Test Lead II – Healthcare Payer Testing

This is a fully remote position, open to applicants in United States.

📋 Description

• Create comprehensive test cases, scenarios, and scripts for claims processing, enrollment, benefits, provider data, and EDI transaction workflows.

• Oversee functional, integration, regression, and UAT cycles for designated payer modules.

• Evaluate requirements and business rules to pinpoint gaps, ambiguities, and issues related to testability prior to execution.

• Manage the defect lifecycle, which includes logging, triage, root cause analysis, retesting, and tracking closure.

• Validate EDI transactions (834, 837, 835, 270/271, 820) against payer business rules and X12 standards.

• Assist in compliance and regulatory test cycles, encompassing ICD updates, CMS mandates, and state-specific Medicaid regulations.

• Collaborate with developers, business analysts, and configuration teams to address blockers and clarify expected outcomes.

• Generate daily and weekly execution status reports that include defect metrics, coverage status, and risk indicators.

• Supervise offshore QA analysts.

• Work closely with the Test Manager and cross-functional delivery teams.

⛳️ Requirements

• Over 5 years of experience in software QA/testing.

• At least 2 years in a lead or senior tester position.

• Strong background in testing U.S. healthcare payer systems, including claims, enrollment, benefits, or provider networks.

• Familiarity with EDI X12 transactions and HIPAA compliance requirements.

• Practical experience in test case design utilizing boundary analysis, equivalence partitioning, and negative testing methodologies.

• Proficient in defect tracking and test management tools such as JIRA, Zephyr, ALM, or similar applications.

• Capability to read and understand payer business rules, EOPs, benefit plan documents, and SLAs.

• Excellent attention to detail.

• Candidates may need to undergo a pre-employment criminal background check.

🏝️ Benefits

• Option for remote work.

• Work hours aligned with Eastern Standard Time.

• Up to 5% travel required.

• Reasonable accommodations available for individuals with disabilities.

• Commitment to equal opportunity employment.

• Focus on workforce diversity and inclusion.