SUMMARY

• 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.
• Implemented and experienced in various QA methodologies.
• Experienced in every phase of Quality Assurance Life Cycle (QALC) and Software Development Life Cycle (SDLC)
• Performed planning and development of Test Plans, Test Cases and Test Scenario to meet product’s business requirements.
• Proficient in Defect Reporting and Tracking throughout the entire defect life cycle.
• Possess strong problem solving skills with the ability to adapt to a new environment and meet deadlines.
• Expertise in Testing of Client/Server and Web based applications.
• Skilled in bug reporting and tracking using Mercury Quality Center, Test Director.
• Strong in IT research, software analysis and design skills.
• Extensive experience in Backend Testing on distributed databases using SQL queries.
• Solid understanding of Membership, Claims Processing, Benefit/Eligibility, COB and have experience in HIPAA standards and corresponding EDI transactions.
• Experience of Medicaid and Medicare Services.
• Run and validate electronic claims for Medicare/Medicaid interfaces.
• Raised defects on Medicare/Medicaid billing defects like incorrect co - pay or coverage
• Followed Workgroup for Electronic Data Interchange standards for testing that need to comply with the HIPAA guidelines.
• Tested the HIPAA EDI transactions 834, 837/835, 276/277, 270/271 according to the requirement test scenarios.
• Hands on experience in testing the claims Adjudication Process using Facets.
• Performed HIPAA Analysis and tested with HealthCare application such as Facets.
• Created Page Check Points, Object checkpoints to understand broken link QTP.
• Good understanding of Object Repositories and update object repositories for elements in QTP.
• Well versed in data driven testing through Parameterization of data by creating table in QTP.
• Called QTP through QC by creating Add on button to take the screen shot of functional testing.
• Optimum use of documentation to avoid any form of miscommunication or misinterpretation during the entire software development process
• Excellent communication and organizational skills with the ability to adapt to a new environment.
• Experience in facilitating meetings with clients to discuss and sign-off on the document.
• Conducted User Acceptance Testing (UAT)
• 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

Platforms: Windows, Mainframe

Testing tools: Win Runner, Quick Test Professional, Quality Center

Change Management Tools: Rational Clear Quest, Test Director, Mercury Quality Center

Office Tools: MS Project, MS Office, MS Visio

Database: MS SQL Server, MS Access, Oracle, Toad

PROFESSIONAL EXPERIENCE

Confidential, Austin, TX

QA Analyst

Responsibilities:

• Analyzed the Service Request Charter, Business User Requirements (BUR), Functional Documents, Detail Design Documents.
• Responsible for holding walkthrough meeting and meeting with Business Analyst and Developers to understand the Business Flow and Process.
• Prepared the Test Approach, Test Plan and UAT Test Strategy for different phases of COR 70.
• Wrote test cases to cover different scenario based on Business User Requirements and Functional Documents.
• Responsible for creating and execution of automated test scripts using Quick Test Pro.
• Used QTP Checkpoints to verify that expected information gets displayed in the AUT during the test run.
• Performed Data-Driven Testing using parameterization in QTP using Data Tables.
• Carried out GUI, Functionality, Integration and Regression testing using Quick Test Pro.
• Performed Data Driven Testing using Quick Test Pro.
• Recording Test cases, scenarios that adhered to the requirements, and executed Test cases using QTP.
• Inserted Check Points to check the broken links, Text and standard properties of an object using Quick Test Pro.
• Created page checkpoints to test the properties and contents of the web page Quick Test Pro.
• Performed Parameterization using Data Driven Testing in Quick Test Pro.
• Documented the UAT test plan and Result for sign-off from Stakeholders.
• Conducted UAT walk through meeting with different Stakeholders on Claims Processing, GUI Modifications, Extract and Report validations.
• Closely work with IV&V, Business Analyst and Test Team to commensurate their comments on Test Approach and UAT Test Plan.
• Coordinate with Test Team to generate new idea for testing, schedule of testing and distribution of work among testers.
• Wrote test cases and tested e-Prescribing & Surescripts to validate that response file includes FFS Claim and MCO Encounters records when Client’s real time medication history were requested.
• Wrote simple and complex SQL query for Back-end testing.
• Performed the data validation testing between database and GUI.
• Prepared the test data based on NCPDP D.0 format for Claims Billing (B1) and Claim Reversals (B2).
• Prepared mock up data and uploaded same in SIT and Dev Environment and UAT Environment for COB testing and third party liability.
• Prepare the data for Co-Pay Amount for the CHIP clients to determine the reimbursement amounts based on AWP and TWP pricing.
• Prepared Mock up Encounter Data to generate different Extract and Report and validate same to make sure claim records are not populating in Encounter Extract and Report.
• Validated different kind of Encounter Extract like OAG, UT, Data Niche, HMO Weekly Extract and One Year Claims and Encounter History.
• Tested various kinds of Encounter report like Formulary Report, OAG Report, Claims Report, Pharmacy Report, Field Report to make sure only claims adjudicated by MCOs are populating.
• Logged and raised defect in Quality Center.
• Conducted end to end testing from creation of data to the validation of pricing and rebate.
• Performed regression testing to validate different scenario after defects are fixed.
• Responsible for preparing Requirement Traceability Matrix for Requirement Coverage.
• Kept track of changes of items and documents requested from last year to this year for internal auditing and external auditing.
• Maintained and documented the tickets and spreadsheets for external auditors on items like Password Configuration, Backend Scripts Screenshots, System Flow Diagram, Unix Password Configuration and etc.

