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Click here or scroll down to respond to this candidateCandidate's Name
Windermere, FL PHONE NUMBER AVAILABLE EMAIL AVAILABLEProfessional ProfilePerformance-focused and detail-oriented Quality Assurance Test Analyst with 5+ years of experience. Technical proficiency in developing and overseeing test plans and test cases. Solid expertise in all facets of software development life cycle. Knowledgeable in utilizing methodologies, such as Agile and Waterfall, and open communication to achieve tight project deadlines. Outstanding interpersonal ability to establish and maintain constructive relationships with individuals and teams across the organization.Technical SkillsTest Management Tools: HP Quality Center/ALMDatabase: Oracle, SQL Server, MySQLApplications: Tableau Dashboard, eClinical, AthenaNet, SoapUI, Postman, EDIAgile Tools: JIRA, VersionOne, Confluence, SharepointTesting Methodologies: Agile, WaterfallWork ExperienceQUALITY ASSURANCE ANALYST (CONTRACTOR) November 2019 PresentRA Data Solutions, Orlando, FLSuccessfully delivered QAM approved projects to production in the Timeshare industry.Worked with developers, business, and product team to create test plans.Developed and executed manual test cases in HP-ALM.Conduct regression, smoke, and integration testing.Assisted business with acceptance testing.Responsible for creating defects in ALM and managing the triage process to closure.Identified, created, and extracted test data for the testing effort using SQL within the environment.Investigated and resolved data quality issues.Created testing results reports in Excel.QUALITY ASSURANCE ANALYST (CONTRACTOR) October 2017 March 2019Bank of America, Orlando, FLReviewed and analyzed Business Requirement and Software Specification Requirements.Performed quality review and testing of web-based and client server applications (Agile Methodology).Worked with developers on testing SOAP and REST web services for proper responses.Responsible for testing defect fixes.Define and track quality assurance metrics such as defects, defect counts, test results and test status.Conducted Resiliency Tests for all projects and responsible for preparation of test cases.Planned, designed, and converted documentation and business requirements into test cases and scripts.Provided oversight to the development and execution of the following:oManual test scripts to perform assessment on web-based user authentication.oClient-based test cases based on documentation from Business Analyst.MEDICARE PHARMACY AUTHORIZATIONS ANALYST November 2016 October 2017CVS/Aetna, Orlando, FLComplete timely and accurate documentation of all Medicare Part D requests.Check eligibility and benefit verification and then determine appropriate course of action for the requests.Approve medication and ensure documentation is in compliance with Medicare guidelines.Utilizing multiple software systems to complete Medicare appeals case reviewsMeeting or exceeding government mandated timelinesComplying with turnaround time, productivity and quality standardsConveying resolution to beneficiary or provider via direct communication and professional correspondenceBILLING AND CODING ASSISTANT May 2015 October 2016Advance Medical Billing Associates, Maitland, FLPrepare, review, and transmit claims using billing software, including electronic and paper processing.Handled claims for all commercial insurance companies, including HMO/PPO, Medicare and state Medicaid.Follow up on unpaid claims/ appeal denied claims within standard billing cycle timeframe.Submission of necessary documentation to the insurance companies with claims.Call insurance companies regarding any discrepancy in payments if necessary.Identify and bill secondary or tertiary insurances.Follow up on monthly aging accounts receivable reports on unpaid claims aged 30 days.Maintains strictest confidentiality; adheres to all HIPAA guidelines/ regulation.Review and validate accuracy of charges, including dates of service, services provided, location, patient identification, and provider signature.Collected, posted, and managed patient account payments, and prepared and submitted claims forms to insurance companies and other third-party payers.Performed insurance verification, pre-certification, and pre-authorization.Entered procedure and diagnosis codes, and requisite patient information into billing software to streamline invoicing and account management; added modifiers, verified diagnosis, and coded narrative diagnosis.Responded to staff and client inquiries regarding CPT and diagnosis codes.MEDICAL BILLING, CONSULTANT February 2013 March 2015Physician Medical Billing Associates, Windermere, FLUsing coded data to produce and submit claims to insurance companies in Kareo EHR system.Working with the insurance company, healthcare provider, and patient to get a claim processed and paid.Work on verifying EDI 837 and 834 files.Collect, post, and manage patient account payments.Verifying patients insurance coverage.Handling collection and unpaid accounts.Coding in ICD-9 and CPT standards, based on diagnosis of illness.Ensuring patients' initial medical charts were completed and appropriately filed.Ensuring all new patient forms were completed, properly verified, and entered into medical systems.FRONT DESK SPECIALISTS April 2008 January 2010R. Arifuddin M. D., Pine Hills, FLResponsible for handling front office reception and administration duties.Greeting and scheduling patients appointments, answering phone calls, handling calling patients to remind them of upcoming appointments.Utilize our medical software to registers new patient and update existing patient demographics by collecting detailed patient information including personal and financial information.Verifying patients insurance coverage.Process payments from patients for co-pays and uninsured visitsMaintain confidentiality of all patient records.SOFTWARE/DATA QUALITY ASSURANCE ANALYST November 2002 September 2004Knova Software Technologies Pvt. Ltd, Karachi, PakistanPartnered with development teams to analyze project goals, requirements, artifacts, and acceptance criteria to develop the overall testing strategy for both front and backend product features.Supported continuous testing activities throughout development lifecycle by writing test scenarios/cases, performing manual testing, documenting/reporting defects back to the engineers, and assisting with automation efforts.Wrote and executed test cases to find system bugs for data integrity, inconsistencies between source / target data.Provided inputs on high-level test scenarios, challenges, risks, resources, and test estimates during test planning meetingsPerformed functional and non-functional testing through a variety of different methodologies (Integration, Smoke, Regression).EducationMEDICAL INFORMATION CODER/BILLER TECHNICAL CERTIFICATE 2012Valencia Community College, Orlando, FloridaBACHELOR OF SCIENCE (B.S) - INFORMATION TECHNOLOGY 2002South City Institute of Management and TechnologyBACHELOR of ARTS (B.A) - BUSINESS ADMINISTRATION 2000Karachi University |
