Michele Vietti

• Managed Obra B pricing on Medicare claims submitted via internal routing system for claims adjustments using multiple references to determine appropriate pricing.
• Communicated with Office of Personnel Management when appropriate for provider updates and discrepancies.
• Price 3 - 5 daily Multiple Surgery claims with CPT codes not found for claims adjusters.
• Assessed 100 - 150 daily Medical/Dental correspondence received by an outside vendor to be forwarded to the appropriate department.
• Analyze and resolve incoming issues for configuration changes and submit the request for updates.
• Review weekly and bi-weekly claims reports to identify issues that are preventing system adjudication. Collaborate with supervisors and associated team members for appropriate pricing and manual adjudication.

• Handled customer inquiries and processed requests courteously and professionally. Managed approximately 30 incoming calls, email and faxes per day from customers.
• Actively listened to customer, handled concerns quickly and escalated major issues to supervisor.
• Updated account information to maintain customer records.

Operational Audit Tester/Migration Tester

• Apply industry standard principles, theories and concepts involving quality and testing.
• Next level End to End testing in a test environment by evaluating, usability, compatibility, accessibility and performance across multiple platforms and devices.
• Mentored junior QA engineers, fostering a culture of continuous learning and professional growth.
• Tested functional and compatibility of new programs or updates in comparison to existing applications.

Dedicated Project Team Tester Sr. QA Engineer

• Ensured high-quality user experiences by evaluating usability, compatibility, accessibility , and performance across multiple platforms and devices.
• Establish successful working relations with Business and IT developers along with customer conferencing to develop requirements and design strategies for customer specific projects.
• Collaborated with Project Lead and IT Developers to manage and achieve project timelines.
• Authored and detailed project documentation on system architecture including Requirements, Design, Traceability Matrix, Release Notes, and Regression scripts for resource reference.
• Prevented post-release issues by proactively identifying potential risks during the development process.
• Escalate project concerns through the defect project process to be re-evaluated by the development and business teams.
• Developed and maintained defect data base for known issues.
• Tested as many as 10 projects in a Release timeframe of four weeks.

Pricing Tester Sr. QA Engineer

• Evaluated function, performance and design compliance of all new code design standards and customer needs.
• Collaborate closely with developers to identify, reproduce, and resolve software bugs.
• Prevented costly post-release issues by proactively identifying potential risks during the development process by regression testing existing code with new code.
• Managed offshore QA resources effectively in order to ensure seamless workflow integration within the team.

Pharmacy Benefit Analyst

• Developed customer specific benefits designs as required for claims adjudication.
• Work closely with Account Manager, customer contact and IT developer to create benefits designs, manage deadlines, shifting priorities as needed.
• Implemented benefit designs for Medicare Part-D for a specific customer.