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Quality Analyst Resume

Cleveland, OH


  • 7 years of experience in Quality Assurance and Software Testing in healthcare industry.
  • Extensive knowledge of all aspects of the Software Development Life Cycle and Defect life cycle.
  • Experience in requirement analysis, creating traceability matrix, test planning, creating test data and implementation of test suite (test plan, test scripts and test cases).
  • Extensive experience in testing Client/Server and Web - based Applications and Service based Architecture.
  • Strong Knowledge of waterfall model, V-Model and Agile methodology of SDLC.
  • Expertise in logging and tracking Defects using Defect Tracking Tools like HP Quality Center, HP ALM, Bugzilla & JIRA.
  • Good knowledge on different modules within healthcare (Membership, billing, enrollment, Claims, capitation, providers).
  • Tested HIPAA regulations in Facets HIPAA privacy module.
  • Experienced working with 5010 transactions changes analysis, design and migration strategy.
  • Have good knowledge of HIPPA 4010 /5010 versions.
  • Profound understanding of insurance policies like HMO and PPO and proven experience with Medicare, Medicaid, & commercial insurances in HIPPA 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).
  • Experienced in DW projects ETL testing against DW testing with Informatica and data stage tools.
  • Expertise in Cognos 8 Suite (framework Manager, Cognos connection, Report Studio, Analysis Studio, Metric Studio, Event Studio and Query Studio)
  • Proficiency in EDI 4010 to EDI 5010. And involved in conversion and mapping HIPAA ICD 9 to ICD 10.
  • Worked on QC and HP ALM (Application Lifecycle Management) and QTP (Quick Test Professional) and provided training for the same to the end users.
  • Experience in writing SQL queries and optimizing the queries in Sybase, Oracle and SQL Server.
  • Maintained Requirement Traceability Matrix and Test summery report.
  • Analyzed test results to ensure existing functionality and recommend corrective action where necessary.
  • Participated in UAT and wrote Test Cases for UAT.
  • Good experience with Sanity Testing, Smoke Testing, White Box testing, Black Box Testing, GUI Testing, Functionality Testing, Positive and Negative Testing, Security Testing, Integration Testing, System Testing, Load Testing, User Acceptance Testing (UAT) and Regression Testing of Web Based Applications and Client-Server Applications.
  • Good working knowledge of major Operating Systems such as Windows and UNIX
  • Experienced in ETL (SSIS) and data validation processes and proficient in reporting services such as SSRS as well as SSAS.
  • Ability to multi-task, prioritize and work with time constraints while paying attention to details
  • Excellent communication and writing skills with the ability to adapt to new and dynamic environments
  • Good team leader, Player and can work alone with minimal or no supervision
  • Good problem-solving, judgment, and decision-making skill


Testing Tools: Quality Center, Soap UI, Quick Test Professional and Rational Team TestBug Reporting: HP QC, Test Director, Rational Clear Quest, JIRA

Databases: MS-Access, Oracle, Sybase, MS SQL Server, MS Access

Operating System: Windows (XP, 2000, 98), Unix

MS Office Tool: Word, Excel, PowerPoint.

