SUMMARY:

• Over 18 years of extensive hands on experience with Project Life Cycle management, Documentation, Interface analyst Methodologies, User acceptance testing, system testing, functional testing and implementation of RUP software quality.
• Proven experience in QA Audits, Impact Analysis, Risk Analysis, Root Cause Analysis, Defect Management, Technical Architecture, Design, Development and Delivery experience.
• Proven experience in the creation of HL7 Interfaces and Design Document for multiple hospital systems
• Proven experience as system analysts in the creation of user requirements, procedures, and problems to automate or improve existing systems and review computer system capabilities, workflow, and scheduling limitations.
• Hands on experience in all types of testing such as Black Box, White Box, Sand Box, Regression, Integration, Load, Stress, Performance and User Acceptance testing, Model creation, Use case development, and Business Case Validation. Developed Test plans, Test Templates and Test cases.
• Expert knowledge in Development Methodologies (Waterfall, RUP and hybrid)
• Extensive business domain knowledge and experience in Healthcare, Banking, Pharmaceutical, Insurance, and Engineering industries, Web/Internet based businesses, EDI/back - end integration, Client/Server Internet, application development, testing and delivery experience.
• Recognized for creativity and innovation in the resolution of difficult and complex situations. Exceptional inter-personal and communication skills, a creative problem solver and enjoy complex, difficult challenges.
• A highly experienced QA Architect, SQA Analyst, Interface Analyst, Business Analysts and Senior Programmer Analyst Professional with more than fifteen years of IT experience. Diversified skills including design, coding, debugging, analysis and testing of mainframe, client/server and web based applications in the financial, government, insurance, communications and healthcare industries.
• Expert knowledge in the creating of plans, test cases, test scripts, regression, interface, integration, performance and load testing.
• Expert knowledge in design coding of mainframe application testing including debugging, technical design and system design.
• Led a team of more than 15 testers both nationwide and offshore.
• Great knowledge of Data Warehouse/datamart and the loading of it from multiple source systems.
• Expert knowledge in development methodologies (Waterfall, RUP, SDLC and TAF (Test Architecture Framework) and hybrid).
• Excelled in solving technical issues and communicate the results to the appropriate member.
• Recognized for creativity and innovation in the resolution of difficult and complex situations.

TECHNICAL SKILLS:

Quality Assurance Software Tools: File-Aid, File-Aid/DataAger, File-Aid/DB2, File-Aid/RDX, Xpediter/Exchange, SQA Suite, Comparex, (LoadRunner Knowledge), (QTP Knowledge), HP/Quality Center version 11.0.0, WinRunner, PVCS, SQA/IBM/Rational Suite, ClearQuest, Hyper Station, Open Connect 1.7.3, (Strobe, Compuware QA Tools) and Peregrine center

Operating Systems: IBM/DOS, MS DOS, MVS/OS 390, UNIX and Windows

Software Languages: Micro Focus COBOL, System/370 assembler (ALC), COBOLII, Easytrieve, Visual basic, C++, Java Scripts and ADS+ 7.0

Window Applications: MS Excel, MS Access, MS Word, Visio, Microsoft project and PowerPoint

Databases: Oracle 10.0, VSAM, IDMS/ADSO, Sybase, IMS DB/DC, DB2 11, Model/204, Total, SUPRA (Cincom), IAM, SQL Server 2000, EPIC Chronicles, TeraData Warehouse and DAF

Middleware: IBM Mqseries

Interface Engine: E-Gate, Neon, Cloverleaf and Vitria.

Utilities: OS/JCL, CICS, MANTIS, Endeavor, ChangeMan, ISPF/TSO, Librarian, SyncSort, SAR, Abend-Aid, LU 6.2, SPUFI, DB2/QMF, HUMMINBIRD, SQL Advantage IDCAMS, IEBGENER, IEBCOPY, BTEQ (Basic teradata Query) Teradata, SQL Assistant and TOAD.

Vendor Products: Medipac, HBOC MHealthquest, Maxmc, Macess, Epic(Bridges Interface,Hyperspace) COMLINK, NASCO, Flexilab,Flexirad Sunquest,Vantage QA IBM, Powerscribe, CERNER clinical system, Cognos Impromptu, PLASM, Confidential Facets 3.11,4.41,4.51,4.71,4,81.5.01 and Confidential QNXT, Amisys Advance,e Misys, ITS 10.1, McKesson ClaimsXten, McKesson ClaimCheck, EASYGroup, Market Prominence, Ramtech HealthSuite and QNXT 5.3

Other: Mercator, Gentran, ECMAP, Claredi, SNOMED CT, Confidential HIPAA Gateway, XML, HL7, EDI, WSF2, Business object and Data Mart

Methodologies: RUP, Hybrid and Waterfall

PROFESSIONAL EXPERIENCE:

Confidential, Richmond VA

Environment: QNXT, Payspan.Macess,Vital,Pivotal,Trapeze,.Dataware and Microsoft office.

