ALI KHAN

Sabha.khaja@gmail.com
732-310-5927

SUMMARY
Over 8 years of Experience in the IT industry with emphasis on Quality Assurance/Software Testing with exposure of both
Manual and Automated testing tools. Expertise in validating and testing, Client-Server and Web-Based Applications in
different environments

PROFESSIONAL SUMMARY:
 Diversified experience in Quality Assurance and Software Testing.
 Good Documentation and Process Management skills with an ability to effectively understand the business
requirements to develop a quality product.
 Excellent understanding of Software Test Life Cycle (STLC) and Test Methodologies. Good understanding of AGILE,
Waterfall software development methodologies.
 Key expertise includes testing & debugging GUI & Multi-Applications environment & automated testing using
Selenium WebDriver.
 Experienced in customizing Selenium API to suit in testing environment.
 Participated in Walkthroughs and Inspection meetings to review Test scripts and results.
 Expertise in using Mercury Interactive Automated Testing Tools Win Runner, Load Runner, QTP, Selenium, Soap UI
and Quality Center
 Worked and implemented application according to HIPAA and CMS guidelines.
 Performed Manual and Automated Testing on Windows and UNIX platform.
 Experienced in developing Test Plans, Test Cases and Test Reports based upon the business requirements.
 Good experience in Web Services testing using SOAPUI, XML, & WSDL. Providing required input data to request XML
& get the required data from response XML & use the response data from other request XML using SOAPUI.
 Strong experience with SOA architecture which include Soap Web Service and RestFul Web Service Testing.
 Extensive knowledge of SDLC as well as STLC.
 Experienced in testing Client-Server and Web-Based Applications.
 Excellent knowledge of HIPAA standards, EDI (Electronic data interchange), transaction syntax like ANSI X12,
Implementation and Knowledge of HIPAA code sets, ICD-9, ICD-10 coding.
 Involved in FACET configuration, Customization, reporting, analysis and enhancement.
 Extensively worked on EDI transaction like 837, 835,834, 820, 270, 271, 276, 277 and 278.
 Using Facets claim for various health insurance areas such as enrollment, member, Products, accumulators,
finalization, remittance, adjustments and other FACETS related modules.
 Knowledge of Medicaid Information Technology Architecture (MITA).
 Experience in Black Box, Positive, Negative, Data-driven, Integration, System, Front-End and Back-End Testing.
 Performed GUI, Regression, Backend and Functional Testing.
 Performed sanity testing, smoke testing, Usability testing of various applications.
 Prepared Data in FACETS required for Manual script executions.
 Used Online Monitors and Graphs to analyze the results.
 Experienced in conducting Performance testing, Stress testing, Load testing and Volume testing.
 Used Quality Center, JIRA for Bugs reporting and communicating to developers, product support and test team
members.
 Extensive knowledge of complex SQL queries as per finding the number of encounter by different submitted and
subscribers/providers.
 Extensive experience in encounter claims processing.
 Excellent in communication, presentation and interpersonal skills.
 Good team player with the ability to lead, manage and work independently in a time sensitive environment.
TECHNICAL SKILLS:

Testing Tools Win Runner, Load Runner, QTP, Selenium IDE, Selenium web driver, SOAP UI, Web
Services (Soap, Rest etc), HP ALM
Scripting Languages JavaScript, UNIX Shell Scripting, XML. VB Script

Languages C, C++, JAVA, SQL, PL/SQL

Operating Systems Windows 98/2000/03/08, XP, UNIX, LINUX

Databases Oracle, MS SQL Server, MS Access, DB2

Bug Tracking Tools Quality center, JIRA, BUGZILLA, Rational clear Quest.

Web Browser Internet Explorer, Netscape Navigator, Firefox, Chrome

Front End Tools MS (Word, PowerPoint, Excel, Access), Visio. Facets 4.71, Macess, Care one

PROFESSIONAL EXPERIENCE

United Health Care, Minneapolis, MN May 2014– Present

Sr QA Tester
United Health Group is one of the leading health insurance providers in US. Application such as Facets has been widely
used across their network for the claim adjudication and claim processing. Facets is a fully integrated claims data
processing and Care Management as well as Utilization Management information system for managed healthcare. Facets
uses the data feed for the claims adjudication, claims error processing and to prepare the auto-generated reports and
correspondence using the Batch Cycle. As a QA Tester, I was involved in various kinds of testing of the Facets application
modules like Membership, Providers, data mapping for Medicare, Medicaid and Commercial Payer.

