Objective

Seeking a fast paced dynamic environment to align my professional skills in the field of software quality assurance and software development with strong work ethic and thereby apply technical and interpersonal skills.

Professional Profile

• Seven Plus years of experience in Software Quality Assurance and Software Testing with diverse projects, clients and industry.
• Highly proficient in interacting with business users and gathering user requirements to develop necessary Test Plans, Test Cases and Test Scripts.
• Experience in both Manual and Automated testing.
• Experienced in developing Test Plans, Test Cases and Test Script.
• Extensive knowledge on HIPAA claims and administration Planning.
• Good hands on experience with EDI HIPAA transactions.
• Hands on experience on using automated tools such as QTP and Load Runner.
• Good skills for problem solving and Bug Tracking using Quality Center.
• Experience in testing Client-Server Applications.
• Extensive knowledge of Software Development Life Cycle such as Waterfall, Agile and Rup.
• Performed SIT and UAT testing.
• Performed Functionality Testing and Regression testing using QTP.
• Performed Back End Testing manually and using automated testing tool by executing SQL queries.
• Used SQL Statements to extract Data from Tables to verify the output Data of the reports.
• Involved in HIPAA Analysis and Testing such as SIT and UAT .
• Extensive Knowledge and Experience on Claims Billing, Claims re- pricing, Claims Payment Processing
• Medical Claims experience in Process Documentation, Analysis and Implementation in 835/837/834/270/271/277/997/999 X12 Standards processes of Medical Claims Industry from the Provider/Payer side
• Communicate and resolve issues with state/ federal HIX Exchange Enrollment teams
• Knowledge of health information and health care services regulatory environment including HIPAA, Medicaid/Medicare and EDI.
• Strong HIPAA EDI 4010 and 5010 with ICD-9 and ICD-10, analysis compliance experience from, payers, providers and exchanges perspective, with primary focus on Coordination of benefits.
• Good experience in creating, modifying and enhancing both manual Test Scripts and Test Scripts created by Test Automation tool Quick Test Pro.
• Experienced in creating Test Matrix, Requirements Traceability Matrix and performining Gap Analysis.
• Excellent communication skills for working independently and as a team member to deliver the goals of an organization in efficient manner

Technical Skills

Confidential

Sr. Quality Analyst

• Avality is clearing house that simplifies payments and transactions between patients, providers hospitals and payers insurance companies, Medicare and Medicaid . RCM- Revenue Cycle Management - main product which help to Simplify provider connectivity ,Improve payment accuracy and efficiency and Increase provider self-service.
• Being part of scrum team I am involved in different stories such as self pay scrub, remit regeneration, elig serialization , last visited table by using different payers such as Medicaid IL, BCBSIL, Humana, Medicaid FL, BCBSMN. In each stories we have to use different functionalities of RCM APP such as eligibility, claim submission , remittance, report analysis , payment, edit/error management, status and administration in different environments such as dev, stage test, prod support and prod.

Roles and Responsibilities :

• Planning , designing and execute test plan, test scenarios and test cases.
• Working with different transactions such as 837 I, P , 835, 270, 271,276 and 277 from end to end
• Import test cases in enterprise tester tool
• involve in everyday standup meetings and weekly planning meeting
• Involve in different kind of testing such smoke test , regression test, SIT system integration testing and UAT user acceptance testing
• Develop test plan and create test scenarios based on functional and non functional requirements
• Setup different configurations in different offices , create different groups and users and give them access
• Associate in reporting to scrum master and product owner about assigned task as well as discuss the task with other QA team members
• Create test data from ICD-9 to ICD-10 by using ICD-10 data.com
• Work on HCPC codes and CPT codes
• Validate backend testing by using SQL queries in oracle sql developer
• Using Jira to log the defect and test again once it resolved
• Using enterprise tester as testing tool to upload and execute test cases
• Involve in manual testing by using RCM app and database testing by using SQL developer tool
• Work on different type of reports such as claim detail report of Ins and Prof claims

Environment: HIPAA EDI, QTP, Quality Center, Enterprise Tester, Jira, SQL developer

Confidential

Software BA/QA

Confidential for those seeking medical, life, disability, long term care and related insurance coverage.

