and Customer Service.
• Verified the user-defined Error Messages Incorrectly Entered Claims
• Used Rational Robot for Defect Reporting and tracking.
• Worked with SME’s to develop different Test Scenarios in claims processing.
• Used Third Party Citrix Web to use and access the FACETS and Rational Testing Tools.
• Used Rational Robot for Functional and Regression Testing.
• Interacted with Business users and BA’s and Benefit Coders regarding the Requirement Issues

Environment: Facets 4.51, TriZetto Networx Modeler, TriZetto Networx Pricer, Rational ClearQuest, Rational Robot, NASCO, TOPPS, Java, J2EE, DB2, IBM Mainframes, Lotus Notes.

Confidential, Boston, MA

QA Analyst

Responsibilities:

• Reviewed Business Requirements, Functional and Technical specifications with business analyst and QA manager to learn the functionality and process.
• Involved in preparing Test Plan and defined the testing approach, resources and time lines.
• Worked with other team members and conducted the weekly status meeting to make sure the all team members are on the same page.
• Keep motivated the other team member and resources to get the job done on time.
• Wrote Test Cases in Excel based on Technical and Functional Specifications and upload them in Mercury Quality Center.
• Maintained Requirement Traceability Matrix (RTM) to make sure that test plans were written for all the requirements.
• Testing member enrollment module by using facets
• Written maximum number of test cases in a very detailed for All the modules of Facets Application Responsible to check whether the interface and the extensions properly integrate with the facets application.
• Performed data validation according to data mapping document with data conversion logics from source system and target system.
• Involved in GUI, Regression, database, Compatibility and Configuration Testing.
• Conducted GUI and functionality testing using QTP.
• Conducted data driven testing using QTP to conduct backend testing.
• Performed Automation of various test cases for sanity testing and functional testing using QTP.
• Extensively user SQL queries and procedures for data validation in both source system and target system.
• Created and maintained SQL Queries for back-end testing.
• Created and managed data base trigger and subprogram using SQL.
• Provide training in using the system, using reports, executing queries and writing in SQL.
• Executed test cases found errors, reported defects, coordinate with developers and business analyst, determined repair priorities.
• Perform regression testing after the defect is resolved and closed defect in Mercury Quality Center.
• Generated test execution reports, get sign off and uploaded validation documents in share point web site for review.
• Executed automated test case and scripts using QTP for the Front-end-applications and analyzed the results.
• Performed User Acceptance Testing (UAT).
• Involved in performing data validation in NASCO production region.

Environment: FACETS, Mainframe, UAT, Oracle, SQL, Mercury Quality Center, MS Office