Role : QA Analyst
Experience : 3 to 6Years
Work Mode : WFO / Hybrid /Remote if applicable
Immediate Joiners Preferred
Responsibilities :
- Develop and execute test plans, test cases, and test scripts for healthcare claims processing systems.
- Perform functional, integration, regression, and end-to-end testing of claims applications.
- Verify the accuracy of claims data, including patient demographics, medical codes (CPT, ICD-10), and payment information.
- Test claims adjudication logic, ensuring compliance with payer rules and regulations.
- Validate electronic data interchange (EDI) transactions related to claims processing (e.g., 837, 835).
- Identify, document, and track software defects using bug tracking systems.
- Collaborate with developers to resolve defects and ensure timely resolution.
- Perform root cause analysis of defects to prevent recurrence.
- Work closely with business analysts, developers, and project managers to ensure quality throughout the software development lifecycle.
- Participate in requirements review and design sessions.
Required Skills And Qualifications
- Bachelor's degree in a related field (e.g., Computer Science, Healthcare Administration).
- Experience : 2 - 8 years of testing exp. 3-4 of relevant experience working in US Healthcare Claims projects
Technical Skill
- Ability to execute SQL queries for data verification fluent in excel formulas & macros
- Proven experience in quality assurance testing, preferably in the healthcare industry.
- Strong understanding of US healthcare payer systems and claims adjudication processes.
- Knowledge of medical coding (CPT, ICD-10) and healthcare terminology.
- Familiarity with EDI transactions (837, 835).
- Experience with test management and bug tracking tools (e.g., Jira, TestRail).
- Excellent analytical and problem-solving skills.
- Strong attention to detail and accuracy.
- Excellent communication and interpersonal skills.
- Preferred : AHIP AHM 250 certification.
(ref:hirist.tech)
