SUMMARY:

• Over 7+ years of experience as Quality Assurance Engineer.
• Extensively worked as a Quality Assurance and Test Engineer, understanding responsibilities in QA plan formulation, developing project plans, communication plans and implementation.
• Good understanding of health insurance policies like HMO and PPO and proven experience with HIPAA 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).
• Strong business knowledge of Healthcare sector and very good knowledge about Faucets, HIX and proven experience with ICD9 - ICD10 conversion.
• Good working experience in analyzing changes and identifying areas of applications to be regression tested.
• Expertise in reviewing requirements, functional and design specifications.
• Strong Knowledge on CMM and Six Sigma Methodologies standards.
• A diversified spectrum of Quality assurance & SDLC experience in support of Enterprise OLTP applications and supporting SIT testing in Healthcare, Life Insurance, CRM and Retail Domains.
• Expertise in writing SQL Queries using Oracle, SQL Server and Teradata in validating data into Data Warehouse/ETL applications.
• Well-versed with all stages of Software Development Life Cycle (SDLC) and Software Testing Life Cycle (STLC).
• Expertise in working with Agile, RUP, SCRUM and Waterfall testing methodologies.
• Ability to write Test plan, Test Strategy, Test cases, Test Scripts from BRD(Business Requirements Documents) and Use Cases.
• Well- skilled with various testing methodologies, testing types, testing techniques and Quality Work Products.
• Proficient in formulating test plan and Requirement Traceability Matrix.
• Strong working experience in the Data Analysis, Data Verification and Validation of an ETL Applications using Backend/Database Testing.
• Hands on experience in writing test plans, test cases, developing and maintaining test scripts.
• Experience in developing Software Test Plans, Test Case Design, Test Scripts, Integration Testing, System, Functional, Regression Testing, GUI, and database testing.
• Hands on experience in Software Verifications, Black box, Unit/Integration (SIT), System, User Acceptance (UAT), Regression, Usability, End-to-End Testing.
• Strong expertise in establishing QA Policies, Root Cause analysis (RCA), Procedures, strategies, metrics, developing appropriate process and team to ensure the quality of product.
• Excellent Experience in Defects Tracking in the Application.
• Strong experience in working in Windows and UNIX environments.
• Expertise in creating Bug Reports using tools like Test Director/Quality Center.
• Hands on experience with Databases Oracle, SQL Server and writing SQL Statements.
• Detailed knowledge in Object Oriented Programming Techniques.
• Update JIRA tickets for tracking issue fixing. And providing detailed descriptions on the tasks.
• Participated in SQA activities like Reviews, Requirement Mapping Root Cause Analysis (RCA) and Metrics.
• Good knowledge of Health Insurance Plans (Medicare Part A, B, C and D), managed care concepts (Medicaid and Medicare) and experienced in determining the membership eligibility, billing experience within life and disability in health plans.
• A motivated, sincere, committed, quick learner, detail-oriented team player with good communication, analytical, leadership, interpersonal and problem solving skills
• Experience in problem solving and defect tracking using tools like Quality Center, JIRA Issue Tracker.
• Knowledge of MMIS (Medicaid Management Information System), MITA ( Medicaid Information Technology Architecture
• Have attended seminars/webinars and gained lot of knowledge on HIX (Health Insurance Exchange), EMR (Electronic Medical Record), EHR (Electronic Health Record) and healthcare reforms like the Patient Protection and Affordable Care Act (PPACA), Emergency Medical Treatment and Active Labor Act (EMTALA)
• Assisted Business Analyst in UAT.
• Conducted extensive review and analysis of existing QA methodologies and development practices and worked on the continuous improvement to yield effective solutions.

TECHNICAL SKILLS:

Testing Tools: ALM/QTP, Test Director, Quality Center,Selenium.

Databases: Oracle, MS Access, SQL Server, DB2

Operating Systems: Windows, UNIX

Languages: C/C++, Java, PL-SQL, web-services, JIRA.

Browsers: Internet Explorer, Google Chrome, Mozilla Firefox, Safari

WORK EXPERIENCE:

Confidential, Mountlake Terrace, WA

Sr. QA Analyst

Responsibilities:

• Review and analyze Business Requirement Documents (BRDs), Technical Requirement Documents (TRDs), and Conceptual Specification Design Documents (CSDs).
• Write Test Scenarios and Test Cases based on the BRDs, TRDs, CSDs, process flows, architectural diagrams and business needs. This activity included Individual and Group Setup in Members Edge; Health Exchange Payment (820); Health Exchange Enrollment (834), UCSW; IVR; Invoice & Billing activities.
• Create Test Data as required. Test Data was created for Standard Payments (820) in ASC X12 005010X218 format; Health Insurance Exchange Related Payments (820) in ASC X12 005010X306 format; Health Insurance Exchange Enrollment (834) in ASC X12 005010X307 format; Setting up a new Health Exchange Groups /Individuals and perform Billing and Fulfillment activities
• Involved in preparation of Test Data to test the functionality of ETL Sources Mappings and Targets.
• Involved with the testing phases for SIT (System Integration Testing), PT (Product Test) and UAT (User Acceptance Testing).
• Responsible for testing and verifying new unemployment claims website compliance to section 508.
• Performed defect tracking and management, interfaced with development teams, configuration management team, RCA team, environment team, UAT team and other application teams.
• Validate EDI 834 enrollment process according to HIPAA compliance
• Created various suites of enrollment process, claim process in Claims Test Pro by creating a keyword file and loading them to FACETS for testing.
• Performed 508- Compliance Testing on applications: CTEP-IAM, CDUS TIME LINE REPORTS, OAOP, PATS AND FIATS.
• Performed technical evaluation of products and built efficiencies across the teams through brainstorm sessions and root cause analysis (RCA).
• Extensively worked on FACETS claims processing system and worked on its different applications like enroll subscriber/member,
• Performed Cross-Browser Testing on different browsers for 508 compliance test
• Used TOAD for Oracle in creating & executing SQL queries for testing ETL process.
• Developed and verified the request codes, response codes, and reason codes using Distributed Applications Technology using JAVA, JDBC and XML.
• Used MQ test and SoapUI for XML response for the member information from Siebel GUI interface purpose and WSDL files uploaded in SoapUI testing using client security certs.
• Updated daily stats of blocked, failed and passed test case and logged execution time in JIRA.
• Identified Test Data by querying and created Test scripts for SIT, Regression and UAT.
• Used various CPT (Claims Test Pro) functions including, Member and Provider Conversion, Created Keyword and EDI File and Modify the Member Data as per the Business Requirement Document and as per the test case. performed All phases of end-to-end testing which includes Smoke testing, Functionality testing, Integration testing, Regression testing, back end testing etc.
• Used JIRA to get DB reports of test runs from DBA team.
• Wrote SQL queries for data Validation
• Rueried the DB2 database in Mainframes for the Proper validating the claims into the Database.
• Used Quality center to developed test cases in Test plan module and executed test cases in Test Lab Module and logged the defect in defect Module.

Environment: Facets 5.01, Edifecs transaction Management, MDE (Medical Data Xpress) Xpress Claim Test Pro, HIPAA EDI, Quality center 10.0, Microsoft visual studio 2010, Java, DB2, JIRA, Ultra edit compare 8.5-0-1025, Microsoft SQL server 2008 R2 (SQL server management studio), Microsoft Out Look, SQL, SOAP UI, web-services, Microsoft Office communicator 2007, share point

Sr. QA Analyst

Responsibilities:

• Preparation of Requirements traceability matrix for each legacy systems to ensure the data migration is achieved with accuracy.
• Preparation of Requirements traceability matrix for HIPAA compliance, various business rules depending on the state and ensuring the MetaVance functionalities are in compliance.
• Performed 508-Compliance Testing on web-based applications.
• Used MS Sql server Management studio for Creating & executing SQL queries for testing the conversion & ETL process .
• Participated in JAD sessions to ensure appropriate scope management for MMIS.
• Analyzing Data Processing implementing Data Mart applications mainly transformation processes using ETL tool and understanding of ETL workflows and ETL mappings and also monitoring the Production Environment.
• Responsible for validating and testing clear ICD-9 to ICD-10 conversion.
• Responsible for gap analysis in changing old MMIS and Involved in testing new MMIS.
• Developed test cases and test documents used for configuring software to meet needs of ICD-10 readiness.
• Knowledge of 837, 835, 276,277, 270, 271, 834, HIPAA EDI and X12 transactions.
• Writing system test plans, test scripts, check lists and its review.
• Experience in testing using message queues (JMS) in SoapUI/GEMS or any supporting tool.
• Extensively performed Manual testing process to ensure the quality of the software.
• Involved in Manual testing using Quality Center to develop test cases, test scripts, executing the scripts and logging the defects.
• Involving in writing the test cases and execution based on the documents such as BRD provided from business users.
• Used SOAP UI for testing web services (request XML and response XML).
• Responsible for special projects, external audits, evaluations and process improvements in support of governance initiatives while working on MMIS application.
• Created Use Cases, Use Case Diagrams, Activity Diagrams, Sequence Diagrams using MS Visio supplement the BRD and FRD.
• Involved in production tickets triaging. Analyzed ticket, Provided RCA, Raise defects, tested again after fix.
• Develop scripts and test cases for Integration Testing, Regression Testing and Stress Testing.
• Extensively used SQL scripts/queries for data verification at the backend.
• Interaction with the legacy SME, business, IT team and HP for technical clarifications.
• Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Medicaid Claims. Worked on EDI transactions: 834, 835, and 837 (P.I.D) to identify key data set elements for designated record set. Interacted with Claims, Payments and Enrollment hence analysing and documenting related business processes.
• Interaction with the QA Team, Business Analyst and Delta IT team for status reporting and tracking.
• Work with Release Management Team to ensure that the correct version of code is pulled from SCCS for the respective testing cycles.
• Analysis of the defect and its root cause, thereby generating the RCA report.
• Managed the execution of SIT and Regression testing for timely delivery of high quality deliverables.
• Familiar with SCCS and was involved in code review with the development team in certain cases to help facilitate troubleshooting and identify the root cause of the bugs reported.
• Worked closely with the legacy team and HP to ensure adequacy of testing through clear understanding of Design aspects and business requirement.
• Logged the issues in internal bug tracking tool JIRA and QC (ALM) as well.
• The areas of online application testing I covered were Membership, Benefits, Claims processing and Billing.
• Prepare and deliver an in-depth presentation on agile methodologies and software craftsmanship including Scrum.
• The Batch testing covered the membership, benefits validation, claims adjudication and processing, payment processing and billing batch jobs. This also covered the legacy data load for each of the functional areas.
• Prepared Robust Regression Test scripts to test each new release provided by MetaVance team.
• Conduct Critical performance tests for the claims adjudication and payment processing systems.

