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consultant

Location:
Philadelphia, Pennsylvania, United States
Posted:
March 20, 2019

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Resume:

COBOL CICS DB* TRON IBM DB*

IBM Mainframe JCL IBM Utilities TSO EDI X12

File-AID TriZetto Facets Networx Pricer/Modeler Oracle

Teradata SQL Assistant/Web Edition ETL ERWIN Teradata Warehouse

Xpress Claim Test Pro Business Objects 6.5 SQL Server Citrix HP QC Cisco Tidal QNXT

Technical Skill

Years of Experience

Mainframe

15

Micro Focus COBOL

2.5

MVS COBOL

15

JCL

15

CICS

10

DB2

10

IMS/DL1

10

VSAM

10

Univac/Unisys Mainframe

1.5

IBM ASSEMBLER

5.0

Professional Summary:

·Over 18 years of extensive hands on experience as Quality Assurance with Project Life Cycle management, Documentation, Interface analyst Methodologies, User acceptance testing, system testing, functional testing and implementation of RUP software quality.

·Proven experience in QA Audits, Impact Analysis, Risk Analysis, Root Cause Analysis, Defect Management, Technical Architecture, Design, Development, and Delivery experience.

·Extensive Experience as a Mainframe tester using mainframe technologies IBM Mainframe, JCL, IBM Utilities, TSO, COBOL, CICS, DB2 TRON, IBM, DB2, Oracle, Teradata Warehouse, Basic Teradata Query (BTEQ), Teradata SQL Assistant/Web Edition, ETL, IRWIN, Web, Business Objects.

·Proven experience in the creation of HL7 Interfaces and Design Document for multiple hospital systems.

·Recognized for creativity and innovation in the resolution of difficult and complex situations. Exceptional interpersonal and communication skills, a creative problem solver and enjoy complex difficult challenges. A highly experienced QA Architect, SQA Analyst, Interface Analyst, Business Analysts and Senior Programmer Analyst Professional with more than fifteen years of IT experience.

·Diversified skills including design, coding, debugging, analysis and testing of the mainframe, client/server and web based applications in the financial, government, insurance, communications, and healthcare industries.

·Extensive business domain knowledge and experience in Healthcare, Banking, Pharmaceutical, Insurance, and Engineering industries, Web/Internet based businesses, EDI/back-end integration, Client/Server Internet, application development, testing and delivery experience.

·Expert knowledge in the creating of plans, test cases, test scripts, regression, interface, integration, performance and load testing.

·Expert knowledge in design coding of mainframe application testing including debugging, technical design and system design. Led a team of more than 15 testers both nationwide and offshore.

·Great knowledge of Data Warehouse/data mart and the loading of it data from multiple source systems.

·Expert knowledge in development methodologies (Waterfall, RUP, SDLC and TAF (Test Architecture Framework) and hybrid).

·Proven experience as system analysts in the creation of user requirements, procedures, and problems to automate or improve existing systems and review computer system capabilities, workflow, and scheduling limitations.

·Hands on experience in all types of testing such as Black Box, White Box, Sand Box, Regression, Integration, Load, Stress, Performance and User Acceptance testing, Model creation, Use case development and Business Case Validation. Developed Test plans, Test Templates, and Test cases.

·Excelled in solving technical issues and communicate the results to the appropriate member. Recognized for creativity and innovation in the resolution of difficult and complex situations.

Education:

·Three years of Computer Systems Technology from Spring Garden College, Philadelphia, PA

Training:

·Temple Computer Institute (CICS command) Philadelphia, PA

·Certificate from IBM global Services Philadelphia, PA

·ADVANCED DB2 SQL Command

·Certificate in Processing of VSAM files, Philadelphia, PA

·Certificate in Assembler Language Programming

·Certificate in DP testing fundamentals Philadelphia, PA

·Certificate in HL7 Messaging Chicago, IL

·Epic Bridges in house training

·Certificate in ADS Language Programming, Philadelphia, PA

·NASCO in House Training

·SAS in House Training

·Federal Employee Health Benefit Program

·IBM in-house training on NASCO Model Office transactions (i.e. HIQK, HROK, HEHK)

Technical Skills:

Quality Assurance Software Tools: File-AID, File-AID/DataAger, File-AID/DB2, File-AID/RDX,

XPEDITER/EXCHANGE,SQA,Suite,Comparex,ClearQuest, Test

Director/Quality Center, PVCS, SQA/IBM/Rational Suite Clearquest,

Hyperstation, Compuware QA Tools and Peregrine center.

