SUMMARY

• 6 years of Software Testing, Development and Quality assurance of Client/Server and Web based applications using Win Runner, Load Runner, Test Director, Quality Center , Quick Test pro and Manual testing.
• Experience in Medicaid Management Information System MMIS . Expertise in various subsystems of MMIS- Claims, Provider, Recipient, Procedure Drug and Diagnosis PDD , Explanation of Benefits EOB .
• Extensive hands-on and HealthCare management experience in a variety of projects involving the customization, design, development, implementation, and testing of automated systems to support the Medical Management Information System MMIS as well as day-to-day business operations.
• Excellent understanding of HIPAA standards, Implementation and Knowledge of HIPAA code sets, ICD-9, ICD-10 coding.
• Good Experience with Test Management and Defect tracking tools Mercury Test Director/HP Quality Center and Rational Clear Quest.
• Involved in developing Test Plans, Test Cases, Test Scripts Manually and also using Quick Test professional QTP and Selenium, Traceability Matrix and Test Environments and analyzing Test Results manually and as well as using Quality Center QC .
• Expertise on EDI 837 transactions, ICD-9/ICD-10 codes.
• Strong knowledge of UML, RUP, Rational Suite including Rational Rose Requisite Pro, Clear Quest and Clear Case, Microsoft Visio.
• Experienced in different types of testing like Black box testing, white box testing, functional, GUI testing, Systems testing, regression,integration, UAT and performance testing.
• Extensive experience in organizing and facilitating joint application development JAD sessions, interviews and workshops with user s , subject matter experts SME's , and business stakeholders. 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.
• Extensive experience with Medicare/Medicaid processing as well as the Claims/Billing.
• Strong experience in conducting User Acceptance Testing UAT and documentation of Test Cases.
• Experienced in maintaining HP Quality Center QC which is test management tool and testing using Quick Test Pro QTP .
• Adequate knowledge in Health Administration Claims processing auto adjudication , COB, EOB/Drafts, Claims pricing and testing, HIPAA, enrollment, EDI, Medicare, Medicaid, CDHP consumer driven health plans
• Extensive experience in Functional testing, , Integration testing, Regression testing, GUI testing, Back-end testing, Browser Compatibility testing, Ad-hoc testing, Black Box Testing, White Box Testing, System Testing, Build Verification Testing, User Acceptance Testing.
• Experience in writing test plans, reviewing test cases and mentoring QA teams.
• Excellent communication and presentation skills, self-starter, quick learner, team player.
• Diverse work experience in analyzing Business Requirements and System Specifications.
• Expert in documentation using MS tools Word, Excel, Project and Access .
• Quick Learner and self-starter with ability to handle multiple tasks and work independently as well as in a team.
• Developed strong communication and interpersonal skills while working in diverse team environment

Technical Skills:

• Automation Tools : MS Visio, Rational Rose, Rational Clear Case, SharePoint, Rational Requisite Pro, Documentum, Caliber RM, DOORS
• Bug Tracking Tools : Mercury Test Director, Rational Clear Quest
• Utility Tools : MS Office Suite, MS Project, TOAD, Adobe Photoshop
• Reporting Tools : Crystal Reports, SQL Server Reports SSRS
• BA Tools : Rational suite Requisite Pro, Rose, Clear case, Clear Quest , Blueprint Requirements Center 2010, HP Quality Center 10
• Data warehousing Tools : Informatica, Business Objects, Cognos, Erwin , Crystal Reports
• Tools : SQL Developer, WinScp, Query Facillities, Queryman, BTEQ,
• Load Export, FastLoad, Mload, FastExport,
• IBM Rational ClearQuest, HP Quality Center, Quick Test Pro 8.2 ,MS Visio

EXPERIENCE

Confidential

Sr. QA Analyst

Responsibilities:

• Analyzed the business and functional requirements of the application and also helped in developing detailed test plan and test cases.
• Defined the test criteria, project schedules and base lined the Test Plan with the help of project meetings and walkthroughs.
• UsedHP Quality Center for creating test cases and created Business component for shakeout scripts.
• Analyzed the existing claims process and specific business rule logic will be applied in the requirement model.
• Conducted UAT to confirm that all derivative products can be successfully processed through stages of the trade life cycle
• Involved in performance testing of Medicaid client server claims processing system, Medicaid MCC / MCO and Medicaid Management Information System MMIS .
• Reviewed and approve technical recommendations related to software and hardware proposals RFP .Also written Request for proposal RFP for getting new MMIS system.
• Produced Gap Analysis documents for HIPAA 5010,ICD-9 and ICD-10.
• Involved in development of Advance Planning Document APD to request for federal funds and participated in the Implementation of Advance planning document IAPD and released RFP for new MMIS system.
• Involved in testing the SOAP messages across the web site and made sure results returned in XML format
• Loaded the defects on to HP Quality Center and maintained a track record of the updates on the defects from the development team.
• Executed Test Cases Manually, once the application is stable and documented the successful or unsuccessful completion of each test case in HP Quality Center QC for End-to-End Scenario based testing.
• Responsible for the UAT testing of the ICD 9 to ICD 10 Diagnostic and Procedure codes while reviewing the information to ensure accuracy.
• Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams, and OOD Generated wireframes and prototype for the GUI. Tested claims adjudication and group and enrollment in Amisys for New Medicare advantage members
• Conducted GUI and functionality testing using QTP.
• Assisted in Requirements Gathering Sessions by working with management and project implementation teams in eliciting product requirements.
• Coordination of numerous project initiatives including: system conversion and integration of a behavioral health acquisition, preparation of numerous RFP responses, other system initiatives related to case management, provider management, eligibility management, claims processing, and prior authorizations.
• Conducted analysis of HIPAA compliance and took part in discussions for designing the healthcare transactions to be HIPAA 5010 compliant.
• Analyzed the impact of new HIPAA standards on targeted systems, processes, and business-associate relationships
• Involved in HIPAA EDI transactions such as 270, 271, 835, 837 P, D, I 276, 277, 278.
• Responsible for creating test scenarios, scripting test cases using testing tool and defect management for Policy Management Systems, Payables/Receivables and Claims processing.
• Conducting requirement sessions and successfully translating of those requirements into Use Cases and GUI wireframes.
• Automation of test scripts was done using QTP for test re-usability of different online transaction modules.
• Design Test Scenarios, Test Cases SQL Queries , Test Scripts and Test Data. Designed the Quality Center Test Labs and Test Sets for Better and Easy tracking of overall project progress.
• Interact with Business Users Application Developers during Integration testing
• Extensive experience in preparing test plans test metrics, test cases, test scripts and test data based on business and functional requirements.
• Wide Exposure to automation tools such as Quick Test Professional, Test Director and Win runner.

Environment: Windows XP Professional, Oracle9i, MS Access 2000, MS Excel, RUP, BluePrint Requirement,Oracle, UML,UNIX, Rational Rose, Requisite Pro, Clear Case 2002, HP Quality Center,Rational Clear Quest 2002, MS Office suite, MS Visio 2003.

Confidential

QA Analyst/Tester

Responsibilities:

• Responsibilities included reviewing and analyzing the requirements of the application. Designing the Test plans, creating and running the automated and manual test cases, identifying the defects.
• Conducted review meetings with the development team to set a hard-freeze date and gather input for creating the Test Plans and Test Specifications.
• Experience in Claims Processing per Medicaid Management Information Systems MMIS 42 CFR 433.
• Involved in applications analysis, which involves claims processing.
• Developed Functional Testing Approach for ICD-10 Remediation and included in UAT Plan.
• Designed a claim processing system for the healthcare management client system. It allowed the user to inexpensively capture information regarding patient, summary of medical history, symptoms ICD-9 codes , and treatment CPT .
• Used HP Quality Center for writing Test plans and Test Cases.
• Worked on Documentum for Version Controlling, to maintain up to date changes in the Documents.
• Analyzed the existing claims process and specific business rule logic will be applied in the ACP model.
• Ensured that ICD-9-CM procedure codes used for inpatient services and CPT codes for outpatient and physician services were not outdated
• The tests also included GUI testing: Testing for validation and display of screens.
• Worked with HIPAA rules and regulations to draft business rules and claim processes
• Involved in creation and execution of manual test cases in Mercury Test Director and automated Test Cases in QTP and analyzed the Test Results.
• Performed testing for Medicare, Medicaid and X-Over claims for Medicaid Management Information System MMIS
• Established questionnaires and resource leveling required for implementing HIPAA 5010 and upgrading ICD-9 diagnosis codes to ICD-10 codes.
• Assisted JAD sessions to identify the business flows and determine whether any current or proposed systems are impacted by the EDI X12 Transaction, Code set and Identifier aspects of HIPAA.
• Core responsibility involved complete manually testing of the User Acceptance Test UAT .
• coordinated the testing during UAT and conducted defect management: tracking, verification closure, using Mercury Quality Center.
• Involved in preparing Test Plans based on User Requirements Document URD and prepared the Test Cases using Test Director/Quality Center.
• Developed strategies with Quality Assurance group to implement Test Cases in Mercury Test Director for stress testing and UAT User Acceptance Testing
• Analyzed results of Regression Testing as performed by Testers using QTP and held meetings with Developers and Testers.
• Automation of test scripts was done using QTP for test re-usability of different online transaction modules.
• UAT testing performed along with call center managers to make sure that application meets their requirements.
• Participated in requirements meetings, writing requirements in CaliberRM, converting requirements from Caliber RM to HP Quality Center
• Conducted Black Box Testing on the application and validated the dataflow in the application.
• Tested security test and audit test for this particular system. Performed Black Box, functional testing, end to end testing for world points system
• Involved in creating logical and physical model of the database using MS Visio, MS SQL Server 2008.
• Designed and developed Use Cases using UML and Business Process Modelling.
• Tested XML files using XML Spy.
• Executed test cases manually to verify the expected results.

