Heera Shelly Email & Phone Number

Raleigh-Durham, North Carolina Area

Sr.Business Analyst serving the Digital Operations Department.

Cary

Collaborate with diverse teams across the organization and responsible for developing business requirements, SLA needs, user remediation plans, expected outcomes, performances needs, implementation/test plans and for working closely with the Solution Designers to review technical requirements to ensure the overall functionality can be delivered. Work as.

• Tested the positive and negative scenarios for all the claim edits related to recipient, provider, diagnosis codes and other third party insurances.
• Validity testing of the NCtracks provider and Operations portal for the online submission and inquiry of claims.
• Tested the pricing of claims as per pricing manual and applied rules and also tested the co pay, patient monthly liability and deductible balance if applicable.
• Created, submitted and tested the 4010 transactions via x12… Show more
• Created, submitted and tested the 4010 transactions via x12 tool and also obtained the 276/277 and 997 responses as per test criteria.
• Responsible for retrieving all claims and claim details from the database thru SQL queries and proving the status of claims for claim type or claim status.

Raleigh-Durham, North Carolina Area

• Participated in requirements analysis and reviews and given feed backs.
• Prepared the alpha test plan with the corresponding testing strategy, test specifications and schedule estimates.
• Write positive, negative and regression test cases for the tools and the video portal involved in the project.
• Provide BAT’s for the tool as well as the video portal and checking the basis tests whenever new builds are ready.