Summary

• Senior QA Analyst with 7 years of experience in business process analysis/modeling, business requirements gathering, database design and development of Web Based, and Client/Server applications.
• Worked in various Healthcare areas like Enrollment, Benefits, Claims, Medicare, and EDI X12 etc. Experience in Healthcare concepts such as HIPAA, SOX etc.
• Worked on various EDI X12 transaction sets 837 I/P, 275/276, 270/271, 834 etc
• Experience as Business/Systems Analyst with expertise in Insurance, Healthcare processes, Systems/ Solutions Engineering, Strategic Planning, and Systems Analysis.
• Involved in Functional, Integration, System, Regression and UAT Testing.
• Extensive experience with Facets and QCare Claim Engines.
• Expertise in reviewing requirements, Business Requirements Gathering, Data warehousing, Evaluating Data Sources, Translating Requirements into Specifications, Application Design.
• Expertise in reviewing requirement, functional and design specifications, developing Test strategies, Test plans and Test cases
• Proficient in business process modeling, documentation, and testing using Rational Suite Rational Rose, RequisitePro, Clear Quest as well as MS Visio and MS Project in combination with UML 2.0 diagramming techniques.
• Extensive experience with SQL and data conversions, Data mapping and data validation
• In-depth knowledge of creating use case, activity, logical, component and deployment views with rational tools to extract business process flows and workflows thereby helping development and quality assurance teams in understanding the requirements.
• Knowledge in the ETL Extract, Transform and Load of data into a data ware house/date mart and Business Intelligence BI tools like Business Objects Modules Reporter, Supervisor, Designer, and Web Intelligence .
• Extensive experience with Front end and back end System Integration Testing SIT .
• Documented project related information like test execution procedures, backup plans, new tester training documents, maintaining test logs, release notes etc
• Extensive experience in all phases of RUP and SDLC processes

PROFESSIONAL EXPERIENCE

Confidential

Quality Analyst Worked in the Enrollment department coordinating with business and other Insurance companies IT team to implement file intake processes for incoming groups. Generated reports and audits for business and management to make sure that implementation has been a success or not. Also worked in Claims area as Business/ Quality Analyst to develop applications which accept different claims like Medical claims, Dental claims, and vision claims from different vendors and route the claims into Batch Adjudication System and Online Adjudication.

Responsibilities:-

• As the Sr. QA Analyst my responsibilities included developing and documenting Product Test Plans, using several SDLC methodologies Assisted in writing efficient and effective Master Test Plan, Test Strategy, System Testing, End-to-End Test and User Acceptance Test Plan
• Performed end-to-end System Integration testing which covered the entire business process flow from the initial point of sales through to all the 10 downstream systems and XML output files, including apps/interfaces.
• Participated in the planning, development, coordination and presentation of specific testing needs as appropriate to the quality assurance needs of the end user
• Developed and executed SQL queries to verify the proper insertion, deletion and updates into the data Warehouse supporting tables and cubes.
• Assisted business users in defining UAT test cases and plans Established and maintained test cases and test data in Quality Center.
• Coordinated with the QA Team for testing activities across multiple systems and managed Conversion test execution.
• Used MS Visio for flow-charting, process model and architectural design of the application.
• Strong experience in conducting Gap Analysis GAP , Functional testing, User Acceptance Testing UAT , and System Integration testing SIT , SWOT analysis, Cost benefit analysis and ROI analysis.
• Involved in implementation of HIPAA EDI Transactions 835,837,820,276
• Facilitated Electronic Data Interchange.
• Performed GAP Analysis for HIPAA 4010 and 5010 transactions.
• Used EDI tools to verify mapping to X12 format
• Recommended changes for 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 ANSI.
• Analyzed HIPAA EDI transactions in XML and X12 responses and of 270 and 276 and looked for defects for amendment.
• Did data analysis for various version changes of EDI messages on different sub-systems.
• Providing the required test data for the developers in order to fix the defects
• Participating in QA team meeting and bug tracking meetings.
• Produced management reports using Informatica relative to inventory, productivity, accuracy and cycle time and maintained team leave documents and artifacts in web based MS Share point
• Tested the enhanced FACETS/AMISYS system, evaluating claims adjudication needs and creating HIPAA-compliant business rules configuration.
• Involved in assessment of tools for use in future HIPAA 4010/5010 migration and compliance by performing GAP Analysis. Provided business and technical process flow recommendations.
• Performed comparative analysis and gap analysis to identify variation in the process as per HIPAA X12 4010 and 5010 guidelines to incorporate updates as per 5010 guidelines
• Mapped EDI 4010 provider claim payment/advice/status 835/837/276 from clearinghouse sources to ASC X12 formats.
• Extensive testing of EDI Eligibility/Inquiry/Response 270/271 transactions via reports generated by developers.
• Mapped claims, payments, and status to back-office database.
• Logged the defects in Quality Center and maintained track of the defects throughout the life cycle.
• Participated in QA Team meetings and bug tracking meetings.

Environment: MS-Visio, MS Office, MS Project, TOAD, SQL, Quality Center, HIPAA/ EDI X12, FACETS, Oracle, SharePoint, Informatica, FTP.

