Become a Digital Payer
Test Lead – Healthcare Payer Testing
Location
United States
Posted
2 days ago
Salary
$100K - $120K / year
Seniority
Senior
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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