ETL Tools: Informatica PowerCenter, Ab Initio, SSIS and DataStage



Quality Analyst


  • Analyzed and defined testable requirements created and implemented test plans.
  • Developed Test Cases/Conditions for manual and Automation testing of the above Applications and Reports.
  • Gathered requirements from the users and analyzed the requirements.
  • Involved in performing functional, application, integration, system, and regression Testing.
  • Involved in testing Web services and XML using SOAP UI. Verified the response received by updating the request XML.
  • Recommend on implementation of HIPAA 5010 (EDI X12 837,834, 820, 278,270,999) in the new System.
  • Prepared and executed different SQL Queries against the Oracle and Sybase Database.
  • Verified and Validated the Rates Calculations and Rate Renewal Calculations for different Products and benefits by Preparing and executing different SQL Scripts.
  • Validate SSRS reports and ETL testing with use of complex SQL queries and UNIX scripting.
  • Performed data validation of reports created by SSRS.
  • Validate EDI Claim Process according to HIPAA compliance.
  • Worked on HIPAA Transactions and Code Sets Standards according to the test scenarios such as 270/271, 276/277,837/835 transactions.
  • Tested stored procedures and triggers on Sybase database to ensure data integrity.
  • Expertise in ICD 9 and ICD 10 Conversion Analysis. Full knowledge of the Diagnosis and Procedural Code changes for Healthcare Entities like Payers, Employer Groups, and Providers.
  • Entered Claims and Customer Service Tasks into the FACETS.
  • Worked on different EDI transactions like 837 for submitting claims, 835 for payments, 834 for benefit enrollment, and 820 for premium payments to insurance products, 270/271 for Eligibility inquiry, and 276/277 for claims status.
  • Set claim processing data for different Facets Module.
  • System Integration testing for Facets core modules with external systems.
  • Data mocking for different Claim file formats.
  • Conducted HIPAA Gateway Testing.
  • Tested the claims processing and Adjudication (EDI 837I, 837P, 837D& EDI 835).
  • Tested Subscribers/Providers and claims in Facets.
  • Tested the Membership and claims files (XML) in Facets.
  • Skilled knowledge of understanding and validating the X12 EDI format files 834 benefits and enrollment.
  • Responsible for creating the test plan and designing test cases for the EDI 834 members’ enrollment file loading Created reports that included a general overview, open bugs, new bugs and enhancement requests. Entered new bugs and maintained the current status of those bugs.
  • Responsible to work on Medicaid Management Information System which includes two divisions: HIPAA compliance and Maintenance units division and Claim processing division
  • Maintained Test Matrix and Requirements Traceability Matrix. Performed Gap Analysis on the same.
  • Involved in building XML modules that API testing test cases uses as input.
  • Tested Regression EDI834, 820 Transactions following the HIPPA compliance EDI Standard of X12.
  • Used TOAD Software for Querying ORACLE. And Used Teradata SQL Assistant for Querying Teradata
  • Involved in the error checking and testing of the ETL programs using Informatica session log and workflow logs.
  • Back-end testing using SQL queries for data validation, Web services testing - validation of data in XML files, SSRS Reports testing.
  • Analyzed and logged defects in ALM and interacted with the developers to resolve technical issues.
  • Reported and tracked defects using Quality Center.
  • Detecting, Tracking and Reporting defects to developing team lead using JIRA and QC following up the status of defects.
  • Generated reports using document generator of Quality Center.
  • Used Descriptive programming in scripting dynamic objects and reusable actions in defining scenario flows in Quick Test Professional (QTP).
  • Involved in using QTP for VB scripting, by using object repository, expert view, Object spy and other main functionalities.
  • Played key role in defining test automation procedure and standards, creating QuickTest Professional scripts for all the modules, which reduced the regression cycle drastically and improved the testing efforts for daily builds.
  • Developed automated scripts using QTP/UFT to perform functional and regression testing.
  • Did the Backend Testing by running the SQL Queries in DB2 Database.
  • Created and uploaded Requirements and Test Cases on HP ALM.
  • Extensively involved in analyzing, designing and implementing Automation Frameworks (Hybrid, Keyword, Data driven in QTP using VBScript
  • Worked on Data mapping, logical data modeling and used SQL queries to filter data within the Oracle database tables.
  • Created new UAT scripts based on requirements
  • Worked on creating templates for UAT test execution
  • Developed custom selection of reports ordering using SQL Server Reporting Services (SSRS)
  • Analyzed inbound X12 HIPAA files and execute Trading partner testing and integration
  • Performed System testing, Integration testing and Usability testing in Quick Test Pro by inserting various check points necessary for HIPAA and Medicaid standards.
  • Followed and Implemented the SDLC to improve the Testing Process and Efforts.
  • Tested the ETL Informatica mappings and other ETL Processes (Data Warehouse Testing)
  • Created UNIX shell scripts, mainframe procedures, and processes to extract data from various sources such as DB2 and Oracle.
  • Coordinated with the Business users, BA’s and Testers in order to perform UAT Testing.
  • Involved in Weekly Testing Status meetings with Testing Team and Weekly Rate Quote Task force meeting with Business Users and Developers.

