SUMMARY:

• Over 9 years of professional work experience with an earned reputation for meeting demanding deadlines and delivering critical solutions on various levels of Quality Assurance in IT, Insurance and Healthcare Industries. Involved in thorough study of Business Requirement Documents Design RDD and functional requirement specifications . Participated in weekly meetings with Business Analysts, Development and QA team to discuss the milestones, progress and the issues.
• Good Hands on Experience with SQL, Tableau and Excel and Excellent understanding on Tableau Workbooks and Background Tasks for Targeted Interactions Validation. Good Knowledge on SQL queries and creating database objects like stored procedures, triggers, packages and functions using SQL and PL/SQL for implementing the business techniques. Exceptional problem solving, decision - making, strong interpersonal and communication skills .
• Strong Knowledge of Medical Billing Rules and Regulations to bill the claims to the Insurance offices to get paid. Having Good Experience with denial management and appeals processes. Sturdy knowledge to handle the 835 and 837I, 837P claims Data Analysis and Strong Experience in Provider Credentialing. Good Hands on Experience with EDI Systems. Able to identify performance issues, assess root cause and develop successful action plans for the Production and Quality improvement. Have good Experience with Facets Claims Processing. Have good Hands on Experience working with Physician Claims ( Confidential or CMS1500) and Hospital claims (UB04).
• Having Good knowledge in US Healthcare Industry end to end (Billing Rules and Regulations, Hospital Claims, DME Claims, Physicians office Claims submission and Insurance office all type of Claims adjudication). Good Hands on Experience to use ICD 9 codes and Good and Strong Experience on EMR files. Good Knowledge of ICD 10. Experience testing migration of EDI transactions and data mapping
• Extensive experience in Healthcare/Claims adjudication with knowledge of ICD-9 & ICD-10
• Good Knowledge in Integrated Eligibility System Solution (RFP or Procurement) to procure the services of a Systems Integrator (SI) to perform the Design, Development and Implementation (DDI) and Application Support (i.e., the “IES Solution”) in support of the statewide Integrated Eligibility System (IES) Program. IEs manage the Procurement, which is being conducted on behalf of the State’s Department of Health (DOH), the Office of Temporary and Disability Assistance (OTDA), and the Office of Children and Family Services (OCFS) under the direction of the IES Program Office.

SKILL:

Methodologies: SDLC, Waterfall, Agile, Scrum

Operating Systems: Win NT/2000/XP, VISTA, LINUX, UNIX. Windows 8/10, UNIX, Sun Solaris.

Testing Tools: Quality Center, RQM Rational Quality Manager, RFT Rational Functional Tool, QTP, TIBCO, FIRST PASS, INTEL ESG,508 Compliance Sheriff, JAWS, WAT, WAB, HP ALM, SIEBEL CRM, VM WARE, Google doc, ITSM/ITIL, ServiceNow, JIRA

Programming Language: HTML, SQL, ORACLE, C, C++, UNIX, VBScript, UNIX Shell Scripting, Pega

Business DATA Modeling Tools: UML, Power Designer and Oracle SQL Developer.

Data Modeling Tools: MS Access, Oracle, MS SQL Server, MySQL, PostgreSQL and MS Access. Siebel CRM Amazon (AWS) EC2, EC3, Elastic Search, Elastic Load Balance. Atlassian JIRA, Confluence, Compass, Pega

HL7 and Claims billing tools: - All Scripts, Misys, FACETS, Medical Billing S/w, JACADA and Main Frame.

PROFESSIONAL EXPERIENCE:

Confidential, Norfolk, VA

Sr. Business System Analyst

Responsibilities:

• The systems analyst will work directly and collaboratively with the business and technical teams to deliver high quality functional IT specifications, gathering and creating specifications from the business teams. Analyses, interprets and recommends through formal proposals and presentations to management on new and effective ways to provide new/updated technology based business systems applications. As a Business Systems Analyst, have designed, build, and test business rules to support operations and business objectives for Community and State claims processes. Passion turned into information is used for decisions made by leadership.
• Strong Knowledge of Medical Billing Rules and Regulations to bill the claims to the Insurance offices to get paid. Sturdy knowledge to handle the 835 and 837I, 837P claims Data Analysis and Strong Experience in Provider Credentialing. Good Hands on Experience with EDI Systems. Have good Experience with Facets Claims Processing. Have good Hands on Experience working with Physician Claims ( Confidential or CMS1500) and Hospital claims (UB04). Validated EDI transactions like EDI 834 (Benefit Enrollment and Maintenance), 277/275(Health Care Claim Request for Additional Information and Response), 276/277(Health Care Claim Status Request and Response), 835(Health Care Claim Payment/Advice), 837 and (Health Care Claim: Professional, Institutional and Dental) as per HIPAA 5010.
• Experienced in Business and Technical writing: Business Case, Scope Document, Business Requirement Document (BRD), Functional Requirement Document (FRD), Non Functional Requirement Document (NFRD), Use Case Scenarios, Test Plans, Test Scenarios, Test Cases, AS-IS and TO-BE Workflows. Excellent knowledge of Health Insurance Exchange (HIX) health Insurance Portability & Accountability Act (HIPAA) standards, Electronic Data Interchange (EDI). Strong knowledge and experienced with Health Care Reform and Patient Protection and Affordable Care Act (PPACA). Validated EDI transactions like EDI 834 (Benefit Enrollment and Maintenance), 277/275(Health Care Claim Request for Additional Information and Response), 276/277(Health Care Claim Status Request and Response), 835(Health Care Claim Payment/Advice), 837 and (Health Care Claim: Professional, Institutional and Dental) as per HIPAA 5010.
• Having Good knowledge in US Healthcare Industry end to end (Billing Rules and Regulations, Hospital Claims, DME Claims, Physicians office Claims submission and Insurance office all type of Claims adjudication). Good Hands on Experience to use ICD 9 codes and Good and Strong Experience on EMR files. Good Knowledge of ICD 10.
• Collabrated with Business users, stakeholders and PO product owners in-order to break down business requirements gatherings into Epic stories,User stories create user stories, mockups, wireframes, documentstions in confluence JIRA to understand code by Developers team,test by QA team in each sprint planning and updating SI Service Items, LOB Line of business and migrating RDD requirement design documnet in Atlassian confluence. GBD Facets Government Business division Medicare & Medicaid for all forms of Health insurance.
• Reviewed requirements for business rules with Product Manager & Product Owner and identified any additional information required for Rule Design. Participated in Feature Refinement & User Story Grooming sessions. Participated in PI Planning and Build Rules. Rule Testing (Unit Testing with mocked data and production data) & Demo results. End to End Testing Support & Support Parallel Test. Supported defect resolution for any defects related to rules. Supported defect analysis for any production issues related to rules. Supported maintenance requests for updates to business rules post deployment. Documentation updating Atlassian confluence, migrating RDD to confluence Atlassian.
• Well versed in the product, process and technology aspects. At the intersection of business strategy, client and implementation vendors and responsible for translating abstract visions into reality while managing client's expectation as well as vendor's work efficiency. Also proficient in all aspects of the agile deliverables required for a technology team to build beautiful products. This includes hands on development of storyboards, wireframes, product backlog, user stories and user acceptance criteria.
• Worked within Agile squads directly supporting Legal, Enterprise Compliance, Enterprise Risk, Information Security, etc. Participated in multiple technology and/ or business releases and play a key role as subject matter expert for successful implementation. Drove User Story generation across business and technology teams to support a healthy backlog of capability development within assigned domain.Identified potential new and improved technical directions, develop strategic options/ approaches to recommend to management.