Senior QA

Responsibilities:

• Wrote test stragety for regression testing
• Wrote test plannig document for upcomng QNXT upgrade
• Validate X12 834 hipaa 5010 files for data accuracy continue to create other matrix document for 2018 QNXT upgrade

Confidential, Philadelphia PA

Environment: XP, ALM,QC, AMISYS MARKET PROMINENCE, EXETER,DOVETAIL Oracle and Microsoft office.

Senior QA

• Wrote test script for Members benefits verification
• Wrote test scripts for SIT testing
• Wrote test scripts for Claims
• Execute test script for Medicare membership enrollment
• Wrote test script for membership enrollment

Confidential, Washington, PA

Environment: XP, Parature, Pervasive, HealthSuite, Cobol,Cics, Java, Unix, IBM Websphere, DB2 and Microsoft office.

Sr. Senior QA

• Wrote test script for Members benefits verification
• Wrote sql statement for to extract providers, claims and member information for validation
• Wrote test scripts for Mercato products testing
• Wrote configuration scripts for Plan, product and benefits
• Wrote configuration scripts Customer Fee schedules
• Wrote test scripts for claims processing
• Wrote test scripts for SIT testing
• Wrote test scripts for ICD10
• Wrote test scripts for DOD member enrollment and claims processing paying out-of-network Medicare claims and standardizing contract management practices for hospitals anwrote test scripts for EASYGroupd physicians.

Confidential, Cincinnati, OH

Environment: XP, AMISYS, HP Quality Center,HP ALMand Microsoft office.

Sr. Senior QA

• Wrote test script for Members benefits verification
• Wrote test scripts for facets products testing
• Wrote test scripts for Claims Adjudication for member Eligibility, Provider/PCP/Network and Pricing
• Wrote test scripts for SIT testing
• Wrote test scripts for UAT testing

Confidential, Raleigh, NC

Environment: XP, Confidential Facets 5.01 Networx, Pricer/Modeler, Mysql, X12,Web, Mainframe, HIPAA Gateway,Citrix. Salesforce, Connecture, ITS,Quality Center and HP ALM.

Senior configuration QA

• Wrote test scripts for Benefit Configuration
• Setup/configure parent group, group and subgroup for members
• Wrote test scripts for facets products testing
• Wrote test scripts for claims processing
• Wrote test scripts for SIT and UAT testing
• Wrote sql statements using Mysql to query Confidential Facets and custom tables.
• Wrote test scripts for Institutional, Professional Dental Claims using ICD 0 Format
• Configure benefits core facets for subscriber and benefits testing
• Configure benefits using the Benefit Configurator application to create and maintain Facets products and models of Facets products
• Configure benefits using the component Modeler application to create and modify collections of component types and IDs that can be used as a model when creating a Facets product.
• Configure benefits using the Variable Component Modeler application to establish and modify collections of variable component benefit levels that can be used as a model when creating a Facets product
• Wrote test scrips Claims Adjudication for member Eligibility, Provider/PCP/Network and Pricing
• Test Connecture membership and group enrollment.
• Wrote test cases for agreement and benefits testing.
• Wrote business user document for Confidential Facets wire retrieval and direct debit applications.
• Wrote test script and test case for system testing
• System Perform integration testing
• Wrote test scripts for ITS home
• Conduct research for provider and member payments.
• Wrote test scripts for hospital and medical claims.

Confidential, Madison, WI

Environment: XP, Confidential Facets 4.81 Networx Pricer/Modeler, Mysql, X12,Web, Mainframe, McKesson ClaimsXten, McKesson ClaimCheck DataWarehouse, HIPAA Gateway,Citrix,Xpress Claim Test Pro and HP Quality