Roles and Responsibilities :

• Provide project level quality assurance leadership and guidance to maintaining specific software quality standards through every phase of the software life cycle Planning, Requirements, Design, Development, Release Management, Configuration Management, and Deployment Management
• Excellent problem solving, interpersonal communication, presentation, and project management skills
• Motivate team confidence to achieve and maintain quality in a creative and effective manner
• Ability to analyze business requirements and develop and build excellent test cases from those requirements
• Have a passion for achieving excellence in process and product quality and reliability
• Strong understanding of different software development life cycles such as waterfall, iterative Agile/Scrum , etc. and the use of modern software quality assurance processes and automated tools
• Proficient with Performance Test tools, Load Runner
• Tests were planned and managed using Test Director and performed Manual Testing
• Have experience in leading and working with distributed team members
• Be extremely detail-oriented with respect to documentation and communication
• Ensure delivery against all QA strategic goals and objectives
• Solid healthcare experience with Enrollment, Billing, Affordable Care Act, HIX Data Mapping experience.
• Communicate and resolve issues with federal HIX Exchange Enrollment teams.
• Involved in Facets Output generation.
• Design and execute Test Matrix, Test Plans, Test Cases, and Test scenarios
• Hands-on experience with all aspects of functional test automation using HP's Quick Test Pro QTP and Hp- Quality Center QC
• Define test cases, establish the requirements traceability matrix for functional and nonfunctional requirements, identifies test data, and assists in the development and execution of test scripts and validation of test results
• Knowledge of claim processing claim adjudication in backend system mainframe
• Test HIPAA transaction ANSI X12 STD and code set standards such as 837/835 transactions I,P , 270/271,276/277/999 and others
• Create test data from ICD-9 to ICD-10
• Validate backend testing by using SQL queries in oracle sql developer
• Work on different type of reports such as claim detail report of Ins and Prof claims
• Planning , designing and execute test scenarios and test cases.
• Worked with providers and Medicare or Medicaid entities to validate EDI transaction sets or Internet portals. This includes HIPAA 4010 837, 835, 834,270/271, and others.
• Created and maintained SQL Scripts and UNIX Shell scripts to perform back-end testing on the oracle database.
• Test HIPAA transaction ANSI X12 STD and code set standards such as 837/835 transactions I,P , 834,270/271,276/277/999 and others
• Work on HIPAA EDI 4010/5010 with ICD-9and ICD-10, analysis and compliance experience from payers, providers and exchanges perspectives with primary focus on coordination of benefits
• Perform different kind of testing like SIT and UAT.
• Work on claims interfaces for members and providers
• Develop the script by using automation tools such as QTP
• Strong knowledge of HP- QC

Environment: HIPAA EDI, QTP, Quality Center, FACETs, Oracle, UNIX, Windows, DB2, SQL

Confidential

Software Quality Analyst

Roles and Responsibilities :

• Plan, Design and Execute functional , manual and regression testing based on the system requirements
• Ability to analyze business requirements and develop and build excellent test cases from those requirements
• Prepare and develop test strategies and test plans.
• Write, review and analyze test data
• Verify quality standards and test procedures
• Understand Testing QA strategy
• Strong knowledge of HP- QC
• Develop the script by using automation tools such as QTP
• Manage and communicate defect status by using Quality Center and updates with developers
• Created and maintained SQL Scripts and UNIX Shell scripts to perform back-end testing on the oracle database.
• Tests were planned and managed using Test Director and performed Manual Testing
• Have experience with front end and backend testing Main frame
• Validate that software meets established and reasonable performance guidelines.
• Test HIPAA transaction ANSI X12 STD and code set standards such as 837/835 transactions I,P ,834, 270/271,276/277/999 and others
• Work on HIPAA EDI 4010/5010 with ICD-9and ICD-10, analysis and compliance experience from payers, providers and exchanges perspectives with primary focus on coordination of benefits
• Experience with Functional, Performance, Stress/Volume, Regression, User acceptance and Integration/System
• Testing.
• Perform Functional, integrations and UAT testing .
• Work on claims interfaces for members and providers
• Work with CICS customer information control system
• Perform End to end claim testing, COB, OPL and TPL claims
• Create Data by using PX, DX , RX and HCPC code
• Work on Pricing Method

