Develop and execute test plans, test cases, and test scripts for healthcare applications, with a focus on HL7 interface testing and claims processing modules
Validate HL7 message flows (inbound and outbound) across systems, ensuring accurate parsing, mapping, and acknowledgment handling
Test claims submission, adjudication, remittance, and denial workflows end to end
Identify, document, and track defects through resolution using bug-tracking tools (e.g., Jira, Azure DevOps)
Perform functional, regression, integration, and user acceptance testing
Collaborate with developers, business analysts, and product owners to clarify requirements and acceptance criteria
Validate EDI transaction sets (837, 835, 270/271, 276/277) for accuracy and compliance
Ensure systems comply with HIPAA regulations and healthcare industry standards
Requirements
3+ years of QA/testing experience in a healthcare or health insurance environment
Strong knowledge of HL7 v2.x message types (ADT, ORM, ORU, DFT, etc.) and interface testing
Solid understanding of medical claims lifecycle; enrollment, eligibility, claims submission, adjudication, EOB/remittance
Experience with EDI healthcare transactions (X12 837P/837I, 835, 270/271)
Proficiency with test management and defect tracking tools
Experience with HL7 FHIR or other modern interoperability frameworks
Familiarity with SQL for data validation and backend verification
Knowledge of ICD-10, CPT, HCPCS coding systems
Experience with test automation tools or frameworks
Understanding of HIPAA privacy and security requirements.