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Claims Tester

Spar Information Systems

Remote • Today

Easy Apply

Contract

MMIS Claims Tester

RyanBPM

Remote • 13d ago

Easy Apply

Contract, Third Party

$40 - $45

Claims Technical Specialist

SANS

Remote • Today

Easy Apply

Contract

Depends on Experience

Technical Claims Specialist

SANS

Hybrid in New York, New York • 15d ago

Easy Apply

Contract

$60 - $80

Claims Examiner - Workers Compensation - W2 Only

Apidel Technologies

Remote • 15d ago

Easy Apply

Contract

52 - 56

Claims Examiner - Workers Compensation W2 Only

Apidel Technologies

Remote • 15d ago

Easy Apply

Contract

48 - 52

Claims Adjuster - General Liability

Apidel Technologies

Remote • 8d ago

Easy Apply

Contract

40 - 44

Automation Tester

Refulgent Technologies Inc.

Hybrid in Raleigh, North Carolina • Today

Easy Apply

Contract, Third Party

Depends on Experience

Healthcare Claims Analyst- ONSITE

Vega Consulting Solutions

Baltimore, Maryland • Yesterday

Easy Apply

Contract

Depends on Experience

Manual Tester with Facets Experience at remote

Khayainfotech

Remote • 5d ago

Easy Apply

Contract

$40 - $50

Epic PB/PB Claims Analyst

The Select Group

Morrisville, North Carolina • Today

Full-time

COB Claims Trainer - Remote

Gainwell Technologies LLC

Remote or Houston, Texas • Today

Full-time

USD 47,000.00 - 67,200.00 per year

COB Claims Trainer - Remote

Gainwell Technologies LLC

Remote or Dallas, Texas • Today

Full-time

USD 47,000.00 - 67,200.00 per year

COB Claims Trainer - Remote

Gainwell Technologies LLC

Remote or Austin, Texas • Today

Full-time

USD 47,000.00 - 67,200.00 per year

Claims AI Business Analyst IV

CareSource

Remote or Dayton, Ohio • Today

Full-time

USD 94,100.00 - 164,800.00 per year

Manual and Automation Tester

Stellar Professionals LLC

Hartford, Connecticut • 2d ago

Easy Apply

Third Party, Contract

Depends on Experience

ETL QA Tester -- P&C Insurance Domain Must

3S Business Corporation Inc.

Cincinnati, Ohio • Yesterday

Easy Apply

Contract, Third Party

Depends on Experience

Functional QA Tester

S Linx LLC

Remote • 2d ago

Easy Apply

Third Party, Contract

50 - 55

Software Tester Salesforce

Diversified Systems, Inc.

Hybrid in Columbus, Ohio • Yesterday

Easy Apply

Contract, Third Party

Depends on Experience

QA Tester Hybrid

Randstad Digital

Edison, New Jersey • Today

Full-time

USD38 - USD45

Automation Tester (Financial Domain/Trading systems)

Citadel Information Services Inc

Hybrid in Charlotte, North Carolina • Today

Easy Apply

Contract

Depends on Experience

Automation Tester

Apex Systems

Charlotte, North Carolina • Today

Easy Apply

Full-time

$45 - $50 per hour

Claims Data Consultant

Deloitte

Arlington, Virginia • Yesterday

Full-time

USD 80,300.00 - 133,900.00 per year

Functional Tester

Smart Folks Inc.

East Hartford, Connecticut • 2d ago

Easy Apply

Contract

Depends on Experience

Junior QA Manual Tester

Ellianse LLC

Remote • 6d ago

Easy Apply

Full-time

30 - 33

Drupal Application Tester

Advance Digital Systems

Washington, District of Columbia • 2d ago

Easy Apply

Contract, Third Party

Depends on Experience

Test Engineer

GovCIO

No location provided • Today

Full-time

USD 85,000.00 - 95,000.00 per year

Automation Tester

Innosoul inc

Hybrid in Raleigh, North Carolina • Yesterday

Easy Apply

Third Party, Contract

Depends on Experience

Manual Tester

Judge Group, Inc.

