Quality Assurance Tester

SUMMARY

Accomplished professional with over 16 years of experience contributing to development of several business enterprises through customer support, business analysis, quality assurance and testing

Experience working on MMIS applications for the states of Alaska, New Hampshire, Mississippi and Georgia

Experience in the Software Testing Life Cycle including analysis, preparation of test plans, development of test cases, test execution, defect tracking and change management

Worked on Business Rules testing within a Rational environment for healthcare applications

Possesses excellent analytical, problem solving and decision making skills with detail oriented approach to testing

Experience in interfacing with stakeholders and senior management with excellent communication and interpersonal skills

Experience in User Acceptance Testing, Smoke Testing, Regression Testing and Functional Testing

Strong skills performing data analysis, writing test cases for User Acceptance Testing. Gathered Functional and Data Requirements, analyzed workflows and created Use Cases, Requirement Specifications

Experience working with Developers, SMEs, and user representatives in application design.

SKILL SETS AND TOOLS

Proficient

Technical Skills

Basic Familiarity

MS Office Suite Application

SAP Rational Clear Quest

MS Visio

Medicaid Claim Processor

Web-based testing

Reqweb

MMIS/Healthcare

Rational Requisite

FOCUS

EDI

Rational Manual Tools

Manual Testing Tools

Excelicare

XML

Web portal

Creation of Test Scripts

SQL Server

QTP

Test Plan/Test cases

LoadRunner

SharePoint

UAT/Defect Tracking

Rational Robot

PROFESSIONAL EMPLOYMENT HISTORY

Centene, Baton Rouge, La May 2016 – present

Louisiana Healthcare Connections

Position: Contract Implementation Analyst

Responsibilities:

Performs day to day duties and testing of contract implementation, including UAT to ensure that system accurately reflect a contract’s negotiated terms.

Performs audits of provider setup within the provider information system to ensure accurate contract implementation and subsequent claims processing

Review and price contract related pends to ensure claims payment accuracy

Ensure accurate contract implementation and subsequent claims processing through provider setup, UAT testing, etc. on basic Change Requests (CRs) (i.e. RHCs/FQHCs/fee schedule updates).

Review contracts and assign pay classes and applicable provider information based on contract language. If configuration is needed to accommodate a contract, notify the appropriate parties.

Assist with the internal communication of all new and revised material contract terms and provisions to all affected departments.

Work with the implementation team to ensure deliverable post deployment check list completed

Skills Used: Amisys, DST Provider Pricing, CRM, Service-Now, SharePoint, PPS (Provider Payments System and Microsoft Office 2013

S2Tech, Xerox, MS

Feb 2015 – Jan 2016

Mississippi Eligibility Modernization Project

Position: Quality Analyst Tester/Business Analyst

Mississippi Eligibility Modernization ABD Project is the process by which a Medicaid application is entered and processed through eligibility factors and a decision is made for all persons in the case as to whether eligibility is approved or denied. My role is eliciting, confirming and documenting business workflows and requirements (functional/non-functional) during the initial phases of a project.

Responsibilities:

Facilitate requirements gathering and gap analysis processes.

Created requirements and design documents

Elicited, analyze, communicate and validate requirement for changes to business processes and systems

Created and executed test scenarios

Defect Tracking

Ensured that system documentation is updated according to client standards.

Built/ maintained strong working relationships with project stakeholders and development teams.

Travel to client location per project needs and requirements

Skills Used: SharePoint, MS Visio, Word, Excel, Rational Tools, Medicaid Eligibility Determination Portlet

S2Tech, Xerox/ACS, Juneau, AK

Apr 2012 – Jan 2015

Alaska MMIS

Position: Quality Analyst Tester

Alaska Medicaid Health Enterprise was a web enabled solution for administering all the medical assistance programs. My role was to generate complex test plan, test case data, procedures and testing script.

Responsibilities:

Manual/Automation Testing Tools (User Acceptance, Regression, Functional/User Interface Testing and Verification/Validation Testing)

Developed test documents and test cases; created test plans, test cases and test scripts

Defect Tracking in Ration ClearQuest Web

Responsible for execution of test cases

Experience working with Developers, SMEs, and user representatives in application design

Able to work independently as well as in a team environment and success with meeting deadlines under pressure

Updated the test cases based on the Change Requests/Enhancements

SQL queries

Skills Used: SQL, MS-Windows XP, Rational Clear Quest, Rational Manual Tools, and MMIS Web portal

ACS, Government Healthcare Solutions, Atlanta, GA

Apr 2003 – Mar 2012

Enterprise MMIS/Georgia Health Partnership

Position: Quality Analyst Tester/Claims Department Lead

Enterprise Medicaid Health Enterprise was a web enabled solution for administering all the medical assistance programs. My role was to generate complex test plan, test case data, procedures and testing script.

Responsibilities:

Developed test documents and test cases; responsible for execution of test cases

Defect Tracking in Ration ClearQuest Web

Created requirements and design documents; experience creating test plans, test cases and test scripts

Managed workflow of the Claims Resolution Unit

Created production reports on a daily basis and review Quality Assurance results with Specialists and created Claims procedure manual

Supervised sixteen employees in the Claims Department

Coordinated and conducted training for Claims Support staff

Excellent analytical, problem solving and decision making skills and detail oriented

Documented the results of research in Omni-track

Keyed and processed Medicaid claims into the MMIS System

Skills Used: User Acceptance, Regression, Functional/User Interface Testing and Verification/Validation Testing, Ration ClearQuest Web, Omni-track

Other Related Healthcare Experiences Jan 1999 – Jan 2003

The Dominion Consulting- Atlanta, GA - Senior Claim Processor

Cigna Healthcare of Georgia, GA – Benefit Analyst

Blue Cross/Blue Shield of Louisiana, Baton Rouge – Claim Processor

EDUCATION

Studies: Business Management and Marketing

Southern University, Baton Rouge, LA Aug 90 - May 1993

PROFESSIONAL DEVELOPMENT / CERTIFICATIONS / COURSES

MMIS Certification

ICD10 coding

CPC coding

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