EXPERTISE

oSelf-starter, dependable with proven ability to assure quality in projects having 7+ years of testing experience in Healthcare domains.

oExperience in writing test plans, test cases, developing, maintaining test scripts as well as documenting all phases of QA process.

oStrong knowledge in Software Development Life Cycle (SDLC) & Software Testing life cycle (STLC)

oGood Experience working with Healthcare business domain.

oExcellent knowledge in extraction, cleansing, and modification of data from/to various data sources like flat files and databases.

oInvolved in Black Box, Positive, Negative, Data-driven, System Integration, System Regression, End to End, Functional, Smoke/Sanity, Static, Interface, SIT and UAT Testing.

oHands on experience in SQL Queries to validate the data in databases

oDemonstrated Experience in Testing EDI Applications.

oExtensive knowledge of health information and health care services regulatory environment including HIPAA, Medicaid/Medicare, and EDI

oExperienced in EDI and HIPAA testing privacy with multiple transaction exposure such as new Member enrolment 834 inbound, 834 Outbound, claim 837 inbound or claim adjudication, response to claim 835 outbound, 276 status inquiry277response, 270 eligibility/271 benefits.

oExperience in Bug Tracking Tools such as ALM/Quality Center and TFS.

oPerformed Back End Testing by executing SQL queries.

oPerformed Sanity, Smoke, Usability and Security Testing of various applications.

oProficient in both Manual and Automated Testing Tools such as QTP and ALM/Quality Center.

oConducted User Acceptance Testing (UAT) and System, Integration Testing

oProficient in using ALM/Quality Center, JIRA and TFS as bug-reporting tools.

oGood team player with the ability to lead, manage and work independently.

oExperience in reviewing and authoring test related documents such as test plan, test cases etc.

oExcellent in communication and presentation skills.

TECHNICAL SKILLS

BUG REPORTING ALM/Quality Center, JIRA, TFS

REQUIREMENT MGMT. TOOLS ALM/Quality Center, SharePoint.

LANGUAGES SQL, JSON, HTML, XML.

RDBMS MS SQL Server Management studio 2008, 2012, 2014.

Tool: SSIS Package, Visual Studio 2015, Postman, DocDNA, Pega Robot Manager

OFFICE SOFTWARE MS Office (Word, Excel, PowerPoint)

OPERATING SYSTEM Windows, UNIX

SDLC & QA Methodologies Waterfall, Agile/scrum, Kanban

PROFESSIONAL EXPERIENCE:

BlueShield California El Dorado Hills, CA.

October 2020 – Till Date

Software QA Engineer

BSC has Adopted Pega Robotic Automation (RPA Technologies) for Adjusting for full credit back, member liability, ITS host process on a claim. So, I was involved in testing this automation. This functionality will avoid Human errors and time consumption.

Responsibilities:

Responsible for creation of test cases according to Business requirements and design documents. Involved in Design, Execution and updating of Test Cases for Functionality testing.

Involving in preparing Test plans based on user requirement documents.

Conducted Regression Test for the fixes of the application.

Validating claims based on legacy claim information by using allowed amounts based on agreements.

Process claims manually based on service category like LOB’s Commercial, PROMISE, MAPD.

Worked on Recoupment and Recoveries functionality in FACETS.

Worked on DocDNA for Credit back process to update the claim status.

Good Understanding of HIPAA (Health Insurance Portability Accountability Act) rules for ANSI X 12 messages 837, 835, 276/277, 270/271, TA1, 999 and 277CA in 5010 Standards.

Responsible for modification and executing of the Test Scripts.

Worked on JIRA to upload the test cases.

Worked on TFS to log defects raised while testing.

Participated and provided input in team status meetings for classification issues.

Provided status report on weekly Basis to Management prior to weekly meeting.

Also involving in Agile SCRUM daily status meetings with Team to discuss the work status and issues.

Worked with SME’s closely to understand the process of the project.

Worked with Off-Shore team for data management related to the project.

Worked directly with the clients in managing and understanding their requirement, and interpret the functional requirements to On-site and Off-shore team for development and execution.

Handle early and late Off-shore calls for data management.

Environment: JIRA, Pega BOT, TFS, GRID, Share Point, Oracle Database, Windows, MS Office, Note++, FACETS, DocDNA, EDI Editor, Pega Studio.

IEHP, Rancho Cucamonga, CA.

Feb 2017– August 2020

Software QA Engineer/EDI Specialist

IEHP has adopted HSP MediTrac as their new core system and thus replacing the legacy Diamond system. As part of this implementation, IEHP aims to maintain accurate, timely and complete Member eligibility and claims Processing of Medi-Cal and Medicare members in HSP MediTrac system. So, I involved in their new core System to validate 834, 837I/P, 277CA, 999, TA1 Testing. Mainly my part is testing Member Eligibility, 837 IB Files Process. Review the Business Rules with Business and implemented in the Process, closely worked with Developer to give them business understanding. Having very good knowledge on HSP MediTrac system.

Responsibilities:

Experienced in project management with HIPAA, X12 transactions 834, 837I/P, 999, TA1 and 277CA.

Develops and executes test cases based on System Design documents.

Created test cases manually to perform diverse types of testing such as positive/negative, Functional/regression, interface, black box, smoke/sanity testing, and Backend testing.

Designs and develops test plans and test strategy to support all QA testing activities with special emphasis Informatics and batches.

Validate the Member eligibility test in HSP MediTrac.

Work on production Claim processing in HSP MediTrac.

Work on HSP clean claim project and relax the edits in the business rule.

