Professional Experience:

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• Over 7 years of experience Software quality assurance, including developing test plans, test procedures/test cases, test scripts, and carrying out tests like black box testing, regression testing, system testing, user/business acceptance testing, performance testing, unit testing.
• Key expertise includes testing and debugging GUI and Multi-Applications environment and automated testing using Quick Test Pro, Quality Center, Win-Runner and performance testing using Load-Runner on Windows
• Sound experience in Creating Test Plan, Test Case, Test Procedures and Test Metrics
• Expertise in formulation of Test scenarios, Test cases, scripts and their execution
• Good experience working as Quality Analyst in Agile and Waterfall methods.
• Experience in all facets of Software Development Life Cycle SDLC , including requirements gathering, designing, coding, testing, and deployment
• Scheduled jobs, prepared batch flows, system and integration test plans. Involved in
• Provided 24X7 supports for production implementation.
• Adept at gathering and documenting requirements, assessing business objectives, and managing all stages of software development and implementation.
• experience in architecture, design, development and implementation of legacy
• Extremely well organized, with proven ability to multi-task and prioritize workload.
• Tested web applications in waterfall and Agile Process.
• Analyzed Business Requirements, Software Requirement Specification to create test plan and test case For Manual and automated testing.
• Experience in different types of testing for example Black Box, White Box, Functional, GUI Testing System, Integration and Performance Testing.
• Good hands of experience on HPSD and Service manager tools.
• Hands-on experience leading all stages of system development efforts, including requirements definition, design, architecture, testing, maintenance and support.
• Excellent skills at programming in PL/SQL, SQL Queries, customization of Reports and Forms, Unix Shell programming.
• Worked as Onsite and Offshore co coordinator.
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Technical Summary

PROFESSIONAL EXPERIENCE:

Confidential has on going Legacy CA-MMIS operations under which includes CA-MMIS Replacement System Design, Development and Implementation DDI. It also includes Implement and Configure a transfer system to replace the Legacy CA-MMIS system. The system is also adding the new functionality to allow the Legacy CA-MMIS to process claims using the new 5010 transaction codes.

Responsibilities:

• Forecast / Estimate the testing requirements and develop and implement test plans, test approach, test procedures based on the test strategy with Time Schedules, Estimated Efforts, Resources, Software, Builds, and required Tools.
• Reviewed and analyzed System Requirement Specs SRS , High Level Requirements HLR , Detailed Business Requirements DBR and design documents.
• Worked closely with Subject Matter Experts to perform gap analysis on ICD 9 and ICD 10 Procedure and Diagnosis Codes to understand differences and new changes to be implemented for ICD 10 codes.
• Extensively worked on testing different types of claims like 837I, 837P, 835 for both Paper and Computer Managed Claims CMC .
• Worked on various Quality Control reports generated through different subsystems of MMIS for validating changes for ICD 10 enhancement.
• Created and maintained templates such as: Quality Strategy, Traceability Matrix, Test Scripts, Test Calendars, Testing Issues, and Test Reports.
• Participated in status meeting.
• Reviewed and analyzed Business requirement documents
• Worked with SQL and PL/SQL relating to testing for test datasets creation and results verifications.
• Logged the defects in ClearQuest maintaining right priority and managed the defects through it
• Analyzed modules and designed test scenarios and test scripts in UNIX environment.
• Extensively worked on Data Extraction, Transformation, and Loading with RDBMS, Flat files
• Created mapping for moving the data from different sources into Oracle database
• Used TOAD for SQL.
• Worked closely with the QA Manager and QA Lead to discuss/decide major activities, scopes and milestones in the QA life cycle.
• Prepared test data for positive and negative scenarios to test the application, along with their expected results and established test environment accurate for executing test scripts in collaboration with other test professionals.
• Performed testing on different MMIS mainframe and non-mainframe subsystems like Claims Processing, EDMS, RTD, ACMS, OLCC and Key Data Entry.

Environment: Rational Quality Manager 4.0.1, Clear Quest 7.1, z/OS, JCL, CICS, MS Office Suite, DB2.

Confidential

Role: Software Quality Analyst for upgrading Facets from 4.71 to 5.01 versions.

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 4.71/5.01.
• Worked on Subscriber/Member, Enrollment, Claims and Pharmacy applications of FACETS.
• Executed Test Cases for Claims processing including Medical Claims Processing Hospital Claims Processing and the Dental Claims processing.
• Created new groups, subgroups, subscribers, PCP to be used as a test data for testing purpose.
• Created new members via Subscriber/Family and Enrollment for new member including new born using groups, subgroups, subscribers as and other page when needed.
• Wrote SQL queries in SQL Server Management Studio for creating data for different testing scenarios.
• Conducted Regression testing for Facets 4.71 version.
• 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, SQL Server Management Studio 2008, Facets 4.71/5.01,BizTalk, MS Office Suite, TIDAL 4.0

Confidential

Role: QA Tester- For HCI project

• HCI Unit, using intelligent optical character recognition, automated business rules, data entry, converts Explanation of Benefits EOB into an Electronic format that can be used by Hospitals, and other major Healthcare clients of Confidential.
• to update patient payment records. It also accelerate cash posting through re-association, and increase collections by establishing contractual standards and monitoring the adherence thereto by Providers, Payers and Financial institution. Top of Form

Responsibilities

• Involve in setting up testing environment.
• Responsible for creating Test Plan, Test Cases, preparing documentation after analyzing the Design Docs.
• Use of ALM- Quality Center 11.0 to create and maintain Test Requirements and to communicate the bugs with the Developers.
• Tested Imaging for ICD 9 ICD 10 Upgrade validation. Heavily responsible for the ICD projects to update from ICD 9 to ICD 10
• Perform Backend Testing extensively by using SQL Queries.
• Used TOAD and SQL developer with to view tables, indexes, stored procedures, triggers etc.
• Provide team support for assigned Healthcare Imaging HCI projects with the Offshore Team in India.
• Ensures Treasury Management products and services meet User requirements and comply with Corporate, Industry and government regulatory standards.
• Support testing for an intelligent Optical Character Recognition OCR application to support Health Care.

