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Test Lead – Healthcare Payer Testing

GeneralGeneralFull TimeRemoteSeniorTeam 1,001-5,000Since 2005H1B SponsorCompany SiteLinkedIn

Location

United States

Posted

2 days ago

Salary

$100K - $120K / year

Seniority

Senior

Bachelor Degree5 yrs expEnglish

Job Description

Test Lead – Healthcare Payer Testing

HealthEdge

• Develop detailed test cases, scenarios, and scripts for claims processing, enrollment, benefits, provider data, and EDI transaction flows • Lead functional, integration, regression, and UAT cycles for assigned payer modules • Analyze requirements and business rules — identify gaps, ambiguities, and testability issues before execution begins • Own defect lifecycle management: logging, triage, root cause classification, retest, and closure tracking • Validate EDI transactions (834, 837, 835, 270/271, 820) against payer business rules and X12 standards • Support compliance and regulatory test cycles — ICD updates, CMS mandates, state-specific Medicaid rules • Coordinate with developers, BAs, and configuration teams to resolve blockers and clarify expected behavior • Produce daily/weekly execution status reports with defect metrics, coverage status, and risk flags • Manages offshore QA analysts.

Job Requirements

  • 5+ years in software QA/testing
  • 2+ years in a lead or senior tester role
  • Solid experience testing U.S. healthcare payer systems — claims, enrollment, benefits, or provider network
  • Working knowledge of EDI X12 transactions and HIPAA compliance requirements
  • Hands-on test case design experience using boundary analysis, equivalence partitioning, and negative testing techniques
  • Proficiency in defect tracking and test management tools (JIRA, Zephyr, ALM, or equivalent)
  • Ability to read and interpret payer business rules, EOPs, benefit plan documents, and SLAs
  • Strong attention to detail — payer system defects have financial and compliance consequences.

Benefits

  • HealthEdge is an equal opportunity employer
  • Committed to workforce diversity

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