Environment: HP Quality Center, QTP, CE2000, Oracle Database 10g, Business Object, MS Office 2010, Alfresco, Web Portal (OS+ GUI), NetExpress, NCPDP D.0, Note ++, Teratrum, Agile Methodology, MF COBOL.

Confidential, San Francisco, CA

QA /EDI Analyst

Responsibilities:

• Assisted QA and BA teams with Data requirements and Defect investigation in testing phase.
• Worked with different teams to understand business flows and scenarios.
• Organized Team knowledge transfer sessions and distributed testing.
• Managed Documentation, Test Plans, and Test Cases and Testing Reports.
• Created Plans and Strategies for BSC to streamline their Systems including EDI Transactions so they are able to pass through the EDI Gateway.
• Managed the testing and verification of HIPAA standard transactions, and EDI messages (837),
• Considered the priorities of different business teams in order to execute testing.
• Created Gap / Defect / test case reports and documents.
• Tested the HIPPA EDI, 834, 270/271, 276/277, 837/835transactions according to test scenarios and verify the data with Facets on different modules.
• Performed SQL queries to determine the data to be used for testing.
• Conducted Backend testing using SQL Commands.
• Extensively used SQL statements to query the Oracle Database for data validation and data integrity.
• Performed Change request analysis and testing.
• Testing on portals for employee benfits/enrollment, and Project configuration tools on JAVA platforms.

Environment: Facets, Informatica, HIPAA 10, SQL, EDI, UNIX, Windows XP, MS Office 2007, Oracle, QualityCenter, QTP, TOAD for Oracle, SOAP UI.

Confidential, Augusta, ME

QA Tester

Responsibilities:

• Created Test Cases and Test Scripts for Data Hub requirements as described in RSD (Requirement Specification Documents) and DSD (Design Specification Documents) as well as HIPAA regulations like 834, 835, 837, etc
• Validated and verified MIHMS files according to MIHMS file format mentioned in RSD
• Validated Eligibility Source Systems data, analyze source system testing and if any testing gaps are identified, created and documents tests for demographic and enrollment records
• Analyzed and worked with HIPAA specific EDI transactions for claims, member enrollment, benefit enrollment, claims processing, and billing transactions. Worked specifically with 270/271,276/277,837, 834/835.
• Gathered Data Hub requirements and responsible for creating test cases and test scripts under Quality Center Test Plan and Test Lab modules, developed automation test scripts in Quality Center
• Assisted SMEs with validation of MIHMS daily error report files and other testing required for User Acceptance Testing
• Extensively involved in Data Hub Back-End Testing using Oracle SQL Server; performed daily process testing using SQL scripts execution and logged test results in Quality Center
• Created and executed test scripts for approved Change Requests, logged their test results and related documentations in Quality Center
• Responsible for defect tracking and bug reporting using Quality Center; interacted with developers and Business Analysts to discuss and resolve defects
• Involved in daily defect review meetings to review the status of defect fixes and upcoming build releases
• Verified and validated all the build or release related issues and resolve then through discussion with business analysts with the users approval

Environment: Windows XP, HIPAA, MMIS, XML, Quality Center, MS SQL Server, SQL, UNIX Shell scripts.