Sr. Senior QA

• Served as a Sr. QA participated in the writing of test Script and give recommendation to client to improve process and the creation on test cases and scenarios and the execution of theses scripts for the Facets or 4.81 implementation
• Wrote sql statements using Mysql to query Confidential Facets and custom tables.
• Wrote test scripts for Institutional, Professional Dental Claims using ICD 0 Format
• Wrote test script for Confidential provider verification.
• Wrote test scripts for the HIPAA gateway interface testing.
• Tested interfaces that using the HIPAA Gateway.
• Wrote business user document for Confidential Facets wire retrieval and direct debit applications.
• Wrote test scripts for SIT testing and participated in the execution of these scripts
• Wrote test script and test case for system testing
• System Perform integration testing
• Conduct research for provider and member payments.
• Wrote test scripts for hospital Claims
• Created binary true table for complex claims validation.
• Wrote test scripts for Pharmacy claims
• Wrote test scripts for providers
• Used Claim Test Pro to assist in the testing process of:
• Reduce over payments to providers, Reduce administrative costs.
• Reducing errors in provider payments reduces manual rework, helping drive down costs.
• Reduce test cycle time.
• Reduce critical defects introduced to production.

Confidential, Dayton, OH

Environment: XP, Confidential Facets 4.71 Networx, Pricer/Modeler,, Oracle, X12,Web, Business Objects 6.5, SQL Server, Citrix and HP Quality Center, Cisco Tidal and X press Claim Test Pro

Sr. Senior QA and BA

• Validate results using Excel and Mercury HP quality center
• Wrote test scripts for Institutional, Professional Dental Claims using ICD 0 Format
• Wrote sql statements using SQL Advantage to query Confidential Facets table
• Wrote test script for Confidential provider web verification wrote test scripts Claims Adjudication for member Eligibility, Provider/PCP/Network and Pricing
• Wrote test script for Business Object report testing
• Wrote test script for Ingenix HSS APC Grouper/Price Calculation
• Validate MAXIMUS application confinement result test cases
• Wrote business user document for Confidential Facets wire retrieval and direct debit applications.
• Wrote business user document for NetworX Pricer standalone product
• Wrote test scripts for NetworX, Pricer/Modeler
• Wrote test scripts for UAT testing and participated in the execution of these scripts
• ·Wrote functional test scriptsfacets
• Wrote test scripts for Facets Billing
• Used Claim Test Pro to assist in the testing process of: Reducing over payments to providers, Reduce administrative costs. Reducing errors in provider payments reduces manual rework, helping drive down costs. Reducing test cycle time. Reducing critical defects introduced to production.

Confidential, Philadelphia, PA

Environment: IKAsystems, Data Warehouse, ArgusHealth, X12,Facets 4.7.1 HP quality center, Oracle, RxFocus, SAS, COGNOS, MS SQL server 8.0.

Senior QA

• Advised client of the best method for integration testing in a Data Warehouse environment.
• Created system testing reporting document for ETL testing verification.
• Created testing artifacts documents for project.
• Created test strategy and plan for data warehouse and performance testing
• Wrote test scripts and test cases for performance and system testing

Confidential, Los Angeles, CA

Environment: XP, Mainframe, TRON, IBM, DB2, Oracle, Teradata Warehouse, Basic Teradata Query (BTEQ), Teradata SQL Assistant/Web Edition, ETL, IRWIN, Web, Business Objects.

Lead QA ARCHITECT

• Advised client of the best method of integration testing in a data warehouse environment.
• Created unit testing reporting document for ETL testing verification.
• Created testing artifacts documents for project.
• Created test strategy for semantic layer testing
• Use Teradata SQL within BTEQ
• Use comments within a BTEQ session
• Run BTEQ batch jobs
• Create and use scripts, run files, and macros
• Use the REPEAT and the HANG command, interrupt and abort requests

Confidential, Schenectady, NY

Environment: XP, TrizettoTriZetto Facets 4.51 NetworXPricer/Modeler, Sybase, Oracle, Web, Business objects 6.5, Macess, MAXMC, Ruby reports, SQL server, citrix and hp quality center.

Sr. QA

• Validate results using Excel and Mercury HP quality center
• Wrote SQL statements using SQL Advantage to query Confidential Facets table
• Wrote test script for MVP and CIGNA provider web verification
• Wrote test script for Business Object report testing
• Wrote test script for Ingenix HSS APC Grouper/Price Calculation
• Validate MAXMC application confinement result test cases
• Wrote business user document forTriZetto Facets wire retrieval and direct debit applications.
• Wrote business user document for NetworXPricer stand alone product
• Wrote test scripts for NetworX, Pricer/Modeler
• Wrote test scripts for UAT testing and participated in the execution of these scripts

Confidential, Detroit, MI

Environment: XP, MVS/390, Confidential Facets, NASCO, DB2, ORACLE, CICS, ITS, Oracle, IMS DB/DC FILE -AID, peregrine, MS ACCESS

