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Data Entry Data Processing Project Management Training Visual Basic
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Daljeet S.

@intouchleo

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Sr.IT Quality Analyst (Software Tester)

$35 USD / Hour

Flag of

India (6:25 AM)

Joined on November 22, 2009

$35 USD / Hour

Manual Testing / Facets Benefit Intent Certification (BIC), Facets Configuration & IVR & Routing UAT. Tools & Applications • Facets • Linx • ISET: Integrated Service Experience Toolset • CBS: Common Benefit Summary • IDRS & EDSS • Cyara IVR Automation Tool • Genesys (WWE, GAX) • Avaya • CA-Rally • SP-Tester • Qfiniti Automation Tool Experience: US healthcare Claims Processing (data Entry, Adjustment, Rework and Appeals), Configuration, BIC - Benefit Intent Certification, IVR (Interactive Voice Response) & Routing Testing, Preparing Team reports on Excel, Presentations PPTs. Also, Online Trainings

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Experience

Business Anaylst

Sep, 2013 - Present

12 years, 10 months

United HealthGroup

Sep, 2013 - Present

12 years, 10 months

I am in a part of UAT (User Acceptance Testing) team, I am aligned to multiple projects. 1. Facets - BIC: Here I validate healthcare benefits on facets, Creating high level scenarios and Testing (executing) test case as per the Scenarios. 2. Linx (Puma): Executing Test scripts on PUMA application 3. Facets - HPHC, Duncan: Creating claims for Test Scenarios for EOB, ECK, PRAand PRC

Sep, 2013 - Present

12 years, 10 months

Configuration Analyst

Oct, 2012 - Sep, 2013

11 months

TriZetto India Pvt. Ltd

Oct, 2012 - Sep, 2013

11 months

Department/Process: Configuration Services/Business Rules Configuration (BRC) Role and Responsibility: The job mainly deals with the configuration of Benefit & pricing along with Unit Testing for Medicare, Medicaid and Commercial Plans. This includes client interaction. Worked on below applications of FACETS: Claim Processing: Medical Claim Processing Hospital Claim Processing Medical Plan: Product, Service payment, Service/Procedure Conversion, Service/Revenue Conversion, Supplemental/Procedure conversion, Supplemental/Revenue Conversion, Service Rule Definition, Deductible Rule and Limit Rule. NetworX: NetworX Qualifier groups, ASC maintenance, APC maintenance, Medical agreement Configurator, Source Maintenance, RBRVS Maintenance. Workflow configuration: Routing rules, Qualifier group, Routing reasons Also Worked on Providers, User warning message. Worked on both Frontend and Backend on Facets 4.71. Application Used: Facets 4.71 and SQL.

Oct, 2012 - Sep, 2013

11 months

Subject Matter Expert

Jul, 2007 - Oct, 2012

5 years, 3 months

United HealthGroup

Jul, 2007 - Oct, 2012

5 years, 3 months

Department/Process: Claims processing/Healthcare, UBH facets (P3) Skills used: Knowledge of US Healthcare & Insurance Role: • Data entry, Processing and Auditing high dollar Physician and Inpatient claims • Working on fresh, adjustments and Escalation (appeals) claims • Preparing reports on Exccell

Jul, 2007 - Oct, 2012

5 years, 3 months

Education

Punjab Technical University

2003 - 2006

3 years

BCA

Flag of

India

2003 - 2006

3 years

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