SUMMARY:

• Software Quality Assurance Engineer with 11+ years of experience in QA Methodologies.
• Experienced in defining Testing Methodologies, Designing Test Plans and Test Cases, Verifying and Validating Web based e-Commerce applications and Documentation based on standards for Software Development and effective QA implementation in all phases of Software Development Life Cycle (SDLC) methodologies such as Waterfall and Agile (Scrum).
• Expertise in Manual and Automated testing of various Web based applications.
• Created Test Plans, Test Cases, Test Procedures and Test Script.
• Strong expertise in establishing QA policies, procedures, strategies and developing appropriate process to ensure the quality of product.
• Experience with Mercury Tools (QTP, Test Director), Rational Tools (RequisitePro, Robot, Test Manager, ClearQuest, ClearCase), PVCS.
• Designed and implemented Functional, Load and Stress test.
• Excellent knowledge in software engineering standards like TMMI, CMM, CMMI and RUP.
• Expertise in writing SQL & testing stored procedures and queries in Oracle.
• Extensively used SQL queries to manipulate the data.
• Experience in performing System, Functionality, User Acceptance, Integration, GUI, Regression testing.
• Expertise in documentation using MS-Office Tools (Word, Excel).
• High interpersonal skills and ability to work individually and as a group member.

SOFTWARE EXPERIENCE:

TOOLS: Rational Suite 2002 (Rational Test Manager, Requisite Pro, Clear Quest), Remedy, Mercury Tools (Test Director)

OPERATING SYSTEMS: UNIX, MVS, AS/400, Windows 98/00/XP//NT

LANGUAGES: C, C++, VC++, Java, J2EE, ASP, COBOL, RPG/400, JCL

GUI: Developer/2000, Visual Basic 5.0/6.0.

DATABASE , Oracle 7/8i, SQLServer, DB2 and MS-Access.

WEB SERVER: BEA Web Logic, IBM Web sphere, IIS.

PROFESSIONAL EXPERIENCE:

Senior QA Analyst

Client: Confidential, Buffalo, NY

Confidential is a not-for-profit organization headquartered in Buffalo, New York. As a Senior QA Analyst I was involved in testing the Claims Applications (Medical and Hospital). As part of testing we had Tested Medical and Hospital Claims for all the Benefit Plan products that needs to be tested with changes in the Claims Application with that of Power MHS changes using HealthRules 5.0

Responsibilities:

• Reviewed and approved QA Analyst Test Scenarios and Scripts
• Analyzed Business Requirements and Detailed Design documents
• Developed Test Scenarios and Test Scripts that map to Business Requirements and Detail Design document for Web- Based
• Working in Agile Process.
• Created test cases for Exchange Small Groups in ALM
• Validated both Medical and Hospital claims in HR(HealthRules application).
• Involved in Analysis, design and testing of Health care applications in Facets 4.71 and Facets 5.01.
• Involved in Analysis, design and testing of ICD 9 and ICD 10 codes in Facets 5.01.
• Experience in HIPAA EDI 837 (Professional and Institutional Claims) and 835 (Claim Payment/Remittance Advise).
• Validated different Benefit Matrix plans(Empower, Evolve plans)
• Validated HCS(Healthcare Services) Authorization claims for all In and OON claims for different plans.
• Created test scripts and test data files for the HIPAA 837/835 (Claims Processing /Claims Payment), and 276/277 (Claims Request and Claims Response) transaction based on the ANSI X12N HIPAA standards.
• Also submitted the 837 electronic claims by modifying the Keyword files on Facets 4.71 and 5.01 systems.
• Created test data files for the EDI 837 (Professional, Institutional, Dental Claims) transaction based on the ANSI X12N HIPAA standards.
• Validated different types of Authorizations like Member pre-auth, Pre- certification with and without penalty cap for In and OON Claims.
• Validate claims for different Benefit Provisions.
• Validated Claim Deductible, Copay, Coinsurance and Allowed Amounts for Pilot Group Benefit Plan and also validating Institutional and professional claims for Benefit Plans, Get Benefits and Medicare Plans Authorization and Referrals claims testing
• Validate whether claims are paying correct copay, deductible, limits and accumulators according to the plan.
• Creating different types of claim and authorization files for testing purpose.
• Created claims for Referral Categories ( Back Surgery, DME, Home, Oncology Programs, Radiology, Others )
• Validated different types of plans for Exchange program
• Imported Test Scenarios and Test Scripts created in MS Excel into HP Quality Centre.
• Used HP Quality Center and Test Director to log and manage defects
• Created Defect Statistics Reports and Test Metrics Reports using Quality Center.

