Summary

• Experience to work as a Quality analyst in Health Care and Telecom.
• Followed the RUP based methods using UML to create Use Cases, Activity Diagrams, State Chart Diagram, Sequence Diagram etc.
• Extensive hands on experience in Software testing, Business Analysis experience in all phases of Software Development Life Cycle SDLC
• Extensive experience to gather requirements and categorized them into FURPS Functionality, Usability, Reliability, Performance and Supportability .
• Strong experience in data warehouse environments and worked with ETL and Reporting Tools like Data Stage, Informatica, Business Objects, Cognos and Hyperion.
• Expertise to design Business Requirement Specification BRD , System Requirement Specification SRS , User Requirement Specification URS , Use Cases Document, Work Breakdown Document WBD , and Requirement Traceability Matrix RTM .
• Experience in FACETS claims Adjudication system.
• Experience in Medicaid Information Technology Architecture MMIS and Affordable Care Act HIX environment.
• Expertise in Rational tools for Requirement Management, Business Process Modeling and defect tracking like Rational Req Pro, Rational Rose, Rational Clear Case, Rational Clear Quest.
• Used requirement elicitation techniques like Interviewing, Brainstorming, Joint Application Development JAD , and Rapid Application Development RAD sessions.
• Proficient in creating Use Case diagrams, Sequence diagrams, Activity diagrams, Class diagrams, E-R diagrams, and Data modeling using MS Visio and Rational Rose.
• Experienced working with x12 version 5010 transactions and ICD -10-CM and ICD-10-PCS Code set changes analysis, design and migration strategy.
• Experienced in different types of testing like Black box testing, white box testing, functional, GUI testing, Systems testing, regression, integration, UAT and performance testing
• Good knowledge on ICD, EDI, HIPAA and CMS.
• Knowledge of using automation tools - Win Runner, QTP, Load Runner, Quality Center and Test Director
• Extensive experience in all testing methods including manual and automated testing using the Mercury tools such as Quick Test Pro QTP , Win Runner, Quality Center and Load Runner.
• Having good experience on Facets Tools.
• Experience with various EDI healthcare transactions such as 837 for submitting claims, 835 for payments, 834 for benefit enrollment, 820 for premium payments to insurance products, 270, 271 for health care benefits and eligibility, 276, 277 for claims status and 278 for transmitting health care service information.
• Experience with web services testing using SOAP UI/WSDL/XPATH and also experience in working with Web Services, WCF, SOAP, WSDL, and REST.
• Made sure that Service Oriented Architecture SOA is implemented by working on validation of XML web services, and used SOAP UI to verify Web Services
• Adopted software development methodologies, including Agile, Waterfall, and hybrids
• Involved in capturing and maintaining business and technical requirements as well as capturing and analyzing process of the DB project, which was developed in Java, J2EE and XML environment.
• Expertise to design mock up for UI solution using Photoshop, HTML, DHTML and XHTML.
• Can effectively use Erwin tool for creation of a basic Data Model and Database Schema.
• Have excellent knowledge of HIPPA 4010 /5010 versions.
• Good working Knowledge on SOA-based applications
• Familiarity with current industry standards such as HIPPA guidelines 4010 5010 and EDI Transaction. Extensive experience in EDI implementations Real and Batch Processing .Excellent experience in EDI transaction like 270, 271, 276, 835, 837
• Involved in design and maintain of Test Plans, Test Cases and Test Scripts using Test Director, Test Manager.
• Experience of developing test scripts in Quick Test Pro QTP both manually and automatically by using VB Script and recording the application
• Proficient in using automated tools like Win Runner, Quick Test Pro QTP , Test Director, HP Service Test, Soap UI, Quality Center and Load Runner.
• Involved Unit Testing, System Integration Testing, System/Black Box Testing, and Regression Testing with QA team.
• Extensively used Clear Quest for bug tracking and Clear Case for Requirements traceability and document version control.
• Strong experience in conducting User Acceptance Testing UAT .
• Strong knowledge of project management skills like time estimation, task identification and scope management.

