Summary:

• Test Over 6 year's expertise in QA Analyst/Tester with hands on experience in Healthcare Sectors.
• Strong knowledge of the Software Development Life Cycle methodologies phases and gates like Agile and Waterfall models.
• 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 and HL7.
• Experience with Iterative Software Development Life Cycle Process as per Rational Unified Process RUP , involved in inception, elaboration, construction transition phases using rational tools like RequisitePro, ClearCase, ClearQuest during various phases of RUP.
• Knowledge of using automation tools - Win Runner, QTP, Load Runner, Quality Center and Test Director
• Extensive experience in Business Requirements gathering and writing skills with expertise in developing and documenting Business Requirement document BRD , Functional Requirement Document FRD ,Software Requirement Specification SRS across the deliverables of a project.
• Effectively used Rational Requisite Pro to organize, track and change requirements of the system.
• Expertise of UML in visualizing and documenting the artifacts using Use Cases, Use Case Diagrams, Activity diagrams, Class diagrams, Data Flow Diagrams, Business Flow Diagrams, Sequence Diagrams using MS Visio
• Experience in facilitating Joint Application Development JAD sessions, Rapid application development RAD sessions , conducting user interviews and acting as a liaison between the customers, development team and testing team
• Experienced in manual and automated testing for both front-end and backend. Extensively used automated test tools of Mercury like Quality Center, Quick Test Pro, Win Runner, Test Director, Performance and Load Runner Testing.
• Strong knowledge on the Systems Development Life Cycle SDLC , Rational Unified Process Methodology RUP , RAD, SWOT, and CRM.
• Strong skills in creating UML Diagrams and Data Models including Use Case Diagrams, Activity Diagrams, Deployment Diagrams, Data Flow Diagrams DFD and Entity-Relationship diagrams using Rational Rose and MS Visio.
• Experience in Clinical Data Management and Clinical Trial Management.
• Strong knowledge of Project management skills includes time estimation, task identification, and scope management.
• Proficient in designing Data Models logical and physical for Oracle, DB2 and SQL Server databases.
• Knowledge in the ETL Extract, Transform and Load of data into a data ware house/date mart and Business Intelligence BI tools like Business Objects Modules Reporter, Supervisor, Designer, and Web Intelligence .
• Facilitated User Acceptance Testing UAT with the stakeholders and the business users as well as trained users to use the system configured.
• Analytical, methodical and resourceful approach to problem solving, identifying root causes and corrective actions to meet short and long-term business, financial and system requirements
• A good team player with excellent communication and interpersonal skills
• Excellent verbal/written communication skills and strong analytical abilities and can perform well both independently and as a team player

Software/Hardware:

C .Net, SQL, IDMS, QTP, MS Windows NT 4.0/2000, Windows 95/98, Windows XP, MS Visual Studio.Net, IBM WebSphere 5.0, Power Builder 5, 6.5, 7, Rational Rose, UML 2.0 , RUP, OOAD, HP QTP, HP QC, MS Visio and Visual Studio.Net, Sybase SQl Anywhere 5/6, Adaptive Server Anywhere, MSSQL 7, Oracle 6 / 7.x / 8i / 9i, Oracle TOAD, Informatica, Bbusiness Object, ETL, Cognos, Erwin ODBC, Visual Source Safe 6.0, Cobol, Source Off-Site, Round-Table, Win CVS, NUnit.net, MS Project, MS-Office

PROFESSIONAL EXPERIENCE:

Confidential

QA Analyst

Responsibilities:

• Performed validations on the Mainframe using DB2, CICS, TSO, ISPF, File Aid etc.
• Expertise in planning/executing Black Box Testing for both Client Server and IBM Mainframe applications.
• Designed and development of test cases based on functional requirements for Institutional and Professional claims for EDI and HIPAA Transactions 837/835, 834, 276/277, 270/271 testing.
• Discussed with SMEs across different business units to gain solid knowledge of the existing Derivatives Exchange Systems and assisted in preparing an advanced Derivatives Valuation and Risk Management.
• Assisted in GAP Analysis identified and documented improving area to meet the end state requirements.
• Designed and developed Use Cases through visually modelled UML diagrams to both management and development teams to ensure uniform understanding of the business scope, and detailed business and functional requirements
• Experience in EDI automated first-pass claim adjudication, requiring thorough understanding of claim processing, both front and backend operations.
• Developed HIPAA EDI Transmissions. Work includes complete business cycle management and hands-on production as well. Create EDI Testing process, documentation, and performance matrices.
• Technical Specification Creation for EDI. Schedule meetings with technical personnel to determine technical parameters for EDI and other related processes, including communication, security, and privacy.
• Collaborated with the development team to enforce the implementation of requirements throughout the entire coding cycle and managed change request using Rational Clear Quest.
• Developed test plans with QA team and helped to develop test scenarios for system testing, integration testing and performance testing.
• Interpreted and calculated the option issues like Option Premium, Strike Price, and Option Intrinsic Value for America/Euro Options in the user manual.
• Conducted Functional Testing, Joint Functional Testing and UAT, documented and reported user feedbacks to management team.
• Used Quality Center/Test Director for requirement management, test planning, scheduling, executing test cases, managing and tracking defects.
• Utilized corporation developed Agile SDLC methodology. Used ScrumWork Pro and Microsoft Office software to perform required job functions.
• Automation of test scripts was done using QTP for test re-usability of different online transaction modules.
• Performed Defect Tracking and Change Control Procedures using Rational Clear Quest and Configuration Management and Version Control using Rational Clear Case.
• Responsible for the User Interface, including screen presentation and reports.
• Involved in Regression testing of each build during the various phases of the application using QTP.
• Coding of QTP automation scripts was done by using VB Script.
• Involved in end to end testing from Quick Quote to the policy activation in both frond end application and in the mainframe.
• Performed sub-system integration test, system test, functionality test positive and negative , and re-test and regression test.
• Assisted JAD sessions to identify the business flows and determine whether any current or proposed systems are impacted by the EDI X12 Transaction, Code set and Identifier aspects of HIPAA.
• Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Medicaid Claims.
• Worked on EDI transactions: 270, 271, 834, 835, and 837 P.I.D to identify key data set elements for designated record set. Interacted with Claims, Payments and Enrollment hence analyzing and documenting related business processes.

Environment: Load Runner, ASP.NET, Java, Oracle, XMLSPY, DB2, TOAD, Windows NT /2000, SQL Server 2005, Microsoft Word, Project, Excel, PowerPoint, Ms-Visio, GIS Tools, Cognos, BI, IBM Mainframe, Sybase, MS Project

Confidential

Sr. QA Analyst/Tester

Responsibilities:

• Testing various change orders of Medicaid applications received from the System Engineer's
• Regression Testing of Web applications and applications dealing with MEDICAID and MEDICARE Services
• Conducted weekly meetings for deciding the Policies and Procedures to be followed while constructing new sites.
• Conduct complex documentation and user needs analysis. Interface with team and staff to develop HL7 integration
• Assisted JAD sessions to identify the business flows and determine whether any current or proposed systems are impacted by the EDI X12 Transaction, Code set and Identifier aspects of HIPAA.
• Developed the strategy for developing and implementing new EDI HL7 and X12 interfaces and converting historical clinical and data.
• Creating Test Plan and Test cases using Mercury Quality centre.
• Worked on Rational Clear Quest for defect submission and tracking.
• Reviewed EDI companion guides for all payers to ensure compliance, edit integrity and maintain up-to-date list of payer contacts.
• Conducted analysis of HIPAA compliance and took part in discussions for designing the healthcare transactions to be HIPAA 5010 compliant.
• Developed QA Test Plan from technical specifications and requirements for this project which deals mainly with three areas i.e. presentation tool, integrated genesis selling tool and catalog API
• different iterations and phases of the Software Development Life Cycle.
• Used Test Director and HP/Mercury Quality Center for updating the status of all the Test Cases Test Scripts that are executed during testing process.
• Involved in testing the conversion of the application into web application using XML web services.
• UAT testing performed along with call center managers to make sure that application meets their requirements.
• Provided superior client interaction to make sure all needs were met.
• Performed testing for Medicare, Medicaid and X-Over claims for Medicaid Management Information System MMIS
• Developed and implemented the MMIS Third Party Liability TPL Subsystem.
• Conducted business-impact assessment and the results were compared with the new HIPAA 5010 standards to determine the current level of compliance and developed an action plan for approval by the project steering committee
• Developed plan for data feeds and data mappings for integration between various systems, including XML, to follow ICD 10 Code set and ANSI X12 5010 formats.
• Involved in gap analysis and implementation of HIPAA 5010, ICD 10 and Claim Validations
• Conducted Gap Analysis, and Gathered User Requirements by Interviews, user meeting, JAD session, and Requirement Elicitation Sessions
• Utilized corporation developed Agile SDLC methodology. Used ScrumWork Pro and Microsoft Office software to perform required job functions.
• All the test scenarios which have been satisfied with the functionality are moved to automation testing using Quick Test Professional.
• Developed and conducted statewide HIPAA 5010 and ICD-10 awareness program for all IDS staff in Tenet.
• Backend testing of the DB by writing PL/SQL queries to test the integrity of the application and Oracle databases using TOAD.
• Involved in analyzing activities for a variety of major projects including Medicare Plan part D, Coordination of Benefits, New Client Implementations, Consumer driven and regularly scheduled system upgrades.
• Extensively interacted with the stakeholders and the IT Department in finalizing the requirements according to the CMS Compliances/Regulations and HIPAA Regulations.
• Assisted to develop the Test Plan, Test Cases and Test Scenarios to be used in testing based on Business Requirements, technical specifications and/or product knowledge.
• Acted as a Business Analyst for the CDS implementation the backbone for data integration among myriad systems, including ERP, CRM, Portal, Workflow Engine, Payroll and related interface
• Prepared graphical depictions of Use Cases, Use Case Diagrams, State Diagrams, Activity Diagrams, Sequence Diagrams, Component Based Diagrams, and Collateral Diagrams and creation of technical design UI screen using Microsoft Visio.
• Analyzed trading partner specifications and created EDI mapping guidelines

Environment: Windows 2000/XP, HL7, Oracle ,Microsoft Office SharePoint 2007, Cognos, Agile, Rational Requisite Pro, MS Office, SQL Server 2005, Cobol, DB2, JAVA, J2EE, MS Project, MS FrontPage 2003, MS Access, EDI

Confidential

Sr.QA Analyst/Tester

Responsibilities:

• Interacted with business heads to finalize the Business Requirements for the application.
• Performed the requirement analysis and documented the requirements using Rational Requisite Pro.
• Used the requirement attributes priority, effort, and risk as the basis for negotiating the inclusion of the requirement, to manage the scope of the system efficiently.
• Involved in creating sample mappings for the conversion of EDI X12 transactions code sets version 4010 to 5010 and translation of ICD 9 codes into ICD 10 codes.
• Involved with the coders in evaluation of CPT and ICD-9 codes to ensure that the diagnosis meets medical necessity for the specific CPT code.
• Extensively involved in the automation of Regression Test Cases by scripting.
• Produced Gap Analysis documents for HIPAA 5010 and ICD-10.
• Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Medicaid Claims. Worked on EDI transactions: 270, 271, 834, 835, and 837 P.I.D to identify key data set elements for designated record set. Interacted with Claims, Payments and Enrollment hence analyzing and documenting related business processes.
• Create and maintain requirements, test cases and defects in Mercury Quality Center
• Involved in mentoring specific projects in application of the new SDLC based on the Agile Unified Process, especially from the project management, requirements and architecture perspectives.
• Represent Operations Team as Client Liaison for Medicare Part D Plan.
• Provided clear and concise documentation regarding requirements management plans, Functional Requirements, supplemental Requirements, Test Plans and Test Cases.
• Conducted Joint Application Development JAD sessions with IT groups. Identified the Key Changes, and participated in Stakeholder Management to communicate effectively with them
• Implemented Data Modeling standards, including element-naming conventions.
• Used SDLC System Development Life Cycle methodologies like the RUP and the waterfall.
• Understand the As Is system and develop the To Be system concept and also prepare the System Process Maps.
• Developed extensive experience in eligibility and benefits calculation for state, federal and local services such as Medicare and Medicaid.
• Analyzed the changes made to different EDI ANSI X12 transactions 837 I and P, 278, 270 and 271 under HIPAA 5010.
• Analyzed the business and functional requirements of the application and developed detailed test plans, test cases in Test Director.
• Defined the test criteria and project schedules, and baseline the Test Plan with the help of project meetings, walkthroughs.
• Performed Requirement Gathering Analysis by actively soliciting, analysing and negotiating customer requirements and prepared the requirements specification document for the application using MS Word.
• Review requirements and understand technical recommendations and constraints, and develop comprehensive and accurate functional specifications Data Mapping, and process flows.
• Created and managed project templates, Use Case project templates, requirement types and traceability relationships in Requisite Pro.
• Followed the UML based methods using Microsoft Visio to create: Use Cases Diagrams, Activity Diagrams, State Chart Diagrams, Sequence Diagrams and Collaboration Diagrams.

