Looking for Facets QA Lead || Kansas City, MO || Fulltime

Hi,

Hope you are doing well.

We do have a position for Facets QA Lead with our client. Please find the details below and if interested please send me your updated word format resume.

Tittle: Facets QA Lead

Location: Kansas City, MO

Duration: Fulltime

Experience : 8-10 Years

Must Have Technical/Functional Skills:

• Strong SME knowledge in Healthcare Claims Processing lifecycle.
• Expertise in EDI formats 837 (P/I/D), 835, 834.
• Hands-on experience in Facets (Claims + Enrolment modules).
• Proficiency in Azure DevOps (ADO) for QA tracking.
• Knowledge of HIPAA compliance and payer systems.
• 8+ years of experience in Healthcare QA/Testing
• 4+ years of experience as Test Lead in Facets projects
• Deep understanding of Claims Adjudication & Payment workflows
• Experience in handling claims denials, adjustments, and reprocessing
• Strong exposure to EDI claim and remittance transactions
• Experience in mocking and validating EDI files (837/835/834)
• Knowledge of ITS claims processing (SF, DF, RF)
• Experience in Member Enrolment workflows (Medicaid, Medicare, ACA)
• Understanding of Billing lifecycle for member enrolment.
• Hands-on experience with ADO Test Plans, Test Suites, and Defect tracking.
• Ability to perform data validation and reconciliation activities.
• Strong experience in functional and end-to-end testing.
• Familiarity with Agile/Scrum methodologies.
• Excellent stakeholder communication and coordination skills.
• Experience in risk identification, defect triage, and RCA.

Roles & Responsibilities:

• Lead end-to-end testing for Claims, Enrolment, and Billing modules.
• Act as SME for Claims Processing and EDI transactions
• Validate Facets Claims and Membership workflows
• Design and execute test strategies, test plans, and test cases
• Perform EDI validation (837, 835, 834) including mock data creation
• Manage defect lifecycle, triage, and resolution tracking in ADO.
• Ensure HIPAA compliance in all testing activities.
• Validate ITS claims processing across SF, DF, RF flows.
• Drive quality metrics, reporting, and release signoffs
• Collaborate with business, development, and partner teams for E2E validation.

Generic Managerial Skills If any

• Leading and Mentoring team members
• Strong problem-solving and critical thinking
• Ability to work with minimal supervision
• Documentation and knowledge sharing
• Excellent communication

Bhakti Chaudhari