• Over 7 years of diverse experience in Information Technology with emphasis on business and system analysis of applications. Well versed with all aspects of Software Development Lifecycle, Waterfall Process, and Agile Methods.
• Followed the RUP based methods using UML to create Use Cases, Activity Diagrams, State Chart Diagram, Sequence Diagram etc.
• Proficient in business analysis, business modeling, document processing, quality assurance to manage, develops and test products. Established and maintained strong working relationships with senior and junior business sponsors as well as technical specialists.
• Extensive experience to gather requirements and categorized them into FURPS Functionality, Usability, Reliability, Performance and Supportability .
• 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 .
• Expertise in Rational tools for Requirement Management, Business Process Modeling and defect tracking like Rational Req Pro, Rational Rose, Rational Clear Case, and Rational Clear Quest.
• Used requirement elicitation techniques like Interviewing, Brainstorming, Joint Application Development JAD , and Rapid Application Development RAD sessions.
• Extensive knowledge of Integration Systems like TIBCO, GIS, STERLING.
• 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.
• Proficient in creating Use Case diagrams, Sequence diagrams, Activity diagrams, Class diagrams, E-R diagrams, and Data modeling using MS Visio and Rational Rose.
• Created mapping documents for X-12 transactions to TIBCO CBO and to the Database.
• 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 data, Test Cases and Test Scripts using Test Director, Test Manager.
• Extensive experience in writing and executing complex SQL queries using TOAD 9.0.1 to validate data within SQL Server 2007 database.
• Experienced in writing test queries/scripts for data analysis and QA report testing
• Experienced in testing applications developed using PL/SQL, Java, J2EE, HTML, XML, ASP, Visual basic and C/C .
• Extensively worked with Mainframe system and Mainframe technologies COBOL, JCL, VSAM, DB2, and CICS, on MVS, OS/390 and Z/OS systems.
• Strong knowledge of project management skills like time estimation, task identification and scope management.
• Strong experience in conducting User Acceptance Testing UAT .
• Extensively used Clear Quest for bug tracking and Clear Case for Requirements traceability and document version control.
• Involved Unit Testing, System Integration Testing, System/Black Box Testing, and Regression Testing with QA team.
• Experienced in Object Oriented Analysis, Data Analysis, Requirement Analysis, Business Modeling and Use Case development using UML methodology
• Expertise in developing QA Test Plan, Test Conditions, and Test Cases ensuring adequate testing of software both before and after completion conducting and documenting UAT.
• Expertise in the management of User Request Change, and handle User Conflicts.

Confidential

Quality Assurance Analyst

Confidential of Tennessee's mission is to provide its customers and communities with peace of mind through affordable solutions for health and healing, life and living. Confidential patient-centric products and services that drive health improvement and positively impact health care quality and value. Confidential of Tennessee Inc. is an independent licensee of the Confidential Association Currently, working on a Blue branded market place project and the scope of the project is with submitting either X12 batch files or web transactions to check mapping at middleware and then response at mainframe. Where validation of various procedure and diagnosis codes for 837 Professional health care claims and 834 Benefit enrollment and maintenance .

Responsibilities:

• Analyzed user requirements and developing test plans, test cases, and test procedures to test the functionality.
• Involved in preparation of Test Plans, Test Scripts, Test Summary Reports and Test cases in Test director.
• Involved in creation of positive and negative Test Scenarios.
• Involved in Regression testing on each build during the various phases
• Participated in preparation of test data and document test data
• Tested the Manual claims, pended claims and Multiplan claims. Involved in developing Test Plans and Test cases for the transactions 837, and 834.
• Tracked defects using JIRA and generated defect summary reports
• Created traceability matrix between requirements and test cases.
• Engaged in Backend testing by using SQL queries in conjunction with database execute methods to access data from different database tables.
• Involved in developing Test Incident Report for Defects on Daily, Weekly and Module basis.
• Performed E2E end to end , System, Integration, Functional and Back End testing.
• Performed End to End testing starting from validating E B, creating auths, submitting claims, validating payment and claim status.
• Researched the existing client processes and guided the Vendors in aligning the HIPAA compliance output with the client systems.