System Requirements Writer:

• New Hampshire: Liquor Commission - Next Generation Systems RFP creation
• West Virginia: Office of Insurance Commissioner - Health Information Exchange HIX RFP

Technical Skills Inventory

Experience Details

Confidential

Sr QA Analyst

Confidential

government, responsible for the health, safety and well being of the citizens of South Dakota. DSS provides services for individuals, children, families and seniors and administers such programs and services as mental health, developmental disability, substance abuse and public health CNSI has undertaken a Pilot project of implementing Java based Medicaid Management information System MMIS from legacy system of DSS. As a Analyst in the CNSI Business team, I am responsible for delivering Business artifacts namely Component Specification Document CSD document to the client. In addition the team is responsible for smoke testing different modules of MMIS. Currently working on implementation of the new South Dakota Medicaid Management Information System SD MEDX , in order to have the centralized repository of the data and for the proper workflow management process. One of the Core objectives of the project is to be able to manage the claims that are coming to the State from other areas.

Part of company-wide design, development, testing, and implementation in transition from a legacy system to facets

Responsibilities:

• Participated in writing Test plan, Test scenarios and Test cases, software documentation from business, technical and functional requirement.
• Wrote test steps and test cases for various functional and non-functional requirements using Test Plan tab in Application Life Cycle Management 11.
• Performed extensive EDI testing on 834, 837, 835, 278 and validated inbound /outbound transactions to FACETS 4.71
• Enhanced scripts by creating Actions, Checkpoints, Synchronization points and parameterization with Quick Test Pro QTP .
• Worked with in the areas of Clinical, Corporate and Finance, Pharmacy, Sales, Provider Network and identified the use of ICD 9 codes and prepared documents for the conversion of ICD 9-10 and vice versa.
• Involved in creating End to end test suite involving FTP file drops and capturing claims status at various points
• Good understanding of QA methodology and Software Development Life Cycle SDLC Agile,Waterfall
• Building and maintaining the transactional web applications knowledge base and ensuring documentation, manuals and procedures are updated.
• Data extraction, Data Migration and Data conversion using ETL tools from application front-end with Oracle databases and data warehouse.
• Enhanced scripts by creating Actions, Checkpoints, Synchronization points and parameterization with Quick Test Pro QTP
• Executed Test Cases for Claims processing including Medical Claims Processing Hospital Claims Processing and the Dental Claims processing.
• In-depth knowledge of HL-7 and HIX Health Information Exchange
• Used gap analysis framework to identify AS-IS processes of claims transactions of HIPAA X12 4010/4010A standard and TO-BE processes ICD-10-CM and ICD-10-PCS compliance requirements of 5010 standard
• 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.
• Performed impact analysis for deadliness of ICD-10 conversion.
• Assist coders to be competent in using ICD-10-CMS/PCS
• Reviewed and comprehend business requirements and functional specifications
• Developed manufacturing processes for Military Hybrids per Mil-Std-38851 and Mil-Std-883C, and IPC-A-610C.
• Worked on Hybrids and did some troubleshooting on them.
• Implemented automated COB processing of Medicare claims into Facets
• Also Responsible for gap analysis in changing old MMIS to new MMIS. Also, accountable for Medicaid Claims Resolution/Reimbursement for peach state health plan using MMIS
• Adopted and trained coworkers on software development methodologies, including Agile, Waterfall, and hybrids Completely comfortable working in an ambiguous and pressurized environment Consistently delivered stakeholders' projects on time and within defined budget
• Worked as UAT Defect manager, managing defects for User Acceptance Team, designed prototypes for UAT testers, organizing meetings, resolving defects and retesting fixes, deliverables.
• Designed and developed project document templates based on SDLC methodology
• Wrote VB Scripts using Quick Test Pro QTP for creating Checkpoints, Synchronization Points Data Driven Testing.
• Coordinated and attended meetings to review these specifications with the Quality Assurance Manager, Business Systems Analysts, RUP Engineers, Project Manager others on the team.
• Responsible for reporting status ensuring accurate coverage of requirements and business rules.
• Involved in Service Oriented Architecture SOA of the claims processing system
• Having good experience with web services testing using SOAP UI tool and WSDL files.
• Having good experience with SOA based applications
• Working with the development team on Process Flows for ETL processing.
• Developing complex data flows and ETL process flow diagrams using MS Visio and PowerPoint decks for presentation to upper management.
• Created Test sets for various testing levels using Test Lab tab of Application Life Cycle Management 11 and scheduled their execution.
• Helped IT developers design the service oriented architecture SOA for the application based on the available resources, and the business requirements.
• Wrote SQL queries in SQL Server Management Studio for creating data for different testing scenarios.
• Designed and developed project document templates based on SDLC methodology
• Translated exhaustive requirements specifications in to UAT Test Cases to recognize errors and gaps that could be present in requirements. Developed and implemented UAT Test Strategy and Test Plan.
• Web services testing using SOAPUI Get Mehod, POST Method -SOAP and RESTFul JSON in Java
• Involved in testing Web services and XML with tool called 'SOAP UI'4.5.1. I have been using this tool to locate WSDL file on internet, create Test cases, run them, do load testing, security testing.
• Assist Project Manager in planning and estimating efforts - providing input/clarity on business requirements, implementation options, phasing strategies, and level of effort estimates.
• Worked on FACETS to automate work, provide real-time delivery of claims and customer service items and reduce costs.
• Gathered requirements and developed Use Cases by interacting with different Functional Groups for ICD 9-10 Conversion.
• Maintained Traceability matrix of test cases to corresponding requirements.
• Conducted Regression testing for Facets 4.71 version.
• Participated in daily scrum to triage the defect tracking process.
• Communicated with business and development teams to resolve issues during test execution and ensured enhancements meet established quality and end user needs.

