VIGNESH KUMAR

Test Analyst with full system development lifecycle experience, including designing, developing and implementing test plans, test cases and test processes fueling swift corrective actions, significant cost savings and fault-free audits

• 8+ years of experience in different areas of manual testing
• This comprises right from System Testing to User Acceptance Testing with vast exposure to various phases of Software Testing Lifecycle
• Worked in various Healthcare areas like Member, Provider, Benefits, Claims, Financial and Billing and good Experience in Healthcare concepts and applications like FACETS and QNXT
• Expertise in Vendor Extracts, Cafe, 834, 837i, 837p,27X,271 EDI Transactions
• Having very good knowledge in Group and Member enrollment and Claim processing applications FACETS, Power MHS, QNXT
• Extensively involved in testing Trizetto's Facets and mainly involved in Enrollment, Eligibility, claims, modules
• Experienced in testing Web-Based Applications
• Extensive knowledge of database management systems such as SQL
• Exposure in QC (HP ALM,JIRA)
• Working with development and BA teams on investigating and correcting software bugs and deficiencies based on the testing results
• Having knowledge in Vendor E2E testing (Worked with multiple vendors like ACS, ALERE, HEQ, PRIME, CSI, GHI, CMS, AIM, EYEMED, SHOV, MAGELLAN
• Extensive experience in coordinating testing effort, responsible for test deliverables, status reporting to management, issue escalations
• Experience in Negative, Unit, Integration, System, Front-End and Back-End Testing
• Performed sanity testing, smoke testing and Usability testing of various applications
• Expertise in Bug tracking using bug-reporting tools such as Quality center and JIRA
• Ability to quickly understand and interpret business requirements
• Good Documentation and Process Management skills with an ability to effectively understand the business requirements to develop a quality product
• Excellent in communication, presentation, and interpersonal skills
• Good team player, manage and work independently in a time sensitive environment.
• Provided valuable input into project planning meetings to ensure accurate timelines were established based on QA resource availability and priorities.
• Mentored junior testers in best practices for software testing methodologies while fostering a collaborative team environment.

Worked as EDI Test Analyst

• Streamlined testing processes for increased efficiency and reduced overall test cycle time.
• Reduced defect leakage rate by conducting thorough root cause analyses and proactively addressing areas of concern in future release cycles.
• Delivered high-quality products on schedule through effective use of automated regression tests utilizing PYTHON tools, minimizing human error during repetitive tasks.
• Additional Roles/Key Skills as working on Migration Project: Working with BA's and Business on second phase or Preliminary meeting while USM's are written [This helps QTD to provide Insights, determine scope(QTD,ES & PVS) and completely understand the ask from business which help the Software tester(QTD) to deliver the Quality Product] Start with a Point of View I apply my expertise to gain trust, and to lead our clients forward
• Seek data, Build Knowledge I use facts to guide my actions and decisions
• Create condition for everyone to thrive I include, enable and invest in everyone around me and make ethical choice