Confidential

Quality Assurance Analyst

Confidential is a leading multi-state, full-continuum home healthcare services provider. Celtic Health care group is a committed organization to serve its registered members/patients with many services. The scope of the project was to build Medical Site which provides Search utility to all the registered patients to view and select Physicians and fix an appointment with Physician to their nearest Location and by physician's name.

Responsibilities:

• Created use cases for various scenarios and developed test strategy documents.
• Created the work flow diagrams using Microsoft Visio for various processes.
• Prepared Test plans, Functional Test cases and executed the test cases in Mercury QC.
• Participated in creation of web based test automation management tool designed to store test data, run automated tests and report results using the QTP automation object model
• Supervised and created comprehensive test plans for System, Enterprise and Regression testing, creation and maintenance of test cases manual / automated , and test data.
• Supervised the system test plan and test case walkthroughs with application partners
• Supervised routine generation of defect metrics and communicated them to upper management on a timely basis.
• Responsible for organizing and conducting daily touch point meetings during the test cycle and for conducting post-deployment project review.
• Involved in functionality, database and error testing of the E-bill application.
• Involved in the black-box testing of the Healthcare application and identified the different test cases for regression testing.
• Tested the aspect of adding additional features to the customer's account based on the account specifications.
• Identified and documented all the possible defects in application functionality using Test Director.
• Acted as a liaison between the end users and the software development team.

Environment: Mercury Quality Center MS Office, MS Visio, MS Project, Rational Test Manager, Rational Soda, HTML, Java, SQL Server 2000, Windows 2000/XP, Rational Unified Process.

Confidential

QA Test Lead

Confidential brings people together from around the world to create innovative surgical products and medical devices that advance surgery and improve lives every day. It does early detection, advanced treatments and faster, easier healing, help patients get back on their feet faster and create positive outcomes for everyone. The latest products and procedures increase efficiency, reduce cost and improve lives.

Responsibilities:

• Analyzed the Use Cases provided by Business Analysts and write Test Plans, Test Cases for Functional Testing, Regression Testing and Integration Testing in Quality Center.
• Updated Traceability Matrix with User Requirement Specifications document for Mobile version of testing.
• Updated UAT test scripts document for mobile version of testing.
• Responsible for providing the testing team with the required business data, rules and logistics from the business people, architecture and development teams and to inspect final scripts and confirm to laid out standards for Testing.
• Responsible in testing iTouch, Blackberry along with performing test lead activities.
• Responsible in guiding the testing team with other mobile devices like Galaxy, HTC, iPad, iPhone.
• Provided the Timelines for Pre UAT, UAT and Post UAT activities.
• Provided the guidelines for the proper training for all involved in testing activities to the successful planning and execution of the entire test plan
• Responsible in keeping track of day to day activities of the testing team and provide the daily status to the manager.
• Used SharePoint for document repository.
• Tracked all the defects by adding artifacts into defect trackers.
• Responsible in training testing team and also testing the desktop version vs mobile version of testing.
• Created and executed Feature Test Cases to verify the functionality of the respective features of the application.
• Developed Test cases for Functional Testing and Regression Testing based on the Business requirements for both Mobile and Desktop versions of testing.
• Involved in Functional Design Specifications and Detailed Level Requirements review Meetings.

Environment: MS Office, MS Visio, Quick Test Professional, HP Quality Center, Test Director, J2EE, SQL server.

Confidential

QA Consultant Confidential , the project encompassed conducting functional, security, integration and regression testing the application for critical business transactions for a Health Care Application. Responsibilities:

Worked closely with the project team in planning, coordinating and implementing QA methodology Participated in Quality Circle meetings with the management and development teams Managed test planning for Functional testing, Integration testing, Systems testing, Acceptance testing, Regression testing for the Health Care application Wrote and distributed reports to describe automation program evaluation problems found, corrections needed, and problem areas. Tracked overall test coverage for application. Linked the test cases and defects in Quality Center and generated reports Created, Setup and Implemented end-to-end test environment including QA Methodologies, Policies, Procedures, Standards and Tools for the Health Care application Automated test cases using QTP and worked on BPT component of Quality Center to create quality scripts Enhanced script by creating standard, text and XML checkpoints parameterized scripts for data-driven tests Automated and tested software programs, including test case design and execution of alpha, beta, functional, regression, and smoke tests. Environment: QC, BPT, Quick Test Pro, Oracle, AS 400, QTP

Confidential

QA Consultant

Member Medical History contains Membership, Group, Claims, Case management and disease management data. This application is used by Providers, Clinical and Nurse practitioners for assessing member health history. MMH plus UI uses web services to fetch the data from integrated repository

Responsibilities:

• Prepared Test Plan and Test strategy
• Design , review and execution of test cases
• Reviewed Requirements ,Data Model, Data Dictionary and ETL Mappings
• Involved in System ,Integration and Regression Testing
• Worked on SOAP UI tool for validating the XML request and responses.
• Wrote and Executed SQL Queries to ensure data accuracy for the data.
• Extensively tested Informatica jobs and reports.
• Performed data profiling for data quality validation
• Verified correctness of data after the transformation rules were applied on source
• Coordination of UAT with business users
• Assign and coordinate tasks with offshore test team
• Conducted Defect triage meetings
• Provided Test and defect status reports

Environment: MS Office, MS Visio, HP Quality Center, SQL server.