Environment: Application Life Cycle Management 11, Windows 7, SOAP UI , IBM Web Sphere ,QTP, SQL Server Management Studio 2008,SDLC, Facets 4.71, BizTalk, MS Office Suite, TIDAL 4.0.

Confidential

Sr. QA Analyst

Project:

Confidential care vendor processing the health insurance claims submitted by various providers. The 5010 HIPAA Project was initiated to perform Gap Analysis and document the necessary changes within the X-12 transactions. I was primarily involved in documenting the changes for HIPAA transaction 276/277 via EDI, Web.

Project:

The NPI implementation project is initiated to incorporate the mandated Federal Regulation of National Provider Identification-NPI for every provider. In order to facilitate the use of NPI as primary number a mapping/relationship needs to be established among NPI provided to internal Legacy numbers. I worked there as a business analyst and my main responsibilities were to analyze current business processes, gather business requirements and documentation with respect to NPI changes.

Responsibilities:

• Worked closely with Business teams/project stake holders/SME to map the expectations to the delivery capabilities.
• Interaction with the Technology teams to facilitate Business and Quality assurance reviews.
• Prepared User Manual and Testing Manuals for new users and testing team.
• Working with the development team on Process Flows for ETL processing.
• Developing complex data flows and ETL process flow diagrams using MS Visio and PowerPoint decks for presentation to upper management.
• Created Test Strategy for Enterprise Data Warehouse in ETL framework, including Business Intelligence.
• Produced Gap Analysis documents for HIPAA 5010 and ICD-10
• Involved in backend testing from FACET database
• Set claim processing data for different Facets Module
• Wrote VB Scripts using Quick Test Pro QTP for creating Checkpoints, Synchronization Points Data Driven Testing
• Developed test cases and test scripts for testing the ETL process.
• Tested the ETL extracts to ensure that they were in sync with the requirements.
• Analysing and drafting mapping specifications for the Authorised Services Model tables in the Integrated Product IP Datawarehouse.
• Will be working with the business running JAD Sessions. Projects focus on new development and maintenance of web based application.
• Responsible for the requirements / ETL Analysis, ETL Testing and designing of the flow and the logic for the Data warehouse project.
• Gathered requirements and modeled the data warehouse and the underlying transactional database
• Participated in full SDLC and handled complex projects involving the different phases of SDLC like requirements gathering, design, coding, testing and maintenance.
• Helped IT developers design the service oriented architecture SOA for the application based on the available resources, and the business requirements.
• Intensive working on the current ICD code conversion from ICD 9 to ICD 10, assisting and leading various teams by complying with already going works in the health care domain and work with the conversion.
• Involving in the Execution of Test cases for the Verification of flow of e-Apply Application, Reports , Interfaces and IVR and SOA testing.
• Participated in UAT with end users to check the Compliance of the system with the business Track defects and documented them in Rational Clear Quest.
• Involved in FACETS end to end testing of FACETS Billing, Claim Processing and Subscriber/Member module.
• Developed manufacturing processes for Military Hybrids per Mil-Std-38851 and Mil-Std-883C, and IPC-A-610C.