• Acted as liaison and primary contact to Business Units, Integration/Infrastructure, Architecture and PMO, providing an advocate for technology initiatives within assigned domain. Assisted managers in change management efforts related to organization, and short- and long-term strategic plans and goals. Proficient in business analysis concepts (business process modeling (BPM), context diagrams, use cases, user stories).
• Acted as critical adviser to the team, providing deep functional expertise in the work plan, standards, process and procedures, and change management efforts. Conducted all phases of complex analysis to prioritize making recommendations toward solutions, and manage resources to achieve unit, division and corporate goals..
• Worked closely with the IT Governing Groups to ensure Development Standards are met. Provided, analyze, recommend, negotiate, and direct work as subject matter expert on complex, technical issues. Facilitated successful delivery for assigned releases - Ensure internal IT and business needs are clearly identified, designed and constructed to meet quality standards. .
• Worked closely with the Business units and IT partners to create, identify, and evaluate deliverables such as user stories, business process models, user manuals, test plans and test results, as well as release plans. Created, evaluate, and present complex technical business cases, as-is and to-be business processes, current and future technology integration design recommendations to colleagues, management, business customers and vendors.
• Collaborated with Business units and IT partners to provide effort estimate / user story points. Assisted managers in developing annual and multi-year department objectives and strategies. Understand the future direction of business, IT impact on the business, the role IT plays, and communicate these trends to the business and IT colleagues.
• Worked directly with the business and technical teams to deliver high quality functional IT specifications, gathering and creating specifications from the business teams. Worked to make User Stories and responsible to complete the stories on time. Developed and implemented data cleansing, data security, data profiling and data monitoring processes. Involved in UAT and Integration testing, Requirement Gathering, creating source of Work, preparing the documents as per the Business request. Gather Data from Help Desk Ticketing System and write Ad-hoc reports and, charts and graphs for analysis. Performed User Acceptance Testing (UAT) to ensure that proper functionality is implemented.
• Responsible for support, enhancement and implementation software applications used within the Healthcare organization. Identified opportunities to leverage technologies in areas that improve and enhance the business practices by designing and implementing application/product enhancements. Worked with/liaison to customers and end-users, appropriate IT personnel and software vendors on a regular basis to align technology functionality to operational processes. Facilitated project implementations. As an individual have doing project implementation. Also performed day to day review of contracts, redefying, and understanding what the client is asking for.Took great notes in regards to what the customers requirements are.
• Possesses and routinely provided broad knowledge of business system analysis processes and procedures. Had the ability to provide solutions to most business system problems and serves as a resource to others in the resolution of the more complex issues. Had the ability to drive processes and improvement initiatives. Problems encountered are frequently diverse in scope where experience and judgment is relied upon for obtaining solutions. Applied a detailed knowledge of business system analysis concepts, practices and procedures to determine most effective business system applications.
• Have the knowledge and skills in delivering requirements design document (RDD) and functional design for internally developed products and 3rd party applications requiring customization. Requires an individual who has the ability to gather and document user requirements and translate or breakdown into User story the information collected to functional requirements including scoping documents, mock-ups, functional requirements and technical specifications.
• Having Good Hands on Experience about Healthcare revenue cycle and accounts receivable management, including payment cycles, key trends, and critical success criteria.

