Sudhakar K

About Sudhakar K

Around 9 years of professional experience in Testing and out of 7+ years experience on US Healthcare Insurance in Testing and implementation of projects, user interaction and systems gap analysis. Hands on experience with Claims/Encounter, X12 mappings like 837 claim, 270/271, 834, ICD10, NCPDP & 835 in 4010 and 5010 formats using Specbuilder HIPAA Validator. Strong experience in Health, Banking, Financial, Transportation, and Hospital domains. Analysis of complex Health Information technology, Medicaid Management Information System databases, reports and system processes. Proficient in healthcare EDI systems and electronic claim transaction technology. Tested new developments of X12 837 claim & 835 and ensured timely and quality delivery of Financial Cycle product releases. Supported the implementation of Statewide Medicaid Management Information System, Web Portal and integration of 38 sub-systems. Played a major role in integration team for TN MMIS claims processing system from legacy to HIPAA compliant system by researching, designing, modifying system components, identifying the required steps and recommended solutions for them to comply with HIPAA rules. The tool used was Specbuilder HIPAA Validator, which produces functional acknowledgement 997. Co-ordinate with RRI team to submit paper claims. Used extensively SQL to perform backend testing, Data integrity and Data mapping. Able to apply technical and functional expertise to organize and implement Black-box and White-box test efforts to analyze requirements for software design, development, and validation. Expertise in developing Test Plans, Test Case Design and Test Scripts based on User Requirements Specification (URS) and System Requirements documents. Actively participated in BSD and TKD meetings to make sure Client Expectations. Preparing gap analysis & Issues documents,scheduling meeting with BA’s, SE’s and Business users. • Expertise in Testing Web Services using SOAP UI. Specialties: Specialties Hands on experience with HC tools like SpecBuilder, Edifices, Test Management tool, Ramp Manager, EDIPAL, Test Transaction Generator and PES tools o Actively worked on Claims/Encounters-Non Claims EDI transactions like 837,834,820,270,271 & NCPDP files. o 4010 and 5010 transactions. o Claims & Non-Claim mappings. o Step-UP_Step-Down_Maps. o State wide Severity files understanding. o Paper & Web Claims. o Report & Letter Generator. o Database Testing

Experience

1. Functional Consultant

   Natsoft

   Jan 2013 — Present · Nashville, TN

   Understand and analyze Business, Functional, and Technical and UI requirements of the project Release. • Providing Test Estimates for the types of testing carried out. • Provide Test Strategy and Test Approach document for releases presenting it to the stake holders for review and keeps updating the documents as and when changes are required. • Working with Application, Technical Architects, Business Analyst and other project stake holders to estimate, plan and execute Application Test. And also responsible for support and co-ordinate during UAT (User Acceptance Test). • SoapUI Testing

Education

• St Joseph high school

  10 th class, High School/Secondary Diplomas and Certificates

  1989 — 1991

• Nagpur University

  MCA, Computers

  1997 — 2000