Sr. QA Lead

• Built and managed team from use case writing to application tester.
• Created test strategy and got sign-off from the client
• Wrote test plan for ITS provider Audit
• Managed client test team as well ours, also managing client expectations well and delivering quality test effort on time and within budget.
• Wrote query against Teradata to extract data for user reporting purposes and user acceptance validation.
• Wrote query to extract data from data marts for reporting.
• Used BusinessObjects to extract data from the universe data based on the metadata.
• Managed the entire testing at our Test Labs and delivering reports online and on a timely fashion.
• Wrote scripts to test ITS Home and Host claims for NASCO.
• Used Open Connect Web based applications to access NASCO legacy data by calling these java objects, securely retrieving information from the mainframe.
• Use the Point and click transactions that are created at design time and business logic that are is easy identified.
• Used multiple host screens, local database and legacy transactions that are were condensed in to single screens. Multiple host screens, local database and legacy transactions may be condensed in to single screens.
• Deployed web service through eclipse and maintaining versions on different region (dev, test, and production).
• Wrote RTM for project
• Wrote system test cases Provider Data Audit
• Wrote test Grid using Microsoft excel for PDA (Provider data Audit)
• Create UAT test grid
• Wrote UAT test scripts
• Wrote functional test scripts
• Execute mainframe job streams to test P&A claims Physician Assistant billing, PA and registration via MQSI and Confidential Facets 4.41
• Used NDM to send Confidential Facets and BCBSM claims to IBM

Confidential, NY

Environment: Windows XP, MVS/390, DB2, LRSP, CICS, IMS DB/DC FILE -AID, MS ACCESS

Sr. QA Lead

• As a senior QA lead wrote Test plan for Blue card balancing
• Wrote the test plan for BlueCard adjustment.
• Wrote ETM for multiple test environment for LRSP (Long range system planning), Financial Processing-Disbursements and ITS.
• Defined testing environment
• Cognos Impromptu to create reports from IBM DB2 tables and distribute them to business users across the organization for better decisions and improved corporate performance.

Confidential, MD

Environment: Windows XP, MVS/390, DB2, CICS, FILE -AID, Microsoft suite

Business Analyst

• Wrote program requirement for documentation for developer to modify in-house system
• Wrote file extract processing tool using FILE-AID to extract FEP, MAJOR MEDICAL and Medicare claims from FLEXX claims file.
• Create HIPAA cross-reference excel spreadsheet for HIPAA rejection code mapping.

Confidential, Detroit, MI

Environment: Windows XP, MVS/390, DB2, CICS, FILE-AID, NASCO, ITS, MS ACCESS and IBM Rational suite

SR. QA

• Work with another team member in the creating of a QA department.
• Used Compuware file-aid tool to extract data from IBM Mainframe to a client server application via Oracle tables.
• Used Compuware file-aid tool to extract NASCO CLAIMS from the local system and populate NASCO TRLOG file.
• Wrote scripts to test ITS Home and Host claims for NASCO.
• Wrote manual test scripts using IBM rational test manager to test claims for new groups that was added to BCBSM national plan.
• Wrote SQL using IBM Rational Robot to extract data from Oracle and Access table; and populate the claims tables for the NASCO nightly run application.
• Wrote test case and manual script using Rational test Manager to verify claims results.
• Used Rational RequisitePro to load project requirement

Confidential, CA

Environment: UNIX, mumps database, IBM MQseries, Test Director 8.0 and HL7

SR. QA

• As a senior tester wrote test cases and test scripts using Test director for EPIC-care (bridge interface), and Misys Laboratory system.
• Added patient data to Chronicles database using EPIC Reg/ADT hyperspace screen.
• Tested HL7 Logical Observation Identifiers Names and Codes (LOINC) for Laboratory (Misys) results and orders via EGATE
• Interface engine and MQseries integration broker system in a UNIX environment.
• Execute Manual test scripts using HP Test director.
• Create order using EPIC hyperspace patient management Reg/ADT

Confidential, Southfield, MI

Environment: Windows XP, UNIX, MVS/390, DB2, CICS, FILE-AID, Microsoft suite, SYSBASE, Confidential Facets, NASCO, ITS,Business object, Oracle, HUMMINBIRD, Gentran, Endevor, BRIO SQR, and Claredi.

