Resume of PP



Resume of P P

SUMMARY OF QUALIFICATIONS:

• Over FIVE years of extensive and diversified experience in Information Technology with emphasis on Manual and Automation Testing of Web based applications, Client / Server based and distributed multi-tier commercial applications.

• Strong knowledge of Health Care Insurance, EDI HIPAA transactions. Worked on EDI Transaction sets including 837, 270, 271, 834, 835, 276, 277. Exposure of Trizetto, Facets and NASCO claims processing system, MMIS, MAS. Good understanding of ICD-9 and impacts related to ICD-10.

• Knowledge of DOORS, Rational Clear Quest and Clear Case. Participated in all phases of the SDLC from analysis, design, and development through testing. Developed Test Scenarios, Test Cases and Test Scripts based on business and functional requirements.

• Automating manual scripts by using Quick Test Pro (QTP) 9.5, 10. Use Mercury Quality Center for Defect tracking and reporting. Extensive Experience in Black Box Testing. Reviewing of Business Requirement Analysis, and System Specifications Analysis.

• Writing positive and negative Scenarios and Test Cases for System & Web testing using QC. Hands on experience testing Commercial Websites and business applications. Database querying and data manipulation using SQL and PL/SQL and involved in back-end testing as well as front-end testing.

• Proficient in back-end database testing on different database systems including Oracle, SQL Server, MS-Access.

• Strong analytical and problem solving, interpersonal and communication skills, self-starter, quick learner and able to adopt new technologies as needed in rapidly changing IT environment.

TECHNICAL SKILLS:

Operating Systems: Windows 95 / 98/ 2000/2003/2007/XP, UNIX.

Testing Tools: Quick Test Pro 9.5/10.0, Clear case.

Query Tools: TOAD, SQL.

Bug reporting Tools: Rational Clear Quest, Bugzilla, JIRA.

Test Reporting Tools: Rational Quality Manager, HP Quality Center 9/10.0, Test Director.

Web Technologies: HTML, XML, VB script.

Database Tools: SQL Server 2005/2008/2012, Oracle 9i/10g, MS Access.

Tools: MS-Office, MS-Visio, MS Project, PowerPoint, Dream viewer.

PROFESSIONAL EXPERIENCE:

Jun ‘13 - Present Xerox Healthcare

Test Analyst West Sacramento, CA

Xerox health care is a Financial Intermediary to operate the CA-MMIS (California version of Medicaid Management Information Systems). The project deals in testing the ICD-10 Crosswalk System. The ICD-9 code (which is required to report medical diagnoses and inpatient procedures for everyone) would be replaced by ICD-10 code sets from October 01-2014. Xerox implemented a backward crosswalk solution for Department of Health Care Services (DHCS), CA to process ICD-10 Diagnosis and Procedure Codes through CA-MMIS.

Responsibilities:

• Reviewed Business Requirements, Functional Specifications with Business Analyst and QA team to learn the functionality and business process. Performed Functional testing and Regression testing of the CAMMIS sub system.

• Developed Test Scenarios, Test Cases and Test Scripts to enhance claims adjudication, eligibility and formulary for expanding client product offerings. Validated and implemented EDI transactions according to HIPAA compliance.

• Participated in analysis workshops for ICD 9 Procedure and Diagnosis Codes in accordance with ICD 10 CM and ICD 10 PCS Conversion Compliances. Validated CPT, HCPC, ICD 9 code sets from Data Flat files to support configured benefit plan building.

• Worked on Claims Processing, Accumulate Claims and Adjudicate Claims. Managed global administration and support of the Documented based Regulatory Electronic Document Information System (EDMS). Facilitated Electronic Data Interchange and storage in the ICD-10.

• Worked on HIPPA Transaction Sets 837P and 837I Standards according to the test scenarios. Created Test Conditions from business requirement document and functional requirement document. Developed Test Cases to test the functionality of the system based on the test conditions.

• Developed Test Scripts linked Test Scripts and Requirements from DOORS to Test Cases in the Rational Quality Manager. Extensively used Rational Quality Manager to monitor the progress of assignment of testing activities and Reported executed results.

• Reviewed EDI 837 claims and flagged HIPPA non-compliant claims received from the Payer side. Logged the defects in Clear Quest tool, assigned the right severity level and managed the defects through it. Coordinated System and Regression testing schedules and completed the same.

• Ensured the functionality meets business requirements as defined in test results logged in RQM. Accessed Diagnosis Master File and Crosswalk Mapping file to use ICD Diagnosis and Surgical Procedure Codes.

• Performed GAP Analysis to make sure that all requirements were covered by test cases. Validated EDI 270/271 Healthcare Eligibility Benefit Inquiry and Response are HIPPA Compliant.