Responsibilities:
 Worked on Agile SDLC approach implementation for the whole testing life cycle.
 Gathered requirements and created, executed and documented Test Cases as per requirements in JIRA.
 Maintained QA lab standards, documentation review assisted in establishing and maintaining best practices for QA.
 Participated in SCRUM process, attended daily scrum meetings, sprint planning and sprint
 Created different test cases in Quick Test Pro according to insurance product requirements.
 Acting as liaison between end user and Facets for user problems, outstanding issues, training needs and new
software releases.
 Strong experience in care management to improve medical practice and customer assistance.
 Maintaining knowledge of Medicare and Medicaid rules and regulations pertaining to the Facets configuration and
evaluating the impact of proposed changes in rules and regulations.
 Worked with business leaders to translate business requirements and processes into test cases according to Facets
package requirements and subsequent effective configuration.
 Involved in FACETS Implementation, involved end to end testing of FACETS Billing, Claim Processing and
Subscriber/Member module in EDI transactions.
 Set claim processing data for different Facets Module.
 Validate EDI Claim Process according to HIPAA compliance. EDI transaction testing based on requirements.
 Following IV&V process for ensuring that end user requirements are met.
 Tested data to check HIPAA- eligible & participation check for individual coverage
 Worked on testing the scenarios where individual might be eligible for Claim Adjustment under Medicaid Program.
 Enhanced and maintained QTP scripts, Configured Shared Object Repositories and developed Reusable Function
Libraries using VBScript.
 Wrote complex SQL queries to Oracle database for backend/frontend comparative analysis i.e., to check the
correctness of the data stored in the database.
 Wrote JUnit Test Cases for REST web service Java API.
 Helped in Utilization Management to map the correct Authorization from Careone.
 Also, worked on Facets to receive, store and send HIPAA-standard transactions.
 Verified the test cases written by Jr. Testers for the verification of rate for different types of coverage. Also verified
the test scripts before manual execution if they cover all the aspects of rate and quote details according to State
Medicaid Policy coverage selection.
 Created and used Base line scripts in order to test the future releases of the application.
 Created test scripts for Positive, Negative and User Acceptance Testing (UAT)
 Wrote complex SQL queries to perform Back-End testing.
 Interacted with programmers to identify and resolve technical issues.
 Involved in weekly defect review meetings to review the status of defect fixes and upcoming build releases.
 Worked on Quality Center for bug status tracking and maintained and created status reports for the application.
Environment: SQL Server, MS Project, JIRA, Facets, Java, XML, HTML, Oracle, Microsoft Office, VB Script, HP QC/ALM,
QTP, SOAP UI, Jira

Blue Cross and Blue Shield of Florida May 2013 – April 2014
Quality Analyst
BCBS provides majorly the latest health care technology for Members, Groups, checking patient eligibility, Claim status
and submitting claims for reimbursement. Diamond processes incoming and outgoing EDI Transactions and EDI analiys.
This System adjudicates claims and generates EOB (Explanation of Benefits) RA (Remittance Advice). I was involved in the
enhancement of the application as per the requirements from the business.

Responsibilities:
 Involved in Analysis and Review of the Draft Use Cases and User-Stories provided by the Business Analysts for every
Release.
 Prepared user Stories for every Sprint for each AGILE release based on the requirements gathered from the Business
users through our Requirement gathering sessions.
 Attended the daily Scrum meetings for status update and determine the objectives for the day and also resolve any
issues we are facing to finish that objective.
 Performed Smoke, Functional, System, Regression and Integration with Positive, Negative Test cases.
 Attended the Requirement Gathering sessions, Requirement Sizing, Resource Allocation, Risk and GAP Analysis
sessions.
 Involved in testing SOA with Restful/SOAP Web Services. Created entire architecture for backend testing internal and
third party API using Test Complete and SOAP UI.
 Performed functional testing of Web services testing using SOAP UI.
 Developing Regression suit for various module using Selenium Web driver with core Java in Eclipse IDE.
 Utilizes Facets, Mercury Quality Center and other business applications to create and execute test cases and reports
results.
 Worked on FACETS on Claims processing module to validate the claims for different plans
 Developed various test cases for testing HIPAA 837, 835.
 Verified and validated (IV&V) the application according to all business/ functional requirements and updated the
difference to Lead and Business Analyst.
 Developed Test Case from User stories using the HP Quality Center.
 Created test scripts for Positive, Negative and User Acceptance Testing (UAT)
 Wrote test cases and executed to keep the Care management process in line.
 Wrote complex SQL queries to perform Back-End testing.
 Executed the test Cases designed through Test Lab within HP Quality Center.
 Created Test Cases for Integration Testing, System Testing and Regression Testing.
 Created Test data for Performance Testing.
 Written Integration test cases for Restful API.
 Developed Test Scripts for Enhancing facets application recommended by the Business Users.
 Performed Database Validation and Integration Testing and manipulations using SQL.
 Provided UAT Demo and Test Data to the Users and interact with them if they need any more information during the
time of UAT.
 Prepared Test Summary Reports, Weekly reports for overall testing status every week.
Environment: Agile, HP Quality Center (ALM), Java, QTP, SOAP UI, Web Services, Windows NT/2000/2003/XP, Facets

