SUMMARY:

• 7 years plus of diverse experience in Information Technology spanning projects with an emphasis on Software Quality Assurance, performing both Manual Testing of stand alone, client/server and web applications
• Extensive knowledge of various phases of different Software Development Life Cycle (SDLC); models like Waterfall, Agile, SCRUM, RUP.
• Experienced in Full life cycle Manual and Automated Testing in a Web - based Applications (JAVA, .NET etc), Client/Server Applications, and mainframe applications in Multi-Tier environments
• Extensive knowledge of different kinds of testing like Back-End Testing, Positive/Negative Testing, Black/White box Testing, Configuration Testing, Data Driven Testing, Smoke Testing, End to End Testing, Unit Testing, Functional, Integration Testing, System Testing and Regression Testing
• Documented and uploaded the testing processes across the Facets, including weekly Status Reports, Test and Defect Metrics Report, Requirement traceability Matrix, Master Test Plan, Test Evaluation Summary Document.
• Expertise in querying and testing using RDBMS tools like Oracle, MS SQL server, PL/SQL, DB2, and MS Access for Data integrity
• Customizing and generating multiple TFS reports to serve company needs
• Testing multiple content controls that are created and incorporated in to TFS work item types.
• Extensive Knowledge of Data Migration and validation
• Thorough understanding of Software Development with various programming languages such as, C, C++, Java, .Net, HTML, XML, etc
• Performed extensive Backend Testing of data validation of applications using SQL queries.
• Clear understanding and Validation of ICD-9, ICD-10-CM/PC, ANSI X12, HIPAA and HL7 standards
• Experience working with Unix/Linux specifically writing batch/shell scripts to test applications with no graphical user interface
• Well versed in Web applications and Client Server application testing
• Good knowledge and understanding of both inbound/outbound HIPAA EDI transaction in support of HIPAA 834, 835, 837 270/271 transactions.
• Huge exposure to various technology domain including; Health Care, Telecommunication, and data warehouse modules.
• Hands on experience working on Trizetto Facets 4.7.1/5.1.
• Experience in validation of EDI 837 claim process (Professional, Institutional) & 835 (Remittance advice or Payment) and Claims Adjudications using Facets 4.7.1.
• Excellent knowledge in SQL and Database/Backend testing with extensive SQL querying.
• Expert in analyzing system and functional specifications used cases, Business Requirements and business rules to prepare Test Plans and design Test Cases from business requirements
• Strong knowledge in Web Services, WSDL, Mainframe, etc
• Good knowledge on different modules within healthcare (Membership, billing, enrollment, Claims, capitation, providers, Other Carrier Liability).
• Expertise in validating XML, X12,Mainframe, and SOA with HIPAA compliance (4010 & 5010) in Healthcare systems
• Experience with Medicare, Medicaid, &commercial insurances in HIPAA ANSI X12 4010, 5010 formats including 270,271, 276, 277, 835, 837, 997, NPI, ICD 9,ICD 10, NDC, DRG, CPT, NCPDP codes for interfaces & images to clearinghouses/ trading partners applications.
• Expert working experience in Mainframe applications including technical support, installation and maintenance, various QA testing and Legacy Mainframe environments, etc

TECHNICAL SKILLS:

Testing Tool: Quality Center/ ALM, LoadRunner, Quick Test Pro, Rational Team TestTest Reporting Tool: Quality Center, Test Director, Rational Clear Quest, DOORS

Operating System: Windows 98/2000/XP, UNIX, LINUX

Database: Oracle, MS SQL Server 2005/2008, MS Access, DB2, QMF

Testing Language: TSL, SQA Basic, VB Scripting

Programming Language: C, C++, SQL, Java/J2EE

Web Technology: JSP, ASP, XML, HTML, .Net

Other: MS Office (Word, Excel, PowerPoint), IBM Mainframe, COBOL, Availity, Diamond, Seibel, Infomatica, Tortoise SVN,MMIS (Medicaid Management Information System), Trizetto Facets, Remedy Call Tracking System, UNIX Nile Server, Remedy Action Request System, Oracle Financials, Diamond, MOJO, OPL, SSPT, ECM.

