Description

You will manage quality assurance for healthcare claims processing systems through rigorous testing and validation.

Responsibilities

• Develop and execute test plans, cases, and scripts for claims applications.
• Perform functional, integration, regression, and end-to-end testing.
• Verify accuracy of claims data, including patient demographics, medical codes (CPT, ICD-10), and payment info.
• Validate EDI transactions such as 837 and 835.
• Identify, document, and track defects using bug tracking systems.
• Perform root cause analysis and collaborate with developers to resolve software defects.

Required Skills

• 2-8 years of testing experience, with 3-4 years specifically in US Healthcare Claims projects.
• Strong understanding of US healthcare payer systems and claims adjudication processes.
• Knowledge of medical coding (CPT, ICD-10) and healthcare terminology.
• Ability to execute SQL queries for data verification.
• Proficiency in Excel formulas and macros.
• Familiarity with EDI transactions (837, 835).
• Experience with Jira and TestRail.
• Proven background in Quality Assurance testing.
• Any Graduate degree.

Preferred Skills

• AHIP AHM 250 certification.

Key Skills

Education

Any Graduate