Greenwood Village, Colorado • Today

Contract

USD 55.00 - 59.00 per hour

QA/Test Engineer (Survivor Portal)

Decisionpoint Corporation

No location provided • Today

Full-time

Job Details

Skills

Healthcare
test cases
MMIS
test data
Claims lifecycle

Summary

Role: Claims Tester

Location: Remote

Duration: 12 Months

Job description:

Responsible for claims testing for MMIS health care projects. Drive the test strategy and process, domain knowledge, perform analysis of business requirements, designs and develops test plans, ensures quality process, coordinates with customers on delivery and deployments. Works in team environment and provides testing guidance throughout the entire life cycle. Responsible to meet customer expectations, troubleshoot problems in the application and assisting customers in implementation decisions.

Candidate should have strong health care domain experience and should have good knowledge of Medicaid and Medicare.
Candidate should have hands-on experience on claims processing and Adjudication processes.
Must have good experience in Reference code/data sets required in Claims adjudication.
Must have prior experience or understanding in configuring benefits or programs in claims system across various sub-systems.
Should be able to run queries and perform basic system analysis, RCA etc.,
Should work closely with the client and development team during the stages of development, and conduct demos at completion of milestone, track and close feedback from such demos
Must have excellent written and spoken communication skills. Should be able to multitask between internal team and clients based on priority tasks
Work Closely with Dev, architecture and Design teams to define the GUI view and platform requirements, which is the foundation of the product.
In depth understanding of Claims and Claims lifecycle:

Member
Provider
Claim submission Paper and EDI X12
Adjudication
Payment Cycle (Finance)
Reporting

Claim Types:

Professional
Dental
Institutional
Pharmacy
Encounters and Capitation

Claim Formats:

EDI X12 formats like 837P/I/D
X12 formats 835, 834, 270/271, 276/277

Claim System:

Familiarity with systems like CMdS, GHS, Facets and etc

Testing knowledge and E2E Testing:

- Validate the entire flow from claim intake to payment and reporting.
- Interface testing - Test integration points between systems
- Design test case based on business rules, coverage policies, and system configurations.
- Familiarity with test management tools like ADO, JIRA,
- Interface/API testing tools like Postman

Technical Skills

SQL: To validate data in backend tables (e.g., claim status, payment details, find members/providers, Benefit Plan).
EDI Tools: Validating X12 files.
Interface Testing: Understanding how data flows between systems and formats and use tools like postman

Preferred skills:

Minimum of 5+ years of experience in health care experience especially in MMIS domain.
Capability to think out-of-the-box to create new solutions as needed.
Ability to validate Test scenarios and test plans, test data.
Should be able to Review requirements, documentation and create Requirements Traceability matrix (RTM)
Should have excellent communication (written and spoken ) skills to engage with different stake holders like QA/dev team, clients, end users of Clients and Business Units.
Ability to assess current functionality available in a product vis a vis market trends, regulatory requirements to be implemented in future version of the product.
Ability to drive and share the requirements with Technical and Architects regarding product features to be implemented.
Test Planning & Reporting: Create test plans, test summary reports, and traceability matrices.
Communication: Collaborate with cross-functional teams including developers, SME's and BA's

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: 90719156
Position Id: 2026-12084
Posted 3 hours ago

Fitment

Dice Job Match Score™

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Similar Jobs

MMIS Claims Tester

Remote

•

13d ago

MMIS Claims Tester Client Minds Print Location: Remote but 25% travel would be required during critical phases Responsibilities Must have very good understanding of the healthcare payer space with a minimum experience of 10 years in the domain. Must have a prior experience in implementing/maintenance of commercial payer claims solution and/or Medicare/Medicaid system Must have good experience with claims processing concepts, along with the provider, member enrolment and care management con

Easy Apply

Contract, Third Party

$40 - $45

Business Analyst — CMdS Claims, Member & Finance Implementation (MES)

Remote

•

2d ago

Business Analyst CMdS Claims, Member & Finance Implementation (MES) Location: Engagement: Experience:12+ years Domain:Medicaid Enterprise Systems (MES) | MMIS modernization | Claims / Member / Finance Role summary Serve as Business Analyst forCMdS product development and implementationon a Medicaid modernization program. Translate legacy MMIS claims, member, and finance behavior and state Medicaid policy into CMdS functional design, requirements, and acceptance criteria. Partner with developme

