Address : Houston, Texas

Email : ad4bra@r.postjobfree.com

Phone : +1-424-***-****

Shital Patil Current Organization : Zadon Technology

Designation : Onshore QA Lead

KEY SKILLS

EDI Testing

837P,837I

TriZetto QNXT

Edifecs

Claims Processing

Health Care

JIRA

HP QC – ALM

Oracle SQL

Functional Testing

Black Box Testing

System Testing

Regression Testing

Defect Management

ETL Testing

Root Cause Analysis Customer Interaction

PROFILE SUMMARY

•Testing professional with 12+ Years of experience in the field of Software Testing with specialization in EDI Testing(837I,837P), Claims Processing, ETL testing...

•Worked in Healthcare (QNXT Claims, Member and Provider) and Finance domains.

•Working experience in different lines of Business for both Medicare and Medicaid

•Well versed in TriZetto QNXT application.

•Well versed in TMUI Edifecs application.

•Test Lead/Coordinator experience in On-site-Offshore model.

•Resource management (allocation, monitoring, motivating, etc).

•Build and integrate complex database queries to retrieve crucial data from DB for validation and validating 837EDI/PAPER, AVAILITY/EPortal Claim sources.

•Basic Knowledge in 834,835 & 270/271 formats.

•Maintain QA environment, from ensuring the environment is up to date with the latest build deployments.

•Strong understanding and experience in working in a High Performing Agile/Scrum Team and utilizing one of the major Agile Lifecycle Management tools like, Jira.

•Well acquainted with the Software Development Life Cycle (SDLC) and Software Test Life Cycle (STLC)

•Effectively utilized testing methodologies such as white/black box, integration, system, regression, etc.

•Effectively utilized time management skills to work on multiple projects simultaneously.

•Leading sessions with business users to plan, coordinate and execute UAT testing

•Proactively worked with IT Manager, Business Analyst, Creative, User Experience and Development to define project requirements and estimate effort to deliver

•Manage communications at a program level with multiple stakeholders and actively communicate on overall program level testing status by working with multiple testing teams in the program.

•Onshore/offshore coordination

•Extensive experience in writing Test Scenarios, Test cases, Test Reports and Tracking Bug Reports using Bug tracking Tools.

•Worked on HP ALM (Test plan, Test Lab, Defects modules), JIRA(Project Management tool) and Good knowledge in Defect Life Cycle in ALM

•Extensive experience in writing SQL queries for Data validation/verification and Debugging Issues.

•Performing regression testing using automation scripts when new build is deployed.

•Experience in various SDLC models Agile methodology and Waterfall.

•Analyzing requirements and developing the test strategy, test plan, test cases and generating test reports, defect reports and product quality assurance documentation.

•Experienced in leading the team and preparing status reports.

•Status Reporting (Daily/Weekly status report, Test Summary Report and Productivity sheet), Test management and updating results in Quality Center.

•Extensive experience in creating test case and test sets, tracing them to requirements and executing them in HP Quality Centre

•Coordinating the Offshore/ Onshore team with respect to testing activities. Working closely with offshore team and assigning responsibilities and follow up till the completion and reporting the status to project manager, updating the weekly reports.

•Knowledge sharing to the new team members, explaining the testing process and clarification on the process followed in the projects.

• Support, co-ordination and responsibility of the testing activities which includes review of test cases and test conditions, walkthrough of test cases with clients.

•Co-ordination with the Project Managers and Development team for resolution of any outstanding issues. Walkthrough of Test Plan, Test cases and Test Reports with Clients and Business Analysts.

•Expertise working with database tools generating SQL queries for checking the data.

Educational Qualifications

•Completed Master of Computer Science from Pune University with first Class

Work History

Total Experience : 14 years 7 months

Currently with consultancy zadon technology

Worked as anchor for Infosys Public services from March 2020 to Jan 2024 for testing activities and deliverable.

Worked as Onshore Test Lead in Infosys Limited, Long Beach California from Nov 2016 to March 2020

Worked as Offshore Test Lead in Infosys Limited, Pune from Apr 2012 to Nov 2016

Worked as senior test engineer in WebLogic technologies Pvt Ltd, Pune from June 2008 to Apr 2012

Key Result Areas:

•Analyzing requirements, conducting meetings to Analyze requirements, preparing test estimates/test strategy/test plan/test specifications/execution plans, preparing test cases, performing test execution, test creation/execution in support of team, review team members work, continuously mentoring team members, defect lifecycle management(ALM),onsite-offshore coordination, status and metrics reporting to customer, providing delivery evidence documents Extensive customer facing experience and Team Management

•Adequate experience with Manual testing, ETL Testing (Informatica), Oracle SQL, managing& coordinating the delivery of release, suggestions on improving the process, metrics reporting and support UAT testing for End-To-End Testing

Professional Experience

Projects Handled

PROJECT-1

•Project: MCG 360 Upgrade

•Client : Molina Healthcare USA California

•Domain : Health Care

•Role : Application Test Engineer

•Tools : GitHub

•Duration : March-2020 to Jan 2024

Description: MCG 360 is an application which stores the data processed for the Emdeon submitted claims. All the claims log and denial and acceptance data will be shown in the application. End customers also have few reports visible based on the security and access provided to them.

