Roobesh has nearly 5 years of experience in healthcare domain testing. He has expertise in requirement analysis, test case preparation, functional and integration testing, defect logging and retesting. Some of the projects he has worked on include testing a vendor portal application, Medicare Advantage and Medicaid administration systems, and ensuring benefit coding matches requirements. He is skilled in test planning, execution, reporting and guiding junior team members.
1. Roobesh S
Mobile: 9944016063
Email: roob75@gmail.com
Experience Summary
I have closeto 5 year of expérience in healthcareDomain. Have a good knowledge on U.S healthcareconcepts
startingfrom member enrollment till claimprocessing.Good in Manual Testing. In the due courseof my Project, I
was involved in creatingtest scenario,test cases,test data, Requirement Analysis, implémentation,Défet logging
and Defect retesting. Performed different types of testing (Functional testing, Field level testing, UAT, System
testing and System Integration testing).
Technical Skills
Hardware / Platforms Windows 98/XP/2000
Technology
Other Utilities
Testing
NASCO, HSP, PMHS, Connecture & Facets
Certifications
Introduction to Managed HealthCare - Cognizant certified professional
Software Testing Cognizant Certified
Level: 0 ISTQB - Cognizantcertified professional
HealthcareClaims for Practitioners CognizantCertified
Relevant Project Experience
Organization: Cognizant Technology Solutions
Project #1
Project Description
Vendor portal is a supportapplication for Agent .Agent Assistants through which agent or assistantcan assistthe
members who want to take Insurancepolicies.
Blue exchange, Consultation exchangeand Agent application actsas a shoppingportal wherethe customers can
browse different plans and then select a plan accordingto the needs. It is builtprimarily to serve as a platformfor
sellingdifferentavailableplans.
Tasks and Deliverables:
Analyzinguse casedocuments and understandingthe requirements.
Knowledge in Test strategy and TAC documents.
Involved in the preparation of Requirement Traceability Matrix.
Prepared test cases and also reviewed the test cases prepared.
Involved in testing web application.
2. Direct clientinteractions on the deliverables
Provided ideas to clientsideand got appreciation mail.
Involved in rising and followup of the defects.
Performed the execution of the test cases which prepared.
Involved in Databasetesting.
Prepared learningdocument for the application which I was working.
Involved in the functional testing.
Performed ad-hoc testing.
Involved in the retesting of the defect fixes.
Active participation in defectdiscussion meeting.
Performed regression testing.
Preparation of daily,weekly status reports.
Project #2
Project Objective
The CHRISTUS Implementation project is charged with buildingcapabilities in-housefor the followingthree
objectives.
CHRISTUS Health is expandingin to Medicare Advantage in New Mexico and is lookingto administratein-
house.
CHRISTUS Health plans to sell ACA Qualified Health plans on public exchanges in New Mexico and Texas.
Administration of Medicaid business in Texas to be migrated in-house,which is currently outsourced to
Aetna.
CHRISTUS Health has selected Health Solutions plus (HSP) and Voyager (Dynamic Health) as the software solutions
that will be implemented to support current business functions and achievefuture goals.CognizantTesting Team
provides test data and testing support through HSP & Voyager for different projects/releases on the course of
implementation of the above objectives planned by CHRISTUS Health.
Project Description
Interpretation of requirements and business processes into testscenarios
System Integration testing to ensure member enrollment flow between systems (Voyager, EDI, HSP and
sub contracted vendors such as superior vision, Dental Quest, CVS/ESI, Carnet & APS )
Quality Assuranceon the MedicareAdvantage, HIX & Medicaid) configured in HSP Application through
various testingtypes namely, member enrollment testing, Claims testing,Provider (Contract & Fee
Schedule) testing, financial management, accumulator & utilization testing
ProcessingEDI transactionssuch as 834,837P & 837I of 5010 standard to ensure member enrollment &
claims load in HSP system.
Role and Responsibilities
Understands and reviews the projectrequirements
Designingdetailed strategy, plan and test cases based on Business requirements and Technical
Specifications
Performs Functional Testing,Integration Testing, System & Regression testing, E2E Testing
Collects the test metrics and reports them and shares itwith the customer
Implements the best practices and provides recommendations/inputs to innovativesolutions
Responsiblefor sharingthe Estimates & Capacity planning
3. Responsiblefor ensuringthat testing commitments are met within the QA team and monitored assigned
QA team projects for potential impacts to target dates or other projects.Communicated potenti al impacts
to target dates to the QA Team Leader
Responsiblefor sharingDaily Status Report(DSR) & Weekly Status Report (WSR) to the client
Coordinates and facilitates daily or weekly defect status meetings
Prioritizethe defect fix based on Test Severity
Coordinates and followup with Development Leads and QA Test Leads on defect fix estimates and
retesting estimates
Project #3
Project Objective
The WellPointserviceis a projectto ensure the Benefit coding accordingto the group specific requirements.
Project Description
WellPointserviceensures the benefit codingfor a particular group,which is goingto be availed by the subscriber
for his particularplan.
Testing to be done for 66 benefits and each packagehavingdifferent coverage for those benefits.
Process
We startcodingthe benefits into the web application with the description changereceived through via -mail
Based on the information in Benefit Grid the codingteam does the coding.Once Codingis completed the ithas to
complete with Auditors
Been a partof auditingteam to ensure the benefits are code correctly as per the Requirement is mentioned
Role and Responsibilities
Team lead
Test Lead to ensure the testing quality & findingthe hidden issues.
Ensure the defects reporting to clients arevalid.
Report generation and Deck preparation
Responsiblefor understandingTest requirements related to Claims
Responsiblefor Test readiness before claimexecutions
Responsiblefor Claimexecutions
Responsiblefor defect reporting and Retest
Assigningtasks to team members, trackingand guidingthe team members.
As a SME, need to clarify the team member’s queries
Declaration:
I hereby declarethat the above particular mentioned is best of my knowledge and belief is true
And correct.
Place: Yours Faithfully,
Date: (Roobesh. S)