Customer Service Quality Assurance
Resume:
Ambika.Ch
************@*****.***
Career Objective:
To obtain a challenging and responsible position in software testing
and quality assurance concepts where I can contribute my technical
skills effectively and achieve the organizational objectives as well as
to hone my expertise and discipline.
Technical Skills:
Software testing tools : Manual testing, HP-QTP, HP-LR
Language : C,C++,VBScript
RDBMS : ORACLE,SQL Server, My SQL
Packages : MS-Office, Open-Office
Mailing tools : MS-outlook
OS : Windows XP,Vista,7,8,2003 & 2008Server
UNIX, LINUX Red hat
Server.
Learned software Testing concepts and HP tools in Mind-Q systems
Pvt.Ltd, Hyderabad and got exposed on the below areas.
Manual Testing
. SDLC Models
. Software Testing
. STLC Process
. Writing Test Scenarios and Cases
. White Box Vs Black Box Testing Techniques
QTP
. Manual Testing Vs Automation Testing
. QTPScript Language
. VBScript Basics
. VBScript Components
. VBScript with SQL
. QTP for DB testing
. Website Testing Vs Web Service Testing
. Can able to access Xml, MS-Excel, MS-Word,Text files.
LR
. Manual Performance testing Vs Automation
. HP-LR Architecture
. Controller Scenario
. Results Analyzer
QC
. QC Architecture
. Network Admin Responsibilities
. Test Lead Responsibilities
. Tester Responsibilities
. Developer Responsibilities
Course Project (Manual)
As a Manual Tester I had done course project on ONLINE INSURANCE SYSTEM.
In this type of OIS,we can create policies through online. This system
consists of Login Page, Policy creation page, Premium payment page and
Policy closing page. For the modules in this pages I wrote Test Scenarios
and Test cases.
Responsibilities:
> Study SRS & Prepared Test Scenarios
> Implemented Scenarios with Cases
> Prepared Test Data
> Involved in test execution
> Reported Defects
> Involved RTM preparation
Course Project (Automation)
As a Automation tester, I automated YAHOO mail website in QTP. In this I
automated Login page, Inbox page, compose mail page, Deletion of mails in
YAHOO website.
Responsibilities:
> Operated yahoo site to understand functionality
> Created POC for QTP
> Developed UDF's
> Generated Test Scripts by using Descriptive Programming
> Executed scripts
> Involved in automation test closure review meeting
Professional Experience
DST World Wide Services [Nov 2013 to till date]
As a Senior Process associate responsible for
> Accurate processing of medical claims in accordance with current and
relevant applicable plan documents with in TAT.
> Verifying the all documentations, letters and attachments to meet
customer, regulatory and internal requirements.
> Preparing and participating in audits.
> Maintaining positive working relationships with internal and external
customers including regulators.
> Documentation of claims details by accumulating the summary of claims
into the processing system.
> Determines covered medical insurance losses by studying provisions of
policy or certificate.
> Resolves medical claims by approving or denying documentation;
calculating benefit due; initiating payment or composing denial
letter.
> Ensures legal compliance by following company policies, procedures,
guidelines, as well as state and federal insurance regulations.
> Maintains quality customer services by following customer service
practices; responding to customer inquiries.
> Protects operations by keeping claims information confidential.
> Accomplishes organization goals by accepting ownership for
accomplishing new and different requests; exploring opportunities to
add value to job accomplishments
United Health Group [July 2012 to Oct 2013]
(Under the payroll of Magna Info tech Pvt. Ltd)
As claims associate in charge for
> Accurate processing and completion of medical claims within the
current turnaround standards.
> Proficiency in product lines applicable to processing unit.
> Ability to understand and apply plan concepts to include: Deductable,
Co insurance, Co pay, Out of pocket, maximums
> Demonstrate increasing productivity to meet minimum requirements while
maintaining quality standards of projects as required.
MD India Health Care Services .Pvt .Ltd [June 2011 to July 2012]
Playing the role of Claims Executive
> Responsible for the accurate processing and completion of medical
claims sent By NWH with defined Norms & Conditions.
> Understanding the regulatory requirements regarding claims processing
and settlement.
> Preparing Investigation Brief & Settlement Sheet.
> Ensure that claims are being processed & settled in the specified
guidelines
> Attend to all inquiries and complaints regarding the processing and
settlement of claims.
> Liaison with Doctors, Hospitals, Field Operations, Legal Other
Departments for Claims Adjudication.
> Preparing the Pending Reports on Monthly, Quarterly, Yearly Basis,
Sending Letters & E-Mails to NWH.
> Analyze Daily Claims Status Reports & Preparing Consolidated Reports
on Daily Bases and Providing Summary manager.
Initiatives & Achievements
. Taken an initiative as a Floor Walker and played key role to
deliver the day to day process updates for the entire team.
. Always mingle with the team in resolving process related queries &
sharing the knowledge.
. Received "Best Employee Award " & " Star Awards".
Academic Profile
> B.sc from Osmania University with an aggregate of 68% in 2010.
> Intermediate from Board of Intermediate with an aggregate of 80% in
2007.
> S.S.C with an aggregate of 83% in 2005.
Personal Details
Father's name : Mohan Rao
Mother's Name : Krishna Suseela
Date of Birth : 13th June 1990
Languages known : English, Hindi, Telugu
Hobbies : Reading books, Listing to melodious
songs
Address : 16-11-20/13/1A/A, Saleem Nagar,
Moosarmbagh,
Dilshuknagar,
Hyderabad.
Contact this candidate