Note: The job is a remote job and is open to candidates in USA. Techgene Solutions is seeking an Edifecs QA Analyst to test healthcare EDI claims transactions across the claims lifecycle. The role develops test scenarios and EDI files, validates claims and acknowledgments using Edifecs, verifies backend data with SQL, and manages defects and regression testing.
Responsibilities
- Analyze HIPAA implementation guides and payer companion guides to develop test scenarios
- Create and maintain EDI test files and regression test cases
- Execute claims files through Edifecs and validate results against SNIP levels and payer-specific rules
- Validate acknowledgments and error responses
- Perform end-to-end testing and verify claim data using SQL
- Report defects, track them to closure, and maintain regression suites and test data
Skills
- Hands-on experience testing HIPAA claims transactions and related acknowledgments
- Ability to read, create, and modify EDI test files manually and using tools
- Strong working experience with Edifecs for validating claims against HIPAA rules and payer companion guides
- Knowledge of the healthcare claims lifecycle, including submission, validation, adjudication, payment, and claim status
- Experience creating positive, negative, and edge-case claim scenarios
- End-to-end claims testing from EDI intake through claims processing
- Knowledge of medical code sets and identifiers
- SQL skills for backend claim data validation
- Experience with trading partner onboarding, clearinghouse integration, or certification testing
- Test automation or scripting for EDI file generation and output comparison
Benefits
- Remote – USA
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