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Technical Support Health Care

Location:
Tallahassee, FL
Posted:
June 16, 2017

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Resume:

EXPERIENCE SUMMARY

Eight (*) years of extensive experience in Information technology with expertise in software development (quality assurance), Requirement gathering (business analysis), Project management and excellent problem-solving skills.

The professional experiences I bring along with my educational background provides an unmatched academic experience and track record for quality and excellence is why I was awarded the “Above and Beyond Award” due to my contribution on several projects at Dell services.

Due to the ever-changing industry of my expertise, I am adept to learning fast and able to work in a team with minimal or no supervision.

SKILLS AND STRENGTH

Project Management

Business Analysis

Report Analysis

Requirement Analysis and Design

Systems Engineering and Analysis

Automation testing

Manual Testing

Backend Testing

Cloud testing, Performance Testing

Good written and verbal communication skills.

Quality Assurance

Software Verification and Validation

AGILE - Scrum and Kanban

SDLC

HIPPA, EDI, FEP Healthcare Claim Processing

Database testing – Oracle. MS SQ

ACADEMICS

Bachelor of Science; University of Ilorin, Lagos Nigeria, BSC Economics

Masters of Science; Hult International Business School MSC

ADDITIONAL INFORMATION

Member: Project Management Institute (PMI).

Member: AIESEC (Association internationale des étudiants en sciences économiques et commercial

TECHNICAL SKILLS

Business Modeling Tools

Rational Rose, MS Visio

Reporting Tool

MS Excel, Outlook 2002

Documenting Tool

Rational Requisite Pro, JIRA

Methodology

Waterfall, Rational Unified Process, Agile scrum, Kaban

Reporting & Testing Tools

HP Quality Center 10.0, Requisite Pro, Availity, Quest, Diamond 950, AMYSIS, SIEBEL, Salesforce, Selenium, Quick test pro (UFT)

ASSIGNMENT DETAILS

Baylor Scott &white, Temple, Texas June 2016- Date

Test Coordinator /soft engineer

Solid understanding of Medicare and Medicaid.

Remove impediments to the team, either personally or by finding the right personnel to do so.

Conduct / facilitate sprint planning, poker estimation, daily scrum, sprint review and retrospective.

Experienced in techniques such as SPRINT planning, Product Backlog management, Agile estimation, daily scrum, metrics such as Burn-down & Velocity charts, Sprint summary report, Sprint review/retro meetings etc.

Worked as scrum masters, Conducted Iteration kick-off meetings to document Product Backlog Items (PBI), monitored work being done and facilitated release planning. Coordinate, schedule, facilitate, and (as appropriate) lead Scrum related ceremonies.

Be able to leverage the numerous, well-documented patterns and techniques for filling in the intentional gaps left in the Scrum approach (e.g., burndown techniques, retrospective formats, test-driven development, etc.).

Facilitated program workshops, managed sprint retrospectives, and led daily scrum to manage stakeholder expectations and drive consensus.

Working Knowledge of HIPAA 4010/5010 versions.

Work with clients and internal stakeholders to ensure business requirements are accurately captured and translated to appropriate solutions.

Experience with EDI transactions such as EDI 834 (Benefit Enrollment and Maintenance), 276/277 (Health Care Claim Status Request and Response), 278(Health Care Service Review Information), 835 (Health Care Claim Payment/Advice), 837P (Health Care Claim: Professional), 837I (Health Care Claim: Institutions), ICD9/ICD10.

Claim Processing of 837, 270 and 276 using FACETS HIPPA gateway to send corresponding responses and acknowledgements.

Expert in testing and validating New Benefit Designs and making sure it maps to the new Rider/Components with the correct co-pays, and deductibles and New payable (New bank code).

Expert in Hospital and Medical Claims Processing (Claims Entry and Re adjudication).

Worked extensively with inbound and outbound 837/835 claim processing systems.

Designed and implemented FACETS system-of-record indicator to be in the MACESS files, allowing for FACETS claims and membership documents to be identified during data entry in MACESS and distributed to respective queues for offshore processing.