Extracted claims from HSP HIPAA Gateway on daily purpose based on LOB.

Processes daily claim files in HSP platform and monitor for any file’s rejection.

Validate daily response files from HSP MediTrac.

Tested based on IEHP 837 Companion Guide, Tested Snip Level 1 and 2(Envelope Level, Structural Level and Functional Level).

Worked on PCPAA project in HSP MediTrac with EDIMS.

Write SQL queries to investigate validate and verify the data integrity of 834 OB files from EDIMS to match exact data from HSP MediTrac.

Validate reporting system from HSP MediTrac. (Reconciliation Report)

Knowledge on how to check the claim adjudication process from HSP Perfect claim platform.

Executing test cases for Functional, integration, UAT and regression testing.

Work in Waterfall/Agile Methodology environment to change the requirements and features set.

Extraction of test data from tables and loading of data into SQL tables and automated the process of loading, pulling the data for test data setup.

Carried out GUI, Functionality, Integration and Regression testing using TFS.

Review SRS and meet with Business to understand the Workflow top come over the Test Scenario.

Conducted Daily stand up for Huddles for any Roadblocks and updated the work in Work Front Tool, Bug Reporting and Tracking using TFS.

Environment: TFS, MTM, Share Point, SQL SERVER, Manual testing, Web Services, Windows, MS Office, Note++, EDIMS, HSP(MediTrac), HIPAA Gateway, Perfect Claim, EDI Editor, Work Front, Postman, JavaScript, Visual Studio 2015.

Bridgecom, Miraloma, C.A.

March 2016– Jan 2017

Quality Analyst

Bridgecom® is a software and services company that provides Healthcare clients a powerful way to close communications and care gaps. I worked on enhancement of Argus files from there big client “Medimpact” healthcare client.

Responsibilities:

Participated in daily Agile/Scrum/Sprint planning meetings, Sprint Release Cycle and retrospectives

Analyzed User Stories from the requirements

Develop/execute test cases based on functional requirements and user interface

Created Traceability Matrix to ensure that all requirements are covered in test cases

Tracked and reported defects / issues in TFS

Performed test cases execution

Worked with development team to verify defect fixes through release cycle

Performed back-end testing using SQL queries to make sure that data entered has been uploaded correctly into SQL Server Database

Performed smoke testing on new builds on various environments

Analyzed User Stories from the requirements

Tested Argus files from pharmacy.

Validate the Claims from EDI transaction in the front end as well as back end

Work closely with EDI to ensure accuracy in data transmissions and shared processes.

Tested on multiple browsers for cross browser inconsistencies

Participated in project meetings and reviews

Expertise in querying and testing MS SQL Server database for data integrity

Involved in UAT testing in UAT environment, prepared UAT test cases and testing estimates

Worked with development and database engineers to ensure accurate results and quality products

involved in Providing the demo to the client

Executing Regression suite for each release

Involved in peer reviews of test cases

Created and executed test cases for smoke testing

Coordinated and worked with development team on the Project going live

Executed test cases during regression cycle in different environments on Internet Explorer, Firefox, Google Chrome, and Safari

Environment: ALM/Quality Center, SQL SERVER, Manual testing, Web Services, XML, Windows, MS Office, Note++, Ultra Edit.

Philips, Baltimore, MD

March 2014–Feb 2016

Quality Tester

The Philips eCareManager is a Hospital to Home application, this application is used in the hospitals, nursinghome etc.Philips is a leading company in electronic Devices and now growing massively in Healthcare and clinical devices, almost 90% of the hospital in America are using Philips application. I worked on the enhancements of the application and involved in Verification and Validation End to End Testing.

Responsibilities:

Prepared detailed test cases by understanding the business logic and user requirements for manual testing.

Created test cases manually to perform different types of testing such as positive/negative, Functional/regression, interface, black box, screen navigational testing, smoke/sanity testing, exploratory testing, or Backend testing.

Review test specifications, cases and performed manual testing.

Performed backend testing for ICD 10 Codes for Specific Patients.

Writes a Test Scripts (use cases) with dry run for a user story.

Interacted with business analysts to gather the requirements for business and performance testing.

Used SoapUI for API testing.

Followed Agile Methodology to emphasize on real time communication over written documentation.

Carried out GUI, Functionality, Integration and Regression testing using ALM/Quality Center.

Developed strategies with Quality Assurance group to implement Test Cases in ALM/Quality Center.

Bug Reporting and Tracking using TFS

Send Interfaces Messages by Rhapsody IDE 5.5, 6.1.

Worked with Data Extraction, Transformation and Loading (ETL)

Extraction of test data from tables and loading of data into SQL tables

Writing test cases for compensation software using the Gherkin format.

Involved in End to End Verification and Validation Testing for FDA Approval and Review.

Participate in team meeting for Product Backlog, sprint Meeting, Scrum meeting and RPE meetings.

Performed configuration and installations migration build from 4.0 to 4.1.

Use SharePoint for the Requirements.

Environment: ALM/Quality Center, SQL SERVER, Manual testing, Web Services, XML, Windows, Oracle, MS Office, Note++, Rhapsody IDE, Terminals, Gherkin, SoapUI.

EDUCATION:

Diamond Bar High School, Diamond bar, C.A

Graduated: 2008

Mt san Antonio College, Walnut, C.A

Attended: 2008- 2010

Premier Career College, Irwindale, C.A

Graduated Nursing: 2012

Teklabs INC, Santa Clara, C.A

QA Training Certified: 2013-2014.

Permanent Address:

6582 Hollis St, Eastvale, C.A. 92880.

Status: USA Citizen

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