Confidential, Jefferson City, MO

QA Analyst

Responsibilities:

• Identified the requirements for accommodating HIPAA 5010 standards for 837P transactions and captured these requirements to develop new GUI for the internet based application.
• Involved in preparing Test Cases based on requirements.
• Verified the test scripts before manual execution if they cover all the aspects of rate and quote details according to State Medicaid and Medicare Policy coverage selection.
• Maintaining knowledge of Medicare and Medicaid rules and regulations pertaining to the Facets configuration and evaluating the impact of proposed changes in rules and regulations.
• Testing different scenarios where individual might be eligible for Claim Adjustment under Medicaid Program.
• EDI Conversion from based on MMIS
• 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.
• 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.
• Responsible for Back-End Testing Using SQL Commands.
• 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.
• 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.

Environment: Oracle, Windows 2000/XP, IIS, Quality Center, Manual Tester.

Confidential, Cleveland, OH

QA Analyst

Responsibilities:

• Reviewed Business requirement Documents and functional requirements.
• Formulating detailed Test Plan using Quality Center after analyzing business rationale and software requirement artifacts.
• Interacted with the team member to ensure meaningful development of the scripts and simulated real time business scenarios.
• Performed the Back-End integration testing to ensure data consistency on front-end by writing and executing SQL statements on the Database
• Reviewed manual testing methods and developed and executed.
• Involved in Configuration testing.
• Used Quality Center for version control, tracking defects, enhancement requests, assign work activities, and assess the real status of project throughout the life cycle.
• Maintained Requirement Traceability Matrix (RTM) to make sure that test plans were written for all the requirements.
• Identifying Test Cases to be run for Regression Testing and conducting Regression testing as and when new builds were made.
• Documented the test results and reported the status of assigned test tasks and issues to project manager.
• Involved in testing HIPAA Transactions & Code Sets Standards like (820- Premium Payment for enrolled health plan members, 834(X12) - Enrollment /Dis-enrollment to a health plan, 835, 837 ...etc.)

Environment: Manual Testing, Facets, Quality Center, UNIX, MS SQL Server

Confidential, Spring Field MO

QA Analyst

Responsibilities:

• Strongly involved in development of detail Test Cases, Test Plan in MS Word and Quality Center.
• Partially involved in collecting and documenting Business Requirements with the end client, along with Business Analyst.
• Conducted Frontend and GUI Testing manually as per the requirement for the end client.
• Performed Security Testing, to ensure User and Payment Authentication.
• Performed Integration Testing and Regression Testing.
• Identified Test Cases to be run for Regression testing and conduct Regression Testing when new builds were made.
• Customized Quality Center to suit the requirements of Testing environment and efforts.
• Used Quality Center to track defects and generate customized graph and reports for the client using Quality Center.
• Reporting Bugs Using Quality Center.
• Attended weakly meeting with team leaders, managers and developers to discuss the issues found during the creation of the test case/script.
• Assisted Business Analyst in creating UML-Use case, sequence diagram using MS Visio.
• Assisted Business Analyst in Software documentation.

Environment: Windows XP, QTP, Quality Center, MS SQL Server/Windows, XML, MS Office, MS Project, MS Visio

Confidential, Deerfield, IL

QA Tester

Responsibilities:

• Involved in preparing Test Plan.
• Developed Test Cases and scripts to validate functionality of the application.
• Involved in Manual Testing.
• Performed Black Box Testing, Positive and Negative Testing.
• Provided test status reports on weekly basis to the project manager.
• Performed Usability and Integration Testing manually.
• Performed Security Testing manually.
• Executed tests before and after bugs fixes as a part of Regression Testing.
• Interacted with developers and assisted to them to resolve bugs.
• Specified test requirements and test plans in the Test Director
• Report defects and generate reports in the Test Director
• Performed weekly walkthroughs and inspection meetings.
• Responsible for arranging team meetings for defect reviews.
• Follow up with developers on the defect status on a daily basis.

Environment: s: Test Director, MS SQL Server/Windows, SQL.