• Extensively worked on Class Plan Application of Medical Plan module in Facets to view and modify the details of medical, dental and drug plan and products. Prepared and submitted weekly test status reports to QA Lead.

• Analyzed the System Impact including MMIS Tables, Windows, Reports and Interfaces on external entities. Validated Professional and Institutional Claims, Processed and Adjudicated the Claims according to test scenarios.

• Maintained Requirement Traceability Matrix (RTM) to make sure that all the requirements are covered in test cases. Communicated with Development team and Business Analyst s to ensure testing issues are resolved.

• Generated test execution reports and uploaded validation documents in share point Web site for review.

Environment: Main frame/CICS/DB2 (Client Server Applications), Edifecs Spacbuilder, Rational Quality Manager, Rational Clear Quest, Visual Slick Edit, Share Point.

Jun ‘12 - Jul ‘13 Premier Healthcare

Quality Analyst/Tester Charlotte, NC

Premier is a non-profit organization. Premier collects data from participating hospitals and houses the nation’s largest detailed clinical and financial database, holding information on more than 130 million patient discharges. Web-based tools allow hospitals to compare their performance in specific areas to peers and best performers, find opportunities for improvement, and track the results of their efforts. This data warehouse is used by the Food and Drug Administration (FDA) for drug surveillance and by the Centers for Medicare & Medicaid Services to evaluate next-generation payment models. This application is implemented using Service Oriented Architecture (SOA). Facets tool is used for claims processing and followed HIPAA regulations.

Responsibilities:

• Involved in analyzing Business requirements and Use Cases and development of Test Plans, Test Cases & Test Scripts. Coordinated with automation team for allocation of task and work done. Performed extensive Data Integrity testing by executing SQL Statements.

• Identified and reviewed the Manual Test Cases to be automated. Performed Load Testing to evaluate the performance of the server using Load Runner tool. Developed SQL scripts to perform Backend Testing. Performed Smoke, Functional, Integration, Interface, Regression, Load and System testing.

• Involved in ICD 9 to ICD 10 conversions. Created test cases and executed using TFS. Used Rational Clear Quest for bug tracking and reporting tool. Involved in the execution of the Limited Regression and Full Regression scripts.

• Worked on the claim routing and claim processing Scenario in legacy and FACETS. Implemented to execute automation test suites during nightly run. Maintained and managed QA Documentation and Automation Scripts in Clear Case tool.

• Tracked the Regression status of the Team members in the Quality Centre. Involved in creating the configuration files for setting up the environment with different databases such as Oracle, MS SQL Server, Sybase and DB2.

• Participated in review meetings and daily status meetings during the testing process. Coordinated with PM/Business Analysts for QA Sign off for Test Cases/Test Plan.

Environment: ASP Net, Visual Basic 6.0, Windows, Oracle, QTP 9.5, Mercury Quality Center 10.0, MS Office, Internet Explorer, Rational Clear Quest, Clear case and TFS.

Mar ‘11 - Feb ‘12 Computer Science Corp

QA Analyst NY, NY

Computer Science Corp. has supported the Department of Health, NY for Health and Dental Insurance Claims and Eligibility efforts. Provides business support for benefit accumulator and claims processing system, NASCO. The core data is in MMIS Legacy system and can handle the processing of different Claims within POS in MVS Site D and AIX Box. The MMIS can handle the HIPAA EDI transactions such as 835, 837 (P, D, I) 276, 277, 278. The Inbound and Outbound is run through JCL in batch mode. As a Quality Analyst Worked on the Claims processing system within the company for scanning and capturing of data including working on UB-92 claims forms. Involved in using the technology to recognize, validate, and store claims and their attachments using HIPAA compliance interface.

Responsibilities:

• Developed Test Cases based on the requirement documents, use cases and technical specification. Provided quality and testing best practice recommendations.

• Run bi-weekly business requirements sessions with the QA resources to ensure requirements accurate understanding and to ensure test cases are easy to understand and execute. Communicated quality and testing goals effectively to project managers, project participants and testing staff.

• Worked on HIPAA Transactions and Code Sets Standards such as 837/835, 270/271, 276/277 transactions. Worked on 837 (Institutional, Dental, and Professional), 835, 270/271, 276/277, 820, and 277U transactions with TSO, ISPF, and File Aid.

• Tested interfaces and ANSI X12 / EDI Version 4010/5010 transactions for (270, 271, 276, 277, 278, 837P, 837I, 837D, 835, 834, TA1, 997 and 824 BRR). Involved in complete integration testing and regression testing. Used Quality center for defect tracking management of test cases.