Confidential, Winooski, VT

Sr. Business System Analyst

Responsibilities:

• Designed and build business rules to satisfy regulatory claims requirements and utilized sharp analytical skills to fulfill the needs of the business and/or clients,I will have an impact on healing the health care system. System Analyst Interact with product owners business analysts and other tech analysts across teams to accurately define stories and associated outcomes within the context of the API domain create technical requirement document.
• Adapted to varying project needs including Business Analysis activities, Project Coordinator activities, Documentation activities or Test Coordination as needed. Familiar with working on initial project scoping efforts (including creating requirements, working on gap analysis efforts, documentation, and project roadmapping).Experienced gathering requirements for Reporting functions and system confirmations.Business rule definition and maintenance experience with Data Conversion (e.g. mapping).Had experience working with technical teams. Documentation of processes - assumptions, requirements, functional and non-functional. Agile Experience (writing stories, collaborating with others to groom backlog) VersionOne Experience,Confluence,Kanban process management and documentation experience.
• Good Knowledge in Integrated Eligibility System Solution (RFP or Procurement) to procure the services of a Systems Integrator (SI) to perform the Design, Development and Implementation (DDI) and Application Support (i.e., the “IES Solution”) in support of the statewide Integrated Eligibility System (IES) Program. IES manage the Procurement, which is being conducted on behalf of the State’s Department of Health (DOH), the Office of Temporary and Disability Assistance (OTDA), and the Office of Children and Family Services (OCFS) under the direction of the IES Program Office.
• Worked with IES requirements for Non-MAGI Medicaid-only cases, SSI-related Medically Needy Aged, Blind, Disabled (including family of one budgeting for children in waiver), Medicaid Buy-In for Working People with Disabilities (Basic Group), Qualified Medicare Beneficiaries (QMB), Qualified Individual (QI),Qualified Working Disabled Individuals(QWDI), AIDS Health Insurance Program (AHIP), Cobra, Incarcerated Individuals etc.
• Worked with IES requirements for NPA SNAP, including SNAP only, SNAP mixed, Transitional Benefit Alternative(TBA), and SNIP; NPA HEAP; and HEAP SNAP Auto Pay, Temporary Assistance for Needy Family (TANF), Supplemental Nutrition Assistance Program (SNAP), Public Assistance (PA)/Temporary Assistance (TA): Family Assistance (FA) and Safety Net Assistance (SNA), Employment and Advancement Services (EAS), Office of Child and Family Services (OCFS ), Adoption, Child Care Services etc.
• Collabrated with Business users, stakeholders and PO product owners in-order to break down business requirements gatherings into Epic Stories, User stories create user stories, mockups, wireframes, documentstions in confluence JIRA to understand code by Developers team,test by QA team in each sprint planning and updating SI Service Items, LOB Line of business and migrating RDD requirement design documnet in Atlassian confluence. GBD Facets Government Business division Medicare & Medicaid for all forms of Health insurance.
• Working with external vendors including on incorporating their offerings into core features or incorporating our APIs into their sites. Domain includes web services API stack and supporting audit and research activities into site usage. GBD Goverment Business division Facets for Medicare and Medicaid.
• Experienced in Business and Technical writing: Business Case, Scope Document, Business Requirement Document (BRD), Functional Requirement Document (FRD), Non Functional Requirement Document (NFRD), Use Case Scenarios, Test Plans, Test Scenarios, Test Cases, AS-IS and TO-BE Workflows. Excellent knowledge of Health Insurance Exchange (HIX) health Insurance Portability & Accountability Act (HIPAA) standards, Electronic Data Interchange (EDI). Strong knowledge and experienced with Health Care Reform and Patient Protection and Affordable Care Act (PPACA). Validated EDI transactions like EDI 834 (Benefit Enrollment and Maintenance), 277/275(Health Care Claim Request for Additional Information and Response), 276/277(Health Care Claim Status Request and Response), 835(Health Care Claim Payment/Advice), 837 and (Health Care Claim: Professional, Institutional and Dental) as per HIPAA 5010.
• Excellent communication skills and proficiency in interacting with the stakeholders, and SME's (Subject Matter Experts) to get a better understanding of the business processes. Proficient in formulating test approaches based on Functional testing, Performance testing, Regression testing, GUI Testing and UAT (User Acceptance Testing).Conducted review meetings with the development team to set a hard-freeze date and gather input for creating the Test Plans and Test Specifications.
• Includes data-mapping and interface mapping to databases and multiple internal and external (3rd party) applications. Demonstrated how the use of Problem Management reduces the number of Incidents in the environment. Escalated Problems which are damaging the quality of service. Fully competent to work at the highest level of all phases of business analysis. May train and guide the work of less experienced analysts.
