Custom Software Engineer

Project Role : Custom Software Engineer Project Role Description : Develop custom software solutions to design, code, and enhance components across systems or applications. Use modern frameworks and agile practices to deliver scalable, high-performing solutions tailored to specific business needs. Must have skills : Business Process Analysis Good to have skills : Test Automation Strategy Minimum 3 year(s) of experience is required Educational Qualification : 15 years full time education

Claims/Data Specialist – BA/QA - Healthcare EDI Experience - 5–10+ Years

Summary BA/QA professional bridging business and technology for healthcare claims and EDI integrations — ensuring accuracy, compliance, and data integrity across payer operations.

Responsibilities

• BA - Requirements elicitation, user stories, process mapping, gap analysis, UAT support Agile ceremonies
• Claims - End-to-end lifecycle — Intake, Adjudication, COB, Pricing, Payment, Appeals
• EDI - 837P/I/D, 835, 277, 999, TA1, 270/271, 276/277, 278, 834
• QA/Testing - Functional, Integration, E2E, Data Validation, Regression, UAT
• Data - SQL-based profiling, reconciliation, root cause analysis across claims systems and EDI gateways
• Defects - Log, triage, manage through closure support release readiness and production validation

Required Skills Domain - U.S. Payer ops, Claims adjudication, HIPAA EDI, ICD-10, CPT, HCPCS, DRG Technical - Advanced SQL, EDI parsing, API testing (Postman/SoapUI), JSON/XML, Data mapping Tools - JIRA Azure DevOps, qTest, SQL Server, Snowflake, Databricks, Power BI