Environment: HP Quality Center11.0, HealthRules 4.6.2, .NET, XML, SQL*Plus, SQL Server 2000, MS Access 2000, MS-Word, Ms-Excel

Senior QA Analyst

Client: Confidential, Buffalo, NY

Confidential is one of the largest Healthcare Providers in New York State. As a Senior QA Analyst I was involved in testing the Claims Applications (Medical and Hospital).

Project Transform: Project Transform is a multi-year initiative to replace the Company’s current core operating system (Facets) with the AMMS system built and maintained by Confidential of South Carolina. It was formerly known as COST (Core Operating Systems Transformation). The Existing technology platforms, Facets, has been extremely customized and has spawned a large number of complex applications that didn’t allow for a simple upgrade, making the move to a new technology platform imperative.

Responsibilities:

• Validate the extracted files (Human, Non-Human and Affiliation) from facets before sending to the BCBS SC.
• Validate the fatal errors on the HUMAN and NONHUMAN extracted files from facets.
• Meetings with UNIT TESTING Team to learn more about Automated Testing. In future we are required to come up with Automation techniques to validate/test the files.
• Created test scripts and test data files for the HIPAA 837/835 (Claims Processing/Claims Payment), and 276/277 (Claims Request and Claims Response) transaction based on the ANSI X12N HIPAA standards.
• Involved in creating the Test cases & test condition for EDI 837 Claims (I & P) Transactions.
• Worked different Claims like Medical, Hospital, and Dental.
• Checked the ISA Segments, Elements, Loops etc. for ANSI X12 5010 Format as per HIPAA implementation guidelines.
• Validated the Claims Against the Facets Online Screens.
• Performed ETL Data Validation using Informatica.
• Worked on Benefit Focus – eBilling Application
• With the addition of the HealthNow-generated invoices to the eBilling application, users will be able to view, adjust and pay invoices quickly and efficiently online.
• eBilling will reduce the time and expenses it takes HealthNow to distribute invoices and receive and process payments
• Validated aMax( Broker Info ), Payment File ( ps Max ), Group Info ( c Max ), and Billing Invoice files( bMax ) using BF application.
• Worked on Facets – Billing application and validated different groups invoices with that of Benefit Focus application( Billing Summary and Billing Entity )
• Created Defect Statistics Reports and Test Metrics Reports using Quality Centre

Environment: HP Quality Center10, Facets 4.71 (Trizetto), C#, V.B, .NET, XML, SQL*Plus, SQL Server 2000, MS Access 2000, MS-Word, Ms-Excel

Senior QA Analyst

Client: Confidential, Chattanooga, TN

Confidential is one of the largest Healthcare Providers in Tennessee State. As a Senior QA Analyst I was involved in testing the Claims Applications (Medical and Hospital). As part of testing we had Tested Medical and Hospital Claims for all the RTM's(Request Tracking Management) which product needs to be tested with changes in the Claims Application with that of PEGA Rule changes using Facets 4.71

Responsibilities:

• Tested for Facets versions 4.71/4.81 for Claims and Provider Process with Pricing tool NetworX pricer
• Worked on Subscriber/ Member Application and created test data for various - Group/Subgroup and Subscriber/Family
• TriZetto Network X Pricer Tested the Medical Agreements for the Procedure Codes for various Providers.
• Tested the Agreement ID used by the Providers for all the Procedure codes for various regions in TN State.
• Created Claims in Medical Claims and Hospital processing application
• Reviewed and approved QA Analyst Test Scenarios and Scripts
• Wrote SQL Statements to query Oracle and DB2 relational database systems
• Imported Test Scenarios and Test Scripts created in MS Excel into Mercury Quality Centre and Test Director.
• Used Mercury Quality Center and Test Director to log and manage defects

Environment: HP Quality Center11, Facets 4.71/4.81 (Trizetto), C#, V.B, .NET, XML, SQL*Plus, SQL Server 2000, MS Access 2000, MS-Word, Ms-Excel

Senior QA Analyst

Client: Confidential, Buffalo, NY

Confidential is one of the largest Healthcare Providers in New York State. As a Senior QA Analyst I was involved in testing the Claims Applications (Medical and Hospital). As part of testing we had Tested Medical and Hospital Claims for all the RTM's(Request Tracking Management) which product needs to be tested with changes in the Claims Application with that of PEGA Rule changes using Facets 4.51. I have involved in testing the NetworX Pricer to validate the claims for different Providers (tested EOB’s and Vouchers)

Responsibilities:

• TriZetto Network X Pricer Tested the Medical Agreements for the Procedure Codes for various Providers.
• Tested the Agreement ID used by the Providers for all the Procedure codes for various regions in NY State.
• Test Cases were written in detailed for all the Subscriber /Member, Claims Processing ITS, Customer Service and for Billing Application
• Created Claims in Medical Claims/Hospital and Dental Processing application
• Validated the Claims with the PEGA Changes with that of Facets
• Participated in testing various interfaces (Inbound and Out bound) of Facets
• Created Defect Statistics Reports and Test Metrics Reports using Mercury Test Director and Quality Centre
• Developed Test Scenarios and Test Scripts that map to Business Requirements and Detail Design document for Web- Based
• Imported Test Scenarios and Test Scripts created in MS Excel into Mercury Quality Centre and Test Director.
• Used Mercury Quality Center and Test Director to log and manage defects

Environment: HP Quality Center10, Facets 4.51 & Facets 4.71 (Trizetto), C#, V.B, .NET, XML, SQL*Plus, SQL Server 2000, MS Access 2000, MS-Word, Ms-Excel

Senior QA Analyst

Client: Confidential, Rochester, NY

Confidential is one of the largest Healthcare Providers in New York State. As a Senior QA Analyst involved in testing the Claims Applications (Medical and Hospital) Membership and Customer Service. As part of testing we had Tested Medical and Hospital Claims for all the Agreement terms using the Procedure codes for various Providers for different regions in NetworX application for Facets 4.51.

Responsibilities

• Expertise in documentation including design, development and execution of Test Plans, Test Scenarios and Test Cases
• Design and developing test plan, test cases and scripts
  Functional, GUI testing, System testing and Integration testing.
• Experience with Rational Suite (Rational Administrator, Rational Test Manager, Rational Robot, Rational RequisitePro, Rational ClearQuest, Rational ClearCase, Rational Rose)
• TriZetto Network X Pricer Tested the Medical Agreements for the Procedure Codes for various Providers.
• Tested the Agreement ID used by the Providers for all the Procedure codes for various regions in NY State.
• User Interface and Business Requirement Analysis
• Testing Methodology and Test Plan Formulation
• Experience in testing Healthcare EDI Transactions

Environment: Java, J2EE, JSP, Servlets, Web logic, Facets 4.51, Rational Suites (Manual Tester, Test Manager, Clear Quest), MS-office, XML.