ROLES AND RESPONSIBILTIES

•Writing high level scenarios and test cases on HP – ALM.

•, Create defects and drive it to closure, prepare test completion/test exit reports, involvement in Go/No-Go decision meetings, create/execute test cases in support of team, metrics reporting.

•Prepared and executed GUI, Functional and System Test Cases

•Reviewed & executed test cases, and reporting defects on Quality Center.

•Implemented the quality process for all the test activities.

•Worked on Functional, Regression and exploratory testing.

PROJECT-2

•Project : Molina Claims Processing

•Client : Molina

•Domain : Health Care

•Role : Onshore QA Lead

•Tools : Claims (QNXT), MCG, Edifecs, JIRA,ALM, Oracle SQL, EDI

•Duration : Nov-2019 to –March 2020

Project Description: Molina Healthcare, Inc., a FORTUNE 500 company, provides managed health care services under the Medicaid and Medicare programs and through the state insurance marketplaces. Medicaid Molina Healthcare contracts with state governments and serves as a health plan, providing a wide range of quality health care services to families and individuals who qualify for government-sponsored programs, including Medicaid and the State Children's Health Insurance Program (SCHIP). Molina Healthcare offers Medicaid plans in California, Florida, Illinois, Michigan, Mississippi, Ohio, Puerto Rico, New Mexico, New York, South Carolina, Texas, Utah, Washington, and Wisconsin.

Molina Medicare

Molina Healthcare offers Medicare Advantage plans designed to meet the needs of individuals with Medicare or both Medicaid and Medicare coverage. Molina Medicare plans offer comprehensive, quality benefits and programs including access to a large selection of doctors, hospitals, and other health care providers at little or no out-of-pocket cost.

•Roles & Responsibility:

•Reviewing the SRs and providing the testing estimates as per the BRD and share with onsite.

•Providing Status Daily/weekly to PM/Business/Stakeholders.

•Attending requirement review/walkthrough meetings, Estimation, and resource allocation.

•Planning for the Test Design, Test Data and Test Execution.

•EDI file preparation, Validation, and processing QNXT through MCG/Edifecs.

•Testing of claims associated EDI X12 837(Health care claim), 276/277(Claim status) transaction files as per HIPAA guidelines.

•Checking MCG validations during file processing and overriding as per logics.

•Validating data for all Snip levels and making claims pass though Edifecs (Qconnect/QNXT)

•Attending Sprint Planning and Analyzing requirements, estimating the Scenarios for each User Story

•Splitting the User Story into Sub Tasks and working based on the tasks daily.

•Attending Scrum Calls with teams and updating the status on the Analysis and highlighting if any gaps

•Performing regression testing using automation scripts when new build is deployed.

•Mocking up the data as per the test scenarios and loading into ST environment for testing

•Checking the Inbound and Outbound files as per the EDI data

•Building SQL scripts to validate the data from Source to target as per mapping document.

•Daily Status reporting and stand-up calls with the team

•Ensuring defect management as per process

•Ensuring quality interaction with clients and timely response to stakeholders

•Preparing traceability matrix in terms of Testing and reviewing with the project team

•Interact with dependent teams, Team Motivation

•Ensuring on time delivery of all deliverables

PROJECT-2

•Project : Molina Claims Processing

•Client : Molina

•Domain : Health Care

•Role : Onshore QA Lead

•Tools : Claims (QNXT), MCG, ALM, Oracle SQL, EDI file Preparation,

•Duration : Nov-2016 to – Nov-2019

Project Description: Molina Healthcare, Inc., a FORTUNE 500 company, provides managed health care services under the Medicaid and Medicare programs and through the state insurance marketplaces. Medicaid Molina Healthcare contracts with state governments and serves as a health plan, providing a wide range of quality health care services to families and individuals who qualify for government-sponsored programs, including Medicaid and the State Children's Health Insurance Program (SCHIP). Molina Healthcare offers Medicaid plans in California, Florida, Illinois, Michigan, Mississippi, Ohio, Puerto Rico, New Mexico, New York, South Carolina, Texas, Utah, Washington, and Wisconsin.

Molina Medicare

Molina Healthcare offers Medicare Advantage plans designed to meet the needs of individuals with Medicare or both Medicaid and Medicare coverage. Molina Medicare plans offer comprehensive, quality benefits and programs including access to a large selection of doctors, hospitals, and other health care providers at little or no out-of-pocket cost.

•Roles & Responsibility:

•Coordinating with Onshore team/Business on the requirements, BRD walkthrough etc.

•Reviewing the SRs and providing the testing estimates as per the BRD and share with onsite.