• Worked as Test Analyst for this project
• Project Description: FACETS is a product produced by Trizetto corporation which handles enrollment, claims processing and other allied services pertaining to the Managed Care business for different clients like BCBSNC
• In order to support the ongoing business requirements, numerous processes are built in and around Facets in the form of extensions, interfaces, and reports/letters
• This project involves Understanding different application groups and applications of Facets
• There are different modules in Facets application like Subscriber/Member, Provider, Claims Processing, Billing etc
• The project involves providing maintenance and performance tuning related services, addressing the enhancements for the Facets application in addition to providing independent testing services
• Power MHS is solution for automation of healthcare administration, with highly-scalable, fullyintegrated intelligent claims processing and Web enabled applications
• Power MHS tasks includes batch processing of claims, member administration, and provider maintenance, claims adjudication, authorization entries, check processing and member/provider inquiries
• The test environment was made up of a POWER (MHS) database, running on an IBM AS/400e series server, populated with data on five million 'members,' created by replicating data from the client's actual database
• The simulated interactive, on-line transactions exactly mirrored the client's current business profile
• Client Description: BCBSNC is a fully taxed, not-for-profit North Carolina company with headquarters in Chapel Hill and major operations centers in Durham, Fayetteville, and Winston-Salem
• BCBSNC is a fully taxed, notforprofit North Carolina company with headquarters in Chapel Hill and major operations centers in Durham and Winston-Salem employing more than 4,500 North Carolinians and serve more than 3.8 million customers
• Projects Worked: Blue Connect – Member Profile, Claims, Benefits, Invoice, etc.., (July 2016-Sep 2017)
• Worked in applications like Facets and Power MHS considered to be the source for Member enrollment
• Registering member in Blue connect portal by creating user ID/Passwords
• Claim creation in Facets and validating the Claims against Source Facets/PMHS
• Comparing Benefits against the Product for the group the member enrolled against source Care Radius – Authorizations and appeals (Oct 2017– Dec 2017)
• Worked in applications like Facets, Care Radius, blue e, edifecs transaction management and Power MHS
• O Creating Authorization in Care radius and validating it in Facets
• Claim creation in Facets and validating the Claims are mapped with the respective authorization
• Creating Authorization via 278 File
• Blue Quote – Enrollment (Jan 2017 – April 2017)
• Worked on LG Group Migration project(Migrate 51+ groups from PMHS to FACETS) from Discovery Phase
• Benefit testing/Group Enrollment/CBE files, etc..
• Validating the data in facets against source Benefit Focus (April 2017 – June 2017)
• Worked on E-Exchange and E-Enrollment
• Member enrollment platform(To generated 834 file providing member details in Application
• Performed 27X validation as per business requirements, X12 file mapping and ECS/EMS service validation
• Member and provider search logics
• O EDI Dashboard validation based on the volume of file processed in edifecs
• Delivered 276/277 transaction individually and worked in 270/271, 278-13/278-11 transaction Performed Regression testing in 837 and 835 transactions
• Enroll member and key claims in facets based on the 270/271 and 276/277 scenarios
• LG Migration Project(January 2017 – till date)
• Worked in multiple application from Enrollment to Portals
• Worked with multiple vendors like ACS, ALERE, HEQ, PRIME, CSI, GHI, CMS, AIM, EYEMED, SHOV, MAGELLAN
• Worked with partner plan like South Carolina and Tennessee
• Creating claims via Facets, Blue 2, Blue e and 837 files
• O Worked with Automation team on creating scripts and run scripts for regression scenarios and support tools on functional testing and played a vital role in effort savings
• Performed Blue2 message validation like General inquiry, Claim appeal, claim misroute and Medical record request etc.
• Performed Explanation of benefit and explanation of payment for the finalized claims
• O Error and batch tracking report validations MOLINA_834 Enrollment(April 2021- Till date)
• Working in Enrollment team(834), New and Maintenance projects All states like IL, KY, UT, NY, CA etc
• Testing methodology- Agile, Type- SIT Roles & Responsibilities: Understanding the Requirements and Functional Specifications of the application
• Ensure 100% compliance to quality assurance Participated in identifying the Test scenarios and designing the Test cases
• Prepared test cases upon the business requirements documentation (BRD), use case documentations(USM), Functional requirements specification (FRS), Functional requirements document(FRD) Involved in preparing Traceability matrix Involved in GUI, Functional, Regression testing and System testing Involved in all testing related documentation
• Involved in Bugs Tracking & Prepare Bug Report Document
• Involved in weekly review meetings and Defect Triage meeting
• Responsible to coordinate with onsite to work on deliverables and deliver the assignments
• Involved in test data creation and mining Documented QA Test Suites, Test Cases, Test results and defects using Quality Centre Creating Test Cases after analyzing the BRD's Execute test case with zero defect leakage Enrolled members through online screens and 834 transactions to BF Worked with multiple vendors on the same time in results of timely deliverables Assigning tasks to team members, tracking and guiding the team members