Job Title: US Healthcare Claims Tester (Functional + Automation)
Location: All Ascendion Locations (Pune, Bengaluru, Chennai, Vadodara and Hyderabad)
Experience: 6+ Years
Employment Type: Full-time
Job Summary:
We are seeking a QA Tester with strong experience in US Healthcare Claims processing and a mix of functional and automation testing skills. The ideal candidate should have hands-on experience in validating end-to-end claims lifecycle and ensuring compliance with US healthcare standards.
Key Responsibilities:
- Perform functional testing across the complete claims lifecycle:
- Claims Intake
- Adjudication
- Pricing
- Payment
- Denials & Appeals
- Design and execute test cases, test scenarios, and test plans.
- Develop and maintain automation test scripts using tools like Selenium, Cypress, or Playwright.
- Validate EDI transactions such as:
- 837 (Claims submission)
- 835 (Remittance advice)
- Perform API testing using Postman or Rest Assured.
- Validate business rules for ICD-10, CPT, HCPCS coding.
- Conduct regression, integration, and UAT support testing.
- Log and track defects using Jira.
- Ensure compliance with HIPAA guidelines.
- Collaborate with BA, Dev, and business teams to clarify requirements.
Required Skills:
- Strong experience in US Healthcare Claims domain.
- Deep understanding of:
- Claims adjudication process
- Benefits, eligibility, and provider contracts
- Hands-on experience in functional testing.
- Experience in test automation (Selenium/Cypress/Playwright).
- Knowledge of EDI X12 transactions (837, 835).
- Familiarity with ICD-10, CPT, HCPCS coding systems.
- Experience in API testing and SQL queries.
- Understanding of SDLC & STLC.
- Experience working in Agile/Scrum teams.
Good to Have:
- Experience with CI/CD tools like Jenkins.
- Knowledge of BDD frameworks like Cucumber.
- Exposure to healthcare data standards like HL7 / FHIR.
- Experience with payer systems like Facets, QNXT, or HealthEdge.
Soft Skills:
- Strong analytical and problem-solving skills
- Good communication skills
- Ability to handle multiple priorities
Education:
- Bachelor's degree in Computer Science, IT, or related field
