Muralikrishna Kambala has over 8 years of experience in IT healthcare, with expertise in EDI, claims processing, testing, and automation. He has strong skills in Java, SQL, Selenium, and testing tools like Quality Center and ALM. Currently he is an Associate Lead at UHG Information Services, managing a team and overseeing testing, defect resolution, and reporting for various healthcare integration projects.

1. Muralikrishna Kambala
Profile
♦ 8+ years of Professional experience encompassing and having 6 years of IT Healthcare
industry experience.
♦ Extensive experience with analysis, design, development, customizations and implementation of
software applications including EDI applications.
♦ Well Versed with Web Applications functional flow
♦ Sound Knowledge in testing Extract Files, Reports and Batch process testing
♦ Acquired good knowledge on EDI formats (EDI 837 Professional, 837 Institutional, 837
Dental,835,999 & 277)
♦ Proficient in Microsoft office and its supporting tools including MS Visio.
♦ Good knowledge of SQL language and exposure on pl/Sql developer.
♦ Expertise on Requirement Analysis, Designing & Executing Test Cases and Defect
management life cycle.
♦ Strong in Manual testing (Functional, Regression, Integration & E2E testing).
♦ Hands on experience on Encounter/Claim processing and expertise on Mercator Map Validation.
♦ Strong Experience in Java programming, Selenium WebDriver and Junit.
♦ Proficient in Test Automation using Selenium Tools.
♦ Well versed with Handling Elements in Selenium WebDriver.
♦ Writing Test cases using Element Locators, WebDriver methods, Java programming features
and TestNG Annotations.
♦ Expertise in implementation of Automation Framework using Selenium.
♦ Good exposure on X12 files and Flat files (Professional, Institutional, NSF and UB92).
♦ Knowledge on Agile Methodology with Scrum Framework.
♦ Excellent training and mentoring skills.
♦ Exposure on data extraction and produce reports and analyses as per the request.
♦ Worked on Test management tools (i.e. Test Director, ALM)
♦ Hands on experience with JCL using Mainframes.
♦ Good project management skills and coordination skills.
♦ Well-rounded interpersonal skills including problem solving and decision making.
♦ Strong analytical skills. Transparent, flexible, and good team player.
♦ IBM Certified Database Associate -- DB2 9 Fundamentals.
♦ Certified by 6 sigma yellow belt.
Plot # 116,117/A, Flat # 101, Vinayaka
Residency, Chintal,
Hyderabad, 500054
muralikrishna.kambala@gmail.com
Cell: +91-966-645-5925
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2. Skill Set
Primary Skills: All phases of SDLC for Mainframe Application, EDI,
Claim Processing Claims Work flow, Claims Adjudication.
Operating System: Windows 98/2000/XP, IBM z/OS, Windows 7
Languages: C, C++, SQL, COBOL, JCL& Java
Database: Oracle 9i
Test Management tools: Quality Center, ALM
Job Management tools: File-Aid, Endeavor and QMF.
Automation tools: Selenium webDriver with TestNG framework.
Education:
 Master of Computer Applications (MCA) in 2008 from Loyola Academy (Osmania University)
with First Class distinction.
 Bachelor of Degree (BSc) in 2005 from KBN College (Nagarjuna University) with First Class.
Professional Experience
Apr16 – Till date, Integration Service Layer (Associate Lead) UHG
Information Services Pvt. Ltd. India
An Associate Lead, responsible for managing, coordinating and monitoring the team.
Description:
Provider Integration Service, defined to send provider ECMM from MDM to CISL and receive
asynchronous acknowledgement response back from CISL for completely processed provider
messages. Provider Integration Service will validate provider ECMM received from MDM, and route it to
CISL over REST/HTTP connection. Once Provider message is received, CISL will process the message
and CISL will send asynchronous acknowledgement response back to UISL over REST/HTTP
connection.
The major systems that will be involved in this flow are mentioned as below:
• Provider MDM(Provider Master Data Management)
• UHC-ISL(UHC- Integration Services Layer)
• CISL(CIRRUS Integration Services Layer)
• CIRRUS (Claims adjudication System)
Roles & Responsibilities:
 Working on the templates and creating reports on a daily basis.
 Involved in System testing, Stage testing, offline testing and Production checkout.
 Involved in Defect triage calls and provide the clarifications to the team towards to close the defects.
 Providing KT to new team members and Do Peer Review Activities.
 Preparing the Status report , Quarter target reports and communicating it to Project Managers and
Clients
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3.  Responsible for process improvement activities.
 Monitor and adhering to scheduled deadlines
 Work forecast for upcoming period.
