Description
Summary: * Extensive hands-on experience on developing, Writing and executing Test Plans, RTM, Test Scripts and Test Cases from Requirements, Use cases, Design Documents and other project documentations and able to work closely with development team and business analyst to analyze test case scenarios. * Extensive Knowledge and experience in all stages of the software development life cycle (SDLC) beginning from initiation and definition to deployment and support with the complete QA cycle from testing, defect logging and verification of fixed bugs. * Detailed understanding of QA methodology (Iterative, Agile, Waterfall) to ensure quality control. * Worked extensively with Inbound and Outbound of 837I and 837P claims processing system as per implementation Guide and State specific requirements * Experienced in EDI testing process including validation of inbound and outbound X 12 files, Pharmacy claims various loops and segments. * Expertise in XML, X 12 data mapping and end to end testing on encounters * Good experience With writing and utilizing SQL queries for data verification in database like Oracle, DB2 and SQL server * XML knowledge and practical experience with XSLT. * Proven ability to multitask on different projects, prioritizing against aggressive timelines without losing attention to details. * Involved in UAT testing & support. * Documented testing processes and reported testing results * Documented, posted test results for further references and reusability * Proven ability in delivering quality results on high impact tasks under immense pressure and tight deadlines. * Excellent communication skill Written and Verbal. Nextgen Healthcare, Horsham, PA February 2017 - June 2017 Project: KBM upgrade - QA specialist Project Description Nextgen Healthcare helps ambulatory care organizations transition to value based care by empowering them to nurture measurably healthier patient communities at a lower cost.Their solutions optimized by physicians, developed with input from 90,000 providers and based on almost 25 years of ambulatory expertise, help ease the burdens of Health Information Technology and enable practices to improve individual outcomes and nurture a healthier population.Now they are in the process of upgrading their templates. Responsibilities: * Reviewed and analyzed specifications and user stories. * Interviewed Business Analysts, Product Owners, and Developers to understand testing requirements * Created test scripts for various testing stages like Functional, Regression, System and End to End testing. * Worked extensively with Quality Center for requirements, preparing test cases, executing, defect openings and closings. * Designed and written test cases and Performed various type of testing like Requirement testing, Medical abbreviations check, Defect testing, System/template testing.Referral template testing. * Identify test cases that are suitable for automation * Execute test script and identify defects. * Extensively used QC ALM for testing & defect logging. * Participated in Kick off meetings and defect meetings. * Written & execute complex SQL queries. * Used SQL for querying and updating records and PL/SQL for retrieving Functions and procedures. * Participated in User Acceptance Testing. Client: Cigna HealthSpring, Nashville, TN May 2016 to July 2016 Project: CMS Audit Remediation - Enterprise Business Tester Project Description: Cigna was in the process of preparing universe for CMS audit for part C and part D. The purpose of CMS audit is to validate performance in coverage determination, appeals and grievances. The sponsor (Cigna-Healthspring) is expected to present its supporting documentation with data that proves that the organization is compliant with CMS regulations regarding Medicare part C and Part D Organizational Determinations, appeals and Grievances. Responsibilities: * Analyzed the available artifacts such as BRDs, both functional and nonfunctional, Use cases, Data Flow diagrams & prepared the test cases according to the requirement. * Attended Kick off meetings & walk through meetings and Identified the scenarios. * Developed Test scenarios, test cases, test scripts and co coordinating different cycles of testing. * Created test data in Facets application using different modules. * Worked in creating Test Data for Appeals in Facets & validated that the member data flow into SQL server. * Validated the data flow from SQL to ODS. * Documented QA test suites, Test cases, Test results and defects using TFS (Team foundation Server). * Validated test data for testing the reconciliation of data for universe creation. * Escalated issues and risks to test manager and Business users. * Attended QA daily status meetings and follow up on the bug tracking. * Followed software development life cycle, QA process and procedures. * Performed data validation from source to destination. * Created the claims & validated the data flow to EDI . * Validated the Data flow from staging Source (Facets) to (SQL) * Validated the Data flow from staging (SQL) to ODS (Teradata). * Uploaded the test cases into TFS. * Used TFS for logging defects & tracking. * Written & executed complex queries in Teradata. * Validated data using complex SQL queries.
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