Nitin Thapa Email & Phone Number

Yonkers, NY

• QNXT Upgrade: The objective of the project was to upgrade Cognizant’s QNXT system, a claims and eligibility system with over 200K patient records that processes around 2M claims annually, to avoid significant upgrade.
• Elicited and documented requirements, and performed comprehensive data analysis, ensuring data consistency and integrity across multiple systems.
• Managed configuration, loading and processing of claims and EDIs (837, 835, 278, 834, 999) ensuring 99% accuracy and alignment of the segments, elements, and values as specified in the companion guide and mapping.
• Developed data mapping and transformation specifications and managed data migration from legacy to EPIC system, including authorizations and referrals, and provider, 278, enrollment and eligibility.
• Developed comprehensive test plans, test cases and scripts for various applications adhering to best practices and rigorous testing methodologies.
• Performed system and regression testing, and managed UAT for claims and interfaces, including EDI claims, NYS Medicaid, paper claims, encounters, claim repricing, claim letters, EOB, remits and enrollment/eligibility.

Charlotte, NC

• The project involved an automated underwriting platform and algorithm, which utilizes electronic data (prescription drug histories, motor vehicle records and responses from the Medical Information Bureau) in.
• Analyzed User Stories and Acceptance Criteria, developing test scopes and plans.
• Executed automated functional and non-functional testing, including regression and stress testing.
• Identified and logged defects into JIRA, expediting resolution.
• Maintained and expanded automated test suite, adhering to best practices.
• Mentorship of new QA team members.

Yonkers, NY

• The project involved care management service model that integrated and coordinated all primary, acute, behavioral health, and long-term services and support to provide higher quality care, while reducing expenditures.
• Gathered and analyzed business requirements for care management projects.
• Managed data migration, including member, eligibility, cases, and care plans.
• Conducted Web Services and API testing through SOAP UI.
• Coordinated with vendors for data transfer and letter generation.
• Ensured data integrity and performed SQL queries for validation.

Bloomfield, CT

• The project involved the solution to the risk involved with 4010 contingencies for Dental ASG (Application Support Group), which mainly involved testing for X12 837 and 835, succeeding upgrade to HIPPA 5010.
• Analyzed and developed Test Plans, Test Cases, and Test Scripts.
• Performed integration, system, and regression testing.
• Validated Dental claims (837) with different providers.
• Executed SQL queries using TOAD and Oracle SQL Developer.
• Maintained bug lists and updated statuses using Quality Center.

Master Of Business Administration - Mba, Business Administration, Management And Operations

Professional Certification, Oracle Database Administration

Bachelor Of Computer Application, Information Technology