Environment: HIPAA EDI, QTP, Quality Center, Oracle, UNIX, Windows, DB2, SQL

Confidential

QA Analyst

Responsibilities:

• Developed Test Cases for manual and automated testing of an application.
• Gathering the requirements and analyzing the requirements.
• Conducted Functional, Integration and Regression testing.
• Analyzed HIPAA 5010 standards for 837P transactions, related to providers, payers, subscribers and other related entities.
• Worked on 834 and 835 projects, including syntax and business rules for X12 HIPAA 4010 and5010 validation for loops, segments, elements, qualifiers and code sets.
• Worked with providers and Medicare or Medicaid entities to validate EDI transaction sets or Internet portals. This includes HIPAA 4010 837, 835, 834, 270/271,999 and others.
• Also worked on 837 ,834 and 835 projects, including syntax and business rules for X12 HIPAA 4010 and 5010 validation for loops, segments, elements, qualifiers and code sets.
• UAT testing for HIPAA 4010 and 5010 projects including legacy testing and HIPAA requirements and compliance mandates.
• Knowledge of claim processing claim adjudication in backend system mainframe
• Performed back-end testing procedures using SQL statements
• Recorded scripts in QTP to perform Functionality testing.
• Tests were planned and managed using Test Director and performed Manual Testing
• Using VB scripting in the expert view did enhancements to the scripts.
• Created different types of checkpoints Standard, Text, Text Area, Bitmap, and Database and checked for properties of fields with respect to requirements.
• Imported/Exported Excel sheets with Parameterized values into/from QTP.
• Managed property values for objects in the Object Repository.
• Developed automation test scripts for performing regression testing on the application using Quick Test Pro
• Perform Backend testing by extensively using complex SQL queries to verify the integrity of the database.
• Performing GAP analysis for the existing systems and processes.
• Conducted Back-End Testing and Regression Testing using various phases of the application.
• Completed several HIPAA 4010 and 5010 Projects, included Medicaid and Commercial entities. Projects include claims and enrollment testing as well as NPI and medical coding and ICD-9 EDI testing.
• Perform Functional, integrations and user acceptance testing- UAT testing.
• Validated triggers using Toad for Oracle.
• Perform End to end claim testing, COB, OPL and TPL claims
• Create Data by using PX, DX , RX and HCPC code
• Work on Pricing Method
• Involved in exporting data from the database to flat files using Toad for Oracle.
• Identified, analyzed and documented defects, error and inconsistencies in the application using Quality Center.
• Created and maintained Test Matrix and Requirement Traceability Matrix and performed GAP Analysis.

Environment: HIPAA EDI, QTP, SOAPUI, Quality Center, Oracle, UNIX, Toad, Windows, DB2.

Confidential

QA Analyst

• Aetna Inc, an American Healthcare company provides consumers directed healthcare products, including medical, pharmacy, dental, behavioral health , group life, long-term care and disability plans, and medical management capabilities.
• The project AIM Aetna Individual Markets was to design an automated underwriting business function, Consumer Portal-Interface for online enrolment, eHealth, eVendors-Broker sites that route business to Aetna through their websites, Billing and enrollment-for Approval/Declines of applications.

Responsibilities:

• Identified the requirements for accommodating HIPAA 5010 standards for 837P transactions and captured these requirements to develop new GUI for the internet based application.
• Participated in setting up testing environment.
• Involved in preparing Test Cases based on business requirements.
• EDI Conversion from 4010 to 5010.
• Tested HIPAA Transactions and Code Sets Standards such as 837/835,834,270/271, 276/277/999 transactions.
• Tested 837/ 835, 834, 270/271, 276/277/999 transactions with File Aid.
• Authored and executed Test cases for Claims and Customer Service Workflow by manually.
• Responsible for writing the Test Cases and Test Scenarios based on the Functional Specification and technical Specification and documented in Mercury Quality Center.
• Wrote Automated Test scripts using QTP.
• Tests were planned and managed using Test Director and performed Manual Testing
• Recorded scripts in Quick Test Pro to perform Functionality testing.
• Imported/Exported Excel sheets with Parameterized values into/from QTP.
• Using VB scripting in the expert view did enhancements to the scripts.
• Managed property values for objects in the Object Repository.
• Inserted Check Points to check the broken Links, Text, and standard properties of an object using Quick Test Pro.
• Solid healthcare experience with Enrollment, Billing, Affordable Care Act, HIX Data Mapping experience.
• Performed GUI, Functionality and Regression Testing in QTP.
• Performed data driven testing using Quick Test Pro.
• Responsible for Back-End Testing Using SQL Commands using TOAD.
• Perform functional, exception and scenario testing.
• UAT testing for HIPAA 4010 and 5010 projects including legacy testing and HIPAA requirements and compliance mandates.
• Logged the errors, reported defects, determined repair priorities and tracked the defects until resolution using Mercury Quality Center.
• Work on claim processing system
• Extensively used SQL statements to query the Oracle Database for Data Validation and Data Integrity.
• Created and maintained SQL Scripts and UNIX Shell scripts to perform back-end testing on the oracle database
• Responsible for performing System and integration testing for release.
• Identified, analyzed and documented defects, error and inconsistencies in the application using Quality Center.
• Created and maintained Test Matrix and Requirement Traceability Matrix and performed GAP Analysis.
• Performed User Acceptance Testing UAT .

Environment: Facets, Windows, QTP, UNIX, Oracle, Quality Center, DB2.

Confidential

Quality Analyst

Responsibilities:

• Design and execute Test Plans, Test Cases, generate Test Scripts and Test scenarios. Designed, Communicated, and enhanced QA testing plan for the application. Wrote and executed Test cases and reported defects using Quality Center.
• Involved in creating documents and diagrams for Membership Enrollment according to the HIPAA 834 Compliance Standards for Membership Enrollment.
• Developed and implemented detailed test plans and test cases.
• Performed sanity and smoke testing on the application.
• Responsible to work on MMIS Medicaid Management Information System which includes two divisions: HIPAA compliance and Maintenance units division and Claim processing division. Thoroughly understand the HIPAA Title I and II rules to create the secure health plans for the customers. Prepared Test cases, according to the business specification and HIPAA standards. Performed System testing, Integration testing and Usability testing in Quick Test Pro by inserting various check points necessary for HIPAA and Medicaid standards. Conducted Security, Positive and Negative testing on the application manually. Created and Executed Test Procedures for Integration and Regression Testing and verified the results against HIPAA standards. Performed back-end testing by extensively using SQL commands to verify the database integrity. Solid healthcare experience with Enrollment, Billing, Affordable Care Act, HIX Data Mapping experience Communicate and resolve issues with State HIX Exchange Enrollment teams. Created and maintained SQL Scripts and UNIX Shell scripts to perform back-end testing on the oracle database. Involved in creation and maintenance of Test Matrix and Traceability Matrix. Analyzed test results using reports and graphs generated in Quality Center.
• Maintained and systematized the documentation process.

Environment: Windows 2000/XP, Oracle, UNIX, QTP, Quality Center.

Confidential

QA Tester:

HMS enables better patient care, patient safety, efficiency, and reduced costs. It provides easy access to critical information there by enabling the management to take better decisions on time. Vaidya Hospital System 4.0, Hospital Management System. Vaidya Hospital System 4.0 has Appointment, scheduling, Inpatient, Out Patient, Case History, Investigations, Pharmacy, Reports, Vaidya Dental Practice 3.0, It is Dental Clinic Practice Management software.

Responsibilities:

• Involved in analyzing the applications and development of test cases.
• Tests were planned and managed using Test Director and performed Manual Testing.
• Tested Various Modules like Admissions, Outpatient and Inpatient Billing and Laboratory Modules, Reports and Dental Practice Management Modules.
• Performed testing of GUI consistency against different browsers running on windows against various screen resolutions.
• Performed Parameterization using Data Driver.
• Inserted GUI checkpoints, Database Checkpoints, Text checkpoints and Bitmap checkpoints to check and analyze the state of application module after transaction.
• Responsible for identifying the functional test cases for Regression Testing and automated these scripts using Win Runner.
• Performed Regression Testing using Win Runner.
• Developed test scenarios and test procedures based on the test requirements.
• Wrote SQL Queries to retrieve the data from various Tables and to test the database.
• Defects were identified and reported to the development team using Test Director.
• Involved in preparing User manual and End-user training.