Senior QA Analyst

Client: Confidential, Mountlake Terrace, WA

Confidential is one of the largest Healthcare Providers in Washington State. As a Senior QA Analyst involved and tested the Membership, Customer Service and Claims as part of upgrade from Facets 4.5 to Facets 4.7 Patches testing. Involved in conducting Functional and Regression testing

Responsibilities:

• Conducted Parallel testing for 4.51 to version 4.71
• Subscriber/ Member - Group/Subgroup and Subscriber/Family
• Claims processing - Medical Claims/Hospital Claims and Dental Claims
• Customer Service
• Billing
• Reviewing the business requirements and working with business Analyst and requirements team for gaps found during the review
• Analysis and Writing the test scenarios based on business requirements and Business use cases
• Test Cases were written in detailed for all the Subscriber /Member, Claims Processing ITS, Customer Service and for Billing Application
• Created Claims in Medical Claims/Hospital and Dental Processing application
• Wrote SQL Statements to query Oracle and DB2 relational database systems
• Analyzed Business Requirements and Detailed Design documents
• Created Defect Statistics Reports and Test Metrics Reports using Mercury Test Director and Quality Centre
• Imported Test Scenarios and Test Scripts created in MS Excel into Mercury Quality Centre and Test Director.
• Identify the Regression Test Scripts and automate them using QTP.
• Compared and validated the reports between Facets 4.51 and 4.71.

Environment: Facets 4.51 & Facets 4.71 (Trizetto), C#, V.B,.NET, XML, SQL*Plus, SQL Server 2000,MS Access 2000, MS-Word, Ms-Excel, NT, Mainframes, Mercury Quality Center.

Senior QA Analyst

Client: Confidential, Owings Mills, MD

Confidential is the not-for-profit, non-stock, parent company of Confidential of Maryland, Inc., and Group Hospitalization and Medical Services, Inc., affiliates that do business as Confidential Blue Cross Blue Shield. Confidential, Inc. is governed by a Board of Directors and special statutes regulating its business in Maryland, the District of Columbia and Northern Virginia. Is the largest health care insurer in the Mid-Atlantic region, serving nearly 3.4 million members. Employs more than 5,000 associates in the District of Columbia, Maryland, Northern Virginia, North Carolina and West Virginia

Responsibilities

• Developed a detailed Test Plan & Test strategy based on Business requirements specifications
• Created Claims in Medical Claims and Hospital Processing application
• Validated the Medical and Hospital claims in the Medical Customer service application.
• Working on migration small and medium-sized groups to FACETS 4.51.
• Tested duties involved: Functional, GUI, ETL jobs/processes to load and transform data from source to target.
• Involved in Data Validation, Data Conversion and Data Reconciliation Testing.
• Involved in Status calls, Business and Technical design meetings.
• Tracked defects using Quality Center Attended Bug-Review meetings.
• Reported the bugs, Email notifications to the developers using Quality Center.

Environment:Facets 4.51, Mercury Quality Centre 9.0, MS-office, XML, Mainframes (COBOL, DB2, JCL, CICS),Java, J2EE, JSP, SQL Server, UNIX, MS-Office, Windows NT/XP.

Senior QA Analyst

Client: Confidential, Province, RI

As a compliance requirement of Confidential, every Plan must maintain the Association’s ITS Blue Card software and that software must integrate with the Plan’s claims processing system.The purpose of the ITS SLS Release 10.2 Project is to convert the remaining ITS databases (OEC suspense database and ALIM/HPA databases) from IMS to DB2 databases, in addition to installing any software contained within the release in support of Confidential enhancements.

Responsibilities:

• Testing the in-house and the association software and also to ensure that the association software integrates seamlessly with the in-house LRSP Claims processing system.
• Tested the encode and decode tables in LRSP
• Validate the modified software; test the Association code for ITS (Inter Plan Teleprocessing System).
• Participated in System, Regression and Acceptance Testing.
• Tested the Various Claims and Payment Patches in LRSP.
• Tested the CICS (Mainframe) Screens.
• Worked with JCL extensively to schedule and execute the jobs in Mainframes.
• Tested the database integrity by writing SQL Queries using QMF on Mainframes.
• Worked with batch jobs (JCL) and validated the reports.
• Tested the TSO/ISPF and CICS applications.
• Traced Defects and prioritized them.
• Worked with all levels of management and resolved the issues found.