Environment: HP ALM, QTP /UFT, VB Script, Informatica, HIPPA,ETL, Sybase, EDI, SOAP UI, Windows, Db2, SQL, PL/SQL, Oracle.


Quality Analyst

  • Discussed enhancements and modifications with the Project Team
  • Involved in developing Test Plan and created Test Cases as per the business requirements in Quality center for Patient Registration Module
  • Involved in preparation of Test cases, Test data in Quality Center for Report Repository upgrade.
  • Developed, maintained and executed Test scripts and Test scenarios on assigned products to assure product quality from a functional and qualitative perspective.
  • Validated 835, 837, 276, 277, Institutional and Professional HIPAA Transaction and X12 format messages.
  • Performed Database testing using DB2 Connect and Extra tools for verification of data tables in database.
  • Performed Table, GUI, Database, and XML Check Points in Quick Test Professional scripts to check the validity of the data.
  • Involved in claims submission and payment (remittance) retrievals by using ASCX12N 820 for the In- bound premium payments; ASC x12N 834 for the Inbound Enrollment and Maintenance; ASCX12 276/277 for the claims status enquiry and response; and ASC X12 835 for the Health care Claim Payments.
  • Worked on billing and payments in the provider module in Claims Test Pro (CTP) of Facets.
  • Wrote and executed complex SQL queries to retrieve data from Facets-Membership Enrollment modules.
  • Responsible for customer interface, requirements definition, general and detailed design, testing, maintenance and training programs and managed requirements using Rational Requisite Pro.
  • Developed SQL queries for data verification in MS SQL server, SYBASE and Oracle.
  • Negotiated and managed multiple priorities, project plans, time frames and trade-offs while ensuring the clinical and administrative staff understood the final results of the projects, sharing detailed vision of cost-benefit analysis
  • Writing Test Plans/Test Scenarios/Test Cases/Test Matrix. Fine-tuning of the database queries for better performance plans.
  • Developed System Integration and regression test plans.
  • Analyzed test cases for automation and used UFT (Unified Functional Testing), Quick Test Professional (QTP) to automate manual test scripts for Regression and Functional testing.
  • Logged the errors, reported defects, determined repair priorities and tracked the defects until resolution using ALM.
  • Extensively used ETL methodology for testing and supporting data extraction, transformations and loading processing in a corporate-wide-ETL Solution using Informatica.
  • Worked with Large DB2 and Oracle, SQL Server databases doing loading, validation and manipulation of data
  • Extensively used the Quality center ALM Test Plans, Test Matrixes, Test Scenarios and Test Cases for all company products. Conducting variance management by analyzing and verifying test results, providing Status and Progress reports and Automated Test Scripts, and Test Steps for all the modules and stored in JIRA
  • Prepared test matrices based through defect status in Quality Center.
  • Involved in using VB Scripts in QTP to access webpage script variables.
  • Responsible for Back-End Testing Using SQL Commands using TOAD.
  • Developed SQL queries, functions, stored procedures and triggers to perform the backend testing of the data
  • Performed User Accepted Testing (UAT) and Production client support.
  • Documented, tracked, and verified defects and enhancements by using Quality Center.
  • Reported Bugs using Quality Center.
  • Validated SSRS reports and ETL testing with use of complex SQL queries and UNIX scripting.
  • Performed data analysis and data profiling using SQL and Informatica on various sources systems including Oracle and Teradata.
  • Created user-defined functions and output values for the content builder and appliance by using QTP/UFT
  • Regularly troubleshoot unexpected circumstances.
  • Worked closely with the User Acceptance Test Coordinator, Project Manager and Business System Analysts to understand business processes and develop concrete UAT cases.
  • Planned designed, executed and evaluated Performance tests of web application and services.
  • Worked on developing the business requirement and use cases for FACETS batch process, automating the billing entities and commission process.
  • Analyzed results for validity and clarity.
  • Involved in configuration of Member and Provider Module in FACETS.
  • Completed tasks within duration and effort commitments.
  • Generated and recorded test scripts that provided extensive application coverage using QTP/UFT.
  • Wrote SQL queries for data Validation and outstanding knowledge of preparing simple/ complex queries.
  • Reported the project status and activities to the Lead on weekly basis.
  • Worked with the Developers, Infrastructure teams to resolve the issues.

