SUMMARY:

• Quality Assurance Analyst with over Seven years of experience in Software Testing for Health Care domain.
• Hand on experience with various testing tools such as Quality Center and Quick Test professional.
• In depth knowledge of different phases of Software Development Life Cycle, Testing Methodologies and level of Testing required at each phase.
• Highly inquisitive minded with excellent communication, presentation and analytical skills.
• Motivated and team player with an ability to work in corss functional team.
• Excellent understanding of Software Development Life Cycle (SDLC) and its modeling techniques like Waterfall, Agile Methodology, and Iterative Models (RUP - Rational Unified Process).
• Hands on experience in writing test plan, test cases (both positive and negative) and test scripts using HP Quality Center and Quick Test Professional for web based applications.
• Proficient in creating User Acceptance Test (UAT) Plans and implementing and coordinating UAT
• Extensive knowledge of HIPPA and different EDI transaction in 4010 and 5010 format.
• Experience in implementing of all informational aspects of our Client's Providers into the TrizettoFACETS system.
• Immense experience in various testing types like Functional, System, Regression, Performance, and UAT testing.
• Experience in Medicaid Management Information System ( Confidential ). Expertise in various subsystems of Confidential - Claims, Provider, Recipient, Procedure Drug and Diagnosis (PDD), Explanation of Benefits (EOB
• Experienced in performing manual testing and defect tracking using HP Quality Center and Clear Quest.
• Proficient in writing advanced DML and DDLSQL Queries for Backend Testing using tools like TOAD to check and analyze data integrity and validation.
• Skilled in creating test data including the Test Input Data, Test Output Data, Test Entry and Exit Criteria for different levels of Testing.
• Excellent knowledge of HIPAA standards, EDI (Electronic data interchange) Transaction syntax like ANSI X12, Implementation and Knowledge of HIPAA code sets, ICD-9, ICD-10 coding, Confidential and HL7.
• In depth knowledge of Design Technique, Basic Specification based Techniques used for Black Box testing.
• Well versed in Health Care with  HIPPA, HL7, EDI and x12  data formats and 270/271, 276/277, 278, 820, 834, 837 and 835 Transactions.
• Experience in regression testing using QTP and performance testing using HP Load Runner
• Excellent Analytical, Decision-Making coupled with good Coordination, communication and interpersonal skills describing a committed Team Player with an ability to handle multiple projects.

TECHNICAL SKILLS:

Programming Languages: C, C++, VB Script, HTML, SQL, XML.

OS: Windows 2000/XP/VISTA, Linux, Unix

Design tools: Microsoft Visio, MS Project

Databases: SQL Server, Oracle, MS Access

Testing Tools: HP Quality Center/ Test Director, HP Quick Test Professional, Load Runner, TOAD

Bug Tracking Tools: Quality Center, Rational ClearQuest, JIRA

PROFESSIONAL EXPERIENCE:

Confidential, Washington, DC

Sr. QA Tester

Responsibilities:

• Actively participated in all phases of testing lifecycle (TestPlanning, Test Analysis and Design, Test implementation, Evaluating Exit Criteria and documentation, Test Closure Activities).
• Analyzed Business and Functional specifications and interacted with Business analyst for formulation of test Plan, test cases and test scripts
• Understood and analyzed differences between 4010 and 5010 formats for each segment.
• Verified crosswalk for understanding major changes from ICD-9 to ICD-10. Drafted the major changes that would appear in ICD-10 version.
• Tested the claims processing  with   EDI transactions (270, 271, 834, 835, 837) in HIPPA and HL7 Environment.
• Worked on EDI 820 Payment Order/Remittance Advice files for Automated Clearinghouse (ACH) system and in ACH banking transaction.
• Worked with Mainframe Test Data Management and Mainframe Batch Testing.
• Mapped between multiple standards and formats by performing gap analysis between different versions of guidelines, mapping between multiple standards and formats, and migrating guidelines between different versions of healthcare standards using Spec Builder.
• Conducted testing of production and test data using mainframe platform (TSO and ROSCO).  
• Verified the EDI raw data as per 5010 formats.
• Participated in the walkthrough for the evaluation of the test plans with QA Lead and the development team.
• Involved in designing the Test plans, creating and running the automated and manual test.
• Manually Conducted Positive and Negative testing
• Wrote test cases and executed them manually from HP Quality Center to test the application for its functionality, system integration.
• Conducted review meetings with the development team to set a hard-freeze date and gather input for creating the Test Plans and Test Specifications.
• Involved in developing Test Plans and Test cases for the transactions 834, 835, 837,270/271, and 276/277.
• Wrote SQL queries to validate the flow of data across multiple platforms including mainframe , client, client/server, and web applications as part of unit, integration, system and regression testing
• Worked on EDI 834 Benefit Enrollment and Maintenance files.
• Set up definitions and process for test phases including Product test, integration test, system test and User Acceptance Test (UAT). Worked with end users to perform UAT Testing.
• Validated  HIPPA rules and HL7 Standards . Created User manuals for UAT testing.
• Performed System, Integration, Functional and Back End testing.
• Validated the reports and files according to  HIPPA and HL7  enforced standards.
• Using DEC-EDI performed data mapping of various data formats and conversion of data to the EDI format. Created Reports/Graphs using analysis tools.
• Wrote PL/SQL queries to do back end testing and validate source to target data.
• Performed functional testing of the application as per the 5010 changes.
• Responsible for writing PL/SQL Queries to find out that the data is correctly populated in each field.
• Used query analyzer to analyze PL/SQL scripts and fine-tune them.
• Documented and analyzed defects using Quality Center and tracked them to completion by communicating with the team

Environment: Quality Center, UAT, Quick Test Pro, Visual Basics, MS SQL Server, Window XP

Confidential, Atlanta, GA

QA 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
• Conducted Black Box Testing on the application and validated the dataflow in the application.
• Medication Management Improvement System ( Confidential ) is designed specifically for home health agencies and was proven effective in a recent clinical trial. 
• 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, 834 (both inbound and outbound) transactions
• Reviewing the Use Case Requirement, Functional Design Documents and Technical Specification documents.
• Creating Test Cases for changes from old Confidential and Involved in testing new Confidential .
• Tested HIPAA 834 Enrollments, 270/271 Eligibility Inquiry/ Response & 820 - Health Plan premium payments for Confidential .
• Performing Functional and GUI testing on Facets.
• Prepared test matrices based through defect status in Quality Center.
• 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.
• Validating member’s benefits against the benefits matrix.
• Analyzed and tested data on claims manually and writing queries on DB database for validating data.
• Involved in writing Detailed Test Plan for the Application under Test (AUT).
• Enhanced the Test Cases by analyzing the Specification Documents.
• Developed, implemented and executed test methodologies and plans to ensure software product quality as per the RUP methodology.
• Worked with Confidential team to provide project oversight for the initiation and planning phases of federally mandated project.
• Designing & Implementation of a new Underwriting System for the new Individual Line of Business catering to Confidential
• Worked on the conversion to 5010 transaction standards, ICD-10 code sets, and an integrated program eligibility system (for Medicaid, food stamps and more).
• Worekd on Medicare parts A, B and D as well as Medicaid Confidential modernization project.
• Used Unified Modeling Language (UML) for process modeling and use cases.
• Worked with Implementation of the Medicaid Modified Adjusted Gross Income changes and New Integrated Eligibility System.
• Worled on Confidential for Real-time processing of claims where providers can submit their claims and follow up immediately if they're being paid.
• Worked on the web portal for the development of new Web-based eligibility verification with additional eligibility information. Provider can go to the web to find if a member is eligible for a service.
• Responsible for training and testing of transactions.
• Tested the system manually and using automated tools.
• Involved in creation of test plan, test scenarios, test cases for unit, system and system integration testing.

