Quality and Compliance Specialist Quality Assurance Analyst
Resume:
WILHELMINA A. MEHTALA
QUINCY, MA 02169
**********.*******@***.***
SUMMARY
Over 10+ Quality and Compliance Specialist and Medical Staff Committees Executive Administrator experience for Medical-Dental Staff Affairs
Excellent analytical, communication and interpersonal skills; multi-tasker, self-starter, team player
Exceptional technical knowledge, problem-solving and troubleshooting skills
Proficient documentation skills, spreadsheets, generating reports and statistics
Certified Medical Billing and Coding Specialist (CBCS) and Certified Medical Administrative Assistant (CMAA)
Over 15+ years of diversified experience in Software Quality Assurance Engineer, Quality Control, Business and Systems Analysts, Data Analysts, Technical & Production Support, Architecture & Enterprise, Software & System upgrades in development and applications
SKILLS
MSOW, Verisys, OIG, New Innovations, MS-Visio, MS Office Suite (Word, Excel, PowerPoint, Outlook), MS Project, MediTech, Medisoft, ICD-9 ( International Classification of Diseases, Ninth Edition), CPT (Current Procedural Terminology), HCPCS (Healthcare Common Procedure Coding Systems)
EDUCATION
Bachelor of Science Degree in Computer Science Engineering, Northeastern University, Boston
Certified Billing and Coding Specialist, Quincy College, MA
Certified Administrative Assistant, Quincy College, MA
EXPERIENCE
Boston Medical Center Health System, Boston, MA
Quality & Compliance Specialist/MDS Committees Executive Administrative April 2014 – Present
Responsibilities
Under the direction of the Director of the Medical Staff Office, and in accordance with Joint Commission and Regulatory standards, oversees and ensures compliance with all aspects of credentialing, privileging and internal policies related to the hospital’s Medical & Dental Staff.
Responsible for all the expirable tracking for all credentialed clinician for BMC & Health Centers.
Responsible for the Professional Practice Evaluation (FPPE & OPPE) for all active BMC clinicians & health centers. Assigns and reviews PPEs including all the follow-ups necessary for any competency issues.
Responsible for all OIG and DMF ongoing compliance requirements. Work with Compliance and Privacy team for any issues with clinicians compliancy.
Responsible for processing and reviewing background checks for incoming providers.
Responsible for MSOW and New Innovations data accuracy.
Responsible for all hospitals and health centers on-demand requests for expirable tracking, misc reports, and data analysis.
Support and work with BMC Clinical Training Center for issues and updates.
Responsible for all software and vendor subscriptions, including any updates & patch work for Medical Staff Affairs.
Support Credentialing and Provider Enrollment teams to correct inaccuracies or complete missing action.
Responsible for creating 340B Compliance report and all follow-up issues with providers.
Responsible for all accounting and finance tasks for the MDS & MDSCC committees, including Medical Staff Affairs vendor & software invoices.
Coordinates and facilitates hospital committees:
Medical and Dental Staff (MDS) Committee
Medical and Dental Clinicians Council (MDSCC) Committee
Professional Practice Evaluation Advisory Committee.
Support Medical Executive Committee and Credentialing Committee.
Amica Mutual Insurance Company, Lincoln, RI
Sr. QA Analyst March 2013 – August 2013
Responsibilities
Worked on web based Guidewire Policy center application. This included Quotes, Changing customer profile, Modifying the User details, Policy Info, Person Info, Losses and Violations, Coverage’s and Risk Analysis customization, and End-to-End testing.
Involved in GUI testing, System testing, Integration testing, Data testing, Regression Testing, Preparation of Test Strategy and Test Plan documents, Business process Flow analysis and Test Case design using Quality Center.
Wrote, maintained, executed and logged test results for more than 900 test cases.
Created underwriting data for Policy Center to process applicants for eligible coverage and premium rate using basic requirements from the Business Process Flow documents. Some test cases were created using black box testing.
Used IBM Rational Clear Quest and Quality Center for Bug tracking.