Operating Systems: MS DOS, MVS/OS 390, UNIX, Windows 2000 Pro, and XP Pro.

Network: Windows NT, UNIX, Lotus Notes, Novel, Rumba, SQL*Net

Software Languages: Micro Focus COBOL, System/370 assembler (ALC), COBOLII,

EASYTRIEVE, SAS,Visual basic 6.0, C++, Java Scripts and ADS+ 7.0.

Window application: MS Excel, MS Access, MS Word, Visio and PowerPoint.

Databases: Oracle 10.0, VSAM, IDMS/ADSO, SYBASE, IMS DB/DC, DB2,

IAM, SQL Server 2000 and DAF.

Middleware: IBM MQSERIES

Interface Engine: E-Gate, Neon, Cloverleaf and Vitria.

Utilities: OS/JCL, CICS MANTIS, ENDEAVOR, CHANGEMAN, ISPF/TSO,

LIBRARIAN, SYNCSORT, SAR, ABEND-AID, LU 6.2, SPUFI,

DB2/QMF, HUMMINBIRD,ATTACHMATE, SQL ADVANTAGE

IDCAMS, IEBGENER, IEBCOPY and Toad.

Vendor products: Medipac, Healthquest, COMLINK, Flexilab, Flexirad Sunquest,

Vantage QA IBM, Powerscribe, CERNER clinical system, Facets

Trizetto 5.xx, Trizetto CareAdvance Enterprise, ITS and ECLIPSYS

Clinical system.

Other: Mercator 6.7, GENTRAN, ECMAP, Claredi, Trizetto HIPAA

GATEWAY, XML, HL7 2.5, EDI, WSF2 and Business object.

Methodologies: RUP, Hybrid, Waterfall and Agile

MAJOR CLIENTS: IBM, Kaiser Permanente, Ameravoice Agilent Technologies, US Government,

CareFirst, Excellus, Vanguard, US government, Wyeth Ayerst, BCBSM, BCBSNC,BCBSLA Trizetto and VPHP.

MAJOR CLIENTS: IBM, Kaiser Permanente, Caresource,Ameravoice,Ameracash,Agilent Technologies,CareFirst, Excellus, Vanguard, US government, Wyeth Ayerst, BCBSM, BCBSNC, BCBSLA,Trizetto and VPHP.

Professional Experience:

Blue cross BlueShield of Luisiana, Baton Rouge August 2018- October 2018

Senior configuration Analyst

Created Business flow document for nextworx pricer ITS Host claims for MA

Created Business Recomendation Document Eligibility, Provider/PCP/Network and Pricing

Created Documentation of what type NetworX fee schedules needd to be used (i.e. Fee Schedule with Modifier, etc.}

Created documentation of what type of claim form is being used for RHC and and FQHC )

Documented what type of claim form is being used for OP Cath Lab

Documented How are the following multiple procedure reductions being applied?

1Diagnostic Imaging

2Endoscopies

3Therapy

4Diagnostic Cardiology

5Diagnostic Ophthalmology

Environment: Web, Facets 5.XX, Microsoft office, Mainframe, client server, Optium Pricer, Ingenix .

AMERAVOICE, Delaware September 17 - July 18

implementation analyst and BA

TIPS Is the only payment processing solution that offers a method of property verification when online transactions are carried out. When a buyer is making a purchase online and is ready to pay, TIPS will call the buyer in a matter of seconds to verify the transaction.

As a Senior Implementation analyst support day-to-day operations and product support, back office support and customer performance reporting.

Translated technical documents from Spanish to English and vice-versa.

Tested Spanish Application for our Latin American office in Panama for online processing

Trained users in Panama.

Presented business Advantages of TIPS

Environment: Web, PHP, Microsoft office.

Virginia Premier Health Plan, Richmond VA February 17- Aug 17

Senior QA

·Served as a Sr.QA in the writing test strategy for regression testing.

·Wrote test strategy for regression and E2E testing

·Wrote test planning document for upcoming QNXT upgrade

·Experience in ETL and data testing from various sources - Flat Files & Relational Tables.

