- 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
ALM/ HP QC, Quest, Availity , SQL, OPL online Screens, Mainframes, Diamond, Load Runner, FACETS
SQL Server, RBMS and Oracle
MS Excel, MS Office, Share Point, Requisite Pro, Microsoft Outlook
Visual Basic, HTML, XML, SQL, PL/SQL
Filezilla ,WinSCP, SQL Plus, DB2 and QTP etc.
Position: QA Analyst
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.
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.