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Quality Assurance Resume Profile

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FL

SOFTWARE QA TESTER

  • Expert in Automated Testing Current Reimbursement Experience 11-Year Record of Proven Results
  • Software Quality Assurance Tester with full system development lifecycle experience in developing and implementing test plans, test cases and test processes fueling swift corrective actions.
  • Qualifications include six years of software testing experience in development and user-acceptance testing and four years of claims adjustment tester and one year of quality assurance provider reimbursement.
  • Backed by strong credentials including a Business Management Degree, cross-platform functionality, expert in Windows, Microsoft applications, HP Quality Center, Mental Health Systems MHS and a Social Work Degree.

SKILLS SUMMARY

  • Test Plans, Cases Processes Migration Testing Quality Assurance Quality Control Standards
  • Functional Testing Kronos Application Defect/Bug Tracking Regression Testing
  • HP Quality Center Microsoft Applications Manual Testing User Acceptance Testing

PROFESSIONAL EXPERIENCE

Confidential

Quality Assurance Tester II/Business Analyst Systems,

  • Promoted to serve as a QA Tester to implement test plans, test cases and test processes. Responsible for plan and perform various levels of testing for new or modified software and data outputs.
  • Complete the QA cycle from the initial requirements phase through to post-production testing for a given project or projects
  • Review of business requirements and technical specifications documentation to analyze test scope and develop test plan, test cases and testing scripts.
  • Develop, document, execute and maintain test plans, test cases and scripts for multiple applications.
  • Identify, investigate, report and track bugs to closure.
  • Communicate test results, as well as any errors or issues discovered during testing to QA team, project managers and developers.
  • Insuring all Validation and GXP Documentation Requirements are met.
  • Insuring all HIPPA guidelines are met with company standards for Auditing.
  • Understanding of project plans with the ability to clearly articulate roles, project goals and timelines
  • Ability to decompose high-level information into details and distinguish user requests from business requirements to create a functional user requirements.
  • Work independently with users to define concepts and document and analyze information to develop functional design specifications, users and system requirements.
  • Test application to ensure it meets technical functionality and usability from the user's perspective.
  • Serve as a key member of the compliance team to insure member's benefits are effective prior to provider administrating vaccines to patients.
  • Utilizing the Pega System to verify members benefits, coverage and eligibility insurance information in which the systems generates an e-mail response to the provider.
  • Receiving and initiating inbound/outbound phone calls from providers and insurance representatives to help resolve issues and directing to appropriate areas for additional assistance.
  • Training associates on health insurance information such as, CPT Codes, ICD-9 Codes and Coordination of Benefits.

Confidential

Shadowing a Case Manager with covering cases. Being trained on conducting home assessments, home safety procedures, filing out and submitting Medical/Dental release forms for the client, attending school visits and attending court hearings.

Confidential

  • Provide intensive In-home services to children and families within the Department of Human Services Division in which the children are in imminent risk of abuse or neglect. Conducting home-visits school visits. Referring children and adults in the family structure to drug/alcohol services mental health and ensuring all children are current with school, medical and dental services.
  • Follow-up on the progress of clients and students within the outside services provided by programs which ensures the basic developmental skills each client needs to continue with the care of their children or to achieve reunification of the family structure.
  • Conduct joint meetings with clients and DHS to provide a family safety assessment. Develop family and individual service plans. Make referrals to appropriate community supports and services and follow-up on services. Attend all court ordered appearances.
  • Advocate for clients to receive supplemental cash, medical and dental support, housing and travel vouchers. Transfer youth clients into foster care homes and residential facilities when needed for safety. Attend weekly supervision meetings, monthly staff meetings and all in-service trainings as required.

Confidential

Claims Payment Adjuster,

  • Promoted to serve as a QA Tester, to implement test plans, test cases and test processes, by using HP Quality Center platforms, for functional, user acceptance, regression and migration testing, ensuring compliance with QA QC standards, federal regulations and customer specifications. Promoted to serve as a Claims Payment Tester II, to execute test scripts, develop workaround solutions for positive payment outcomes, report issues of payment risks, status and resolutions to management team and trained associates on medical coding workarounds and test scenarios. Served as a Claims Payment Adjuster, to process and adjust incorrect provider and facility claims.
  • Analyzed Business Requirements, module specific functionalities, identified testing requirements and formulated test plans.
  • Created and design test cases for functional, regression and user testing from various releases and rebuilds.
  • Identified and documented all issues and defects to ensure the quality of applications.
  • Lead several major and minor release projects without sacrificing scheduled deadlines.
  • Executed test scripts by manually entering claims into MHS System and making the required corrections to ensure the expected outcome for quarterly system releases.
  • Participated in Business Review meetings.
  • Developed system workarounds to minimize rejected claims for member benefits and enrollment.
  • Processing and adjusting provider and facility claims for member's in/out-of state.
  • Converting Foreign Currency claims into US Dollars by utilizing Foreign Exchange System.
  • Maintained an accurate and current inventory listing of problematic claim submissions.
  • Investigated and adjusted delayed and rejected claims for the Domestic and International Facility Claims Department.

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