ACS Government HealthCare, Atlanta, GA September 2011– April 2013

Quality/Tester Analyst
I was involved in a project to re-engineer a suite of Medicaid management products and create a core application called
Enterprise. My team was responsible for receiving, documenting, tracking and addressing the problems encountered by
the customers of Flagship software product EPM (Enterprise Practice Management) while generating 837 Professional,
Institutional, and Dental claims, Functional, Claim Status Inquiry/Response 276/277 Unsolicited for their destination
direct Payers or Clearinghouses such as Proxy Med, Web etc. The product was also integrated with Facets application for
Claims processing.

Responsibilities:
 Created Test Documentation and Test Plans.
 Involved in HIPAA/EDI Medical Claims Analysis, Design, Implementation and Documentation.
 Entered numerous claims for testing purposes to ensure accurate and quality adjudication and implementation of business
and operational requirements.
 Worked on Data Mapping to map Facets data to outbound eligibility extracts.
 Wrote SQL queries to extract and validate the data from the Facets database.
 Designed Activity, Sequence and Process Flow Diagrams using MS Visio to simplify and elaborate certain selection criteria
and filter conditions.
 Extensively worked with Member/Subscriber and HIPAA Privacy Facets application groups.
 Use Quality Center to create to create Test Plan, Test cases and test scripts as well as steps for manual and automated
implementation of test cases in Quality Center.
 Developed and maintained complex SQL queries for MS SQL Server and MS Visual SourceSafe for extensive back end
testing purposes.
 Worked closely with Utilization management team to identify the requirements in facets.
 Involved in creating Frame work in QTP and business object in Quality Center.
 For testing purposes, manipulated Members information in the QA environment through Facets front-end application.
 Web testing utilizing HP Quick Test Professional (QTP), Client Server application manual testing utilizing Windows XP, Oracle
and SQL Server. Clear Quest for defect tracking and test cases repository and maintaining RUP documentation.
 Monitoring the performance of the system on a day-to-day basis.
 Regression testing on weekly builds. Performed weakly Walkthroughs and Inspection meetings.
 Performed Black Box Testing. Performed Positive and Negative testing for the system.
 Conducted Back End Testing to test the connection between Store’s system and the database in order to verify data
integrity.
 Performed IV&V for applications and data to make sure that all information is correctly displayed and dispatched.
 Made sure that the systems complied with the rules of HIPAA and CFR Part 11
 Documented the dimensional models of ETL system
 Used SQL to test various reports and ETL load jobs in development, QA and production environment
 Monitor and analyzed activity report. Created reports for Server monitoring and Transaction time
 Bug reporting using Quality Center.
 Involved in manually testing the application from the backend to carry out data validation.
 Environment: Quality Center, JAVA, QTP, Oracle, ANSI X12, HTML, XML, HIPAA, EDI, MS Office, Windows XP.

CVS Health, Scottsdale, AZ February 2010 – August 2011

Quality Analyst
CVS Health is an American retailer and health care company. CVS Health operates over 7,800 CVS Pharmacy, Longs Drugs
and Navarro Discount Pharmacies stores. Company uses Facets application to process all medical claims. The Project was
to enhance the application so that claims are processed with correct pricing and replacement of legacy MMIS System to
web based MMIS.