Environment: Jira 4.0,5.0, Windows 2010, LINUX, SQL EDIFECS Ramp Management tool, Spec Builder, IBM Data Studio, Quick Test Pro, Visual Basics, SQL Navigator, Window XP, EDI generator and analyzer, Mainframe System, TSO/ISPF, FILE-ID/MVS, FILE-ID/DB2, Quest.

Confidential

EDI Testing specialist

Confidential is one of the nation's leading providers of health care, disability, life, and accident insurance benefits. Cigna helps companies succeed by helping to improve the productivity and quality of life of their employees. Confidential is the only health benefits company with its own pharmacy, behavioral, dental, vision and disability businesses, therefore its able to provide industry-leading services that treat the whole person.The scope of the project was the conversion of the 270/271, and 276/277 EDI format from 4010 X12 formats to the 5010 X12 format. Gap Analysis is carried out to identify all changes before actual testing. Worked on all HIPAA transactions, which are Eligibility and Benefits 270 , Medical Clearance 278 , Provider Claim Status 276 .This project deals with submitting either X12 batch files or web transactions and to check mapping at middleware and then response at mainframe. Currently, working in a project where conversion from 4010 to 5010 format occurs and validation of various procedure and diagnosis codes for 278 Medical Clearance at gateway is done.

Responsibilities

• Actively participated in all phases of testing lifecycle Test Planning, Test Analysis and Design, Test implementation, Evaluating Exit Criteria and documentation, Test Closure Activities
• Analyzed user requirements and developing test plans, test cases, and test procedures to test the functionality.
• Involved in preparation of Test Plans, Test Scripts, Test Summary Reports and Test cases in Test director.
• Involved in preparation of positive and negative Test cases.
• Participated in system testing, Regression testing and UAT.
• Participated in preparation of test data and document test data
• Understood and analyzed differences between 4010 and 5010 formats for each segment.
• Verified the EDI raw data as per 5010 formats.
• Involved in System and Integration Environment testing.
• Followed waterfall process throughout the SDLC.
• Tested the Manual claims, pended claims and Multiplan claims. Involved in developing Test Plans and Test cases for the transactions 270/271, and 276/277.
• To validate various field types: Text field, drop down or radio button, screen labels, field lengths and required/situational fields, as per 5010 requirements are tested and validate whether it mapped to X12 format correctly.
• Performed Batch testing where scripts are generated governed by CONTROL M jobs, which run automatically, and enqueued auths 278 present in FQ to Diamond claims management system .
• Manually Conducted Positive and Negative testing.
• Wrote test cases and executed them manually from HP Quality Center to test the application for its functionality, system integration.
• Performed E2E end to end , System, Integration, Functional and Back End testing.
• Performed End to End testing starting from validating E B, creating auths, submitting claims, validating payment and claim status.
• Perform EDI batch testing, creating EDI files according to scenarios and validate mapping of each data element and major 5010 changes.
• Tested NIA and I-core vendor transaction and implementation of 5010 changes using SOAP UI tool.
• Involved in creating Auth, inquiring and updating Auth for 278 transactions.
• Involved in gathering Test data from Mainframe system
• Involved in testing Provider Claim Status web portal 276 transactions to validate all fields mapped correctly at Gateway.
• Involved in creating different NPI scenarios and validate adjudication of claims in Diamond
• Performed automated testing using QTP tool and involved in automated and manual during release end.

• Documented and analyzed defects using Quality Center and tracked them to completion by communicating with the team.

Environment: Quality Center 10.0, IGATE,HP Screen Recorder, EDIFECS Ramp Management tool, SpecBuilder, IBM Data Studio, Quick Test Pro, Visual Basics, SQL Navigator, Window XP, EDI generator and analyzer, Mainframe System, Diamond Claim Processing Tool ,TSO/ISPF, FILE-ID/MVS, FILE-ID/DB2, Quest, IBM data studio, SOAP UI,Microsoft .Net Application C .Net, ASP.Net ,

Confidential

Quality Assurance Analyst

Confidential is one of the largest life insurers in the Confidential. A member services application developed in client/server architecture and web-based portal. Web based portal registers members to obtain details of long term car insurance schemes and benefits.