Environment: Mainframes (JCL, CICS, DB2), Java, J2EE, JSP, Servlets, Web logic, MS-office, MS-Excel

Senior QA Analyst

Client: Confidential, Portland, OR

Confidential is one of the primary health insurance carriers in the Pacific Northwest. Regence is focusing on a phase approach to update all their Plans (Oregon, Washington, Utah, Idaho and Asuris) to one common system which is Trizetto Facets 4.31. CP-SS (Common Process Single System) is the internal initiative that will accomplish this goal for the four states mandates accommodation of numerous underwriting differences among the plans and rules with provisions for accommodations across the four states. BCBS is in the process of implementation of FACETS 4.31 from its legacy system Amysis .I was involved in system integration testing team which does the integration of Facets with different extensions.

Responsibilities:

• Participated in Requirement Analysis, Business Analysis, Use-Case Analysis and Gap Analysis.
• Developed Test Plans, Test Cases, Test Scripts, Test Scenarios, Test Beds, Test Data and Traceability Matrix.
• Analyzed Business Requirements and System Specifications to understand the Application.
• Created test cases and test data by studying and analyzing Functional and Technical Specification Documents
• Conducted Integration, System, Functional, GUI, Regression, Smoke, Database Integrity, User-Acceptance (UAT) and Performance testing.
• Created test scripts using Rational Robot and performed functionality, and regression testing on new builds of the software
• Developed Test Cases and Test Design using Test Manager
• Created Traceability between Requirements and Test Cases
• Tested the Claims processing
• Worked with EDI transactions (270, 271, 835, 837)
• Tested the Members, Subscribers, Facets Workflow and Claims in Facets.
• Tested the mapping and integrity of data populated in the database using SQL scripts in SQL*plus.
• Wrote SQL queries to test database
• Worked Closely with Development team in the execution of job schedules
• Participated in document Reviews and inspections.
• Identified Software bugs and interacted with developers to resolve technical issues.
• Tracked the defects using Rational Clear Quest and generated defect summary reports
• Maintained Test Logs, Test Summary reports and participated in defect review / Status / GO-NOGO Meetings.

Environment: Java, J2EE, JSP, Servlets, Web logic, Facets 4.31, Rational Suites (Manual Tester, Test Manager, Clear Quest), Sybase, MS-office, XML

QA Analyst

Client: Confidential, Chandler, AZ

I have worked for Confidential on Payment Manager Application which deals with the different types of payments like International transactions, Domestic Transfers etc. The pipe line of the process starts after receiving the test file from the customer which has different type of payments depending upon the customer profile. We process the file from UNIX to Web Methods 6.2 where we validate the fields like Account Number, Routing number, Amount of Money etc.., and send back the Acknowledgement for the test file and Check Layouts to the customer to approve for go-live. The backend database utilized was Oracle.

Roles & Responsibilities:

• Involved in analyzing system specifications, designing and development of test
• Plan for collection Applications
• Reviewed the Business and System requirements. Attended core team meeting And walk-through for review and resolution of Business and System requirements
• Created Test Plan, gathered test data and created Test Cases, Matrices and scripts. Coded and executed automated test scripts using Quick Test Pro.
• Involved in User Interface Testing, Negative Testing, Positive testing,
• Acceptance Testing, Conducted the functionality testing for the application
• Executed Test Cases and verified Actual Results against Expected Results.
• Bugs traced and reported to the developers.
• Performed Regression Testing to assure fixes are working fine and not creating
• Another issue Involved in acceptance testing on every new build from development.

Environment: QTP 8.2, UNIX, Web Methods 6.2, Payment Manager, Oracle