Vaishnavi Soner

Project Overview:
Responsible for testing a comprehensive insurance claim processing system that manages claim submission, status tracking, approval workflows, and settlement calculations for policyholders.

Key Responsibilities:

• Analyze business requirements for claim submission, validation, approval, and settlement processes.
• Create detailed test cases covering diverse claim scenarios such as new submissions, modifications, rejections, and cancellations.
• Execute functional tests to ensure accurate input and processing of claim details including policy and claimant information.
• Perform API testing to verify seamless integration between claim processing, underwriting, payment gateways, and third-party services like fraud detection.
• Conduct regression testing to confirm recent updates do not impact existing functionality.
• Automate testing workflows using tools such as Selenium and Postman to enhance efficiency.
• Test integration with associated modules like policy management, billing, and customer support.
• Validate business rules for calculating claims payouts, deductibles, and co-payments based on policy terms and coverage.
• Address exception cases such as incomplete or duplicate claims, missing documents, and expired policies.
• Ensure compliance with industry regulations like HIPAA, SOX, and insurance-specific laws.
• Perform performance testing to evaluate system behavior under high claim volumes during peak times.
• Log defects with detailed reproduction steps and collaborate with developers to resolve issues promptly.
• Document test results and create reports for audit and quality assurance purposes.

Typical Test Scenarios:

• Successful submission and processing of valid claims with complete documentation.
• Testing of multiple insurance types such as health, auto, and life claims.
• Handling claim rejections and validations for non-compliance or missing information.
• Verifying accurate claim payout calculations based on policy parameters.
• End-to-end tests from claim registration to final settlement and notifications.
• Stress and load testing during high claim activity periods to ensure reliability.

Tools & Technologies:
Selenium (automation), Postman (API testing), JIRA (defect tracking), SQL (database validation), Jenkins (CI/CD).

This project exemplifies the QA Engineer’s essential role in delivering a reliable, compliant, and user-friendly insurance claim system that supports efficient and error-free claims processing.

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• Managed service desk ticketing system to track user requests and incidents.
• Troubleshot and resolved hardware, software, network, and peripheral device problems.
• Collaborated with IT teams to address complex technical challenges.
• Documented troubleshooting procedures and created how-to guides for end users.
• Assisted users with installation of applications and software updates as needed.
• Provided remote assistance via phone or desktop tools to resolve user issues.
• Ensured compliance with IT service management best practices and policies.

• Efficiently handled requests for client dedicated tools to ensure prompt service delivery.
  Maintained all KPIs, supporting team growth and achieving target performance scores.
  Trained new employees on operational protocols to enhance efficiency.
  Managed B2B and Console to Mica cases, ensuring timely resolution of issues.
  Tracked escalation points through Outlook and Microsoft Teams for effective case management.
  Collaborated with project stakeholders and subject matter experts to consistently meet deadlines.
  Navigated multiple queues with significant user interaction via emails, chats, and calls.