·Validated X12 834 HIPAA 5010 files for data accuracy

·Created other matrix document for 2018 QNXT upgrade

Environment: QNXT, (IDX Mainframe Mumps),Payspan, Macess, Vital, Pivotal, ETL, DW, Trapeze, UFT, Data-warehouse and Microsoft office.

DST Systems, Philadelphia, PA July 16 - Dececember 16

Senior QA

·Served as a Sr. QA participated in the writing of test Scripts for SIT testing.

·Wrote test script for Members benefits verification

·Wrote test scripts for SIT testing

·Wrote test scripts for all type of Claims

·Execute test script for Medicare membership enrollment

·Wrote test script for membership enrollment

Environment: XP,ALM,QC, AMISYS MARKET PROMINENCE, AXIOM TransSend, EXETER,DOVETAIL Oracle and Microsoft office.

Ramtech,inc Fort Washington, PA February 2015 - July 2016

Sr. Configuration Analyst

As a Sr. Configuration QA and participated in the writing of test Scripts for Configuration and SIT testing.

·Wrote test script for Members benefits verification

·Wrote SQL statement for to extract providers,claims and member information for validation

·Configure for Mercato products for testing

·Configure Plan, product and benefits

·Configure Customer Fee schedules

·Wrote test scripts for claims processing

·Wrote test scripts for SIT testing

·Wrote test script for prepayment Audit for random Claims.

·Wrote test script for prepayment Audit for Targeted Claim Audit Claims.

·Wrote test script for prepayment Audit Releasing Claims after Audit

·Wrote test scripts for ICD10

·Wrote test scripts for all type of Claims

·Wrote test scripts for DOD member enrollment and claims processing

·Wrote test scripts for the following clinical editing services paying out-of-network Medicare claims and standardizing contract management practices for hospitals and wrote test scripts for EASYGroup physicians.

·Preparing data for Data Warehousing. Using Informatica to do massive updates (ETL - data Extraction, Transformation, and Loading).

·Wrote test scripts for UM Utilization Management Import bath jobs to verify that the correct date were loaded into the application, and create the test data

·debug COBOL Db2 programs and report my finding to the developer manager.

·Wrote test script for UM(Utilization Management, UM Logging, Provider Case Fees,Confinement and Case Management)

Environment: XP, Parature, Pervasive, HealthSuite, Microfocus COBOL, CICS Mainframe, Java, ETL, Unix, IBM Websphere, DB2 and Microsoft office.

Mount Carmel Cincinnati, OH September 2014 - January 2015

Sr. Senior QA

As a Sr. QA and participated in the writing of test Scripts for UAT and SIT testing.

·Wrote test script for Members benefits verification

·Wrote test scripts for facets products testing

·Wrote test scripts for Claims Adjudication for member Eligibility, Provider/PCP/Network and Pricing

·Wrote test scripts for SIT testing

·Wrote test scripts for UAT testing

Environment: XP, AMISYS, HP Quality Center,HP ALM and Microsoft office.

Blue cross BlueShield of North Carolina Raleigh, NC October 2013- August 2014

Senior configuration Analyst

As a Sr configuration QA in the writing of test Script and give recommendation to client to improve process and the creation of test cases and scenarios and the execution of these scripts for the Facets or 5.01 implementation

·Wrote test scripts for Benefit Configuration

·Setup/configure parent group, group, and subgroup for members

·Wrote test scripts for facets products testing

·Wrote test scripts for claims processing

·Wrote test scripts for all type of Claims

·Wrote test scripts for SIT and UAT testing

·Wrote SQL statements using Mysql to query TriZetto Facets and custom tables.

·Wrote test scripts for Institutional, Professional Dental Claims using ICD!0 Format

·Configure benefits core facets for subscriber and benefits testing

·Configure Networx, Pricer/Modeler and benefits testing

·Configure Medical Plan Plans in Facets.

·Configure benefits using the Benefit Configurator application to create and maintain Facets products and models of Facets products

·Configure benefits using the component Modeler application to create and modify collections of component types and IDs that can be used as a model when creating a Facets product.