Boston Financial Data Services, Quincy, MA Sr. QA Analyst October 2011 – May 2012
Responsibilities
Developed and executed test plans and materials for web based new products being developed to service the need for robust Financial Intermediary Administration data in an Omnibus processing model.
Wrote SQL queries to validate data in the database.
Tasks include development of a defect tracking system and process, SharePoint development, and developing a repeatable, reliable testing model for the new emerging software.
South Shore Hospital, Weymouth, MA August 2010 – October 2011
Responsibilities
Outpatient Coding: Working on multiple tasks including reporting analysis for the outpatient medical billing and coding using MediTech, Emergency Department (ED) patient records, and auditing for captured and lost billing and coding statistics.
Prepare and sort patient chart records from ED for coding or further research.
Analyze ambulatory dispatch and hospital list to resolve discrepancies in charges and coding.
Training in outpatient and ED medical coding using ICD-9, CPT and HCPS.
Assist the HIM Director in daily duties and special projects.
Verify and analyze patient records are complete and accurate in accordance to the Joint Commission on Accreditation of Healthcare Organization (JCAHO), and hospital bylaws.
Compile and provide data and reports based on the verified and analyzed patient's medical records.
Fidelity Investment: Institutional Product Group Technology Boston, MA
Software Quality Assurance Engineer February 2009 – December 2009
Responsibilities
Worked with Enterprise Infrastructure: System Capacity & Characterization (Capacity & Storage Management); Systems-Operations Engineering (Application Infrastructure/Mainframe Service Delivery).
Managed high profile cross company project for QA, Test & Systems Management group to do extensive analysis & testing’s for XRC (eXtended Remote Copy) conversion to be used as standard the Disaster recovery for IPGT.
Involved in all Disaster Recovery testing’s, executions and developer support. Automated Policy & Procedures to simplify and improve support both for Disaster Recovery team and developers/Sub-System owners.
Responsible in performing extensive analysis to search for hardcoded fields from the system applications
Investors Bank and Trust (State Street Bank, Copley Plaza) Boston, MA
Software Quality Assurance Engineering December 2008 – February 2009
Responsibilities
Reviewed business requirements, IT technical documents and prepared test plans
Developed Test Plans, Test Cases, Test Scripts, Test Scenarios, Test Data
Executed Test Scenarios and Test Strategies using Mercury Quality Center QA Tool where defects are opened, inked and assigned to developers
Planned and managed testing strategies through all phases of the software development, test and revision cycles Mercury Test Director
Charles River Analytics, Inc Cambridge, MA
Software Quality Assurance Engineering September 2008 – October 2008
Responsibilities
Performed QA testing and evaluation on a high-visibility Human Behavior Reasoning tool. PC-based application (Java,C, C++)
Performed positive/negative/system/functional and end-to-end testing’s to ensure that applications meets all requirements and specifications.
Initial testing is based on the Training Tutorial & User Guide manuals.
Rewrite & reformat Training Tutorial manual to be users friendly for its final distribution
Used Jira to log and create problem tickets by components to correct problems; Responsible for retesting all resolved issues.
Worked closely with software developers and installers with all issues and resolutions
State Street Bank, Milton, MA
Quality Assurance Analysts March 2008 – September 2008
Responsibilities
Worked for Global Securities Movement and Control/Custody Systems conversion for Investor Bank & Trust gap analysis.
All QA testing’s were executed in a QA/Mainframe/CICS/DB2/Datacom and miscellaneous distributed applications regions.
Wrote SQL queries to validate data in the database.
Worked on Global Corporate Actions, ICASH, IBT (Investors Bank & Trust Co), WMS (Wealth Manager Services), TLM (Transaction Lifecycle Management), Swift MT300 client reporting real-time messaging, DLO (Directed Lending Operations) & 3rd party lending.
Also worked on SMAC (domestic) on corporate actions as-of positions for integrations.
Develop Test Plan, Test Estimates, %weekly, %complete and Test Cases matrices to define scope of testing based upon the requirements from FSD & BSD.
Performed positive/negative/system/functional & end-to-end testing’s to ensure applications meets all requirements and specifications.
Logged bugs in cycles based upon build schedule and migration of code from QA through Production regions.
