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Qa Analyst Resume Profile

Chantilly, VA

PROFESSIONAL SUMMURY

  • Six years plus of solid experience as a Quality Assurance Engineer in Health care, Insurance and SAP BI applications or domains.
  • Good in creating test cases and scenarios using BRD, FRD, Use Cases, SDS, TDD, UML and Activity Diagrams and etc.
  • Good knowledge in Web base Apps testing, Manual and Automation on UNIX and Windows environments with primary focus in manual and black box testing.
  • Very familiar with testing tools such HP Quality Center, QTP, FTP's, SQL and etc.
  • Strong HIPAA EDI 4010 and 5010 and ICD-9 and ICD-10 processes for member, payers, providers including Coordination of benefits, Copays, benefits and etc.
  • Good knowledge in validating XML and X12 files and Mortgage Loan Origination.
  • Expertise in Claims, Subscriber/Member, Plan/Product, Claims, Provider, Commissions and Billing Modules of Facets.
  • Involved in Facets Output generation, Interface development and Facets Migration Projects.
  • Provided analytical solution to the customers for Facets Production Issues.
  • Solid experience in System, Backend and Front end, Regression testing, End to End testing etc.
  • Very familiar with Waterfall and Agile SDLC's methodologies.
  • Good analytical, communication and problem solving skills.
  • Good experience in SAP BI and BO testing.
  • Knowledge of work flows and business and technical requirements
  • Experience with user acceptance testing, functional and regression testing techniques
  • Ability to extract data utilizing SQL Oracle and DB2
  • Knowledge of Health Claims Systems - Professional, Institutional, RX, ICD-9, CPT4, PX/DX Relationships, and Medical Terminology
  • Understanding of Healthcare Insurance Exchange Plan Management HIX
  • Knowledge of OPL, COB, Pricing, Benefit testing - End to End Claims Business Process Testing
  • Knowledge of defect management processes
  • Knowledge of Mainframe/DB2
  • Knowledge of Client Server applications

TECHNICAL EXPERIENCE

Testing Tools

ALM/ HP QC, Quest, Availity , SQL, OPL online Screens, Mainframes, Diamond, Load Runner, FACETS

Databases

SQL Server, RBMS and Oracle

Documentation Tools

MS Excel, MS Office, Share Point, Requisite Pro, Microsoft Outlook

Languages

Visual Basic, HTML, XML, SQL, PL/SQL

Other Tools

Filezilla ,WinSCP, SQL Plus, DB2 and QTP etc.

Work Summary

Position: QA Analyst

Confidential

Role and Responsibilities:

  • Worked closely with software engineers, internal and external customers to gather comprehensive testing criteria and plan requirements to ensure accuracy and timeliness of projects.
  • Developed and maintained innovative Test cases based on Functional Requirements, Use Cases, user interface designs, system design documents and domain knowledge
  • Involved in preparing the Test Scenarios for Health Care Claim Payment/Advice
  • Worked on HIPAA Transactions and Code Sets Standards according to the test scenarios such as 270/271, 276/277,837/835 transactions.
  • Enrolled members through online screens and 834 Transactions to Facets.
  • Modified the 834 file and then checked if the eligibility enrollment is properly loaded onto Facets.
  • Processed 837P, 837I and 837D transactions, verified those 837 transactions were converted correctly to XML file format and verified the claims data loaded to Facets for further processing.
  • Worked with Accumulators, Deductibles, Coordination of Benefits and Overrides of the Claim Line detail and used them for testing various claims scenarios in Facets.
  • Maintained strong relationships with developers which helped in better execution of test plan.
  • Worked extensively using SQL for Back End Testing to validate data in the tables of the database.
  • Executed commands in Unix to view the files
  • FTP the files to Unix server for processing.
  • Analyzed and translated requirements and business design into Test Cases.
  • Used Quality Center for bug tracking, reporting and analysis.
  • Involved in coordination between the automated testers, manual testers and system administrator for the precise scheduling of test runs.

Environment: FACETS, Quality Center, SharePoint, SQL, UINX, Oracle DB, QTP, Microsoft outlook, Clear Quest.

Confidential

Position: QA Tester

Role and Responsibilities:

  • Created test deliverables and perform testing for internally developed or external purchased products
  • Performed static, functional, technical integration and end-to-end
  • Executed job streams for creating test beds, assigning test scenarios, writing test scripts and tracking defects to certify that applications meet technical and business requirements
  • Analyzed and make specific recommendations on improvements that can be integrated into business processes
  • Participated in reviews throughout the development life cycle
  • Facilitated User Acceptance Testing by providing the necessary support to the business users
  • Prepared Test Cases using BRD, TDD, Test Plan and Approach etc.
  • Designed and prioritized test scenarios and test cases that will provide efficient coverage of requirements consistent with acceptable level of risk.
  • Submitting electronic and paper claims
  • Involved in end-to-end testing of 834, 837, 835 and etc.
  • Set claim processing data for different Diamond module testing.
  • Validated X12 and XML for EDI transaction.
  • Tested the HIPPA EDI 834, 837/835 transactions according to test scenarios and verify the data on different modules.
  • Conducted Back-End table testing using SQL and DB2.
  • Executed commands in Unix to view the files and FTP the files to Unix server for processing.
  • Tested claims Benefits, Payment, Authorization, Pricing for both institutional and professional claims.
  • Performed Functional, Regression, and system testing for claims processing, members and providers.
  • Extensively used SQL statements to query the Oracle Database for test data.
  • Executed test cases, logged and reported defects.
  • Responsible for Performing Integration Testing.
  • Attended review, defect and team meetings.

Environment: Quality Center, Diamond, SQL, UINX, Oracle DB, QTP, Microsoft outlook, etc.

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