• Informed resolver groups when Incident or Problem trends appear and agree the course of action required to enable identification of root cause and resolution of Known Errors within SLA. Used business knowledge and commercial awareness in order to minimize the impact of any reported Problems on the Business. Reported on service trends, identify root causes and propose appropriate solutions. Ensured Configuration Items (CI) are linked to all Problems. Provided regular updates on Problems to the Customer. Analyzed ticket call data to identify trends, aging tickets and project work progress.
• Provided production support of several Priority 1 external facing critical business applications. Ensured that all problems are resolved within the timescales set in Service Level Agreements (SLA) and appropriate Operating Level Agreements. Provided on-call support (24x7) during critical issue resolution including war rooms. Ensured overall organizational support goals are met (i.e. SLA, incident/problem reduction, application availability). Performed root cause analysis for permanent resolution of incidents. Ability to troubleshoot complex production issues. For application defects, worked with the Business teams to gather requirements, providing status updates and delivering solutions in a timely manner. Developed innovative solutions to meet the Business needs. Ensured overall organizational support goals are met (i.e. SLA, incident / problem reduction, application availability).
• Provided management and oversight of service restoration processes across multiple business and operational functions to actively govern the performance of product support efforts. Developed and maintains the Incident Management process including documenting process and procedures in accordance with ITIL /ITSM standards. Performed Problem Management deals with solving the underlying cause of one or more incidents. Restored the service as quickly as possible to meet Service Level Agreements. Coordinated root cause analysis efforts for permanent resolution on all Incidents. Worked with the Development team to understand the new functionality being deployed and ensure all support readiness requirements are met. Collaborated with cross functional teams on issue resolution.
• Provided single point of ownership for incident lifecycle for Ratings Services applications. Worked with the on/offshore production support team handling Incident and Problem tickets. Ability to work independently to complete assigned tasks. Worked with Service Level Owner (SLO) on other ad-hoc duties as assigned
• Understood technical issues and work with Level 2/3 teams to analyze and resolve service outages, performance, and high severity incidents. Raised incident tickets for emerging system issues based on event notifications generated automatically or reported through other channels. Facilitated triage sessions for Level 2 Triage Committee during service outages, high severity incidents and events and escalate to Level 3 wherever necessary.
• Researched and evaluated alternative solutions and recommends the most efficient and cost effective solution for the systems design, considering existing systems, available technology, the capacity and limitations of equipment, operating time, and form of desired results. Worked with development, operations, technical support and other IT areas as appropriate throughout the development lifecycle. Analyzed existing system logic difficulties and revises the logic and procedures involved as necessary assisted in the supervision and preparation of logic flow charting.
• Worked under limited direction and independently determines and develops approach to solutions with evaluation upon completion for adequacy in satisfying objectives. Elicited, analysed, document, and validate requirements for financial systems. Wrote detailed software requirements specifications that describe functional and non-functionals requirements. Created modelling diagrams such as Swim lanes, Activity flow diagrams, and Data Models.
• Experience with full Software Development Life Cycle (SDLC) and project life cycle including Feasibility Analysis, Requirement Gathering and Management, Application Design and Development, Testing, Implementation and Post-Implementation Validation, and Solution Assessment. Strong knowledge of various methodologies such as Waterfall, Agile , Rapid Application Development (RAD) and Joint Application Design (JAD).
• Involved in thorough study of Business Requirement documents and functional requirement specifications . Involved in writing SQL Queries for different projects for verifying the data in database and for creating the different policies used for testing claims project scenarios. Participated in weekly meetings with Business Analysts, Development and QA team to discuss the milestones, progress and the issues. Analyzed testing results and generated QA daily status Reports and communicate with team for future priorities. Exceptional problem solving, decision-making, strong interpersonal and communication skills .

