Healthcare Claims Quality Engineer (QE Lead / Senior QA Engineer)-Hartford, CT (Hybrid)

Job Description

We are seeking experienced Healthcare Claims Quality Engineers with deep expertise in the US Healthcare Payer domain to support Agile product delivery teams. The ideal candidate will possess strong knowledge of healthcare claims processing across Medicare, Medicaid, and Commercial lines of business, combined with hands-on experience in modern test automation, API testing, and AI-assisted quality engineering practices.

Key Responsibilities

• Validate end-to-end healthcare claims workflows against business and functional requirements.
• Perform comprehensive testing across UI, API, database, and business requirements documentation (BRD).
• Design, develop, execute, and maintain test plans, test scenarios, test cases, and automation scripts.
• Ensure quality throughout the claims lifecycle, including claim intake, validation, adjudication, pricing, payment, denials, adjustments, and appeals.
• Collaborate closely with Product Owners, Business Analysts, Developers, and QA teams within Agile delivery environments.
• Manage defects through closure using tools such as JIRA and Zephyr while providing regular status reporting.
• Support test data creation and management activities.
• Contribute to CI/CD-enabled testing practices and continuous quality improvement initiatives.
• Leverage AI-enabled development and testing tools such as GitHub Copilot, Claude, and Cursor AI to improve productivity and testing effectiveness.
• For lead-level candidates, provide test strategy guidance, framework design support, troubleshooting expertise, and mentorship to QA team members.

Required Qualifications

• Strong expertise in US Healthcare Payer Operations with hands-on experience supporting Medicare, Medicaid, and Commercial Claims.
• Deep understanding of claims adjudication processes and end-to-end claims lifecycle management.
• Knowledge of member eligibility, benefits, provider networks, Coordination of Benefits (COB), and reimbursement methodologies.
• Hands-on experience with:
  • UI Testing
  • API Testing
  • Cloud Database Testing
  • BRD and Functional Validation
• Strong experience with Playwright automation framework.
• Proficiency in at least one programming language: JavaScript, TypeScript, or Python.
• Experience working within Agile/Scrum environments.
• Familiarity with CI/CD pipelines and modern QA practices.
• Experience with JIRA, Zephyr, and defect lifecycle management.
• Excellent verbal and written communication skills.
• Knowledge of AI concepts and practical experience using AI-assisted testing and development tools.

Preferred Qualifications

• Experience designing and maintaining automation frameworks using Playwright.
• Prior experience leading QA initiatives or mentoring team members.
• Exposure to cloud-native testing environments and enterprise healthcare applications.
• Strong analytical and problem-solving skills with the ability to work independently and within cross-functional teams.