PROFESSIONAL SUMMARY

Senior QA Analyst / BA Testing Consultant / UAT Tester / Systems Integration Tester

A proven Senior IT professional with more than 15 years of experience including 12 years of Quality assurance testing along with 6 years specializing within the healthcare environment. A skillful Business Analyst and Quality Assurance tester of HIPPA federal mandates, system conversions, 5010, and the ICD-9/ICD-10 initiatives. Skilled with 12 years hands of systems, systems integration, and user acceptance testing conforming to the Software Development Life Cycle expectations.

TECHNICAL SUMMARY

Skills & Languages:

WEBSTRAT, WINSTRAT, ICD-9, ICD-10, Network Access, Prototype Hospital, QCARE we, CPT-4, ICD-9, SDLC, Mercury Test Director, QC, Test Partner, Rational Clear quest, Hiperstation , COBOL, COBOL II, COBOL LE, OS/JCL, IBM Utilities, VSAM, CICS (Command Level Application Programming), VISION, INTERTEST, BMS, DB2, SQL, SPUFI, QMF, TSO/ISPF, FILE-AID, ENDEVOR, VIASOFT, PC, MS Office, MS Outlook Express, Windows Internet Explorer, LAN Desk, Information Server, Proxy Server, Access for Windows 95, Advanced Excel for Windows 95, MS Access 2.0, Oracle 8i, Microsoft Analysis Services, MS Data Analyzer, Business Objects.

Operating Systems/Environments:
WEB, Oracle, Websphere, J2EE, Java, Sybase, HTML, Client Server, IBM MVS/XA/ESA, OS/390, UNIX, MS DOS, Windows95/98/ME/XP, Windows NT/2000, VM/CMS, ICCF

PROFESSIONAL EXPERIENCE

Confidential,GHI NY, 441 9th Ave. New York, NY
May 2010-Present
Senior QA Analyst/UAT Tester

• Successful testing and implementation of APR DRG pricing methodologies for inpatient hospital claims.
• End to End system testing of claims processing and all interfaces for modifications related to the HIPAA 5010 standardized claim format.
• Pricing verification utilizing Westar and Winstra methodologies for Inpatient Claims to validate DRG groupings.
• Regression testing to identify potential breakage to previous releases and to justify acceptable variances.
• Documenting of process improvements and updating of test plans and test cases for re-usable scenarios with future releases.
• Coordination with Medical and Hospital claims processing for combined DED/CAP/OOP benefit plans.
• Completion of all projects to signoff with accurate documentation of each defect and resolution, along with any conditional information or exceptional conditions identified in testing.
• Interaction with SMEs, Test Management, and development team members to ensure accurate communication during the project life cycle.

Confidential, HIP NY, 55 Water St. New York, NY
July 2009-Mar 2010
UAT Tester

• Created test cases for enforcement of benefits processing, updating of benefits tracking including copayments, deductibles, and out of pocket expenses for accurate reimbursements.
• Reviewed and modified test plans as needed for accurate UAT acceptance in accordance with change control project enhancements.
• Analyzed Business Requirements document, traceability matrix, test scenarios, data setup, execution, test case review, defect management, documentation, metrics and post implementation reviews.
• Established traceability matrices for each assigned project associated to Provider Contract pricing, PT/OT Palladian, COB Savings, Medicare 2010, Check Rollup Up, and QUAL Care network.
• Defined scenarios covering all lines of business and benefit groups within the QCARE claims processing environment, to ensure accurate UAT was completed and documented with reusable test scripts.
• Interpreted provider contracts, plan benefits, Pre-authorizations, claims configuration such as system edit rules, code sets (ICD9 and CPT), Medicare and Medicaid fee schedule updates, general policies and procedures to ensure the timely and accurate testing of claim transactions.

Confidential,Morristown, NJ
July 2006 May 2008
Senior Quality Assurance Specialist

• Perform User Acceptance testing. Validated data integrity of UAT test results and inform user community of any discrepancies that could impact clients.
• Document testing issues and keep all concerned parties informed.
• Review requirements documents, evaluated business requirements that impact the application
• Reviewed and modified technical design documents during system testing to accurately reflect changes discovered during testing.
• Reported issues and defects to upper management for resolution and repair prior to production implementation.
• Performed post implementation reviews confirming accuracy of data and to ensure that existing system functionality was not compromised.
• Coordination of monthly billing schedule to ensure the proper handling of data captures, environment sync-ups, database changes, base line executions, conversion processes, stress testing, component turnover, DASD maintenance and parallel regression testing.
• Enhancement of procedures to properly handle system outages and streamline communication to appropriate support personnel via automated email response.
• Analyze technical and business requirement documentation to establish re-executable test plans for assigned tasks and projects.
• Utilized SQL, execute manual and automated test scripts in accordance with test plan to identify variances and defects to be resolved prior to production implementation.

Confidential,Warren, NJ
Feb 2005 Mar 2006
Release Coordinator

• Organized the monthly release schedule and regression testing for the Vision Billing system including inputs and rating, captures, bill run cycles and rollbacks.
• Conducted daily User Acceptance meetings in a distributed environment to obtain release status and identify any risks or issues impacting testing.
• Established alternative testing plans and provided solutions to streamline testing activities for accurate delivery of software to production environments.
• Provided status updates to upper level management and test plan changes with all test coordinators and test leads.
• Obtained signoff from the national testing team comprised of the Northeast, Midwest, West and South areas.

