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Yyyyyy x. yyyyyy

1501 Rahling Road, Apt, 412, Little Rock, AR 72233 xxx-xxx-xxxx ●


Senior Quality Assurance Analyst

Test Planning ~ Test Cases ~ Manual Testing ~ Bug Detection ~ HIPAA Compliance

Requirements Gathering ~ Agile / Scrum ~ Troubleshooting ~ SDLC ~ Status Reporting




         Proficiency in using Agile / Scrum testing methodology for client/server and web applications with specialization in the healthcare sector.

         Well-versed in steering projects from initial requirement stage through to successful implementation including creating test strategy, test plans, test cases, test scripts and test scenarios, and driving defect management.

         Constantly focus on optimizing software performance, reliability, usability, security and compliance.

         Considerable expertise in identifying and troubleshooting software deficiencies, generating instructions for enhancements, and thoroughly tracking defects through to prompt resolution.

         Expert in functional, integration, end-to-end, regression, back-end, and user acceptance testing (UAT).

         Excel at analyzing business requirement documents (BRDs), functional specification documents (FSDs), system requirements, design documents, use cases, UML diagrams, and requirements traceability matrices (RTMs).

         Possess excellent skills in using both manual and automated testing tools, and fostering cooperative relationships with clients and project team members.

         Advanced understanding of X12 transactions, EDI/HL7 formats in a healthcare billing environment, and Medicare and Medicaid domains of healthcare systems.

         Consistently ensure critical compliance with legal/regulatory standards along with client requirements.

         Solid ability to join forces with all levels of management, peers, clients and technical specialists to expedite project success.


Professional Experience


Amitech Solutions / Arkansas BCBS, Little Rock, AR, 2015 to Present

Data Analyst / Systems Coordinator

         Analyze, support, maintain, and continually optimize AMISYS Exchange products in seamless collaboration with multidisciplinary technical personnel and internal/external users.

         Play an integral role in supporting ANSI HIPAA transactions, COBC, ICP, HDMS reporting, BHI reporting, and data warehouse extracts.

         Diligently respond to project requests for internal/external reporting for claims, membership, and billing.


Ciber Inc. / Wellcare, Tampa, FL, 2012 to 2015

Senior QA Analyst / Lead

         Established and executed test plans, test scenarios, test scripts and test cases, prepared defect and status reports, and authorized project sign-off for Medical Management Platform project;

o    Attended bi-weekly meetings with developers and QA team to clarify requirements.

o    Gathered requirements for HIPAA EDI transactions during multiple phases of implementation.

o    Analyzed BRD, system requirements, FSD, design documents, use cases, UML diagrams, and RTM.

         Methodically tested 2015 Medicare AEP web changes within secure and unsecured portals as part of annual enrollment period, and verified functionality of websites in multiple browsers.

o    Strategically employed HP application lifecycle management to monitor test progress, manage test cases, and reliably track defects through to successful resolution.

o    Coordinated and efficiently completed UAT, regression testing, and integration testing.


Continued ►



Professional Experience continued Yyyyyy x. yyyyyy Page 2 of 2


         Spearheaded quality assurance for Care Core Expansion project featuring real-time service authorization transactions from CCN National for advanced radiology, cardiology, pain management, sleep diagnostics, lab management, and PT/OT using CCN web service.

o    Reviewed results returned in XML format and tested Web Services using SOAPUI platform.

o    Ensured functionality adhered to business requirements, examined EDI 837 claims, and flagged HIPAA non-compliant health claims received from payer side.


Amtex Enterprises / Blue Cross Blue Shield, MA, 2011 to 2012

Quality Assurance Analyst

         Actively supported HIPAA 5010 migration project to achieve regulatory compliance while also facilitating development of a next-generation EDI infrastructure and business services.

         Authored test cases and test scripts, explored 5010 system impact and changes, and performed GUI, functional, and regression testing.

         Performed backend testing via SQL queries to verify database integrity and resolved and/or tracked defects.

         Cultivated unified and productive efforts among QA team for testing X12 transactions, and formulated reports and graphs to present test results to management.

         Increased productivity by automating test scripts of WSDL functions using Rational Service Tester.


Independence Blue Cross, Philadelphia, PA, 2009 to 2011

EDI Tester

         Created test plans, test scripts, and test cases to ensure insurance claims processing aligned with rigorous HIPAA X12 standards and guidelines.

         Participated in UAT for provider enrollment, prior authorization, benefits administration, claims and encounters, and eligibility subsystem.

         Worked extensively on paper claims in NSF and UB92 format, managed claim routing on EDI, CIS and MHS through GUI, and validated reports and files complied with HIPAA X12 standards.

         Performed manual testing of MAPPO application and manual and automation testing for entire FEP project.

         Discovered and reported defects, interfaced with business analysts for UAT, and strategically tested possibilities of system failure with UAT.

Health Alliance Medical Plan, Urbana, IL, 2007 to 2009

QA Analyst

         Devised test plans, test scripts, and test cases to execute functional, GUI, and security testing.

         Promoted cohesive efforts with trading partners to swiftly resolve inbound and outbound EDI errors.

         Analyzed system requirements and established scenarios for functionality, navigation, performance, and security testing of the application.

         Confirmed EDI process remained HIPAA-compliant and aligned precisely with ANSI X12 standards.

         Thoroughly tested claims for billing and payment, benefits enrollment, and pre-adjudication.

         Administered load and stress tests to evaluate and optimize system performance.

         Executed test cases manually to substantiate actual vs. expected results, and prepared associated reports.

         Structured and configured GUI maps in WinRunner for standard and custom objects.


Verizon Wireless, Ashburn, VA, 2005 to 2007

QA Analyst

         Scrutinized BRDs and technical specifications, and played a vital role in producing RTMs, test scenarios, test scripts, and test cases.

         Performed back-end/database testing via SQL queries and reported bugs to developers.

         Programmed SQL commands to fetch data through queries for testing.




Quality Test Pro, Quality Center, Load Runner, Test Director, Rational Test Manager, Requisite Pro, ClearCase, ClearQuest, Bugzilla, Rational Rose, Visual Paradigm, Microsoft Office (Project, Word, Excel, PowerPoint, Access, Visio), SharePoint, Oracle, SQL Server 7.0, SQL Server 2005, Toad, SQL Management Studio, PL/SQL Developer, AMISYS, WinSCP, Informatica

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