Environment: Windows 2000/XP, Java, Eclipse, UNIX, DB2, SSRS, ETL, Oracle,Sybase, Facets, MS office, QTP /UFT, VB Script, ALM.

Confidential,New York

QA Tester

  • Elicit requirement to be able to generate the tools and info needed to process the ICD-10 information by 2013 (Claims Processing, Training etc.)
  • Mapping of ICD-10 codes to procedure and diagnostic codes in Facets.
  • Reviewing all codes and appropriately applying them.
  • Conduct meeting with the stakeholders and assess their accurate involvement with ICD-10.
  • Develop and coordinate implementation timelines with Trading Partners including readiness assessment and coordinated testing.
  • Documented defects in JIRA General Access (JRA) and helped DIA team & developers to identify the performance issues and modules to be fixed.
  • Identify processes and systems to enable to trade files with non ICD-10 complaint trading partner.
  • Help in preparing the ICD-10 context diagram.
  • Analyzed the ICD conversion information provided by the CMS and gained understanding of ICD-9 versus new ICD-10 codes sets.
  • Prepared Test Cases based on business requirements and business rules for HIPAA EDI Transaction 270/271, 837/835, 834.
  • Manually performed User Acceptance Testing of FACETS implementation.
  • Work as a Data analyst to set Facets data in Claims Processing, Members/Subscribers, Groups, Billing for different testing efforts.
  • Developed data quality test plans and manually executed ETL and BI test cases.
  • Performed Backend testing on Membership Enrollment of Facets functionality.
  • Performed manual testing to conduct backend testing using UNIX shell scripts and SQL Queries
  • Multiple 837 map set developed for each client (clearinghouse, internal, and external trading partners), as well unique mappings were needed in each map to accommodate various conditions dealing with Provider, Subscriber, PAY-TO and BILL-TO Provider information needed to identify multiple conditions dealing with batch Wrote and executed complex SQL queries to retrieve data from Facets-Membership Enrollment modules.
  • Responsible in handling Defect Tracking and Mapping reporting through Quality Center.
  • Enhanced the Test Scripts by adding Check Points in QTP / UFT.
  • Involved in the development of test plans and created test cases and test scripts needed to validate the requirement.
  • Analyzed and logged defects in Quality Center and interacted with the developers to resolve technical issues.
  • Used QTP Checkpoints (GUI, Database and Bitmap) for comparing behavior of Application from previous builds.
  • Help the developers to understand the requirements in order to design the software modifications needed to support the requirements.
  • Review Implementation Plan and testing types, techniques and environmental needs.
  • Defect Management & triage, provide expertise to resolve defects that raise business issues.
  • Reviewed existing QTP Test Scripts, and modified as required for new changes.
  • Developed custom selection of reports ordering using SQL Server Reporting Services (SSRS)
  • Tested the ETL Informatica mappings and other ETL Processes (Data Warehouse Testing)
  • Verified Informatica sessions, worklets and workflows in QA repository.
  • Worked with Teradata, Mainframes (DB2, Copy book, Sequential files), SQL Server and Oracle.
  • Actively involved in documentation of UAT (User Acceptance Test), Functional Test, Integration Test Scenarios and Bug Log.
  • Extensively used SQL statements to query the Oracle Database for Data Validation and Data Integrity.
  • Actively participated in weekly status meeting with Team members, Team managers, Business analysts & Technical team and also generated Weekly Status Reports to the Team manager.
  • Tracking Software defects collected from different sources and categorized severity in HP Quality center.