Confidential,Warren, NJ
Feb 2005 Mar 2006
UAT test coordinator

• Utilized Test Director to accurately track UAT test cases and statistics for senior level management reporting.
• Updated test metrics on a daily basis to track testing statistics and defect resolutions.
• Coordinated meetings with Client Account Managers, development managers and test leads to establish test plans that accurately interpret approach document requirements.
• Identified testing community associated with each project and communicated on a regular basis to maintain accurate and prompt completion of testing tasks.

UAT Tester

• Utilized Test SQL and Db2 file aid to create test data associated with each project. Created test plans with traceability to business requirements.
• Utilized Executed test plans, tracked defects and provided all testing status to test coordinators.

Confidential, Montvale, NJ
July 2002 Jan 2005

• Project Lead: Attended regular meetings with business partners and development groups to determine the testing needs for projects such as Hipaa, SSN to Nonssn Conversion, Flexible Products and Combined out of Pocket initiatives. Established daily status meetings and provided input to Senior Level Management reporting. Supervised QA analysts by providing tasks and tracking progress for the monthly releases.
• Training: Trained QA analysts and new consultants on automated tools, defect tracking and creating test plans. Provided on-line training of the POS claim processing system, eligibility and Client profile setups.
• SDLC process: Established test plans based on business requirements for large scale company initiatives for the United Healthcare client. Created matrix cross-referencing the individual requirements with the individual test cases to ensure proper testing.
• Defect Tracking: Opened process defects using Rational Clearquest for Monthly release tracking. Attended daily Defect meetings and informed upper management of status.
• POS Compliance: Responsible for the monthly Book of Business release testing. Established the necessary eligibility, group, and pharmacy claim data to complete the required QA testing scenarios.
• Reviewed and provided test output for the client’s approval, ensuring the test conditions were properly executed. Developed and maintained Hiperstation scripts, as well as other in-house testing databases.
• HIPAA: Performed QA testing for CICS and DB2 applications that were re-designed for the HIPAA Compliance initiative. Utilized automated tools such as Hiperstation, to capture, maintain, and execute TCP/IP and 3270 mainframe scripts against Eligibility, Client Profile, and Pharmacy claim processing systems. Validated results using Comparex and in-house tools to analyze variances between baseline and subsequent script executions. Identified application errors and provided details to production support areas for resolution.
• UAT tester: Assist in the coordination and execution of user acceptance testing of the applications Coordinate and direct testing resources and analyze the application output to ensure business goals are achieved. Manage the implementation process for small-scale projects

Confidential, Newark, NJ
May 1999 Jan 2002
QC Project Leader

• Managed QC work assignments for multiple projects simultaneously. Analyzed each project, reviewed technical documentation, divided projects by groups of related elements and delegated assignments to QC personnel.
• Gathered environmental and task information so as to analyze and created appropriate documentation for implementation of Clean Management Control. Identified discrepancies and inconsistencies and reconciled accordingly.
• Establish technical design documents to assist QA with creating test scenarios that contain traceability to the system requirements.
• Originated meetings with clients, developers and PAS/QC group members in order to secure a comprehensive understanding of all processes and procedures necessary for creation of PAS/QC Turnover Check List. Performed visual review of all critical modules before the actual QC analysis in order to identify potential testing problems.

Confidential,Newark, NJ
May 1997 April 1999
Programmer/Analyst (May, 1997 April, 1999)

• Programmer Analyst: Served key role in Year 2000 full remediation for various batch and on-line applications using COBOLII, CICS, DB2, SQL, JCL, VSAM and practicing Windowing and Expansion methodology. Used Endevor, Data-Expert, Expediter, Interest, Viasoft and Ager2000. Served as Technical Viasoft Lead as well as created manuals for Viasoft tools such as Smart/Edit, Smart/Test, Via/Insight, Via/SmartDoc and Tca report. Conducted training for Keane employees.
• Systems Analysis: Authored technical design documents for standardization of the Y2K logic to handle a uniform and accurate conversion of century digits.
• Participated in Exchange Area Code project for Customer Information System. Changed source code in all programs using Area Code field. Created stand alone Jobs and PROC’s to perform unit tests and produced various reports for client approval.
• Involved in project for Gas Rate Split System Enhancement. Responsible for design, coding, testing, and debugging of Cobol and CICS on-line programs. Prepared program documentation.
• Managed team for DB2 Table Expansion and was responsible for creating tables with new column description, loading and unloading data using BMC utilities, as well as generating DCLGEN to include new SQL and source language declarations. Assist in the coordination and execution of user acceptance
  testing of the applications. Gather, verify and test to ensure that business requirements have been met for application upgrades, fixes, and deployments.

Confidential, New York, NY
Sept 1996 May 1997

• Programmer Analyst: Worked on system generating client Request for Status claims reports. Responsible for program design, coding, testing and debugging of batch programs. Prepared program documentation. Wrote programs in COBOL, COBOLII, JCL, and IDMS.

EDUCATION

Oracle DBA Classes including Database Design, Backup and Recovery, and other major areas of Oracle Database Administration. Created test databases on Windows NT and Unix platforms, loaded tables and databases using Oracle Utilities including SQL*Loader and Export/Import. Performed hot and cold backups of test databases.