Abbas Hakkim Samath Basha
Business Analyst
Coimbatore,TN
Summary
1.Highly skilled and dynamic QA Analyst - 14 Years of IT experience exclusively in Healthcare domain demonstrating strong “Business Analyst” capabilities with uncompromising focus on Clients Business needs.
2. Proficient knowledge in Pharmacy Benefits Management (PBM) Business and experience in testing various benefits.
3. Certified Professional in AHM250
4. Excellent Knowledge & Exposure to Healthcare Concepts & Domain.
5. Strong knowledge of Healthcare Claims processing.
6. Supports in testing benefits and coordination of implementations.
7. Expertise in developing requirements and performing interface analysis.
8. Collaborate with Technical team, Subject Matter Experts, Product Managers to find the best approaches to address the client’s requirements.
9. Facilitation of requirements sessions and prototyping.
10. Proficient in performing claims analysis.
11. Having good amount of experience in Functional Testing, Integration Testing and Regression Testing
12. Excellent Knowledge of AS400 based application (RxClaim) Testing.
Overview
14
14
years of professional experience
Work History
Subject Matter Expert
Safety Stratus
03.2024 - Current
- Owned end-to-end implementation quality of the EHS platform, ensuring client requirements were correctly translated into system functionality
- Acted as the primary bridge between client testers, internal QA, and development teams to resolve issues efficiently
- Validated fixes and enhancements before sign-off, ensuring production-ready and client-acceptable solutions
- Coordinated issue analysis, root cause discussions, and re-testing with developers
- Provided system walkthroughs and demos to clients after fixes and enhancements were completed
- Ensured smooth handover by aligning business expectations, technical implementation, and testing outcomes
- Supported clients during testing cycles to ensure successful adoption of EHS workflows
SME
Quant systems Inc
07.2022 - 09.2023
- SME role:
- 1. Providing complete technical support for 5 members team and ensuring quality deliverables
- 2. Performing Functional testing by processing claims for the test members created in AS400 Rx claim system and Regression testing in Production Environments
- 3. Involved in the Test data setup using AS400 Mainframe system
- Reviewing the complete Test Cases and results prepared and executed by team members
- 4. Coordinating with Business team and onsite point of contact for requirement clarifications and for smooth transition of work responsibilities
- 5. Having good working experience in test management tool SFDC
- 6. Responsible in daily status call with client team and involved in defect triage calls for Quick and smooth execution of the project
- 7. Designing the claims in such a way to test benefits offered by various plans (both dollar& clinical benefits)
- 8. Well versed with HIPAA, claim adjustments, claim processing from point of entry to finalizing, claim review, identifying claims processing problems, their source and providing corresponding solutions
- 9. Involved in Query validation of coding by fetching data from Mainframe to excel and validated it based on the requirement
- 10. Good Documentation and Process Management skills with an ability to effectively understand the business requirements to develop a quality product
- 11. Analyzing and Understanding the Requirements for Prescription Drug Plans (MEDD, Medicaid, Exchanges and Commercial) for benefit coverage details
Technical Test Lead - Projects
Infosys
11.2021 - 06.2022
- Quality Analyst /Test Lead Role:
- 1. Experienced in Agile process
- 2. Planned and created test cases based on stories and sprints
- 3. Creating and executing manual test cases for various scenarios
- 4. Working as Test Lead and leading 12-member team for this project and involved in organization level process related activities
- 5. Responsible in scrum call and daily status call with Onshore for providing updates on the user stories
- 6. Experienced in validating the data in database tables using Microsoft SQL server 2008
- 7. Experienced in RTC (Rational team concert) and having working knowledge on SOAP UI
- 8. Having good experience in test management tool RQM for storing test cases, recording test execution and results, mapping testing onto requirements
- Blue Cross Blue Shield Association (BCBS, BCBSA) is a federation, or supraorganization, of, in 2022, 34 independent and locally operated BCBSA companies that provide health insurance in the United States to more than 115 million people
- Project 1: Client - Blue cross Blue shield
Associate - Projects
Cognizant
09.2011 - 11.2021
- Quality Analyst Role:
- 1. Performing Functional testing by processing claims for the test members created in AS400 Rx claim system and Regression testing in Production Environments
- 2. Involved in the Test data setup using AS400 Mainframe system
- 3. Creating Test Scenario, Test Case, Test Evaluation Summary, Maintenance Documents
- 4. Preparing the Test Cases, Reviewing the Test Cases, and Executing the Test cases
- 5. Coordinating with Business team and onsite point of contact for requirement clarifications and for smooth transition of work responsibilities
- 6. Having good working experience in test management tool SFDC and working knowledge in HP ALM
- 7. Having good working experience in internal automation tool Benefits Serv and helped automation team with appropriate data to develop the tool
- 8. Carried out Ad- hoc testing in situations deemed necessary
- 9. Responsible in daily status call with onsite team and involved in defect triage calls for Quick and smooth execution of the project
- 10. Designing the claims in such a way to test benefits offered by various plans (both dollar& clinical benefits)
- 11. Well versed with HIPAA, claim adjustments, claim processing from point of entry to finalizing, claim review, identifying claims processing problems, their source and providing corresponding solutions
- 12. Involved in Query validation of coding by fetching data from Mainframe to excel and validated it based on the requirement
- 13. Played SME role for the welcome season testing from the year 2016 to 2021, supported 11 member team in improving productivity and quality of the deliverables
- 14. Good Documentation and Process Management skills with an ability to effectively understand the business requirements to develop a quality product
- 15. Conducted successful projects with the help of teams to achieve deadlines timely and proficiently
- 16. Analyzing and Understanding the Requirements for Prescription Drug Plans (MEDD, Medicaid, Exchanges and Commercial) for benefit coverage details
- 17. Experience working in Medicare, Commercial, Medicaid and Exchange projects
- CVS Health (formerly CVS Caremark Corporation) is an American retailer and health care company. CVS/Caremark, the pharmacy benefit management (PBM) and mail service pharmacy division of CVS Health, provides a full range of PBM services, including mail service pharmacy offerings, plan design and administration, formulary management, discounted drug purchase arrangements, Medicare PartD services, retail pharmacy network management services, prescription management systems, clinical services and disease management services. It was the largest company in either list with operations solely in the United States.
- Client - CVS Health - Benefits Testing Period :-
Education
SSLC -
Tirumathi rukumani ammal higher
Pollachi04.2004
Bachelor of computer Science - BCA
Sree Saraswathi theyagaraja college
Pollachi04.2011
HSBC - undefined
Tirumathi rukumani ammal higher secondry school
Pollachi04.2007
Skills
Interpersonal Skills
Extra-curricular activities
Awards and Certification, Cognizant 1. Awarded “Star Award” for Q2 2018 by QE&A department 2. Recognized as “Pillar of the Month” for the month of December 2016 by QE&A department 3. Awarded “WOW Employee” for Q4 2012 4. Awarded “Best Performer” for Q3 2014
Interests
Photography, thriller movies
DECLARATION
I hereby declare that the above information is true to the best of my knowledge.
Timeline
Subject Matter Expert
Safety Stratus
03.2024 - Current
SME
Quant systems Inc
07.2022 - 09.2023
Technical Test Lead - Projects
Infosys
11.2021 - 06.2022
Associate - Projects
Cognizant
09.2011 - 11.2021
Bachelor of computer Science - BCA
Sree Saraswathi theyagaraja college
HSBC - undefined
Tirumathi rukumani ammal higher secondry school
SSLC -
Tirumathi rukumani ammal higher