Role OverviewWe are seeking a QA Lead with strong domain expertise in healthcare claims processing to lead quality assurance for our claims adjudication and payment platforms.
What You Will Do
Define and drive the QA strategy for the full claims lifecycle, lead functional, regression, integration, and end-to-end testing, and validate adjudication logic.
Why It Might Be a Fit
The ideal candidate will have 8+ years of QA/testing experience, 3+ years of leading teams, and 4+ years of hands-on experience testing healthcare claims systems.
Requirements
- 8+ years in QA/testing, with 3+ years leading teams
- 4+ years of hands-on experience testing healthcare claims systems (payer or TPA environments)
- Strong understanding of claims adjudication workflows, benefit plans, COB, and provider reimbursement methodologies
- Working knowledge of X12 5010 transactions (837, 835, 834, 278, 277) and HIPAA requirements
- Solid grasp of medical coding: ICD-10, CPT, HCPCS, revenue codes, modifiers, and place of service
- Proficiency in SQL for validating claims data and financial outcomes
- Experience with test automation (e.g., Selenium, Cucumber, Postman, Python/Java) and API testing
- Experience with test management and defect tools (JIRA, Azure DevOps, TestRail)
- Excellent communication, analytical, and leadership skills
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