PROFESSIONAL EXPERIENCE:

Confidential, Jessup, PA

EDI Tester

• Assisted QA Lead and Project Manager in developing Test Plan and communicated with Project managers and supervisors to provide the best test strategy as per Agile Testing Life Cycle
• Work closely with the QA lead and assisted with the development of test plan and walk through meetings in Her absence
• Performed manual testing to conduct backend testing using UNIX shell scripts and SQL Queries
• Designed and prioritized Test scenarios/ Test Cases that will provide efficient coverage for requirement consistence with acceptable level of risk
• Facilitate UAT Testing by providing necessary support to the Business users.
• Wrote complex SQL queries to perform the backend testing of the Oracle database using PL/SQL developer and UNIX shell commands
• Provided sample Clients for the API, trained Support with Soap UI and built tools to quickly debug customer issues.
• Proficient in creating queries in TFS to validate results of TFS reports.
• Worked closely with the developers during unit testing and also monitor resolution of open defects
• Execute job streams for creating test beds, assigning test scenario, and Tracking defects to clarify that the application meets Technical and Business requirements
• Used Microsoft Visual Studio TFS for defect tracking and updated project plan information
• Extensively worked on DB2, Oracle data bases
• Perform automated testing on applications and ran regression testing mostly with automation tools.
• Performed Automated testing on various legacy COB/OPL(Other Party Liability) applications
• Conducted Manual Integration Testing and Functionality Testing of the application.
• Analyze and make specific recommendations on improvements that can integrate into the business process.
• Performed several testing on mainframe applications running on TSO/ISPF, IMS, Z/OS, for both online and batch process
• Performed manual and automated test procedures for functional testing of Web services using Soap UI
• Performing Functional and GUI testing on Facets Billing, Customer service and Subscriber application under Facets.
• Actively Performed End to End Testing of claims, Benefit, ICD10, COB.
• Validated X12 and XML files for various EDI transactions 837/ 835, 270/271, 276/277.
• Performed Back end Testing on data base tables using SQL Navigator and IBM data studio
• Tested Benefit Plans from enrollment stand point and claim processing
• Involved in Backend Database manual testing in Oracle using SQL.
• Created and maintained SQL queries to perform Back-End testing on the DB2 database.
• Good understanding of data flow architecture, system integration, database behavior, and testing strategy
• Performed compliance testing on 837 I and P, 834 and 820 EDI transactions
• Validated EOB and RA, including MHS(Monthly health statement), QHS(Quarterly Health Statement)
• Tested claims benefits, payment, pricing for both institutional and professional claim types.
• Performed End to end testing on Other Party Liability system prop
• Performed rigorous manual testing such smoke testing, Integration testing and System Testing.
• Extensively use SQL queries for back end testing and also to query the Oracle Database for Data Validation and Data Integrity.
• Documented XML file processing Use case, as well as identified XML file level processing errors.
• Performed compliance testing on 837 I and P, 834 EDI transactions.
• Worked with providers and Medicare or Medicaid entities to validate EDI transaction sets or Internet portals
• Perform series of testing including system, smoke, regression, End to End, Unit,

Environment:: DB2, ORACLE, SQL server, TFS, Availity, Soap UI, IMS, TSO, Diamond, Gate keeper, PIP(provider Portal), Microsoft suits, SQL navigator, Seibel, OPL(legacy system), ICD manager, Blue square, GAP, eRate, SSPT.

Confidential, Virginia Beach, VA

EDI/ Test Analyst

• Review product requirement documents, functional specifications, and involved in developing test strategy, test plan and test case documents.
• Working with development teams investigating and correcting software bugs and deficiencies based on the testing results.
• Involved in analysis Health Care Claim Acknowledgement for HIPAA Version 5010.
• Created Host Claims in Medical Claim Processing (ITS) and Hospital Claim Processing.
• Test planning for Claims, Incentives and Finance modules.
• Test Data preparation for both Institutional and Professional Claims.
• Used SQL queries to validate the data between the backend and the front end
• Performing Backend Testing extensively by writing validation queries on DB database
• Worked on migrating ICD-10 codes and mapping ICD-9 and ICD 10 codes
• Preparation of list of Delivery, Development, QC and Release Items for a Sprint in the form of TFS Team Query after Sprint Planning.
• Responsible for Code Freeze before the Release.
• Preparation of list of Deployment Artifacts in the form of TFS Team Query before Release.
• Responsible for writing the Test Cases and Test Scenarios based on the Business Requirement Document (BRD) and technical Specifications and loaded in Quality Center.
• Identified issues with the testing tools and the environment configurability and reported to the Lead.
• Did the Backend Testing by running the SQL Queries in DB2 Database.
• Designed and developed test scenarios for Manual Testing of all the modules and performed the tests.
• Performed the Backend integration testing to ensure data consistency on front-end by writing and executing SQL queries
• Provided sample Clients for the API, trained Support with Soap UI and built tools to quickly debug customer issues.
• Performed detailed testing for Authorization of claims, Benefits, Claims Payment, Pricing, Member Accumulator and System Readiness Review testing.
• Extensively used SQL statements to query the Database for checking GCP updates, agreements for providers, test members and test claims in the testing environment.
• Performed Backend Testing by using SQL Queries.
• Performed End-End Testing to check the configuration of agreements built in regarding the benefits and pricing module.
• Performed Member Accumulator check based on the respective claims and member plans.
• Designed and developed test scenarios for Manual Testing of all the modules and performed the tests.
• Tested EDI 837,835,834 files in compliance with HIPPA 5010 and ICD10
• Analyzed HIPAA 5010 related to 837,835, 834. Transactions and performed gap analysis between the 4010 and 5010.
• Logged defects, determined repair priorities and tracked the defects until resolution using Mercury Quality Center.