Environment: Application Life Cycle Management 11.0, Windows XP, HIPPA, HCI, Oracle 10g, Toad 9.5, Microsoft Project, MS Office Suite.

Confidential

Role: QA Analyst

Worked on New Hampshire and Minnesota All Payers All Claims APAC Data Reporting Program. As a part of APAC Program, New Hampshire Insurance Department NHID and Minnesota Department of Health have requested WellCare to submit Medicare Part-D Members eligibility and Pharmacy Claims regulatory reports. These reports have to be submitted for every month with previous month data.

Responsibilities:

• Developed technical design documents and mapping documents for implementing health care HIPAA transactions like 834, 837I 837D, 837P, 997,276, 277.
• Implemented HIPAA transactions 837I, 837D, 837P, 834, 276, 277 by gathering the requirements, built Maps to translate HIPAA ANSI X12 data to XML format and Custom format to X12 Format, performed unit/integration testing.
• Involved in preparing Test Cases, Test Script based on Uses Cases and BRD documents and high level X12 based business requirements.
• Used Biztalk tool to convert and map XML to X12 files and vice versa.
• Played major role in 24/7 production support for transactions like 834, 837I, 837D, 837P, 276, 277, 820.
• Used HP Quality center for defect tracking management of test cases.
• Worked with Trading Partners to establish and test communications as well as implement data exchange processes.
• Performed extensive backend testing and wrote complex SQL queries involving multiple joins.

Environment: Oracle 10g, HP Quality Center 9.5, Edifecs X-engine, Spec builder, Biztalk, PL/SQL, Oracle SQL developer, Toad, Microsoft Project, MS Office Suite

Confidential

QA Analyst

Responsibilities:

• Designed and developed Test plan, Test strategies, and Test Cases using Quality Center.
• Managed quality and testing deliverables, including coordination across interfacing segments
• Validated EDI 270/271 Healthcare Eligibility Benefit Inquiry and Response are HIPAA Compliant
• Formulated system design, methods, procedures, policies and workflows affecting Medicare/Medicaid claims processing in compliance with government compliant processes like HIPAA/ EDI formats and accredited standards like ANSI.
• Involved in testing HIPAA EDI Transactions.
• Wrote SQL Queries to conduct backend testing.
• Involved in testing the Member Enrollment, Eligibility Enquiry, Eligibility Response, Claim Status Enquiry, Claim Status Response and conversion of Financial Claims
• Performed User Acceptance Testing UAT and was fully involved until implementation.
• Developed high-level design of new processes, graphically presented IT management.
• Defined structured testing methodology and standard testing procedures
• Created Functional and Integration Test Folders in Quality Center
• Reviewed EDI 837 claims and flagged HIPAA non-compliant claims received from the Payer side.
• Managed and coordinated testing process with in-house testers and outside testing resources

Environment: Quality Center, .NET, C, XML, Java, HTML, Web logic, SQL

Confidential

QA Analyst

The PHCS Network is the largest proprietary preferred provider organization PPO network in the country. With nearly 450,000 providers and over 4,000 facilities in the Network, health plan members have access to a quality network of providers wherever they may be. PHCS performs rigorous credentialing for providers in the Network to ensure that they meet our quality standards.

Responsibilities:

• Worked on detailed design documents and Business requirement documents in Quality Center to understand testing needs and understand complete business process.
• Prepared test data for positive and negative scenarios to test the application, along with their expected results and established test environment accurate for executing test scripts in collaboration with other test professionals.
• Assisted with testing EDI 837 I, D, P , 835, 834 transactions processing flow from the Trading Partners to the translator to the Mainframe and back to the Trading Partner.
• Performed manual testing of the application to test the system for both the functional and business requirements for positive and negative scenarios using Quality Center.
• Wrote SQL queries including select update, delete, group by, order by and various functions using TOAD for backend testing
• Worked extensively on EDI 834/835 for different business users.
• Participated in daily scrum to triage the defect tracking process.
• Generated defect summary reports and test metrics to provide project status to upper management.

Environment: UNIX, ASP, PL/SQL, Quality Center, QTP, Oracle, SQL Server, SQL Query Analyzer, SQL Enterprise Manager, CAST SQL Builder, SQL Server Compare.

Confidential

QA Analyst

The application was developed in Oracle and consisted of three main modules: 'Query', 'Policy' and 'Rate Quote'. The 'Query' model was the interface with the insurance agent to query the database and generate customizable reports. The 'Policy' module concerned the various insurance sectors including, Behavioral health, Dental and Life insurance.

Responsibilities:

• Participated in writing Test plans, Test scenarios and Test cases, software documentation from business, technical and functional requirement.
• Used Quality Center to track and report system defects and bugs.
• Performed Integration testing, Functional Testing, Black Box Testing, User acceptance testing and System testing.
• Involved in analysis of minimal and optimal HIPAA compliance alternatives, including the recommended approach
• Good working knowledge with HIPAA 270/271, 278, 276/277, 820, 834 Transaction and Code Set, Privacy and Security regulations .
• Set-up Multi-machine Load Test Environment using Load Runner
• Report any defects in the Quality Center Database.
• Performed regression, black box-white box, functional, data driven testing of the application using Win Runner.

Environment: QTP, Win Runner, Load Runner, Quality Center and Manual Testing, VB, HTML, DHTML, IIS, Oracle, SQL, Unix, Data warehouse.