Confidential, Albany, NY

Sr.Business System Analyst

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 . Analyzed the Business Requirements Design document and Requirement Design Document (RDD) with the Business and Development teams to understand the architecture and functionality of the application. Developed, implemented and executed test methodologies and plans to ensure software product quality. Interacted with the Business Analysts and key stake holders and clarified the requirements that were inconsistent and ambiguous.
• Good Hands on Experience with SQL, Tableau and Excel and Excellent understanding on Tableau Workbooks and Background Tasks for Targeted Interactions Validation.
• Having Good Hands on Experience about Healthcare revenue cycle and accounts receivable management, including payment cycles, key trends, and critical success criteria
• Good Knowledge on SQL queries and creating database objects like stored procedures, triggers, packages and functions using SQL and PL/SQL for implementing the business techniques.
• Strong Knowledge of Medical Billing Rules and Regulations to bill the claims to the Insurance offices to get paid.
• Sturdy knowledge to handle the 835 and 837I, 837P claims Data Analysis and Strong Experience in Provider Credentialing. Good Hands on Experience with EDI Systems.
• Have good Experience with Facets Claims Processing. Have good Hands on Experience working with Physician Claims ( Confidential or CMS1500) and Hospital claims (UB04).
• Having Good knowledge in US Healthcare Industry end to end (Billing Rules and Regulations, Hospital Claims, DME Claims, Physicians office Claims submission and Insurance office all type of Claims adjudication).
• Good Hands on Experience to use ICD 9 codes and Good and Strong Experience on EMR files. Good Knowledge of ICD 10.
• Performed Functional, Regression, Integration, Smoke testing, Adhoc testing, Black box testing, and Usability testing, Positive and Negative testing of different modules of NY-HX application. End to End Testing (E2E), System Integration Testing (SIT), Release Integration Testing (RIT) and User Release Testing (URT) and assisted the end users in performing User Acceptance Test of the application.
• Specified Test Cases and Test scripts for the testing. Attended review meetings , performed Walkthroughs with the developers. Involved in thorough study of Business Requirement Design documents and requirement specifications . Participated in weekly meetings with Business Analysts, Development and QA team to discuss the milestones, progress and the issues.
• Experience testing migration of EDI transactions and data mapping. Extensive experience in Healthcare/Claims adjudication with knowledge of ICD-9 & ICD-10
• Extensively involved in using Agile/Scrum Methodology and involved in SCRUM meetings

Environment: SharePoint, RQM Rational Quality Manager, RFT Rational Functional Tool, 508 Compliance, Lotus Notes, Soap UI, Web Services, Oracle, EDI Manager TIBCO, FIRST PASS, INTEL ESG, 508 Compliance Sheriff, JAWS, DB2, MS Office 2007, IE, Firefox, Chrome, Safari, Windows XP, XML, XML Generator, Siebel CRM, Tableau

Confidential, FL

Sr. Business System Analyst

Responsibilities:

• Reviewed the Business Requirement Documents (BRD) and the Functional Specifications. Created Test Plans by going through the design and functional specifications. Involved in developing Test Scripts as per the business requirements in Quality center. Followed Agile - Scrum testing methodology.
• Analyzed the system requirement specifications and developed appropriate test plans, test cases test scripts and executed testing. Performed data-driven testing to read test input data from an Excel File so as to test the application with different positive and negative data.
• 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.
• Validated EDI transactions like EDI 834 (Benefit Enrollment and Maintenance), 277/275(Health Care Claim Request for Additional Information and Response), 276/277(Health Care Claim Status Request and Response), 835(Health Care Claim Payment/Advice), 837 and (Health Care Claim: Professional, Institutional and Dental) as per HIPAA 5010. Validated and analyzed EDI outbound and inbound Transactions. Worked on the EDI claims including both the batch processing BER (Batch Engine Refactoring) and direct data entry.
• Performed Positive and Negative testing, Black Box testing, and End User testing . Validated all the information from HIPAA to QICLINK .Migrated and validated all information from MC400 iSeries legacy system to QICLINK in DEV environment. Resolved any problems found within QICLINK and when testing the SQL data database while validating against the business rules.
• Worked with other teams to review and modify process flows to increase productivity and effectively utilize QICLINK features not provided by the MC400 iSeries legacy systems. Worked with Qiclink System implementation, Claims and Benefits configuration set-up testing, Inbound/Outbound Interfaces and Extensions, Load and extraction programs involving HIPPA 834,820 and proprietary format files and Reports development.
• Development team to fix the issues raised during the conversion period. Assisted informational needs in mapping of Test Cases. Validated the application against the expected results by inserting Database and GUI checkpoints. Extensively used of JIRA tool for defect reporting and tracking and prioritizing defects Performed QA Acceptance testing for test workflows with business users and performed data encryption testing as per HIPPA guidelines to ensure the privacy, security and confidentiality.

