SUMMARY

• Over 7+ years of experience as a Quality Assurance Analyst with extensive knowledge and experience across the project life cycle in Systems Development Life Cycle (SDLC) in the fields of Insurance, HealthCare and Finance.
• Experienced in implementing various QA methodologies.
• Experienced in every phase of Quality Assurance Life Cycle (QALC) and Software Development Life Cycle (SDLC).
• Good experience in performing planning and development of Test Plans, Test Strategies, Test Cases and Test Scenario to meet product’s business requirements.
• Experienced in high volume Mainframe Testing and Mainframe environment like ISPF, TSO.
• Extensively used Rational Tools like Rational Clear Quest, Rational Robot and Rational Requisite Pro.
• Expertise with system testing, Integration testing, Functional testing, Backend testing, regression testing and User acceptance testing (UAT) with different testing tools such QTP and HP Quality Center.
• Proficient in Defect Reporting and Tracking throughout the entire defect life cycle.
• Expertise in Testing of Client/Server and Web based applications.
• Skilled in bug reporting and tracking using Test Director, HP Quality Center.
• Good Work experience on HIPAA EDI 835, 837, 271/272, 278 use cases and collaboration templates according business requirements in FACETS Claims Process.
• Extensive working experience with healthcare tools like, EDI X12 transactions, Trizetto Facets, ICD - 9, ICD-10 and ETL tool Informatica for extracting, transforming & loading the data into database.
• Excellent experience in and ICD 9 to10.
• Strong in IT research, software analysis and design skills.
• Extensive experience in Backend Testing on distributed databases using SQL queries.
• Experience in Functional Testing, System Integration Testing, Back End Testing, GUI Testing, configuration Testing, User Acceptance Testing.
• Experienced working in a migration process and respective GAP Analysis.
• Solid understanding of, Claims Processing, Billing, Benefit/Eligibility, Authorization/Referrals, COB, and have experience in HIPAA standards and corresponding EDI transactions.
• Knowledge of Medicaid and Medicare Services.
• Experience in performing functional testing using Quick Test Pro.
• Followed Workgroup for Electronic Data Interchange standards for testing that need to comply with the HIPAA guidelines.
• Proficient in working with FACETS, claim processing systems.
• Optimum use of documentation to avoid any form of miscommunication or misinterpretation during the entire software development process.
• Experience in facilitating meetings with clients to discuss and sign-off on the document.
• Possess strong problem solving skills with the ability to adapt to a new environment and meet deadlines.
• Motivated self-starter with exceptional team building, leadership, and interpersonal skills. Good team player with the ability to work in time sensitive environments.

TECHNICAL SKILLS

Methodologies: SDLC, RUP, Agile, Waterfall.

RDBMS: Confidential 9.x/10g, SQL Server 2005/2008, My SQL, DB2 and MS Access

Programming Languages: PL/SQL, VB.Net, QBasic, C++, C#, Java, HTML, PHP, ASP.Net, Java Scripts.

Platforms: Windows, Unix, Mainframe, RS 6000, Linux

Testing tools: WinRunner, LoadRunner, Quick Test Professional (QTP).

Change Management Tools: Rational ClearQuest, TestDirector, HP Mercury Quality.

Office Tools: MS Project, MS Office, MS Visio.

Database: MS SQL Server, MS Access, Confidential, Toad.

PROFESSIONAL EXPERIENCE

Confidential

QA Tester

Responsibilities:

• Involved in HIPAA/EDI Medical Claims Analysis, Design, Implementation and Documentation.
• Developed and implemented EDI applications to process Health Care transactions as per the HIPAA implementation
• Processed EDI 834 with various scenarios and validate the related tables from database using SQL query.
• Tested EPS (Enrollment Processing system) for Add, changes and Term Transactions.
• Diverse experience in Information Technology with emphasis on Quality Assurance, Manual Testing, Automated Testing using Quick Test Professional, Stess, Quality Center, Load Runner.
• Conducted Black Box Testing on the application and validated the dataflow in the application.
• Involved in creating the test data for testing EPS system.
• Tested the claims in facets to see if it is actually hitting the edit or not and send them for UAT testing.
• Creating and testing 834 transactions for 5010 and 4010 and mapped the changes according to ICD 9 and ICD 10.
• Involved in preparing the Test Scenarios for Health Care Claim Payment/Advice.
• Written multiple Test Cases (System, Integration) for multiple transactions include 837I, 837P, 835, (both inbound and outbound) transactions.
• Participated in UAT with business owners for specific test scenarios and in reviewing test results along with providing Adhoc test results.
• Interfaced with the development team utilizing ASP, JavaScript and Visual Basic and produced detailed user-interface prototypes and performed usability testing.
• Queried the DB2 database in Mainframes for the Proper validating the claims into the Database.
• Involved in creation and execution of manual test cases in Mercury Test Director and automated Test Cases in QTP and analyzed the Test Results.
• Extensively used SQL statements to query the Confidential Database for Data Validation and Data Integrity.
• Reviewed the Use Case Requirement, Functional Design Documents and Technical Specification documents.
• Created Test Cases after analyzing the BRD’s.
• Used Clear Quest for Loading New and updated requirements.
• Performed HIPAA Analysis and Testing on 4010/5010, including Claims handling, with Payer and Provider experience and EDI file generation and testing
• Performed Functional and GUI testing on Facets.
• Prepared test matrices based through defect status in Quality Center.
• Involved in testing of FACETS Implementation, involve an end to end testing of FACETS Claims Processing module, and benefits.
• Created HIPAA ANSI X12 EDI claim files that are submitted to the application under test, following the request through the multiple applications and validating the responses.
• Performed Backend Testing extensively by writing validation queries on DB database.
• Validated member’s benefits against the benefits matrix.
• Analyzed and tested data on claims manually and writing queries on DB database for validating data.
• Involved in validating member’s accumulator track right member’s benefits and making sure that Claims gets paid according to the SEPY’s rule.
• Logged defects in Quality Center and interacted with the developers to resolve technical issues.

