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Senior QA/ Organization Systems Analyst with X ages of expertise in company procedure analysis/modeling, business demands gathering, database style and design and advancement of Net Based, and Client/Server programs.· Worked in various Healthcare regions like Enrollment, Advantages, Claims, Medicare, and EDI X12 etc. Practical experience in Healthcare principles such as HIPAA, SOX and so onBug Tracking System.· Labored on numerous EDI X12 transaction sets 837 I/P, 275/276, 270/271, 834 etcetera· Experience as Business/Systems Analyst with skills in Insurance policy, Healthcare processes, Systems/ Options Engineering, Strategic Arranging, and Techniques Study.· Associated with Purposeful, Integration, System, Regression and UAT Tests.· Considerable experience with NASCO, Facets and QCare Declare Engines.· Abilities in examining requirements, Company Requirements Accumulating, Details warehousing, Assessing Knowledge Sources, Translating Prerequisites into Requirements, Software Layout.· Skills in examining prerequisite, practical and style specs, growing Test methods, Check programs and Examination circumstances· Proficient in business enterprise procedure modeling, documentation, and testing working with Rational Suite (Rational Rose, RequisitePro, ClearQuest) too as MS Visio and MS Undertaking together with UML 2.0 diagramming tactics.· Considerable working experience with SQL and info conversions, Facts mapping and info validation· In-depth knowledge of making use case, activity, reasonable, element and deployment sights with rational equipment to extract enterprise practice flows and workflows therefore supporting advancement and high-quality assurance groups in comprehending the necessities.· Knowledge during the ETL (Extract, Renovate and load) of data right into a data ware house/date mart and Business enterprise Intelligence (BI) tools like Organization Objects Modules (Reporter, Supervisor, Designer, and Net Intelligence).· Intensive experience with Entrance end and back finish System Integration Testing (SIT).· Documented job similar information and facts like exam performance processes, backup programs, new tester teaching documents, preserving check logs, launch notes etcetera· Intensive practical experience in all phases of RUP and SDLC processesTechnical Capabilities Enterprise Modeling: MS Visio, Rational RoseQA Tools: Mercury Excellent Heart, Test Director, Swift Exam Pro, Rational Clear circumstance, ToadDetails warehousing Resources: Informatica, Enterprise Objects, CognosMethods: Mercury TestDirector, Rational ClearQuestOperating System: Windows 2000/XP/Vista, UNIX, Linux Languages: SQL, ASP, Java Script and VB Script, HTML, XML Databases: Oracle 9i/8i, 10g, MySQL, MS-Access, SQL Server, DB2, Documentation & Management: MS-Office, MS Word, Rational Requisite pro, MS challenge, SharepointEDUCATIONPROFESSIONAL ExpertiseHealth care, - Location Sr. Top quality Analyst DayI worked from the Enrollment department coordinating with business enterprise and other Insurance plan companies IT team to implement file intake processes for incoming groups. Generated reports and audits for business and management to make sure that implementation has been a success or not. I also labored in Claims area as Business/ High-quality Analyst to develop applications which accept different claims like Medical claims, Dental statements, and vision promises from different vendors and route the claims into Batch Adjudication System and Online Adjudication..Responsibilities:· As the Sr. QA Analyst my responsibilities included creating and documenting Product Test Strategies, applying several SDLC methodologies; Assisted in writing efficient and effective Master Examination Plan, Check Strategy, System Screening, End-to-End Exam and User Acceptance Test Plan· Performed end-to-end "System Integration" screening which covered the entire organization method flow from the initial point of sales through to all the (10) downstream systems and XML output files, including apps/interfaces.· Participated during the scheduling, enhancement, coordination and presentation of specific testing needs as appropriate to the excellent assurance needs of the close user· Developed and executed SQL queries to verify the proper insertion, deletion and updates into the details Warehouse supporting tables and cubes.· Assisted company users in defining UAT exam scenarios and plans; Established and maintained exam conditions and exam information in High-quality Middle.· Coordinated with the QA Team for screening activities across multiple systems and managed Conversion exam execution.· Used MS Visio for flow-charting, process model and architectural structure of the application.· Strong encounter in conducting Gap Analysis (GAP), Functional tests, User Acceptance Tests (UAT), and System Integration testing (SIT), SWOT examination, Cost benefit research and ROI evaluation.· Involved with implementation of HIPAA EDI Transactions ( 835,837,820,276)· Facilitated Electronic Information Interchange.· Performed GAP Research for HIPAA 4010 and 5010 transactions.· Used EDI tools to verify mapping to X12 format· Recommended changes for system style, methods, procedures, policies and workflows affecting Medicare/Medicaid promises processing in compliance with government compliant processes like HIPAA/ EDI formats and accredited standards ANSI.· Analyzed HIPAA EDI transactions in XML and X12 responses and of 270 and 276 and looked for defects for amendment.· Did details evaluation for various version changes of EDI messages on different sub-systems.· Providing the required examination information for the developers in order to fix the defects· Participating in QA team meeting andBug Tracking SystemsoftwarProduced management reports making use of Informatica relative to inventory, productivity, accuracy and cycle time and maintained team leave paperwork and artifacts in world wide web dependent MS Share point· Tested the enhanced FACETS/AMISYS system, evaluating claims adjudication needs and generating HIPAA-compliant organization rules configuration.· Involved with assessment of tools for use in future HIPAA 4010/5010 migration and compliance by performing GAP Research. Provided enterprise and specialized procedure flow recommendations.