Responsibilities:
 Analyzed business and system requirements.
 Attended requirement review meetings and walkthroughs with business analysts, project managers.
 Involved in writing Test plans and Test cases based on Requirements and Use cases.
 Created Test cases for Functional, Regression, integration testing.
 Extensively used SQL Queries to perform Back End Testing and Wrote Executed SQL Queries to check the integrity of
the data.
 Used Clear Case, Clear Quest, Clear View, Quality Center, QTP, Load Runner, SOAPUI to automate the process.
 Assisted in finding solutions for Object Identification issues and error handling issues.
 Submitted EDI X12 837 Claim submission transactions and verified the claim information is correctly populated in the
Member services application.
 Provided test results and reporting for product owners and othergroups.
 Performed functional and regression testing in support ofquality of IT products for business users.
 Used Quality Center to report defects and test results.
 Conducted lesson learned activities.
 Experience in leading integration testing / end-to-end testing QA efforts across multiple applications.
 Experienced including developing and maintaining automation scripts as well as establishing automation
frameworks.
 Validated that all the data from MMIS was correctly transferred to web based MMIS.
 Used care management standards to implement correct services in the application.
 Ability to define problems, collect and analyze data, establish facts, draw valid conclusions and recommend
solutions.
 Proactively worked ethic with the ability to deliver results and meet challenging deadlines.
 Ensured software defects, future enhancements, and usability issues in assigned projects which are tracked,
summarized and presented to senior management usingQuality Center/ALM.
 Involved in co-ordination with team members and development team in order to solve issues.
 Prepared Defect, Project Status reports for submitting to Senior Management.
 Environment: Quality Center/ALM, QTP, Selenium IDE, Selenium Web Driver, JAVA, Windows, UNIX, Oracle, MS Word,
MS Excel

United Health Group, Hyderabad, India August 2008 - December 2009

QA Analyst
UHG is an innovative leader in Health Care Industry, serving more than 55 million members across United States. As a QA
Analyst, I was involved in various kinds of testing of the Facets application modules on Claims, Membership, Providers,
Finance and Vendor testing.

Responsibilities:
 Worked on Agile SDLC approach implementation for the whole testing life cycle.
 Reviewed Functional requirements documents, High level design requirement documents and finalize the testing in
scoops and scenarios for Integration testing for each project.
 Gathered requirements and created, executed and documented Test Cases as per requirements in Quality Center.
 Wrote JUnit Test Cases for REST web service Java API
 Interacted with the team member to ensure meaningful development of the scripts and simulated real time business
scenarios.
 Worked on FACETS Pre-pricing process – Subscriber/member eligibility, Plan benefits.
 Maintained QA lab standards, documentation review assisted in establishing and maintaining best practices for QA.
 Acting as liaison between end user and Facets for user problems, outstanding issues, training needs and new
software releases.
 Maintaining knowledge of Medicare and Medicaid rules and regulations pertaining to the Facets configuration and
evaluating the impact of proposed changes in rules and regulations.
 Worked with business leaders to translate business requirements and processes into test cases according to Facets
package requirements and subsequent effective configuration.
 Worked on testing the scenarios where individual might be eligible for Claim Adjustment under Medicaid Program.
 Verified the test cases written by Jr. Testers for the verification of rate for different types of coverage.
 Also verified the test scripts before manual execution if they cover all the aspects of rate and quote details according
to State Medicaid and Medicare Policy coverage selection.
 Transfer and maintain FTP files in Mainframe environment for Vendor testing in Vision. Also, submitted batch jobs to
the operating system so that they may be executed.
 Tested HIPAA EDI Transactions and Code Sets Standards such as 837/835 and 834 transactions.
 Authored and executed Test cases for Claims and Customer Service Workflow by manually.
 Experienced with batch processing system for claims electronic and manual transaction.
 Well known with frontend processing for the Claims, Subscriber/Family and with Providers.
 Experienced with External claim editing system on frontend system of Facets.
 Responsible for writing the Test Cases and Test Scenarios based on the Functional Specification and technical
Specification and documented in Mercury Quality Center.
 Performed the Back-end testing in Sybase tables, in mainframe environment, by writing and executing SQL-Queries.
 Worked on uploading all the Test cases and Scenarios to the Quality Center for the current and prior releases.
 Involved in weekly defect review meetings to review the status of defect fixes and upcoming build releases.
 Used Quality Center for version control, tracking defects, enhancement requests, assign work activities, and assess
the real status of project throughout the life cycle.
 Identifying Test Cases to be run for Regression Testing and conducting Regression testing as and when new builds
were made.
 Documented the test execution summary results and reported the status of assigned test tasks and issues to project
manager for approvals.
 Environment: Quality Center, JAVA,QTP, Facets, EDI, HTML, UNIX.