Environment: Java, Business Object, Quick Test Pro 8.2,Clear Case HP Quality Center,BluePrint Requirements,UNIX, Mercury Quality Center, UNIX, XML, Sybase, SQL, PL/SQL, Oracle9i, MS Vision. MS Office,Quality Center 9.0, QTP, Crystal Report, Quick Test.

Confidential

QA Tester

Responsibilities:

• Designed and documented test plan, test strategies, test cases in EDI Test Manager by evaluating the requirement document in Requisite Pro and performed hands-on testing for complex test conditions, scenarios and scripts so HIPPA transactions in EDI formats are verified.
• Authored Test Plan, Test workflow, Defect Management Plan, Software QA presentation.
• Performed Positive and Negative testing, Black Box testing, and End User testing.
• Performed Black Box testing and conducted Functionality and Regression testing on various phases of the Management software
• Facilitated the User Acceptance Testing UAT of the application by working with users and documenting gaps in the beta version of the application.
• Prepared automated generic Test Scripts and Functions using Rational Robot for functional/GUI and regression testing
• Followed AGILE METHODOLOGY and participated in meetings.
• Developed scripts and scenarios for automated testing new and enhanced web based products using Load Runner.
• Monitored revenue cycle process and implemented ICD-9 ICD-10 mapping and crosswalk analysis.
• Performed all test cases consisting with teams members in-house and remote offices, vendors, clearinghouse, state governments, satellite offices, and financial institutions using HP Quality Center Enterprise Edition / Mercury Test Director.
• Participated in requirements meetings, writing requirements in CaliberRM, converting requirements from Caliber RM to HP Quality Center
• Creation of Test Cases for functional testing of the system.
• Throughout the project, was involved in giving clarifications on domain and product functionality for the team.
• Incorporated and implemented all the HIPAA standards, Electronic Data Interchange EDI , transaction syntax like ANSI X12, ICD-9, ICD-10 coding.
• Prepared Test Plans for each release, written Test Cases and executed them as part of Functional Testing. Prepared Test Reports and Deliverables and submitted for version releases.
• Conducted Smoke Testing of the new ICD-10 UAT region and recorded all the testing results in RTM.
• Performed all test cases consisting with teams members in-house and remote offices, vendors, clearinghouse, state governments, satellite offices, and financial institutions using HP Quality Center Enterprise Edition / Mercury Test Director.
• Established traceability matrix using Rational Requisite Pro to trace completeness of requirements in different SDLC stages.
• Automated confidence tests that run on new builds on regular basis.
• Involved in setting up different configuration environment for compatibility testing and manual testing.
• Upgraded the existing Test Scripts and created new scripts for client application to be able to work for new versions and patches, which improved product quality.
• Created test scripts for all the test cases in PL/SQL.
• Wrote Test Cases, Generating Test sets, executed Test Cases -generated reports for tracking progress in general and for tracking defects using Test Director
• Worked with business analysts, developers, and content department to resolve issues that blocked further testing.
• Attend Business Meetings with the Customer the In-House team and develop strategies to better suit to the Client needs..

Environment: Java, Quick Test Pro 8.2, MS Visio, MS Office,Clear Case,HP Quality Center ,Mercury Quality Center 9.0,UNIX, Load Runner 8.2, Oracle 8i/9i/10g, SQL Server 2000, DB2, MS-Project 2000/2003.

Confidential

QA Analyst

Responsibilities

• Involved in gathering Business Level Requirements and reviewed manual testing methods
• Prepared Test plans which includes an introduction, various test strategies, test schedules, QA teams role, test deliverables, etc.
• Extensively interacted with the stakeholders and the IT Department in finalizing the requirements according to the CMS Compliances/Regulations and HIPAA Regulations.
• Involved in the analysis of HIPAA compliance and EDI transaction sets and actively participated in the designing of the EDI transactions using the new HIPAA 5010 version also including the use of ICD-10 codes.
• Responsible for writing Test cases to cover overall quality assurance using Test Director
• Performed initial manual testing of the application as part of sanity testing
• Performed various tests such as positive, negative to check business functionality manually
• Performed Black Box testing and conducted Functionality and Regression testing on various phases of the Management software
• Developed executed several Optimized queries in SQL on this data.
• The tests also included GUI testing: Testing for validation and display of screens
• Created dummy accounts on our system and verified the account generation process and date integrity
• Designed and developed Project document templates based on SDLC methodology
• Created and enhanced TSL scripts using Win Runner
• Created various checkpoints in the script using Win Runner
• Created reports using Mercury Interactive Test Director
• Application and network performance testing analysis
• Developed Shell Scripts to automate loading processes
• Writing shell scripts to run batch processes and to run Oracle background Processes
• Used SQL queries to test the integrity of data by querying the database
• Interacted with the development team to assure that all the defects are addressed in time
• Participated in the team meetings to discuss the issues arising out of testing

Environment - Win runner, Test Director, Windows 2000 Professional, SQL.