• Worked on Hybrids and did some troubleshooting on them.
• Produced Gap Analysis documents for HIPAA 5010 and ICD-10
• Adopted and trained coworkers on software development methodologies, including Agile, Waterfall, and hybrids Completely comfortable working in an ambiguous and pressurized environment Consistently delivered stakeholders' projects on time and within defined budget
• Met with business users and stakeholders to understand the customer requirements through surveys, interviews group and one-on-one along with JAD sessions.
• Identifying process and technology improvement opportunities that solve technical and/or business issues of varying complexity
• Recorded the Test cases using Automation tool QTP and checked the functionality of the application for every release
• Web services testing using SOAPUI Get Mehod, POST Method -SOAP and RESTFul JSON in Java
• Web services testing by SOAP UI tool.
• Responsible for creating business work flows and processes and creating management reports based on the analysis.
• Identified Gaps between legacy MMIS and New Web-Based application.
• Parameterized the scripts to avoid code redundancy and avoid hard coding of frequently changing values using Quick Test Pro QTP
• Knowledge of HIPAA ANSI X12 4010/5010 formats including EDI transactions 270/271, 276/ 277, 837/835, 834, 997 and codes NPI, ICD9/ICD10 NDC, DRG, CPT, NCPDP
• Worked as UAT Defect manager, managing defects for User Acceptance Team, designed prototypes for UAT testers, organizing meetings, resolving defects and retesting fixes, deliverables.
• Executed and recorded results of test cases using QTP as the tool. Interacted with developers to report software bugs and re-tested the fixed issues found during UAT.
• Researched EDI claims and claims adjustments data to determine root causes of data errors.
• Developed and executed SQL queries on claim records to validate reporting data.
• Writing complex SQL queries to validated 837 and 835 XML data on DA layers by performing intensive back-end querying using utilities such as SQL Navigator and TOAD on the oracle based Data marts.
• Mentored less experienced analysts and team members on data validation strategies for data warehouses and reports.
• Performed testing for Medicare, Medicaid and claims for Medicaid Management Information System MMIS
• Worked with Development Team to generate EDI HIPAA 837, 820, 834, 270, 271, 276, 277 Transaction Set using Companion Guides.
• Developed requirements specification and process diagrams including context, dataflow diagrams.
• Involved with all the phases of Software Development Life Cycle SDLC methodologies throughout the project life cycle.
• Developed Use Case diagrams by analyzing the business process followed by Class diagrams, Activity diagrams and Collaboration diagrams in UML.
• Involved in creation and execution of manual test cases in Mercury Test Director and automated Test Cases in QTP and analyzed the Test Results.
• Coordinated and attended meetings to review these specifications with the Quality Assurance Manager, Business Systems Analysts, RUP Engineers, Project Manager others on the team.

Environment: Windows 2000, MS Word, MS Excel, MS Project, IBM Web Sphere, SOAP UI, FACETS, C, QTP, C , MS Visio, HTML, XML, Informatica ETL Tool , Java, Oracle.

Confidential

QA Analyst

The Hospital Management System provides fully integrated software that allows seamless flow of information within a hospital and across hospital networks. The system allows for an environment where the healthcare provider is capable of electronically-accessing active and historical patient information regardless of where it resides.