Environment: Qiclink, Soap-UI, Web Services, JIRA, Oracle, MC 400, EDI Manager DB2, MS Office 2007, Windows XP, XML, XML Generator

Confidential, MD

Sr. QA Analyst

Responsibilities:

• Validated EDI transactions like EDI 834 (Benefit Enrollment and Maintenance), 277/275(Health Care Claim Request for Additional Information and Response), 276/277(Health Care Claim Status Request and Response), 835(Health Care Claim Payment/Advice), 837 and (Health Care Claim: Professional, Institutional and Dental) as per HIPAA 5010.
• Multiple 837map set developed for each client (clearinghouse, internal, and external trading partners), as well unique mappings were needed in each map to accommodate various conditions dealing with Provider, Subscriber, PAY-TO and BILL-TO Provider information needed to identify multiple conditions dealing with batch processing of claims. Involved system testing on EDI transaction 270/271 for both inbound and out bound. Verified and validated HIPAA compliant X12N format for both inbound and outbound healthcare EDI transactions as per ICD 10
• Troubleshoot any problems found within FACETS and when testing the SQL data database while validating against the business rules. Responsible for working with the team to review and modify process flows to increase productivity and effectively utilize FACETS features not provided by the legacy systems. Worked with Facets System implementation, Claims and Benefits configuration set-up testing, Inbound/Outbound Interfaces and Extensions, Load and extraction programs involving HIPPA 834 and proprietary format files and Reports development.
• Validating all the information from HIPAA to FACETS. Created Claim Test Data and tested various scenarios. Worked on the EDI claims including both the batch processing and direct data entry.
• Used SOAP UI for testing Web Services, inspecting WSDL files, generating SOA envelopes, and accelerating many other common XML tasks encountered when developing Web-Service enabled applications. Involved in creating projects, test suites and done parameterization in SOAP. Validated XML, XSD, XPath Syntax, Web Services
• Worked with the client and stakeholders to design and configure all the required claims processing rules.
• Involved in Test Plans and wrote Test Scripts for Manual Testing. Performed Positive and Negative testing, Black Box testing, and End User testing. Assisted informational needs in mapping of Test Cases . Performed GUI testing, Integration testing, Regression testing, Ad -hoc testing, Negative testing, End to End testing, Load testing, User Acceptance testing on multiple projects. D evelopment team to fix the issues raised during the conversion period

Environment: Rational Rose, MS Office Tools, MS Visio, .Net, C#, BizTalk, Windows XP, AS 400, Oracle, SQL, Quality Center, QTP, Crystal Reports, Facets, soap-UI

Confidential, OR

Sr. Test Analyst

Responsibilities:

• Interacted with the SME’s to discuss the system requirements and uploaded it to Quality Center. Identified, analyzed and documented all defects that are inconsistent with stated requirements and design specifications by providing meaningful defect reports within the defect tracking system (Quality Center) . Worked with the application programmers to resolve defects identified during the system test. Reviewed, Tested and Verified the Standard Operating Procedures, written for testing the application
• Analyzed system requirements and developed detailed Test plan and Test cases , using Quality Center for testing the functionality, GUI, security, and usability of the system .
• Developed and executed test cases based on the requirements document and the test plan using Quality Center. Executed test cases developed by self or peer. Compared and analyzed actual to expected results and reported all deviations for resolution.
• Used SOAP UI Web Services tool for testing Web Services, inspecting WSDL files, generating SOAP envelopes, and automating or accelerating many other common XML tasks encountered when testing Web-Service enabled applications. Created test data (XML payload) using XML generator and executed test cases to test the Web Services using Soap-UI testing tool. Created Assertion to Automated the Web services testing
• Created data files for EDI 837/835, 270/271 and 276/277 transactions. Uploaded EDI 837 files for batch processing. Identified and created test data to support the successful execution of “Claim to Payment” scenarios
• Tested migration of 4010 to 5010 and validated EDI X12 transactions such as 834, 837/835, 270/271 & 276/277
• Performed functional testing, regression testing, and integration testing, according to the requirement specification to check if the application is error prone. Verified that all the features work as described in the Application documentation provided by the Development Team and as defined through study of screens and underlying application code.

Environment: Facets, Soap-UI, Web Services, Quality Center, Oracle, AS 400, DB2, MS Office 2007, Windows XP, XML, XML Generator