·Configure benefits using the Variable Component Modeler application to establish and modify collections of variable component benefit levels that can be used as a model when creating a Facets product

·Wrote test scrips Claims Adjudication for member Eligibility, Provider/PCP/Network and Pricing

·Test Connecture membership and group enrollment.

·Wrote test cases for agreement and benefits testing.

·Wrote business user document for TriZetto Facets wire retrieval and direct debit applications.

·Wrote test script and test case for system testing

·System Perform integration testing

·Wrote test scripts for ITS home

·Conduct research for provider and member payments.

·Wrote test scripts for hospital and medical claims.

Environment: XP, TriZetto Facets 5.01 Networx, Pricer/Modeler, Mysql, X12,Web, Mainframe, HIPAA Gateway,Citrix. Salesforce, Connecture,ITS,Quality Center and HP ALM.

WPS, Madison, WI June 2012 - August 2013

Sr. Senior QA

As a Sr. QA participated in the writing of test Script and give recommendation to client to improve process and the creation of test cases and scenarios and the execution of theses scripts for the Facets or 4.81 implementation

·Wrote SQL statements using Mysql to query TriZetto Facets and custom tables.

·Wrote test scripts for Institutional, Professional Dental Claims using ICD10 Format

·Wrote test script for WPS provider verification.

·Wrote test scripts for the HIPAA gateway interface testing.

·Wrote test scripts Networx, Pricer/Modeler

·Tested interfaces that using the HIPAA Gateway.

·Wrote business user document for TriZetto Facets wire retrieval and direct debit applications.

·Wrote test scripts for SIT testing and participated in the execution of these scripts

·Wrote test script and test case for system testing

·System Perform integration testing

·Wrote test script for UM(Utilization Management, UM Logging, Provider Case Fees,Confinement and Case Management)

·Wrote test scripts for UM Utilization Management Import bath jobs to verify that the correct date were loaded into the application

·Conduct research for provider and member payments.

·Wrote test scripts for all type of Claims

·Created binary true table for complex claims validation.

·Wrote test scripts for Pharmacy claims

·Wrote test scripts for providers

·Wrote test script for prepayment Audit for random Claims.

·Wrote test script for prepayment Audit for Targeted Claim Audit Claims.

·Wrote test script for prepayment Audit Releasing Claims after Audit

·wrote test scripts Facets Real Time using CareAdvance Enterprise to test Data Entities

·Used Claim Test Pro to assist in the testing process of :

·Reduce over-payments to providers, Reduce administrative costs.

·Reducing errors in provider payments reduce manual rework, helping drive down costs.

·Reduce test cycle time.

·Reduce critical defects introduced to production.

·Configure medical plan for UM testing

·Wrote test scripts for UM Utilization Management Import bath jobs to verify that the correct data were loaded into the application.

·Wrote test script for UM(Utilization Management, UM Logging, Provider Case Fees)

·Wrote test scripts for Case Management to validate the fifteen sections of the application

Environment: XP, TriZetto Facets 4.81 Networx Pricer/Modeler, Mysql, X12,Web, McKesson ClaimsXten, McKesson ClaimCheck Data Warehouse, HIPAA Gateway, Citrix, Xpress Claim Test Pro, (Trizetto CareAdvance Enterprise on Microsoft online transaction processing (OLTP)) and HP Quality Center.

CareSource, Dayton, OH ` May 2011 - March 2012

Sr. Senior QA

As Senior QA in the writing of test Scripts for Facets upgrade from 4.61 to 4.71. This was for the state of OH Medicaid system.

Wrote test script for more than one hundred TriZetto Facets patches and enhancements. Those patches included all of the major TriZetto Facets modules (claims processing, UM, Membership, provider, billing, NetworX, Pricer/Modeler, EDI, application support and accounting)

·Validate results using Excel and Mercury HP quality center

·Wrote test scripts for Institutional, Professional Dental Claims using ICD!0 Format

·Wrote SQL statements using SQL Advantage to query TriZetto Facets table

·Wrote test script for Caresource provider web verification

·wrote test scripts Claims Adjudication for member Eligibility, Provider/PCP/Network and Pricing

·Wrote test script for Business Object report testing

·Wrote test scripts for Networx, Pricer/Modeler

·Wrote test script for Ingenix HSS APC Grouper/Price Calculation

·Wrote test script for prepayment Audit for random Claims.