Environment: Windows, Confidential, Oracle, PL/SQL, Data Stage, MS Excel, MS Project, RUP, UML, Requisite Pro, Clear Case, Rational Clear Quest, MS Office suite, MS Visio

Confidential, Minneapolis, MN

Quality Assurance Tester

Responsibilities:

• Analyzed business use cases and technical design specifications to create goals, test strategies, test cases and test scenarios.
• Designed detailed workflows for major testing activities covering all aspects of software testing of the customized FACETS system.
• Extensively created test cases for the FACETS claims administration and customer service modules.
• Performed manual and automated testing of subscriber/member enrollment, adding premium rates, billing, entity relations according to the organization’s rules and policies.
• Tested NetworXPricer functionality by creating the workflow for customers to automatically identify, prioritize and route claims according to specific criteria, such as provider contract provisions and date of submission.
• The auto pricing of the updates of the claims from the old codes to the new codes in NetworXPricer was tested using automatic QTP scripts.
• Involved in validation of HIPAA for 834, 837,835,270,271,276,277 claims.
• Worked with 834 document files on, Subscriber name and identification, Plan network identification, Subscriber eligibility and/or benefit information and Product/service identification.
• Responsible for validating HL7 messages before it reaches the “Integration Engine”.
• Handled both In-Bound and Out-Bound transactions.
• Sending validated HL7 transactions and checking error log for “Failed Transactions”.
• Conducted System and Functional, User-Acceptance (UAT) and Sanity testing of applications.
• Created Test scripts and UAT test cases and coordinated with the UAT Team and Project manager and performed User Acceptance Testing (UAT) with the Users.
• Enhanced the Loadrunner scripts by editing the code for pacing and iterations to test the update of customer claims.
• Partly responsible for HL7 System and Integration Testing on Clinical Trial.
• Analyzed various graphs generated by LoadRunner to identify bottlenecks and test results and provide suggestions and recommendations to clients for performance improvements as needed.
• Remotely monitored the output of Loadrunner for continuous evaluation and analysis.
• Using TOAD checked and updated the PL/SQL tables in database.
• Executed PL/SQL DDL, DML statements for checking the validity and integrity of the data in Oracle to perform back-end-Testing by using TOAD
• Recorded & forwarded test-logs on timely basis after automated regression test run.
• Involved in testing FACETS Provider, Membership, Claims and Product based applications and customer service functionality
• Logged defects and managed the defect cycle as per priority and severity

Environment: Quality Center, QTP, UAT, FACETS, NetworXPricer, WINDOWS, Oracle, MS Excel, MS Visio, HIPPA

Confidential, Oakland, CA

QA Tester

Responsibilities:

• Analyzed the Business Specification and created the test plan, test cases for functional testing.
• Coordinated the end-to-end testing efforts of the HIPAA compliance and EDI transactions.
• Tested Transactions for HIPAA compliancy, Tested and verified Code sets along with the Code Set Team
• Created Test plans and performed manual testing of the application to test the system for both the functional and business requirements using Mercury Quality Center.
• Prepared manual testing strategy documents and test plans, review sheets, enhancement requests and QA Performance reports
• Identified the high-risk points and the priorities of the application and was involved in Risk Assessment.
• User Acceptance Testing validated end-to-end business process, system transactions and user access, confirms the system or application is functionally fit for use and behaves as expected
• Prepare test data in HIPAA compliant X12N format for both inbound and outbound healthcare EDI transactions
• Put together a Team that would execute the (UAT) Test Cases.
• Performed both manual and automated testing
• Collected the Test Data in the pre-testing phase for positive and negativescenarios
• Tested the software using different browsers to study the compatibility.
• Created Manual and Automated Test Cases using Mercury Tools like Quality Center and Quick Test Professional.
• Performed GUI testing on various screens and verified the properties and functionality of the objects on various windows
• Categorized the test cases, test data and maintained separate test sets to execute various real time transactions and tested the new and modified pages, components added to the system
• Responsible for performance testing of claims processing module by using HP Load Runner.
• Performed load Tests to optimize the performance of the application.
• Updated the team status in Quality Center as how many test cases were executed, how many failed as compared to the total no of test cases in each module.
• Performed data validation testing by executing SQL queries on Oracle database.
• Wrote and executed complex SQL queries including JOINS to validate Back-end data.
• Maintained trailing history of the defects and defect tracking using ClearQuest tool.

Environment: Quality Center, QTP, Windows server, MS SQL Server, UAT, Clear Quest