Easy Apply

Contract, Third Party

Depends on Experience

Healthcare Tester, Remote, $40, Multi year long Project

Remote

•

Today

Job SummaryWe are seeking an experienced Healthcare Tester to join a long-term, multi-year project. The ideal candidate will have strong experience in healthcare applications, software testing, and healthcare industry workflows. The candidate will be responsible for developing and executing test scenarios, identifying defects, validating system functionality, and ensuring applications meet business and regulatory requirements. Key ResponsibilitiesAnalyze business and functional requirements and

Easy Apply

Third Party, Contract

30 - 40

Manual Tester with Facets Experience at remote

Remote

•

5d ago

Role: Manual tester Work location remote Need Mandatory Facets Experience Healthcare EDI 837 Manual Tester with Facets Experience We are looking for an experienced Healthcare EDI Manual Tester / QA Analyst with strong hands-on experience in 837 Professional (837P) and Institutional (837I) claims and TriZetto Facets. Required Skills * 5+ years of experience in Healthcare IT / Claims / EDI testing. * Strong hands-on experience with manual testing of 837P and 837I healthcare claims. * Strong u

Easy Apply

Contract

$40 - $50

Job Details

Skills

Healthcare
test cases
MMIS
test data
Claims lifecycle

Summary

Role: Claims Tester

Location: Remote

Duration: 12 Months

Job description:

Candidate should have strong health care domain experience and should have good knowledge of Medicaid and Medicare.
Candidate should have hands-on experience on claims processing and Adjudication processes.
Must have good experience in Reference code/data sets required in Claims adjudication.
Must have prior experience or understanding in configuring benefits or programs in claims system across various sub-systems.
Should be able to run queries and perform basic system analysis, RCA etc.,
Should work closely with the client and development team during the stages of development, and conduct demos at completion of milestone, track and close feedback from such demos
Must have excellent written and spoken communication skills. Should be able to multitask between internal team and clients based on priority tasks
Work Closely with Dev, architecture and Design teams to define the GUI view and platform requirements, which is the foundation of the product.
In depth understanding of Claims and Claims lifecycle:

Member
Provider
Claim submission Paper and EDI X12
Adjudication
Payment Cycle (Finance)
Reporting

Claim Types:

Professional
Dental
Institutional
Pharmacy
Encounters and Capitation

Claim Formats:

EDI X12 formats like 837P/I/D
X12 formats 835, 834, 270/271, 276/277

Claim System:

Familiarity with systems like CMdS, GHS, Facets and etc

Testing knowledge and E2E Testing:

- Validate the entire flow from claim intake to payment and reporting.
- Interface testing - Test integration points between systems
- Design test case based on business rules, coverage policies, and system configurations.
- Familiarity with test management tools like ADO, JIRA,
- Interface/API testing tools like Postman

Technical Skills

SQL: To validate data in backend tables (e.g., claim status, payment details, find members/providers, Benefit Plan).
EDI Tools: Validating X12 files.
Interface Testing: Understanding how data flows between systems and formats and use tools like postman

Preferred skills:

Minimum of 5+ years of experience in health care experience especially in MMIS domain.
Capability to think out-of-the-box to create new solutions as needed.
Ability to validate Test scenarios and test plans, test data.
Should be able to Review requirements, documentation and create Requirements Traceability matrix (RTM)
Should have excellent communication (written and spoken ) skills to engage with different stake holders like QA/dev team, clients, end users of Clients and Business Units.
Ability to assess current functionality available in a product vis a vis market trends, regulatory requirements to be implemented in future version of the product.
Ability to drive and share the requirements with Technical and Architects regarding product features to be implemented.
Test Planning & Reporting: Create test plans, test summary reports, and traceability matrices.
Communication: Collaborate with cross-functional teams including developers, SME's and BA's

Dice Id: 90719156
Position Id: 2026-12084
Posted 3 hours ago

Fitment

Dice Job Match Score™

🫥 Flibbertigibetting...

Create job alert

Never miss an opportunity! Create an alert based on the job you applied for.

Similar Jobs

MMIS Claims Tester

Remote

•

13d ago

Easy Apply

Contract, Third Party

$40 - $45

Business Analyst — CMdS Claims, Member & Finance Implementation (MES)

Remote

•

2d ago

Easy Apply

Contract, Third Party

Depends on Experience

Healthcare Tester, Remote, $40, Multi year long Project

Remote

•

Today

Easy Apply

Third Party, Contract

30 - 40

Manual Tester with Facets Experience at remote

Remote

•

5d ago

Easy Apply

Contract

$40 - $50