Environment: Configuration and Testing Management (In house Tool), Facets 4.71, DB2, Java,TSO, Facets, Interactive SQL, MS Word, MS Project, MS Excel, Regression, Mainframe testing, Quality Center, QTP.

Confidential

QA Tester

Responsibilities:

• Participated in setting up testing environment.
• Reviewed Business requirement Documents and functional requirements.
• Involved in preparing Test Cases based on business requirements.
• Authored and executed Test cases for Claims and Customer Service Workflow by manually.
• Entered Claims and Customer Service Tasks into the FACETS.
• Created Logical and Physical Test case for Step-Up and Step-Down EDI Transactions for 4010 and 5010.
• Performed GUI/ Usability testing manually.
• Conducted UAT with end users to go over the test process and test results for approval.
• Responsible for writing the Test Cases and Test Scenarios based on the Functional Specification and technical Specification and documented in Mercury Quality Center.
• Experienced in load testing Client Server, Web Applications using Quality Center, Load Runner tool
• Developed Test cases for manual testing and automated them using Win Runner, Silk, Load Runner, Silk performer and QTP.
• Performed Impact analysis for readiness of ICD-10 conversion.
• Responsible for Back-End Testing Using SQL Commands using TOAD.
• Creating and consolidating SIT Test Cases and UAT test Cases using MS Excel.
• Provide support to end users while execution of UAT with proper test scenarios & test data.
• Developed SQL queries, functions, stored procedures and triggers to perform the backend testing of the data.
• Queried the DB2 database in Mainframes for the Proper validating the claims into the Database.
• Perform functional, exception and scenario testing.
• Logged the errors, reported defects, determined repair priorities and tracked the defects until resolution using Mercury Quality Center.
• Generated test cases in Claims Analyzer Editor Professional to ensure unification with ICD-10 codes
• Created Guide for 5010 testing project, documenting all the processes, tools, techniques used.
• Extensive knowledge of Test Matrix, Traceability Matrix.
• Quality Center was used to create the test plan, store test cases and run the test sets.
• Provides feedback concerning completeness and accuracy of AUT.
• Used Quality Center to analyze, track and report defects.
• Worked on uploading all the Test cases to the Quality Center for the current and prior releases.
• Responsible for performing System and integration testing for release.

Environment: Windows, Facets, Confidential, SQL, Mainframe TSO, Java, Mercury Quality Center, MS Office, MS-Visio, SOAP UI.

Confidential, Chicago, IL

QA Analyst

Responsibilities:

• Reviewed Business Requirements with Project Manager and Lead Developer to learn the functionality of the application.
• Involved in preparing Test Plan and Test Cases based on business requirements.
• Wrote Test Cases in Excel based on Technical Specifications, Functional Specifications and Business rules for online application system. used load runner to check the system response time under peak load
• Authored Test cases for HIPAA EDI Transactions 270/271, 276/277,837/835.
• Executed Configuration Testing to check if the application was compatible in different environment for each module of the application.
• Support UAT testing with weekly meeting with users and demonstrating the QA testing results with walkthrough and getting feedback
• Conducted data driven testing using QTP to conduct backend testing.
• Involved in working on real time test harness.
• Developed, modified and executed test cases and scripts using Quality Center for Functionality and Regression testing. Created test automation scripts in Load Runner using VuGen and Performance Center.
• Executing UNIX Shell Scripts for data validations, done FTP for transferring file to different servers.
• Used VB scripting in the expert view to enhance the scripts.
• Logged defects in Quality Center and interacted with the developers to resolve technical issues.
• Prepared test matrices based through defect status in Quality Center.
• Authored and executed Test cases manually for Tiered Benefit and mapped from website to PMHS.
• Responsible for writing the Test Cases and Test Scenarios based on the Functional Specification and Technical Specification in Excel and exported them in Mercury Quality Center.
• Trouble shooting, analysis of UAT & production defects along with QA Release management
• Logged errors reported defects, determined repair priorities, did regression testing and close by using Mercury Quality Center.
• Performed Integration Testing with PMSH, LRSP and Website, System Testing and Regression Testing.
• Responsible for performing User Acceptance Testing.