Environment: Oracle, PL/SQL, DB2, SQL Developer, UNIX, Windows XP, web-services, JIRA, SOAP UI, HP Quality Center, Facets, MS-Office, Agile, ALM/QTP.

Sr. QA Analyst

Responsibilities:

• Analyzed use-case document and functional requirement specification document.
• Prepared and maintained the Requirement Traceability Matrix to ensure completeness.
• Created test cases and test data from the functional requirement specifications.
• Primarily responsible for reviewing the approved Change in Requirements and analyzing and identifying the impact to existing test cases and scripts.
• Primarily responsible for reviewing the approved Change in Requirements and identifying and preparing the new test cases and test scripts.
• Hands on experience on numerous Healthcare domains and knowledge of HIPAA, EDI (834 and 837) and HIX (Health Insurance Exchange)
• Extensively used ETL methodology for supporting data extraction, transformations and loading processing, in a corporate-wide-ETL Solution using ETL tools like Informatica and Data Stage
• Worked on Medicaid Recipient processing including specialized knowledge of Recipient processing, Portals, and Enrollment Subsystems of MMIS.
• Involved in Black box, Manual Testing and prepared Test Suite for all the Test Cases.
• Created different document and matrices like test log, test incident report, test coverage matrix, tractability matrix etc.
• Generated test reports and test cases using QC.
• Experienced at testing ETL's and flat file data transfers without relying on a GUI layer.
• Tested the system to verify the compliance with HIPAA in terms of privacy, security and standards
• Conducted review sessions on regular basis with QA and development teams for preparing status, delivery report and client reporting for MMIS testing.
• Worked on solving the errors of EDI 834 load to Facets through MMS (Membership maintenance sub-system).
• Involved in detailed Functional and GUI testing and User acceptance testing (UAT).
• Involved in writing SQL queries for Backend data verification, retrieving data from related tables and Testing.
• Conducted End-to-End testing of the system manually.
• Detected bugs and reviewed them with business and developers and classified them based on the severity.
• Generated various Reports for PMO including Weekly Status Report and Open Defect Report using Excel.
• Conducted the Regression tests for already reported Bugs and change requests to test whether fix has been applied or not and to test and ensure the fix does not cause a new problem or break existing functionality.

Environment: Windows XP, HP Quality Center, UNIX, Oracle, Java, MS-Office.

QA Analyst

Responsibilities:

• Reviewed the Requirements document for 4010 and prepared the test plan and test cases.
• Involved in Manual Testing of the application.
• Conducted functional, system, data and regression testing.
• Interacted with the Developers and BA for defects and problem resolution.
• Wrote SQL statements to extract data from Tables
• Worked with transactions and validated the data by using SQL.
• Generated Bug Reports and Test case coverage reports for status meeting and also involved in resource planning for test cases coverage
• Responsible for testing all new and existing ETL data warehouse components.
• Involved in Bug Review meetings and participated in weekly meetings with management team.
• Provided testing results and weekly status reports to the QA Manager
• Using FTP we upload and download files for testing data
• Using Text pad to validate the data
• Involved in the error checking and testing of the ETL programs using Informatica session log and workflow logs.
• Tested the web services for Provider and Recipient Portal.
• Designing test scripts for testing of Claims in Development, Integration and production environment.
• Involved in testing HIPAA EDI Transactions (837I/P/D, 270/271, 276/277, 835,834, 820) for 4010
• Involved In loading the flat files into Oracle Database and involved in writing Complex SQL Queries.
• Involved in writing Complex SQL Queries using TOAD to validate the loads.
• Validated the data on web screens against the data points and database.
• Validated the data on screens against the database
• Prepared Test Plan and testing strategy for both ETL and BI testing needs.
• Wrote the SQL queries on EDW tables and Data Mart Staging Tables to validate the data results.
• Record Count Verification DWH backend/Reporting queries against source and target as an initial check and incremental loading check.
• Assists in the confirmation of problems reported from outside sources, and assists system development staff in understanding problems and desired resolution.
• Backend testing of the DB by writing SQL queries to test the integrity of the application and Oracle databases
• Responsible for writing version release notes as well as maintenance of the defect tracking system
• Maintained Metrics participated in weekly status updates showing the progress of the testing effort and open issues to be resolved.

Environment: Oracle 11g, Ms Office, Text pad, UNIX, FTP client, Clear case, Clear Quest, Spec builder 6.2/7.0, Quality Center, Cognos, Informatica.