- Remote, United States
- Remote
- Full-time · Senior
- $96K–$110K per year
- 8+ years
Senior Healthcare QA Engineer – Payer/ Claims
Compensation
The annual salary for this position is between $96,000 to $110,000 depending on experience and other qualifications of the successful candidate.
Responsibilities
- Analyze healthcare claims requirements, user stories, and business rules to develop comprehensive test scenarios and test cases.
- Execute functional, regression, integration, and end-to-end testing across healthcare payer claims-processing workflows.
- Validate the claims lifecycle, including pre-adjudication logic, business validations, claim edits, rejects, pend scenarios, and downstream claim outcomes.
- Perform EDI/X12 transaction testing with a strong focus on 837 Professional (837P) and 837 Institutional (837I) transactions and related healthcare claims interfaces.
- Perform SQL and database validation, data analysis, reconciliation, and test-data preparation to support test execution.
Requirements
- Bachelor’s degree in computer science, Information Technology, Engineering, or a related field.
- Nice to have: PEGA-based healthcare solutions
- Nice to have: AI-powered testing tools or GenAI capabilities