Worked with developers & other Software Quality Assurance teammates to get bugs submitted, tracked, fixed, retested and verified. Review defects with development team and rebuild test cases matrices based on retest fixes.
Certify Software Quality Assurance criteria are met for signoff.
Responsible in mentoring Junior QA experience personnel’s.
Reviewing and correcting (if necessary) their work to be 100+% accurate for Software Quality Assurance execution.
Fidelity Investments, Merrimack, NH & Boston, MA
Quality Assurance; Business & Systems Technical October 2006 - January 2008
Global Platform Technology Group (GPTG), Merrimack, NH
Responsibilities
Responsible for performing Scalability and Performance testing with Payroll application developers.
Monitored performance and analyzed results by using Strobe and supported by Performance & Storage technical staff.
Improved performance: Analyzed Batch Payroll Cycles (VOYAGER) and make all necessary improvement and upgrades to make procedures run faster, efficiently and cut cost.
Worked with FTG (Fidelity Technology Group) to be a liaison between Applications and technical operations group to coordinate necessary upgrades.
Fidelity Brokerage Company Technology, Boston, MA
Responsibilities
PAS (Portfolio Advisory Services) Technology
Worked with technical and business staff to create, interpret, and implement business requirements into technical specifications.
Conducted variance management by analyzing and verifying test results, providing status and progress reports.
Identified, analyzed and developed extracts to create historical conversion files and all other data files needed to create the initial Performance Reporting flow.
Responsible for Data mining to satisfy all the test requirements. Built all the data needed to load the production and SIT/Alpha environment.
Involved in reviewing SDS (System Delivery Specification) and created TSD (Technical System Design) and Test Strategy documents. Coordinated Unit, DIT (Design Integration Testing) and SIT (System Integration Testing) testing’s with the PAS technology.
Fidelity Brokerage Company Technology, Boston, MA
Architecture Strategy and Formulation
SCO (Self-Clearing Outsourcing) Project
Performed various types of testing, such as functional, regression, user acceptance, negative and installation testing
Responsible for conversion of standard CICS programs to use HANDLE CONDITION for Proof-Of-Concept (POC) on FCT exits
Validated conversion processing tools, codes and testing’s to reflect business needs
Analyzed conversion processing requirements versus data available on the legacy systems
Executed POC integration testing for developed test cases.
Assumed responsibilities in documenting POC strategic processing.
FBSI Discovery and Documentation Project: Developed methodology to map FBSI(Fidelity Brokerage Systems Information) into logical applications:
Analyzed existing mainframe applications to understand interrelationships between existing modules, Endevor and Subsys (internal tool).
Developed repeatable and automated procedures for clearly defining sub-components of FBSI mainframe, complete with all resources and artifact for each-subcomponent.
The method also helped synchronized all tools involved.
Developed batch processing for CICS table entries (FCT, PCT/PPT and PLT ) to identify all online elements’ relationships and ownerships to all sub-applications.
Acted as a liaison between applications and systems developers to incorporate required components to facilitate automation processing and Documented all developed automated processing.
Stop and Shop Supermarket Companies, Ahold Information Systems, Braintree, MA
Project Lead/Quality Assurance/Business Systems Analyst; July 1999 – December 2005
Responsibilities
Implement all on-site business requirements for applications upgrades and conversion of current processing of legacy systems for the POS system.
Lead application, software, hardware, platform and system conversions and consolidations.
Managed and supervised project plans with the team and cross-team developers.
Worked on complex systems analysis and programming assignments.
QA Tester responsible for developing, implementing and providing operational support of application programs to support business segment components of the IT business systems plan.
Developed project plan using life cycle methods (ADOM:Sarbanes Oxley) and tools (MS Project).
Assumed responsibilities in overseeing the integrity of the complex/critical business applications on a day-to-day basis.
Assisted in training less experienced Developers in all phases of the standards development methodology, life cycle, and concepts for design, programming and other technical supports
Developed user documentation for user training in a new designed system application to support the business.
Improved and designed business processes within user area by developing and implementing the use of automated systems.
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