Specialist - Quality Engineering

Role:Functional Tester

5 - 8 years of experience in the US Healthcare Payer domain with strong knowledge of Claims Billing Member Enrollment Eligibility and Provider Management

Handson experience testing Facets modules including Membership Claims Processing Benefits Configuration Provider and Billing functions

Strong expertise in HIPAA EDI transaction testing specifically 834 Enrollment and 837 Professional Institutional Claims including validation of X12 file structures and data mapping

Experience in creating and executing Functional Integration System Regression and EndtoEnd test scenarios and test cases

Good understanding of healthcare claims adjudication benefit validation deductibles copays coinsurance accumulators and payment processing workflows

Proficiency in backend data validation using SQL and experience working with defect tracking and test management tools such as ADO Jira or ALM

Strong analytical communication and stakeholder management skills with experience working in AgileScrumbased healthcare transformation programmes