SQA Lead

• Wrote test plan for HIPAA 837 professional and institutional
• Created test cases for (835 Health Care Claim Payment/Advice institutional, dental, professional), (837 institutional, dental and professional) HIPAA transactions on an IBM Mainframe.
• Wrote test scripts for HIPAA transactions for online line and batch processing on an IBM Mainframe.
• Modified and create RTM for HIPAA transactions.
• Wrote multiple SQL statement for DB2 databases using SPUFI and QMF to view results.
• Used Claredi to verify that the incoming 837 claims and the outbound 835 Health Care Claim Payment/Advice transactions from EDI are HIPAA ANSI X12 compliance.
• Wrote UAT test scripts
• Wrote functional test scripts
• Created test grid for HIPAA transactions. worked with user to define user acceptance test cases.
• Wrote script to test UB92 version H Medicare Part A national standard format from version 6.0 records
• Modify RTM and create data map for Medicare & Medicaid Services HCFA 1500 Medicare claims

Confidential, Santa Rosa, CA

Environment: Windows, JAVA, C++, VB, ATM and Rational Clearquest.

SQE Lead

• Wrote the test plans and scripts for WEB remote application. Execute test cases for ESA, and PSA Spectrum analyzers via the Web.
• Wrote C++ program to calculate Mean and standard deviation for FFT in an NT environment
• Wrote multiple VB Scripts using via COM API application.
• Coordinate meeting and steer team to follow testing methodology fundamentals.
• Created baseline scripts for testing PSA, VSA, ESA Spectrum analyzers and Infinium scope.
• Submit multiple defects using ATM and Rational Clearquest application.
• Wrote UAT test scripts
• Wrote functional test scripts

Confidential, Malvern, PA

Environment: Legacy, VSAM, DB2, UNIX, IBM MQseries, VB 6.0, Candle and IBM Rational suite

SR. QA

• Wrote project the requirement for automated environment monitor using Rational Robot REQ PRO 4.5.
• Wrote test scripts and test the availability of the WEB using rational team test 7.1.
• Wrote test scripts to connect to MQSERIES server via UNIX.

Confidential, CA

Environment: UNIX, Vantage QA and NEON INTERFACE ENGINE and HL7

SR QA/Analyst

• Execute stored procedures using Oracle database.
• Wrote SQL query to access and update Oracle Laboratory database.
• Wrote UAT test scripts
• Wrote functional test

Confidential, San Antonio, TX

Environment: Legacy, Healthquest 2000, McKesson medipac, PAS, CLOVERLEAF, CICS, HL7, ADS/PLUS, VSAM, IMS DB/DC and DAF

Senior Prog/Analyst

• Modified and tested programs for the following HealthQuest Modules:
• Patient management, Patient accounting Receivables,Registration, Prebill, Revue cycle Utilities
• Physician Line Item,Medic cal records/utilization,Chart Management,Patient care and Patient appointment
• . Modified HealthQuest Patient Accounting and HealthQuest patient management system using ASC X12N format for Medicare-A & B, Medicaid, Champus Military Personnel and commercial insurance.
• Modified HealthQuest Patient Care and tested screens vs*) modified HealthQuest Patient appointment files and map(kc*)
• Tested every screens in the HealthQuest application
• Modified medical records programs and tested (KM*) maps
• Modified HealthQuest programs to send ADT interface to CLOVERLEAF
• Tested PAS and billing Medipac systems in a MVS mainframe environment.

Confidential, New York City, New York

Environment: Legacy, UNIX, RISC6000, AS400, Healthquest, Medipac, CLOVERLEAF, DATAGATE, HL7, DB2, Powerscribe, file-aid, DATAGATE, ADS/PLUS, VSAM, IMS DB/DC,MODEL 204, Compuware QA Run, Winrunner and DAF.

SR QA/Analyst

• Executed compliance and integration testing on vendor applications incorporated into the network.
• Tested Health Quest 2000 patient management system in a MVS mainframe environment.
• Tested the following HealthQuest Modules:
• Patient management, Patient accounting Receivables,Registration, Prebill, Revue cycle Utilities
• Physician Line Item,Medic cal records/utilization,Chart Management,Patient care and Patient appointment
• Tested laboratory systems using DATAGATE and Cloverleaf interface engine.
• Tested mainframe applications using Compuware File-AID testing tool.
• Recorded application results in the QA test repository and created appropriate reports for the lead person for the project
• For him/her to understand in HL7 format and to ensure that the interface engine DATAGATE is receiving the correct ADT records.
• Tested interface for HBOC Medipac Financial system using ASC X12N format for Medicare-A & B, Medicaid, Champus
• Military Personnel and commercial insurance.
• ·Wrote UAT test scripts
• ·Wrote functional test scripts