Infinite Computer Solutions (ICS)
Infinite Computer Solutions (ICS)

QA Manager - Healthcare EDI Claims 837, 835

Remote • Posted 4 hours ago • Updated 4 hours ago
Full Time
Remote
Up to $120,000/yr
Fitment

Dice Job Match Score™

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Job Details

Skills

  • QA Manager
  • EDI
  • 837
  • 835
  • Healthcare
  • MMIS
  • JIRA

Summary

Skill Matrix:

Skill

Rating 1-5

Exp

QA Manager

EDI transactions (e.g., 837, 835, 270/271, 276/277)

MMIS ( Medicaid Management information system )

SQL

ALM, JIRA

Job Description:

  • Lead end-to-end testing activities for healthcare projects, including requirement analysis, test planning, test estimation, and risk assessment.
  • Develop test plans and test schedules.
  • Resource must understand how claims work(EDI 837), how claims get priced and paid. How does the member benefit works after the claim submission. How does the claims financial(EDI 835) works after the claims get paid
  • Design, review, and execute test cases, test scripts, and test scenarios for claims processing systems.
  • Ensure full test coverage of claims lifecycle: intake, validation, adjudication, pricing, benefits application, provider contracting, and payment.
  • Validate EDI transactions (e.g., 837, 835, 270/271, 276/277) and ensure compliance with HIPAA standards.
  • Interfaces exchange files validation and operational reports validation.
  • Identify defects, perform root cause analysis, and drive resolution.
  • Work closely with business SMEs to understand payer policies, benefits, provider contracts
  • Validate claim accuracy against benefit rules, pricing and configuration settings.
  • Lead daily defect triage meetings, status reporting, and quality updates.
  • Ensure alignment with compliance, audit, and documentation standards.
  • Coordinate and oversee the work of onshore/offshore QA teams.
  • Experience with healthcare Application such as QNXT or similar.
  • Experience in MMIS

Tools & Technologies preferred

  • Healthcare claims platforms ( QNXT)
  • Test management tools (ALM, JIRA)
  • API/Postman for API testing
  • SQL for backend/data validation
  • Must have lead experience prior with daily/weekly status reporting

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.
  • Dice Id: 10199915
  • Position Id: 8948736
  • Posted 4 hours ago
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