•Planning for the Test Data preparation and Test Execution.

•EDI file preparation, Validation, and load to the MCG and QNXT

•Attending Sprint Planning and Analyzing requirements, estimating the Scenarios for each User Story

•Splitting the User Story into Sub Tasks and working based on the tasks daily.

•Attending Scrum Calls with teams and updating the status on the Analysis and highlighting if any gaps

•Performing regression testing using automation scripts when new build is deployed.

•Mocking up the data as per the test scenarios and loading into ST environment for testing

•Checking the Inbound and Outbound files as per the EDI data

•Building SQL scripts to validate the date from Source to target as per mapping document.

•Daily Status reporting and stand-up calls with the team

•Ensuring defect management as per process

•Ensuring quality interaction with clients and timely response to stakeholders

•Preparing traceability matrix in terms of Testing and reviewing with the project team

•Interact with dependent teams, Team Motivation

•Ensuring on time delivery of all deliverables

PROJECT-4

•Project: PAC_MIGRATION

• Client : ANZ

•Domain : Finance

•Role : ETL Test Engineer, Senior Application Test Engineer(Test Lead)

•Tools : JIRA, DATA STAGE, Confluence, Oracle SQL, Assure NXT, UNIX, Shell Script

•Duration : Dec-2017 to –Jan 2019

Description: PAC Migration Project is to migrate the BTWS source system into two different target systems (COBRA and PYTHON). Migration takes place to load the data into target as Entity by Entity to ensure that the data in BTWS migrated to COBRA and PYTHON. PAC Migration is to Migration the data till the staging environment of COBRA and PYTHON and the data load to Target environments are taken care by other vendors.

Roles & Responsibility:

•Attending Sprint Planning and Analyzing requirements, estimating the Scenarios for each User Story

•Splitting the User Story into Sub Tasks and working based on the tasks on a daily basis

•Attending Scrum Calls with teams and updating the status on the Analysis and highlighting if any gaps

•Planning for the Test preparation and Test Execution with Test Project Manager

•Building Automation Scripts to automate DB test cases

•Integrating the Automation Scripts with ALM and running test cases on daily basis

•Performing regression testing using automation scripts when new build is deployed

•Mocking up the data as per the test scenarios and loading into ST environment for testing

•Checking the Inbound files from SFDC team and highlighting gaps if any as per mapping document

•Writing Test Cases for Sanity Testing, ST and Pre Deployment and executing Assure NXT Tool( ETL Automation)

•Building SQL scripts to validate the date from Source to target as per mapping document

•Daily Status reporting and stand up calls with the team

•Ensuring defect management as per process

•Ensuring quality interaction with clients and timely response to stakeholders

•Preparing traceability matrix in terms of Testing and reviewing with the project team

•Interact with dependent teams, Team Motivation

•Ensuring on time delivery of all deliverables

PROJECT-5

•Project :NEP-PHI-PJ-TF-HPGM

•Client : Philips

•Domain : Health Care

•Role : ETL Test Engineer, Senior Application Test Engineer (Test Lead)

•Tools: UFT, HP ALM, Informatica, Oracle SQL, UNIX, Shell Scripting

•Duration : Apr-2012 to –Nov 2016

Description: Philips BPDH5.0 is an enhancement release to handle the changes to the existing IDD Application to include the Workflow of Data from MDM to SFDC though outbound and to ensure the data flow to MDM from SFDC though Inbound

Roles & Responsibility:

•Requirements Analysis and estimating the Scenarios for each User Story

•Attending Scrum Calls with teams and updating the status on the Analysis and highlighting if any gaps

•Planning for the Test preparation and Test Execution with Test Project Manager

•Performing regression testing using automation scripts when new build is deployed.

•Writing Test Cases for Sanity Testing, SIT and Pre-Deployment and executing in HP ALM

•Building SQL scripts to validate the date from Source to target as per mapping document.

•Daily Status reporting and stand-up calls with the team

•Ensuring defect management as per process

•Ensuring quality interaction with clients and timely response to stakeholders

•Preparing traceability matrix in terms of Testing and reviewing with the project team

•Interact with dependent teams, Team Motivation

•Ensuring on time delivery of all deliverables

Achievements

•Delivering each ticket/project with zero defect slippage from production.

•Customer/Health Plan satisfaction for the deliveries till data with timely delivery

•Test Lead for 7 releases in IJSFA project and successfully delivered the product to the customer.

•Awarded “Inspiring Performance” from Client for my individual contribution in Project.

•Have received excellent contribution ratings for all appraisals.

•Achieved the given targets before the timelines by putting the extra efforts.

Personal Details

•Marital Status : Married

•Permanent Address : Pune India

•Present address : Houton, Texas

•Email : ad4bra@r.postjobfree.com

•Contact # : +1-424-***-****

•Nationality : Indian

•H1B : Approved H1B till 2026

Contact this candidate