Responsibilities:

• Involved in reviewing Business Requirement Documents and the Technical Specifications for Facets Claims/Services/ Providers/ Enrolments
• Prepared Test Scenarios and Test Cases as per functional
• Used Mercury Quality Center in Citrix environment to manage the requirements, test cases and also defects.
• Worked as UAT Defect manager, managing defects for User Acceptance Team, designed prototypes for UAT testers, organizing meetings, resolving defects and retesting fixes, deliverables.
• Performed Manual testing prior to automate testing on the application.
• Involved In Testing the EDIs according to HIPPA code set 834 enrolment and disenrollment in a health plan using QTP
• Involved in testing EDIs according to code set X12 835 Claim Payment Remittance Advice Claims processing and 837 Claim transactions.
• Ensured all artifacts complied with corporate SDLC Policies and guidelines.
• Generated and Edited the scripts using VB Script in QTP for Automation
• Conducting validations using check points and transactions in QTP to perform System Testing
• Designed the Recovery Scenarios using External Function calls.
• Web services testing using SOAPUI Get Mehod, POST Method -SOAP and RESTFul JSON in Java
• Involved in gap analysis and implementation of HIPAA 5010, ICD 10 and Claim Validations.
• Used XML files in Sending/receiving XML requests using SOAPUI.
• Extensively used Fiddler to validate the Web Services - Restful Conversion and SOAP.
• Analyzed the business requirements, functional specification and use case documents.
• Developed test plans, test cases using requirements, use cases, wire frames and design documents.
• Developed manufacturing processes for Military Hybrids per Mil-Std-38851 and Mil-Std-883C, and IPC-A-610C.
• Worked on Hybrids and did some troubleshooting on them.
• Performed extensive manual testing of each module.
• Interacting with developers on various issues relating to software defects, builds.
• Performed the stress testing by varying loads using Load Runner on the server by way of changing the virtual users and monitoring the servers.
• Performed data-driven testing on Oracle RDBMS with SQL queries and wrote PL/SQL stored procedures as well.
• Compiled test metrics on a weekly basis and tracked the status of the test cycle.

Environment: Quality Center, QTP, LoadRunner, Windows NT, SOAP UI ,SQL Server, SQL, PL/SQL, Oracle 9i

Confidential

QA Tester

Project: Confidential It is a part of U-verse to support light speed where delivery of the VoIP, Enhanced Broadband and Switched Video Services to the Consumer Market through deployment of fiber cable. The application is accessed via different channels like consumer's TV U-verse , telephone i.e. via call center or the internet.

Responsibilities:

• Analyzed business requirements, Functional Requirements, Technical Specifications.
• Prepared test strategy, test scripts, test scenarios, modular automated tests from the business requirements.
• Performed Integration, Functional, Data Integrity, GUI, Navigational and Regression Testing.
• Maintained Bug tracking status using Quality Center and performed regression testing on fixed bugs.
• Wrote data extraction data population queries to SQL server for conducting load tests.
• Adopted and trained coworkers on software development methodologies, including Agile, Waterfall, and hybrids Completely comfortable working in an ambiguous and pressurized environment Consistently delivered stakeholders' projects on time and within defined budget
• Worked on Hybrids and did some troubleshooting on them.
• Developed manufacturing processes for Military Hybrids per Mil-Std-38851 and Mil-Std-883C, and IPC-A-610C.
• Performed Server Side Testing using Fiddler to validate Request and Response in Soap and Rest Services between Client and Server.
• Performed functional testing of LSPE application and analyzed the response times under various loads, using Loadrunner.
• Building and running test cases using the Selenium IDE.
• Maintained and managed Test Assets in Quality Center.
• Performed demos and organized various meetings with the developers, clients, and the management team to discuss major defects found during testing, enhancement issues, and future design modifications.

Environment: WinRunner 7.0, Test Director 7.6, Windows 2003/XP Professional, SOAP UI ,SQL Server 2000, SQL, MS Office 2003 and VB Script.