Responsibilities:

• Reviewed the Business Requirements document with the business and development team to understand the architecture and functionality of the application.
• Performed Manual and Automated testing using QTP.
• Developed the Test Plans, Test Cases, Test Scenarios and executed them using QTP and Perform Data Driven Testing for multiple sets of data. .
• Reviewed test cases based on functional requirements and use cases specifications.
• Developed and wrote a suite of Test Scripts that included User Acceptance, Functional and Regression test cases using QTP.
• Enhanced the scripts by descriptive programming, Parameterization, synchronization points, check points, regular expression and associating function libraries.
• Involved in implementing the Automation Frameworks and used various customized tools for the process of key driven testing and data driven testing.
• Coded in VB for some of the functions in the framework library files, environmental files in descriptive programming. And automated result which includes its snapshots in html.
• Developed various object repositories to develop effective scripts and designed master Scripts so as to invoke sub scripts.
• Involved in different phases of SDLC and Agile methodology.
• Attended in scrum meetings with Business Analysts and Software Developers.
• Wrote SQL, PL/SQL queries to access the data from the database tables and crosscheck the results to perform the Back End Testing.
• Executed the test scripts on different releases and validated the actual results against the anticipated results.
• Analyzed and developed the test results reports.
• Debug the Test Scripts, created Batch tests, verifying the Test results and reporting the defects to Test Director.
• Also took part in the daily standup meetings with Sr. Business Analyst and managers and understood various process plans, business process, and functionality in detail.

Environment: Visual Basic, Oracle, Test Director 7.5, QTP 8.2, Windows XP, MS Outlook Express, XML Web Services, Excel.

Confidential

EDI Tester

Responsibilities:

• Involved in writing Test scenarios, Test plans, Test cases and responsible for executing the Test Scripts.
• Responsible for designing, developing test plans use cases and executing test scripts.
• Performed Integration, functional, Regression, and system testing.
• Interacted with Business users and Technical team in providing clear solutions to requirements.
• Involved in testing HIPAA EDI Transactions and mainly focused on PA and 270/271 Eligibility Transactions.
• Experience working with FDA regulatory process and standards.
• Transactions focused on were 270,271, 834, 835, and 837.
• Worked Extensively with Inbound 837 I and 837 P, 835s Out bounds claims processing systems
• Experience in documenting Electronic Medical records submitted for audits to the Department of Federal Drug and ensuring that the Part 11 is met with all the necessary rules as established by the FDA.
• Extensively used the MVS utilities like File-Aid, QMF and DB2 Load for scheduling the jobs.
• Used Clarity tool to verify mapping to X12 format.
• Used IBM Mainframes- CICS, ISPF, File Aid, IMS, and TSO for mapping Datasets and fields.
• Worked on JCL to run the batch during the end of the business day
• Used Quality Center for preparing the test plans and manual test scripts.
• Worked extensively with Quality Center for requirements, Preparing Test cases, Executing, Defect openings and closings.
• Involved In loading the flat files into Oracle Database and involved in writing Complex SQL Queries.
• Involved in generating Reports using Oracle Report Builder and testing the reports using Oracle Run Time.
• Involved in writing Complex SQL Queries using TOAD to validate the loads for Caremark and DEA.
• Involved in writing UNIX shell scripts.
• Executed a whole bunch of PL/SQL code including stored procedures, functions and triggers using TOAD.

Environment: Cobol, CICS, EDI X12N 4010, Sybase Paper Free HIPAA Toolkit, DB2, TSO/ISPF, FILE-ID/MVS, FILE-ID/DB2, Endeavor, Serena Changemen, XPEDITOR, SPUFI, QMF JCL, CA-ADS, Visual Basic, ASP, Java Script, VB Script, XML, SQL, MS Access, UNIX, Oracle Run Time, IAS Web server, Web logic, BEA Tuxedo, Windows95/98/NT/2000/XP and Internet Explorer.