Environment: MS Word, Excel, PowerPoint, Access, Facets, Soap UI, SQL, Oracle,DB2, TOAD, EDI, Quality center, Express Claims Test Pro, Claims look-up Environment (CLUE), Optum Encoder Pro, Pre-Certification look-up tool (PLUTO) Confidential, Blue Bell, PA

EDI QA Tester

• 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.
• Tested HIPAA Transactions and Code Sets Standards such as 837/835, 270/271, 276/277 transactions.
• Tested 837/ 835, 270/271, 276/277 transactions with File Aid.
• Execute end-to-end NHIN and web testing utilizing SOAP UI test scripts.
• Responsible to check whether the interfaces and the extensions properly integrate with the Facets application.
• Involved in testing HIPAA EDI Transactions.
• 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.
• Performed Manual Testing and regression testing after new feature was added.
• Migrated data from DB2 environment to SQL Server
• Created the bug metrices report for checking the overall productivity of the team in TFS 2010 using the reporting services with SQL Server 2008
• Helping the Project team to get transformed to agile methodology using TFS 2010
• Created test scenarios and tested HIPAA Transactions and Code Sets Standards such as EDI 837/834/835, 270/271, 276/277.
• 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.
• Extensively used SQL statements to query the Oracle Database for Data Validation and Data Integrity.
• Executing SQL commands performed back-end testing.
• Executed SQL statements to check if the data integrity has been maintained.
• Created SQL queries for data validation.
• 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: MS Visio, Word, Excel, PowerPoint, CMMI,TFS, Facets, Clarity, SQL, DB2, Oracle, J2EE, Java, SOAP UI, EDI, Quality center.

Confidential, Falls Church, VA

QA Tester

• Executed test scripts to verify the expected results based on the system requirements maintained in Quality Center.
• Responsible to report bugs using Quality Center and MS Excel
• In depth knowledge of Health Insurance process, Claims, HIPAA & its approved transaction codes.
• Used an extensive working knowledge of Facets.
• Analyzing the Facets Requirements and thus conducting gap analysis.
• Created and maintained templates such as: Quality Strategy, Test Plans, Requirements, Traceability Matrix, Test Scripts, Test Calendars, Testing Issues, Project Sign­off and Test Reports
• Reviewed EDI 837 claims and flagged HIPPA non­compliant claims received from the Payer side
• Worked on UNIX Platform and experienced in back end testing by executing SQL Queries.
• Checked the data flow through the frontend to backend and used SQL Queries to extract the data from the database.
• Involved in writing extensive SQL Queries for back end testing oracle database.
• Written several SQL queries and analyzed them to validate the business rules in Oracle database through SQL Developer as part of Backend testing.
• Retrieved files using SQL statements and UNIX commands.
• Created and maintained SQL Queries for back-end testing.
• Performed manual back­end testing using PL/SQL to connect to an Oracle 9i database on a UNIX server.
• Established and maintained test cases and test data in Quality Center.
• Drafted test strategies, test cases and test plan based on functional specifications
• Establish test data for testing the application
• Analyzed and worked with HIPAA specific EDI transactions for Claims, member enrollment, billing transactions. Worked specifically with 837, 835, 834, 270/271
• Executed test cases manually and also used automation tool, compared and analyzed actual with expected results and reported all deviations to the appropriate individual(s) for resolution.
• Manual Testing for checking the flow of the application functionality
• Conduct the testing (system and regression) of all applications to ensure application integrity both AS/400 based systems and web-based applications. Entails: Managing/executing the testing effort, logging detailed accounts of errors/defects in the systems, and coordinating with the Application Development and Operations teams to diagnose and troubleshoot any errors/defects.
• Developed SQL queries, functions, stored procedures and triggers to perform the backend testing of the data
• Performed Test Execution & wrote & Executed Test Scenarios/Test Scripts.
• Writing PL/SQL Procedures & Batch Processes
• Writing Test Plans/Test Scenarios/Test Cases/Test Matrix
• Executing System Test, Regression Test, User Acceptance Testing (UAT)
• Used Test Director for setting up and maintaining projects on Test Director. Execute test cases using Win Runner scripts through Test Director
• Performed manual back-end testing using SQL Plus to connect to an Oracle 9i database on a UNIX server.

Environment: Windows, Rational suite (Rational Rose, Rational Requisite Pro, DB2, Rational Clear Quest, Rational Clear Case), EDI, Facets, SharePoint, Manual Testing, Agile, MS Office, SharePoint, UML, SQL, Test Director, Quality Center.