Acting as liaison between Centers for Medicare and Medicaid Services (CMS) and Medicare Advantage Drug Plan (MAPD).

Test Result documentation using Rally.

Created and implemented queues for claims and membership documents to distribute accurately and to be worked in FACETS.

Insuring enrollments received are processed timely according to CMS guidelines.

Environment: Amysis, FACETS, Windows, SQL, PL/SQL, MS Visio, HTML, DHTML, Rally, Macess

USAA, PLANO, TX June 2015- June 2016

soft engineer

Responsibilities

Actively involved in testing effort estimation along with development team and submitted in the baseline presentation for further business approval.

Wrote and document business requirements. Business process mapping and Gap analysis.

Lead 2 cohesive scrum teams as Scrum Master.

Developed Test Plan and Test scenarios from UML flow and other Visio diagrams and algorithms.

Modeled best practices and encouraged cross-functional collaboration, communication, feedback, and learning among the team.

Plan test schedules or strategies in accordance with project scope or delivery dates.

Write detailed test cases using JIRA for backlog grooming.

Identify program deviance from standards, and suggest modifications to ensure compliance.

Evaluate and track bugs using JIRA, monitor bug resolution efforts and track successes.

Provide technical support during software installation or configuration.

Coordinated with Release Manger on scheduling builds to test and staging

Drove the effort with the Automation QA team in defining the development of automated scripts and has the ability to execute and edit these scripts independently.

Responsible for writing SQL Queries to find out that the data is correctly populated in each field.

Hands on experience with Selenium IDE (Record and Playback), Selenium RC, (Scripting), Selenium GRID, Selenium Web Driver.

Test estimation and project planning. Hiring new resources, taking interviews, working with different teams to understand and suggest improvements wherever applicable.

Created a clear and concise plan for overall program activities of QA to fit the program schedule.

Participated in release planning, sprint planning, as well as daily scrum team meetings.

Project forecasting, Resource allocation, Process improvement and Monitoring and reporting Project Progress.

Environment: SCRUM, Agile, MS SQL Server 2008, Oracle 11G, Windows 2003/2008 Server, Jira, Version One, SharePoint, Selenium

SABRE TECHNOLOGIES, SOUTHLAKE, TX March ’13– May ‘15

QA Software Engineer

Responsibilities

Gathered requirement during JAD sessions for documenting customer business processes, user story creation, workflows and requirements.

Assessed SABRESONIC web and loyalty Business systems to verify processes and responses.

Point of contact for resolving issues from the testing team.

Gathered requirement during JAD sessions for documenting customer business processes, user story creation, workflows and requirement.

Explained all flows in form of user stories to the stake holders to get confirmation.

Reviewed and gathered necessary information from CRS (central reservation System) manual to put together the required documentation.

Developed use case documents, activity diagrams, workflows and process maps.

Expert level skills in using Peripro custom Call switching applications in developing and testing Intelligent Voice Recognition Systems (IVR) for Callers.

Complied documents for sabresonic Web, myfares, pricing, loyalty, agency activity, Travel bank, Guest connect, Chain maintenance and Hotel configuration on the synxis CRS platform.

Followed agile iterations in writing documentation for wed products.

Created a Requirements Traceability using the corporate standard templates which would be leveraged by all impacted downstream applications.

Worked with cross functional/multiple business teams to gather the functional requirements.

Environment: MS SQL Server 2008, Windows 2003/2008 Server, MYSQL, Selenium, Rally, Share point, Sabre, IVR.

DELL SERVICES, PLANO, TX Mar’10 – March 13

Software Engineer

Client 1; CAPITAL ONE, PLANO, TX

Managing new software releases, upgrades, development lifecycle planning, bug tracking and issue tracking on JIRA.

Provide technical support for banks on BankWorld Multi-Channel solutions across ATM, EMV, Internet Banking, Mobile platforms and channels.

Implementation, configuration and testing of BankWorld applications and System Integration Testing (SIT) to Core Banking Applications and Third-Party applications

Provide consultancy and advisory on Cards Issuing and Acquiring Projects, ATM, Mobile and Internet Banking solutions for banks.