·Wrote test script for prepayment Audit for Targeted Claim Audit Claims.

·Wrote test script for prepayment Audit Releasing Claims after Audit

·Validate MAXIMUS application confinement result test cases

·Wrote business user document for TriZetto Facets wire retrieval and direct debit applications.

·Wrote business user document for NetworX Pricer standalone product

·Wrote test scripts for NetworX, Pricer/Modeler

·Wrote test scripts for UAT testing and participated in the execution of these scripts

·Wrote functional test scripts facets

·Wrote test scripts for all type of Claims

·Wrote test script for UM(Utilization Management, UM Logging, Provider Case Fees,Confinement and Case Management)

·Wrote test scripts for Case Management to validate the fifteen sections of the application.

·Wrote test scripts for Facets Billing

·Used Claim Test Pro to assist in the testing process of :

·Reducing over-payments to providers, Reduce administrative costs.

·Reducing errors in provider payments reduces manual rework, helping drive down costs.

·Reducing test cycle time.

·Reducing critical defects introduced to production.

Environment: XP, TriZetto Facets 4.71 Networx, Pricer/Modeler, Oracle, X12,Web, Business Objects 6.5, SQL Server, Citrix and HP Quality Center, Cisco Tidal and Xpress Claim Test Pro

PerformRx, Philadelphia, PA November 2010 - April 2011

Senior QA

As a Senior QA and system analyst in the creation of test plan and scripts for PerformRX reports and data warehouse testing.

Advised client of the best method for integration testing in a Data Warehouse environment.

·Created system testing reporting document for ETL testing verification.

·Created testing artifacts documents for the project.

·Created test strategy and plan for data warehouse and performance testing

·Wrote test scripts NDCs and related information when drugs are billed on professional

·Wrote test scripts and test cases for performance and system testing

·Wrote test script for Pharmacy prepayment Audit for random Claims.

·Wrote test script for Pharmacy prepayment Audit for Targeted Claim Audit Claims.

·Wrote test script for Pharmacy prepayment Audit Releasing Claims after Audit

Environment: IKAsystems, Data Warehouse, ArgusHealth, X12,Facets 4.7.1 HP quality center, Oracle, RxFocus,SAS, COGNOS, MS SQL server 8.0.

Medicare y Mucho Más San Juan, Puerto Rico March 2010 - October 2010

Senior QA

As a Senior QA and system analyst in the creation of the test plan for ACT V finance and membership module of the project.

·Wrote test script and test case for system testing

·Perform integration testing

·Create UAT and integration document for user

·Conduct research for provider and member payments.

·Tested Claims to using the new ICD10 format

·Perform system and user acceptance testing for the QNXT finance module.

·Created binary true table for finance cash distribution.

·Wrote SQL statement to validate reports results for accuracy

·Created testing artifacts documents for the project.

·Wrote report defects for the testing manager.

·Wrote test scripts for all type of Claims

·Guide full-time personnel in the creation of desktop procedure.

·Created desktop procedure.

·General System Requirements

·Created Finance Use Cases

·Created Functional Requirements document

·Created Design-EOP For Members

·Created Design-QNXT Detail Payment Balancing Report

·Created Finance Process Workflow

Environment: XP, Trizetto QNXT 4.64, PORTICO,EZCAP,Great X12, plain Accounting,DHI (data warehouse),COGNOS, MS SQL server 8.0.

California Southern Edison, Los Angeles, CA June 2009 - January 2010

Lead QA ARCHITECT

As a Lead QA ARCHITECT Senior Design, plan, execute, monitor, and improve the testing process for a testing engagement.

Advised client of the best method of integration testing in a data warehouse environment.

·Created unit testing reporting document for ETL testing verification.

·Created testing artifacts documents for the project.

·Created test strategy for semantic layer testing

·Use Teradata SQL within BTEQ

·Use comments within a BTEQ session

·Run BTEQ batch jobs

·Create and use scripts, run files, and macros

·Use the REPEAT and the HANG command, interrupt and abort requests

·Wrote file extract processing tool using FILE-AID to extract member information from Teradata.

Environment: Windows XP, IBM Mainframe,JCL,IBM Utilities,TSO, COBOL, CICS,DB2 TRON, IBM, DB2, Oracle, Teradata Warehouse, Basic Teradata Query (BTEQ), Teradata SQL Assistant/Web Edition, ETL, IRWIN, Web, Business Objects.