Environment: Windows, DB2, Confidential, Mercury Quality Center, validation testing, Java Script, MS Excel, MS-Visio, File Aid, Confidential, HIPPA, EDI 5010, XML, Mercury Quality Center.

Confidential

QA Tester

Responsibilities:

• Implementing an RUP methodology, assisted the Project manager with Project Initiation, business case development, phase planning, iteration planning, and risk analysis. Also implemented roadmap for Project implementation, conducted assessment, defined various stages, deliverables, templates and acceptance process
• Managed the requirements gathering process including scheduling interview and brainstorming sessions with user groups to gather, prioritize, and to decompose business and technical requirements
• Elicited, documented, and analyzed health and life insurance processes and procedures to conceptualize New Business Enrollment process, Commissions Process, and Claims process; and created a set of requirements to be used for workflow automation
• Managed Scope and change throughout the SDLC process of the product.
• Rational ClearCase was used to manage all the changes and change requests in the projects. Worked with QA team with the aid of ClearQuest for the bug tracking and Mercury Test Director for Test Case Management.
• Designed and implemented SQL queries for QA testing;
• Drafted many documents including Analysis Document, User Requirements Document, Functional Specifications Document, Design Specifications Document, Test Plan & Strategy, Traceability Matrix, and Manual
• Captured data requirements for EOBs providing information about claim payment information and Confidential responsibility amounts
• Assisted in monitoring ancillary data transactions and addressed problems with HL7 messages.
• Worked extensively with ASC X12N 837I and ASC X12N 837P
• Performed extensive data modelling to differentiate between the OLTP and Data Warehouse data models
• Designed and developed Project document templates based on SDLC methodology
• Helped with data modeling and defining the conceptual and logical model of the data warehouse.
• Drafted UML Diagrams such as Use Cases, and Swim Lane Activity Diagrams, and reviewed with SMEs
• Drafted Request For Proposal (RFP) and sent out to 3rd Party Vendors (Varicet, SAP, Centive, Trilogy, Xactly, Synygy, Confidential, Intellinet, Varicent, Actek, Callidus) for a new Commission/Incentive Management solutions
• Rated all the vendor responses on a scale of 1-5 (1-Strong Negative, 2-Caution,3-Promising, 4-Postive, 5-Strong Positive) based on Aflac’s needs and priorities; cost, vendor’s ability to deliver, and vendor support
• Executed PL/SQL queries during manual testing to functional test, end-to-end test, and regression test TRAC (the commission processing mainframe system), SNG, AWES, and PBI systems; assisting the Software Testing System team
• Prepared meeting materials including agenda; wrote down minutes of meetings during meetings; distributed and post them to the project repository; and did follow-ups monitoring work progress versus assigned tasks
• Always maintained excellent problem-solving and communication skills; and effectively listened, negotiated, debated, discussed, brainstormed, communicated, and collaborated with a variety of individuals and groups

Environment: Life70, DB2, QSAM, VSAM, TeamWorks, Java Script, COBOL, Load Runner, Assembler, J2EE, MS SQL Server 2005, Mercury Quality Center, MS Office, MS Visio, Certify, MQC, VB.Net, Java.

Confidential

QA Analyst

Responsibilities:

• Reviewed Business requirement Documents and functional requirements.
• Maintained Requirement Traceability Matrix (RTM) to make sure that test plans were written for all the requirements.
• Functional testing on SIT, UAT, Crystal Reports environment
• Analyzed system requirements and developed detailed test plan for testing.
• Performed Functionality, GUI, Regression, and Security testing using Win Runner.
• Conducted Data driven testing in Win Runner and data were read from Excel spreadsheets.
• Performed Smoke and Sanity Testing manually.
• Performed positive testing and negative testing manually.
• Detected and reported defects using Test Director.
• Identifying Test Cases to be run for Regression Testing and conducting Regression testing as and when new builds were made.
• Used QC, JIRA and Clear Quest as bug tracking tool for individual Vendor application and for logging defects, defect tracking, verification & closure activities.
• Executed Configuration Testing to check if the application was compatible in different environment.
• Administration of Test Director for Bug Tracking and Reporting, Generating customized graphs and reports.
• Performed configuration/ compatibility and user interface testing manually.
• Used IP Spoofing to simulate multiple users from different machines trying to access the website.
• Documented the test results and reported the status of assigned test tasks and issues to project manager.
• Verified HIPAA rules.
• Involved in testing HIPAA Transactions & Code Sets Standards like (820- Premium Payment for enrolled health plan members, 834 Enrollment to a health plan, 835, 837 ...etc.)
• Organized and participated in weekly QA team meetings
• Coordinated with developers and Project Manager.

Environment: Facets, HIPAA, EDI, XML, Test Director, Window, MS Office, Confidential .