Work with solution architects, developers, product managers on system analysis and design of new solutions for clients.

Provide speedy and comprehensive resolution of technical challenges and business issues that have been escalated.

Troubleshooting and debugging of technical issues raised by clients.

Liaise and work closely with the development and product teams on escalated technical issues and new changes/features.

Ensuring appropriate planning, communications, expectation setting, scope, issue and risk management throughout project delivery.

Provide relevant technical expertise and non-technical support throughout project lifecycle.

Delivery of projects using either agile or waterfall methodologies – ability to flex project management approach to fit specific project needs.

Analyze current and future state processes to define system/technology/business requirements and upgrades.

Provided advisory services on ATM Acquiring projects, payments and transaction processing, merchant management systems, automated treasury and reconciliation systems.

Support delivery of quality functional and non-functional application designs.

Proactively identify business and technology needs, improvements, possible risks and failure points.

Client 2; Avmed Healthcare

Business Systems Analyst

Actively participated in all phases of testing lifecycle (Test Planning, Test Analysis and Design, Test implementation, Evaluating Exit Criteria and documentation, Test Closure Activities)

Involved in designing the Test plans, creating and running manual test.

Write test cases for IVR, GUI, client based mainframe applications

Performed User Interface and functional testing of the Siebel application as per the Requirement.

Documented and analyzed defects using Quality Center and tracked them to completion by communicating with the team.

Co-ordinate with SME, Business users and Developers for understanding requirements.

Imported requirements into Quality Center in MS Excel format.

Conducted Validations for different Amisys Advance Release Modules Providers credentialing, Claims and Membership, COB.

Worked closely with senior Management, Finance and human resources to process commission and bonus payouts using the Callidus application

Evaluate commission reports, report all exceptions or over/under payments and other possible errors.

Performed validation of data transfer between Siebel and Amysis.

Co-ordinated with Finance team to run batch jobs on apps-work for data transfer.

Enrolment of new Members to Siebel and coordinating with Amysis to validate enrolment and quote acceptance.

Environment: Siebel, Pivotal, Windows, SQL, PL/SQL, MS Visio, VB Scripts, HTML, DHTML MS SQL Server 2005, Windows 2003 Server,.NET, HP ALM Quality Center, Quick Test Professional, AMYSIS, CALLIDUS, STEPWISE, IVR, AMYSIS, BOLT

Blue Cross Blue Shield, Jacksonville, Florida SEPT 2008 – FEB 2010

Business System Analyst

Responsibilities;

Excellent Business writing skills in creating Business requirements document (BRD), use-case specifications, functional specifications, and systems requirements specification (SRS).

In depth knowledge of current industry standards such as HIPPA guidelines (4010 & 5010) and EDI 837, 835, 834, 820, 270/271, 276/277, 278 Transactions.

Involved in Functional and UAT Test plan and Test cases for manual and automated testing from the business requirements to match the project's initiatives.

Monitored the generation of different types of acknowledgments TA1, 999 & 277CA to ensure the delivery to the respective Trading Partners and Direct Submitters upon successful validation of Transactions.

Understood and reviewed Gap analysis of EDI 4010 to 5010 format to perform functional testing of conversion from 4010 to 5010 formats as per the implementation guide

Created and executed Automated Test Cases from Quality Center

Tested EDI formats for the healthcare benefit eligibility inquire/response (270/271), health care claim payment (835) and health care claim (837) for structure and content.

Created test cases and verified, analyzed and documented the test results against the expected results prepared as per the user requirement.

Executing test cases, identified products issues, wrote detailed bug reports and participated in bug review during the product development stages.

Maintained the test logs, test reports, test issues, defect tracking using Quality Center.

Created and reviewed data flow diagrams/ activity diagrams displaying all major actors in the claim management system regarding HIPAA, EDI provider claim transactions, and clarified all system use cases / activity diagrams regarding claim submission and providers to come up with Test plans.

Developed a UAT (User acceptance Testing) plan to guide a select group of key end-users in testing the user interface and functionality of the application.



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