Confidential

EDI Tester

Farmers offer various insurance policies to customers. Confidential is designed for quote, new business and customer care models. The main purpose of Confidential is to get the quote for auto insurance through online.

Responsibilities:

• Automated and customized the scripts for the entire application using Quick Test Professional.
• Reviewed the Business Requirement specification Document and the technical specification of the application
• Reviewing System Requirements to define testing scope for various levels of testing Functional, System, Regression, and UAT .
• Experience testing Transaction processing system for End Users during UAT and ensuring that payments made and received were calculated based on all the Business rules.
• Developed Test Objectives and Test Plans.
• Created manual and automated Test Cases and Test Scripts.
• Created Standard, Image, Table, Page, Text/Text Area Checkpoints.
• Parameterized the test s and modified steps affected by parameterization.
• Worked with developers to communicate regarding issues in the application.
• Coordinated the testing effort towards End-to-End testing to verify the proper functioning.
• Created several compiled modules and high level scenarios
• Creation and execution of low level test scripts for functional testing
• Interacting with the clients for status updates and understanding requirements
• Coordinating with the vendor Stellent to convey the requirements
• Coordinating with the development team for bug fixing.
• Creation of automation suite for the regression testing using QTP 9

Environment: Windows 2000, HTML, Java, MS SQL Server, Test Director 7.0

Confidential

QA Tester/BA Analyst

Confidential Web and Claims Adjudication process, As a QA Analyst performed functional, regression, performance and UAT testing of various functionalities like member enrollment, benefit administration, billing, reimbursement, claims productivity, claims adjudication FACETS to ensure consistency and also to make the system user-friendly and error-free for its customers. Interacted with the End users and conducted JAD sessions to ensure that their requirements are compliant with the code tested.

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.
• Interacted with Business users and Technical team in providing clear solutions to requirements.
• Involved in testing HIPAA EDI Transactions and mainly focused on PA and Eligibility Transactions.
• Experience working with FDA regulatory process and standards.
• Transactions focused on were 270,271, 834, 835, and 837.
• Worked Extensively with Inbound 837 I and 837 P, 835s Out bounds claims processing systems
• Experience in documenting Electronic Medical records submitted for audits to the Department of Federal Drug and ensuring that the Part 11 is met with all the necessary rules as established by the FDA.
• Extensively used the MVS utilities like File-Aid, QMF and DB2 Load for scheduling the jobs.
• Used Clarity tool to verify mapping to X12 format.
• Modifying JCL's accordingly to run the required tests submitting the batch jobs
• Base-line and Regression tests were scheduled and performed on every Release and build.
• Use of QMF and SPUFI in extracting the queries and File Aid to edit Data sets
• Extensively involved in real time testing.
• Review FTP processing jobs using with Core FTP Lite tool.
• Extensively involved entire Reference subsystem with COBOL and JCL jobs.
• Extensively involved in Reference Interface In bound and out bound testing.
• Used IBM Mainframes- CICS, ISPF, File Aid, IMS, and TSO for mapping Datasets and fields.
• Worked on JCL to run the batch during the end of the business day
• Used Quality Center for preparing the test plans and manual test scripts.
• Worked extensively with Quality Center for requirements, Preparing Test cases, Executing, Defect openings and closings.
• Involved In loading the flat files into Oracle Database and involved in writing Complex SQL Queries.
• Involved in generating Reports using Oracle Report Builder and testing the reports using Oracle Run Time.
• Involved in writing Complex SQL Queries using TOAD to validate the loads for Caremark and DEA.
• Involved in writing UNIX shell scripts.

Environment: EDI X12N 4010, Sybase Paper Free HIPAA Toolkit, DB2, LDAP, TSO/ISPF, JCL, Visual Basic, ASP, XML, SQL, MS Access, UNIX, Oracle Run Time, Windows95/98/NT/2000/XP and Internet Explorer, I-Frame Port lets, Site minder.