 Maintains the issue tracker.
 Escalate Issues and Risks to onshore
 Prepare Test Plan for all work items in every release
 Review Test Closure Reports after SIT for every release
 Update Master understanding document which was prepared during KT Phase
 Internal team meeting for Status, Issues and Risks
 Maintain internal document share point
Environment: LISA Work Station, Autopilot, Beyond Compare, XML Editor, WinScp, SOAP UI,
Selenium Webdriver and Test NG Framework.
Team Size : 15
Sep15 – Mar16, Payment Engine (Associate Lead) UHG Information
Services Pvt. Ltd. India
An Associate Lead, responsible for managing, coordinating and monitoring the team.
Description:
One Pay will build out claims Payment Engine (from UNET) to the following strategic claims processing
platforms - COSMOS, Oxford Pulse, CSP, NICE and RV Facets linking the platforms and creating a
single payment interface with providers. There will also be common overpayment recovery, electronic
adoption campaign and migrate the EPS (Payables) portals to Cloud technology. One Pay will deliver a
common on ramp, will accommodate multi-platform paying capability, remove the Oracle Business Suite
from Payment Engine and build the PRA customization capability.
Roles & Responsibilities:
 Responsible for process improvement activities.
 Monitor and adhering to scheduled deadlines
 Work forecast for upcoming period.
 Maintains the issue tracker.
 Escalate Issues and Risks to onshore
 Update Master understanding document which was prepared during KT Phase
 Internal team meeting for Status, Issues and Risks
 Maintain internal document share point
 Key projects handled so far include One Pay and COSMOS.
Environment: WinScp, TWS, DB2 Visualizer and Middleware applications (SOAPUI, Claredi,
Faciledi, CDB)
Team Size : 10
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4. May 11 – Sep 15, EDI Expert (SME) UHG Information Services Pvt. Ltd.
India
As an EDI expert responsible for Analysis, design, development, testing and implementation of different
applications like UFE (United Front End), B2B (Business to Business) and UMR (Unified Medical
Resource).
Description:
United Front End (UFE) is the central point for receipt and routing for all United Health Group health
claims. It is the single entity for entering UHG health claims data and directing that data to the correct
claims adjudication system. To our customer’s, Health Plans, Processing Centers, Regional Mail
Organizations, etc., UFE presents a unified structure for data entry and routing, regardless of where the
claim data is actually processed and stored.
Supported claim formats include 837 Professional and Institutional, NSF and UB92
In addition to claim routing, UFE supports requests for re-pricing, 835’s, and Referrals.
1) For re-pricing requests, UFE provides edit processing and passes the claims to NDB for profiler
processing and subsequent re-pricing via ppoONE.
2) UFE accepts 835’s in a proprietary internal format from Payment Engine, Cosmos, Optum
Health (UBH) and PHS. UFE maps the 835 flat files to HIPAA X12 format and interfaces with
Payables for financial consolidation per provider. Consolidated 835’s are then delivered to the
submitter.
3) UFE processes referrals submitted in the HIPAA 278 format that are routed to UNET.
B2B is EDI gateway which is used by its Clients (Health Care Providers and Clearing houses etc) to
send various requests through web services which B2B processes and sends the response back to the
submitter.
B2B does not have a portal or a GUI of its own. It is just a collection of web services which are used by
the clients to communicate with UHG in order to share/retrieve important data or information.B2B is
developed as gateway for processing HIPPA 5010 and 4010 compliant X12 requests (270,276,278
etc), Health Level 7 and supports other proprietary EDI communication formats.
Roles & Responsibilities:
 Review of Design Document for test plan preparation and updating the issues and getting those
clarified with SA.
 Identifying test Scenarios for test case preparation and create and executed them using Uconnect.
 Generating test scripts, modifying test scripts to do regression test.
 Involved in Development and peer review of automated scripts.
 Executing the test scripts for every Quarter and Updating the test results based on the importance
of the functionality.
 Uploading the Scripts to Quality Centre and Executing those from QC.
 Executing the Regression suite when new build deploys on the server.
 Preparing the test suite for real time transactions like 270,276 and 278and do Validation against
expected results.
 Modifying XML based test cases based on the test date requirements for all transactions and
Uploading them into Uconnect,
 Configuring DBvisualizer to verify the Transaction events for both real time and Batch transactions.
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5.  Involved in System testing, Stage testing, offline testing and Production checkout for B2B module.
 Involved in Defect triage calls and provide the clarifications to the team towards to close the defects.
 Providing KT to new team members and Do Peer Review Activities.