Trizetto, Schenectady, NY June 2008 - March 2009

Sr. QA

As a Sr. QA participated in the writing of test Script and testing the upgrade from 4.41 to 4.51

Wrote test script for more than two hundred TriZetto Facets patches and enhancements. Those patches included all of the major TriZetto Facets modules (claims processing, UM, Membership, provider, billing, NetworX, Pricer/Modeler, EDI, application support and accounting)

·Validate results using Excel and Mercury HP quality center

·Wrote SQL statements using SQL Advantage to query TriZetto Facets table

·Wrote test script for MVP and CIGNA provider web verification

·Wrote test script for Business Object report testing

·Wrote test script for Ingenix HSS APC Grouper/Price Calculation

·Validate MAXMC application confinement result test cases

·Wrote business user document forTriZetto Facets wire retrieval and direct debit applications.

·Wrote business user document for NetworXPricer standalone product

·Wrote test scripts for NetworX, Pricer/Modeler

·Wrote test script for UM(Utilization Management, UM Logging, Provider Case Fees, Confinement and Case Management)

·Wrote test scripts for all type of Claims

·Wrote test script for prepayment Audit for random Claims.

·Wrote test script for prepayment Audit for Targeted Claim Audit Claims.

·Wrote test script for prepayment Audit Releasing Claims after Audit

·Wrote test scripts for UAT testing and participated in the execution of these scripts

·Wrote test scripts for the following clinical editing services

Environment: XP, Trizetto Facets 4.51 NetworXPricer/Modeler, Sybase, Oracle, Web, Business objects 6.5, Macess, MAXMC, Ruby reports, SQL server, Citrix and hp quality center.

Blue Cross Blue Shield of Michigan, Detroit, MI (New contract ) January 2008 – June 2008

Sr. QA Lead

As a QA Lead Built and managed team from use case writing to application tester. Created test strategy and got sign-off from the client Wrote test plan for ITS provider Audit Managed client test team as well ours, also managing client expectations well and delivering quality test effort on time and within budget.

·Wrote query against Oracle table to extract data for user reporting purposes and user acceptance validation.

·Wrote query to extract data from data marts for reporting.

·Used Business Objects to extract data from the universe data based on the metadata.

·Managed the entire testing at our Test Labs and delivering reports online and on a timely fashion.

·Wrote scripts to test ITS Home and Host claims for NASCO.

·Used Open Connect Web based applications to access NASCO legacy data by calling these java objects, securely retrieving information from the mainframe.

·Use the Point and click transactions that are created at design time and business logic that are is easy identified.

·Used multiple host screens, local database and legacy transactions that are were condensed into single screens. Multiple host screens, local database and legacy transactions may be condensed into single screens.

·Deployed web service through eclipse and maintaining versions on different region (dev, test, and production).

·Wrote RTM for project

·Wrote system test cases Provider Data Audit

·Wrote test script for prepayment Audit for random Claims.

·Wrote test script for UM(Utilization Management, UM Logging, Provider Case Fees,Confinement and Case Management)

·Wrote test scripts for Case Management to validate the fifteen sections of the application:

·Wrote test script for prepayment Audit for Targeted Claim Audit Claims.

·Wrote test script for prepayment Audit Releasing Claims after Audit

·Wrote test Grid using Microsoft excel for PDA (Provider data Audit)

·Wrote test scripts for all type of Claims

·Create UAT test grid

·Wrote UAT test scripts

·Wrote functional test scripts

·Execute mainframe job streams to test P&A claims Physician Assistant billing, PA and registration via MQSI and TriZetto Facets 4.41

·Used NDM to send TriZetto Facets and BCBSM claims to IBM

Environment: windows XP, IBM Mainframe, JCL, IBM Utilities, TSO, TriZetto Facets, NASCO, COBOL CICSJCL, DB2, VSAM.ORACLE, CICS ITS, Oracle, (IMS/DLI databases in a IMS DB/DC environment) FILE -AID, peregrine, MS ACCESS

Blue Cross Blue Shield of Michigan, Detroit, MI July 2006 - January 2008

Sr. QA Lead

As a QA lead Built and managed team from use case writing to application tester. Created test strategy and got sign-off from the client