Environment: MS SQL Server 2005,, Flat Files, DB2, SQL Profiler, ETL, Claim Test Pro (CTP), SSRS, TOAD, MS Office, Facets, XML, Windows Server 2003, Quality Center, Agile Scrum, Test Plan, Test Cases, Test Scripts


QA Tester

  • Tested and delivered Inbound/Outbound Facets interfaces
  • Manually entered additional test claims data for those scenarios where a specific claim is not found in Production
  • Provided the test summary report to the QA lead and coordinated with the fellow QA lead to plane test execution by using JIRA.
  • Involved in Facets Implementation, end-to-end testing of FACETS Enrollment Claim Processing and Subscriber/Member module
  • Data mocking for different Claim file formats.
  • Conducted HIPAA Gateway Testing.
  • Participated in developing and implementing End-End testing.
  • Tested the GUI / User Interface of the Web applications.
  • Performed Functional testing on Facets, Customer service and Subscriber application under Facets
  • Participation in requirement / Use Case analysis, risk analysis and configuration management.
  • Transactions focused on were 270,271,276,278,834, 835, and 837.
  • Validated the reports and files according to HIPAA X12 enforced standards.
  • Automated Claims & Members screens in Facets using QTP.
  • Used Quality center for test cases, defect logging and defect tracing.
  • Involved in testing HIPAA EDI Transactions and mainly focused on PA and Eligibility Transactions.
  • Prepared Test Cases based on business requirements and business rules for HIPAA EDI Transaction 270/271, 834,837/835.
  • Created test data for 837I, 837D, 837P to have Segments/loops information with different combination of Submitter, Receiver, Billing Provider, Pay-To-Provider, Subscriber, Payer, Patient, Claim Information, Physicians, Referring Provider, Service Line Info, Adjudication Information
  • 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).
  • Identifying Test Scenarios, prepare Test Specification document and Test cases in MTM
  • Performed Manual Testing using Quality Center (QC) and User Acceptance Testing (UAT)
  • Created data structures by using SQL in Teradata & TOAD.
  • Developed SQLs for Extracting data from database and built data structures, reports
  • Designed and developed various Ad hoc, Daily, Weekly, Monthly and year-end reports for the Business Analyst using SQL, Ms Excel, Ms Access and Teradata
  • 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.
  • Created Data for XML Requests in SoapUI.
  • Analyzed business rules to generate consolidated (fact/summary) data identified by dimensions using Informatica ETL (Power Center) tool.
  • Maintained stored definitions, transformation rules and targets definitions using Informatica repository manager.
  • Scheduled sessions and Batch process based on demand, run on time, run only once using Informatica server manager.
  • Designed and developed user defined functions of QTP with well-versed VB scripting.
  • Used descriptive programming in scripting dynamic objects and reusable actions in defining scenario flows in Quick Test Professional (QTP).
  • 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, ANSI X12,MTM, JavaScript, HTML, XML, HIPAA, EDI, UML, MS Office, Windows XP/,Java/J2EE,.


QA Analyst

  • Conducted GUI and functionality testing using QTP.
  • Conducted data driven testing using QTP to conduct backend testing.
  • Created and executed the Test plan, Test Cases, Automation Test Scripts, and Test Steps for all the modules and stored in JIRA. Expert in Defect Tracking, Report generation and requirement tracking throughout the test life cycle using HP Quality Center.
  • Responsible for attaining HIPAA EDI validation from Medicare, Medicaid and other payers of government carriers.
  • Verifying Healthcare Eligibility, Claim, Benefit and Service using ANSI ASI X12 Standards.
  • Monitored the compliance mapping of transactions to the EDI transactions standards ANSI -X12.
  • Developed SQL queries, joins, functions, stored procedures and triggers to perform Back- End testing in Oracle Database.
  • Designed and developed Use Cases using UML and Business Process Modeling.
  • Developed QA Test Plan, test conditions and test cases, as well as assisted with QA team in System Testing using Mercury Test Director
  • Involved in creating reports for the end users using Crystal reports from the gathered requirements.
  • Developed User Manual and Provided User Training.
  • Performed UAT after the completion of the phase of development in the production environment and participate in JAD sessions for the second phrase.
  • Conducted User Acceptance Testing

Environment: RUP, UAT, UNIX, Java, SharePoint, Sybase, SQL, Microsoft Word, Project, Excel, PowerPoint, GAD (Gap Analysis Document), HTML, XML, SQL, MS Visio.

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