SUMMARY:

• Work in an IT organization having professional work environment to deliver results which helps in customer satisfaction to customer delight. Progressively build a career in Quality Assurance field and implement testing process & quality standards for manual and automation testing.
• 6 plus years of IT and Management experience in Software Development Life Cycle (SDLC) and Project Life Cycle working as Quality Analyst and Strong knowledge and experiences of Health care.
• Documenting the testing activities including all Test documents, test execution results and defect reports and status reports
• Good experience with Test Director, Quality Center, Quick Test Pro, HP ALM and Load Runner
• Developed and implemented test suites, which includes features like synchronization points, Data Driven, Database Checks, Batch and Functions etc.
• Strong understanding and experiences for testing and creating Test Cases for different EDI transactions and exposure to ICD 9
• Involved in preparing test cases for HIPAA 5010 transaction code sets.
• Experience testing and validating the load time error for different EDI transactions. Solid Knowledge.
• Experience in web applications developed with .net, Rails java and validate XML
• Extensive knowledge in writing SQL Queries, creating tables, views, stored procedure, triggers. Proficient in writing and executing SQL queries for backend testing.
• Strong experience in enhancing the scripts in Quality Test Professional using VB script.
• Extensive experience in analyzing Business and System Requirements, preparation of various documents including BRD, SRS and Use Cases. Proficient in MS Project for planning and status reporting and excellent in MS. Office package for documentation.
• Experience in Writing SQL and Pl SQL Stored Procedures and Triggers for Business applications to validate data and Strong in writing Shell Scripts.
• Extensively used Mercury Quality Center and Bug Tracking System for reporting Defects.
• Extensive experience in drafting Test Flows, Test Plans, Test Strategies, Test Scenarios, Test Scripts, Test Specifications, Test Procedures and Test cases Test Status Reports.
• Experience in Testing Database Applications using ORACLE, MS SQL Server, Sybase and MS Access.
• Excellent Communication skills with ability and willingness to work towards the business and technical requirements of clients and users.

PROFESSIONAL EXPERIENCE:

Confidential, West Sacramento, CA

QA Tester

Responsibilities:

• Reviewed Business Requirements, Functional Specifications with Business Analyst and QA team to learn the functionality and business process
• Performed Functional and Regression testing of the CAMMIS sub system
• Developed Test Scenarios, Test Cases and Test Scripts to enhance claims adjudication, eligibility and formulary for expanding client product offerings
• Validated and implemented EDI transactions according to HIPAA compliance
• Participated in analysis workshops for ICD 9 Procedure and Diagnosis Codes in accordance with ICD 10 CM and ICD 10 PCS Conversion Compliances
• Validated production data for newly installed retailers on the POS system
• Validated CPT, HCPC, ICD 9 code sets from Data Flat files to support configured benefit plan building
• Worked on Claims Processing, Accumulate Claims and Adjudicate Claims
• Managed global administration and support of the Documented based Regulatory Electronic Document Information System (EDMS)
• Facilitated Electronic Data Interchange and storage in the ICD - 10
• Worked on HIPPA Transaction Sets 837P and 837I Standards according to the test scenarios
• Created Test Conditions from business requirement document and functional requirement document
• Developed Test Cases to test the functionality of the system based on the test conditions
• Developed Test Scripts, linked Test Scripts and Requirements from DOORS to Test Cases in the Rational Quality Manager
• Extensively used Rational Quality Manager to monitor the progress of assignment of testing activities and Reported executed results
• Reviewed EDI 837 claims and flagged HIPPA non-compliant claims received from the Payer side
• Logged the defects in Clear Quest tool, assigned the right severity level and managed the defects through it
• Coordinated System and Regression testing schedules and completed the same.
• Ensured the functionality meets business requirements as defined in test results logged in RQM
• Accessed Diagnosis Master File and Crosswalk Mapping file to use ICD Diagnosis and Surgical Procedure Codes
• Performed GAP Analysis to make sure that all requirements were covered by test cases
• Prepared and submitted weekly test status reports to QA Lead
• Analyzed the System Impact including MMIS Tables, Windows, Reports and Interfaces on external entities
• Validated Professional and Institutional Claims, Processed and Adjudicated the Claims according to test scenarios
• Maintained Requirement Traceability Matrix (RTM) to make sure that all the requirements are covered in test cases
• Communicated with Development team and Business Analyst s to ensure testing issues are resolved
• Generated test execution reports and uploaded validation documents in share point web site for review

Environment: Main frame/CICS/DB2 (Client Server Applications), Edifecs Spacbuilder, Rational Quality Manager, Rational Clear Quest, Share Point, Visual Basic.