Environment: Rational Rose and Requisite Pro, MS Visio, MS Office, Mercury, MS Project, Agile, UML, Oracle, XML, Windows XP, NT/2000, HTML, Cobol, DB2, SQL Server 2000, JAVA, J2EE, HL7, Vignette Content management Tool

Confidential

QA Analyst/Tester

Responsibilities:

• Met with client groups to determine requirements and goals. Utilized Rational Unified Process RUP to configure and develop process, standards, and procedures and create a Business requirement Document.
• Created new database objects like Tables, Procedures, Functions, Indexes and Views using T-SQL in Development and Production environment for SQL Server 2000.
• Designed and development of test cases based on functional requirements for Institutional and Professional claims for EDI and HIPAA Transactions 837/835, 834, 276/277, 270/271 testing.
• Experience in EDI automated first-pass claim adjudication, requiring thorough understanding of claim processing, both front and backend operations
• Created Process Work flows, Functional Specifications documents and documented system requirements.
• Conducted business-impact assessment and the results were compared with the new HIPAA 5010 standards to determine the current level of compliance and developed an action plan for approval by the project steering committee.
• Performed all necessary programming, testing and documentation for COBOL, DB2 batch programs and sub-routines.
• Used Test Director to detect defects, communicate to the developers and tracking the defects.
• Used Test Director and Mercury Quality Center for updating the status of all the Test Cases Test Scripts that are executed during testing process.
• Produced Gap Analysis documents for HIPAA 5010 and ICD-10.
• Conducted interviews, meetings and JAD sessions during the process of Requirement Gathering.
• Extensive involved in Conducting Market Research, Feasibility Studies, Data Analyses, System Analyses, Gap Analyses, and Risks Analyses.
• Develop detailed unit test plans and scripts and conducted rigorous testing per requirements and assisted in data mapping.
• Provide implementation assessment, strategy, and mentoring services for Rational Rose, UML and RUP.
• Interacted with various cross-functional teams on building business use cases, and understanding expenses and revenue stream.
• Participated in the UAT for Broker/Dealer conversion for integration using Mercury Test Director
• Performed extensive Requirement analysis and developed use cases and workflows.
• Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams, and OOD
• Worked with Quality Control Teams to develop Test Plan and Test Cases.
• Interaction with the developers to report and correct bugs.
• Developed Test Plans and Test Cases according to Business Requirements.
• Use HL7 implementation methodology to create specifications, assist with unit testing, and perform integrated testing for messaging between the state Departments of Health and the location office

Environment: Servlets 2.2, JMS, Java2 JDK 1.3 , STRUTS,JDBC2.0, DB2, XML, XSL, XSLT, Oracle, Rational Rose, PL/SQL, HTML, CSS, JavaScript, Cognos, HL7, MS Word, Excel, Access, Project, Visio.