Test Lead II – Healthcare Payer Testing
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Job Description
Test Lead II leading QA for HealthEdge’s healthcare payer systems. Validating claims, enrollment, benefits, provider data, and EDI transaction flows.
Responsibilities:
- Develop detailed test cases, scenarios, and scripts for claims processing, enrollment, benefits, provider data, and EDI transaction flows
- Lead functional, integration, regression, and UAT cycles for assigned payer modules
- Analyze requirements and business rules to identify gaps, ambiguities, and testability issues before execution
- Own defect lifecycle management, including logging, triage, root cause classification, retesting, and closure tracking
- Validate EDI transactions (834, 837, 835, 270/271, 820) against payer business rules and X12 standards
- Support compliance and regulatory test cycles, including ICD updates, CMS mandates, and state-specific Medicaid rules
- Coordinate with developers, business analysts, and configuration teams to resolve blockers and clarify expected behavior
- Produce daily and weekly execution status reports with defect metrics, coverage status, and risk flags
- Manage offshore QA analysts
- Collaborate closely with the Test Manager and cross-functional delivery teams
Requirements:
- 5+ years in software QA/testing
- 2+ years in a lead or senior tester role
- Solid experience testing U.S. healthcare payer systems, including claims, enrollment, benefits, or provider network
- Working knowledge of EDI X12 transactions and HIPAA compliance requirements
- Hands-on test case design experience using boundary analysis, equivalence partitioning, and negative testing techniques
- Proficiency in defect tracking and test management tools such as JIRA, Zephyr, ALM, or equivalent
- Ability to read and interpret payer business rules, EOPs, benefit plan documents, and SLAs
- Strong attention to detail
- Candidates may be required to undergo a pre-employment criminal background check
Benefits:
- Remote work arrangement
- Working hours aligned to Eastern Standard Time
- Up to 5% travel
- Reasonable accommodations for individuals with disabilities
- Equal opportunity employment
- Workforce diversity and inclusion
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