Confidential, Louisville, KY

QA Analyst

Responsibilities:

• Involved in writing Test plans, Test cases and responsible for executing the Test Scripts.
• Responsible for designing, developing test plans use cases and executing test scripts.
• Performed Smoke, Integration, functional, Regression, and system testing.
• Mapped test cases to functional/system/integration requirements for appropriate testing coverage in HP-ALM.
• Creating automation with selenium WebDriver in Java and C# using eclipse, Ant, Maven, TestNG and jUnit.
• Identified and creates test data to support testing, processes and workflows, ICD9 and ICD 10 codes, medical billing and claims testing.
• Interacted with Business users and Technical team in providing clear solutions to requirements.
• Involved in testing HIPAA EDI Transactions 270,271,276,278,834, 835, and 837 and mainly focused Eligibility Transactions.
• Used FACETS Analytics for fast and easy retrieval, display and grouping of information for performing queries and generating reports.
• Worked on legacy conversion data base systems on claims processing.
• Maintained Traceability matrix and Test Matrix.
• Automate WAPI testing using tools such as JBEHAVE, Postman and SOAP UI in the Java environment
• Reviewed EDI 837 claims and flagged HIPPA noncompliant claims received from the Payer side
• Maintained various versions of Test Scripts
• Performed Sanity Testing and Smoke Testing
• Investigating software bugs and reporting to the developers using Quality Center Defect Module
• Analyzed system requirements and developed detailed test plan for testing
• Used FACETS to provide seamless transactions between the provider, members and the plan
• Worked extensively with CPT/ ICD Codes. ICD-9 and ICD-10.
• Used Quality Center for preparing the test plans and manual test scripts.
• Writing test scripts from functional specifications in test plan within Mercury quality center.
• Involved in loading the flat files into Oracle Database and involved in writing SQL Queries.
• Involved in writing SQL Queries using TOAD

Environment: HIPAA, Visual Basic, ASP, XML,Java Web services, SQL, MS Access, UNIX, Windows95/98/NT/2000/XP, Quality Center, SQL, MS Office, ORACLE, MS office

Confidential, Dayton, OH

QA Analyst

Responsibilities:

• Reviewed Business requirement Documents and functional requirements.
• Formulating detailed Test Plan using Quality Center after analyzing business rationale and software requirement artifacts.
• Interacted with the team member to ensure meaningful development of the scripts and simulated real time business scenarios..
• Performed the Back-End integration testing to ensure data consistency on front-end by writing and executing SQL statements on the Database
• Reviewed manual testing methods and developed and executed.
• Involved in Configuration testing.
• Used Quality Center for version control, tracking defects, enhancement requests, assign work activities, and assess the real status of project throughout the life cycle.
• Maintained Requirement Traceability Matrix (RTM) to make sure that test plans were written for all the requirements.
• Identifying Test Cases to be run for Regression Testing and conducting Regression testing as and when new builds were made.
• Documented the test results and reported the status of assigned test tasks and issues to project manager.
• Involved in testing HIPAA Transactions & Code Sets Standards like (820- Premium Payment for enrolled health plan members, 834(X12) - Enrollment /Dis-enrollment to a health plan, 835, 837 ...etc.) f X12
• Implemented manual test cases for each sprint task and executed them using Soap UI.
• Testing backend APIs using the Soap UI.
• Involved in upgrading HIPAA 4010 transaction to HIPAA 5010 transaction project, processed 837 claims file and verifying 277 report, checking various 835 ERA
• Involved in testing of HIPPA 835 for the payment of claims and transfer of remittance information
• Executed Performance test procedures to check to time span
• Validated member’s benefits against the benefits matrix
• Analyzed and testing data on different billing and membership functionality manually and writing queries on database for validating data

Environment: Windows, Facets, QTP, Oracle, SQL, Mainframe, Mercury Quality Center, MS Office, MS-Visio, SOAP UI.

Confidential, MA

QA Specialist

Responsibilities:

• Responsible for decomposition of the requirements based on the functional specifications, d testing, and documentation of applications to satisfy requirements. Performed Positive and Negative Testing manually.
• Extensive work as a claims adjuster and configuration professional, cleaning up errors with claims, benefits, and provider contracts
• Prepared Test plan and Test cases based on the functional specifications.
• Verified the different Product Benefit Configuration for different Members.
• Tested HIPAA regulations in Facets HIPAA privacy module
• Executed SQL queries for searching, creating and updating test data.
• Identified, analyzed, and documented defects, errors, and inconsistencies in the application using Alexsys.
• Reported defects according to Defect Life Cycle.
• Membership/enrollment and billing-entered information on Facets to ensure correct eligibility, etc.
• Coordinated with the developers on Defects Status on a regular basis.
• Participate in various meeting and discussed Enhancement and Modification request.
• Participated in Status Review Meetings.
• Tested and validated for facility affiliations, facility addresses and facility network in Facets.

Environment: Windows, Facets, QTP, Oracle, SQL, Mainframe, Mercury Quality Center, MS Office, MS-Visio, SOAP UI.