• Extensively used Mercury Quality Center to monitor the progress of assignment of testing activities. Logged the defects in Quality center maintaining right priority and managed the defects through it. Validated EDI 270/271 Healthcare Eligibility Benefit Inquiry and Response are HIPPA Compliant.

• Coordinated UAT, Regression and Integration testing schedules and completed the same. Ensured functionality met business requirements as recorded in test results logged in Quality Center. Downloaded Data from application server to testing server and use ICD Code.

• Defined structured testing methodology and standard testing procedures. Created Functional and Integration Test Folders in Quality Center. Reviewed EDI 837 claims and flagged HIPPA non-compliant claims received from the Payer side.

• Managed and coordinated testing process with in-house testers and outside testing resources. Interacted with developers & Business Analysts to resolve application defects. Attended project meetings, release meetings, and QA status meetings. Involved in migration from HIPAA 4010 to HIPPA 5010.

Environment: J2EE, QTP, Quality Center, JSP, SQL, Oracle, UNIX.

Feb ‘10 - Jan ‘11 AmeriPath

QA Analyst Dallas, TX

Patient Care system (PCS) is a Web based documentation deals with creating a patient assignment and identification lists in different areas and it is one of the important applications used by Health Industry. This is an intranet system used by the public relations representatives. This system deals different types of patients like outpatient therapy, mammography, outpatient radiology, inpatient survey and emergency center. The system will retain information on all patient complaints. It will list/capture/store patient comments, personal issues, Blood group information, and will be able to lookup patient’s information based on a unique patient ID.

Responsibilities:

• Wrote Test Plans in MS Word for Manual Testing, System Testing, Integration Testing, Regression Testing & reviewed their consistency with the business requirements. Reviewed Technical Specs together with the team of two developers

• Effectively analyzed and decomposed business requirements to extract test requirements. Executed test cases manually to verify the expected results. Performed Functional, Regression, Integration, and Database testing based on Test Plan and Test Cases.

• Involved in Development of test data for test scenarios as per the functionality of the application. Executed the test cases using Quality Center. Used QC for managing Test Plans, Test Cases, Tracking defects making defect reports and comparison chart.

• Involved in Functional, Regression and smoke testing Manually. Used Mercury Quality Center to track, analyze and document defects. Performed Black Box testing and conducted Functionality and Regression testing on various phases of the management software.

• Recorded user action on GUI using QTP and performed regression testing on builds. The tests also include GUI testing: Testing for validation and display of screens. Involved in Database testing by writing & executing SQL queries by using SQL.

• Documented the outcomes of all the testing in MS Word and MS PowerPoint. Testing of individual Web pages and integration between the Web pages of JAVA.

• Prepared PowerPoint slides of all the outcomes [with the focus on defects] and presented to the team of Business Analyst and the Developers.

Environment: Java, Manual Testing, Quick Test Pro 9.5, Mercury Quality Center 9, MS Excel, MS Project, MS Word, SQL.

Aug ‘08 - Nov ‘09 Intermountain Healthcare

QA Test Engineer Salt Lake City, UT

Worked as a QA in the Intermountain Healthcare where made changes to the existing payer system used for processing claims. Inclusion of the ICD code and billing code were also a part of the project to assign specific code to the disease injury to make it more consistent and precise to that of the provider’s information as a part of the claim process.

Responsibilities:

• Preparing test plan and test cases in Quality Center. Converting test plan and test cases of test Director into (Electronic Document) in order to share. Procedure throughout the world via internet. Worked extensively on inbound transaction set 834 (Benefit Enrollment & maintenance) claim.

• Adjudication EDI (837), Remittance (835) and Claim status (276/277). Involve in weekly status updates with the Manager and Project Leader. Coordinated UAT, Regression and Integration testing schedules and completed the same.

• Used TOAD GUI tool for querying Oracle database. Executed tests for Rehabilitation visits for members using ICD codes as well as CPT codes. Analyzed the QNXT (claims engine) data and discussed with the Business team regarding the Requirement.

• Involved in the reporting analysis and configuration in Trizetto QNXT (3.2) System. Ensured functionality met business requirements as recorded in test results logged in Quality Center. Defined structured testing methodology and standard testing procedures.

• Validated CPT, HCPC, ICD 9 code sets from Data Flat files to support configured benefit plan building. Created and maintained templates such as: Quality Strategy, Test Plans, Requirements. Traceability Matrix, Test Scripts, Test Calendars, Testing Issues, Project Sign-off and Test Reports.

• Created Functional and Integration Test Folders in Quality Center. Managed and coordinated testing process with in-house testers and outside testing resources.

Environment: Windows XP, UNIX, Perl, QTP, VB Script, Quality Center, .Net, XML, SQL, Oracle, HTML, MS Excel, MS Office.

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