Wrote test plan for ITS provider Audit Managed client team as well our test team, by managing client expectations well and delivering quality test effort on time and within budget Managed entire testing at our Test Labs and delivering reports online and on time

·Wrote test plan and strategy for the project

·Wrote scripts to test ITS Home and Host claims for NASCO

·Wrote scripts to test Federal Employee Health Benefit Program

·Wrote RTM for project

·Wrote system test cases Provider Data Audit

·Wrote test script for UM(Utilization Management, UM Logging, Provider Case Fees,Confinement and Case Management)

·Wrote test script for UM(Utilization Management, UM Logging, Provider Case Fees,Confinement and Case Management)

·Wrote test scripts for Case Management to validate the fifteen sections of the application:

·Wrote test Grid using Microsoft excel for PDA (Provider data Audit)

·Validate that provider can be found on the web.

·Create UAT test grid

·Wrote and modify job streams in an IBM mainframe environment

·Wrote file extract processing tool using FILE-AID to extract FEP, MAJOR MEDICAL and Medicare claims from Nasco claims file.

·Execute mainframe job streams to test P&A claims Physician Assistant billing, PA and registration via MQSI and Facets 4.41

·Used NDM to send facets and BCBSM claims to IBM

·Validate results using Excel and Access data base

·Project 2 Data Match

·Senior QA

·Validate and execute job streams for CMS (Centers for Medicare & Medicaid Services) via GHI GroupHealth

·Incorporated GHI) using facets, NASCO and BCBSM membership data

·Create utility to transfer file to local network from the mainframe.

·Validate results using DB2 SPUFI, Fileaid, Excel, and Microsoft Access data base

·Used Peregrine and Excel spreadsheet to track defects and maintaining traceability between use cases, test cases and defects.

·Conducted E2E for NPS system

Environment: Windows XP, IBM Mainframe, JCL, IBM Utilities, TSO, TriZetto Facets, NASCO,(IMS/DLI databases in a IMS DB/DC environment) COBOL CICS,JCL, DB2, VSAM. ITS, Oracle, IMS DB/DC FILE -AID, peregrine, MS ACCESS

Excellus, Syracuse, NY January 2006 - June 2006

Sr. QA Lead

As a senior QA lead wrote Test plan for Bluecard balancing

·Wrote test plan for BlueCard adjustment.

·Wrote ETM for multiple test environment for LRSP, FPD, EPC and ITS

·Defined testing environment

Environment: Windows XP, IBM Mainframe, JCL, IBM Utilities, TSO, TriZetto Facets, COBOL, CICS, DB2, VSAM.ORACLE, CICS ITS, Oracle, (IMS/DLI databases in a IMS DB/DC environment),. FILE -AID, peregrine, MS ACCESS

CareFirst Blue Shield of Maryland Owings Mills, MD July 05 through December 05

Business analyst

As business analyst wrote System Development / Enhancement Work Paper to test HIPAA 835

·Wrote file extract processing tool using FILE-AID to extract FEP, MAJOR MEDICAL and Medicare claims from FLEXX claims file.

·Create HIPAA cross-reference excel spreadsheet for HIPAA rejection code mapping.

·Wrote BRD EDI processing

Environment: Windows XP, IBM Mainframe, JCL, IBM Utilities, TSO DB2, CICS, Facets, FILE -AID, Microsoft suite

Blue Cross Blue Shield of Michigan, Detroit, MI September 2004 - June 2005

Senior SQA

As a senior tester wrote test scripts using IBM Rational tools to test claims for NASCO system. Attended training by IBM personnel for NASCO ONLINE claims entry corrections and pending. Work with another team member in creating an QA department

·Used Compuware file-aid tool to extract data from IBM Mainframe to a client server application via Oracle.

·Used Compuware file-aid tool to extract NASCO CLAIMS from the local system and populate NASCO TRLOG file.

·Wrote scripts to test ITS Home and Host claims for NASCO

·Wrote scripts to test Federal Employee Health Benefit Program

·Wrote Automated test scripts using IBM rational test manager to test claims for new groups that was added to BCBSM national plan.

·Wrote SQL stat using IBM Rational Robot to extract data from Oracle and Access table; and populate the claims tables for the NASCO



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