 Preparing the Status report , Quarter target reports and communicating it to Project Leaders and
Clients
 Leading the team and distributing the tasks to the team member.
 Leading the team and preparing the weekly status reports and presenting it to Clients and Project
Leaders.
 Establish Quality Procedure for the team and continuously monitor and audit to ensure team meets
quality goals.
 Key projects handled so far include ICD10, BPT (Business Process Testing), Migration projects
Environment: Mainframes (PROCLIB’s, DSNPARM’s, COBOL and ISPF) and Middleware
applications (SOAPUI, Claredi, Faciledi, CDB)
Team Size : 5 to 8
Aug 10 – May11, Testing Analyst Cognizant Technology
Solutions, Hyderabad, India
AmeriChoice, a business unit of UnitedHealth Group (UHG), serves more than two million beneficiaries
of government health care programs in 21 states and the District of Columbia. In order to support the
ongoing business requirements, Processes are built in and around AmeriChoice in the form of Batch
Process, interfaces and reports/letters. AmeriChoice Health plans operating in the different states offer
more number of health care services. There are different modules in AmeriChoice like
Subscriber/Member, Web Applications, Financial, Claims, Reporting/Quality and Provider etc.
The project involves providing maintenance and application performance tuning related services.
Address the enhancements for the AmeriChoice application in addition to providing independent testing
services.
Roles & Responsibilities:
 Well Versed with Web Applications functional flow.
 As an active team member, I set up the test data. I have validated their respective functionalities.
 I am well versed with retrieving the data from oracle Database and got the hands on SQL.
 Preparation of Test Cases and Test Scenarios.
 Involved in Peer review of Test Scenarios and System Test cases.
 Maintaining Defect/Issues/Observations Tracking sheet.
 Requirement Understanding.
 Test case Writing & Execution.
 Defect Tracking & reporting.
 Database testing of Interfaces and Batch Process.
 Analysis of test results.
 Conducted functional testing and regression testing.
 Onsite/Offshore Co-ordination.
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6.  Daily/Weekly status calls from the Client/Onsite Coordinators are scheduled on my daily calendar.
 Involved in the process related activities like preparing WSR (Weekly Status Report) which will be
shared to the client.
 Taken the initiation non project related activities like SCM (Software Configuration Management)
and Defect Prevention coordinator, participated in the process audits.
 UAT support.
Environment: Quality Center, Oracle 9i
Team Size : 12
Jun 08 – Jul 10, Programmer St Francis P G College, Hyderabad, India
Stagefreaks (http://www.stagefreaks.nl/) provide online shopping for musical as well as electronics
equipments .Having the facilities for adding banners, adding forums and main functionality that a
customer can add second hand products from frontend.
 Developing custom module for adding products from frontend.
 Adding of Question and Answer module for every product along with email functionality.
 Adding advertising banners.
Roles & Responsibilities:
 Preparation of Test Cases and Test Scenarios.
 Involved in Peer review of Test Scenarios and System Test cases.
 Maintaining Defect/Issues/Observations Tracking sheet.
 Requirement Understanding.
 Test case Writing & Execution.
 Analysis of test results.
 Conducted functional testing and regression testing.
Environment: Windows2000, Java, Quality Center, MS Access2000
Team Size : 4 to 5.
References: Available upon request.
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7.  Daily/Weekly status calls from the Client/Onsite Coordinators are scheduled on my daily calendar.
 Involved in the process related activities like preparing WSR (Weekly Status Report) which will be
shared to the client.
 Taken the initiation non project related activities like SCM (Software Configuration Management)
and Defect Prevention coordinator, participated in the process audits.
 UAT support.
Environment: Quality Center, Oracle 9i
Team Size : 12
Jun 08 – Jul 10, Programmer St Francis P G College, Hyderabad, India
Stagefreaks (http://www.stagefreaks.nl/) provide online shopping for musical as well as electronics
equipments .Having the facilities for adding banners, adding forums and main functionality that a
customer can add second hand products from frontend.
 Developing custom module for adding products from frontend.
 Adding of Question and Answer module for every product along with email functionality.
 Adding advertising banners.
Roles & Responsibilities:
 Preparation of Test Cases and Test Scenarios.
 Involved in Peer review of Test Scenarios and System Test cases.
 Maintaining Defect/Issues/Observations Tracking sheet.
 Requirement Understanding.
 Test case Writing & Execution.
 Analysis of test results.
 Conducted functional testing and regression testing.
Environment: Windows2000, Java, Quality Center, MS Access2000
Team Size : 4 to 5.
References: Available upon request.
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