Note: The job is a remote job and is open to candidates in USA. The hiring company is seeking a hands-on QA Analyst to validate the EDI integration layer of a healthcare core administration platform. The role focuses on designing and executing tests for EDIFECS configurations and HIPAA X12 transaction flows, supporting production troubleshooting, and collaborating with QA, configuration, development, and client teams.
Responsibilities
- Design, develop, and execute comprehensive test plans and test cases for EDIFECS trading partner configurations, transaction maps, and validation rules covering X12 transactions (270/271, 834, 835/837, 275, 276/277)
- Perform functional, regression, integration, and end-to-end testing of EDIFECS configurations and EDI transaction flows across development, UAT, and production-support environments
- Validate inbound and outbound EDI transaction processing — including segment-level and element-level compliance against HIPAA X12 implementation guides and payer companion guides
- Test and certify trading partner onboarding configurations, including acknowledgment flows (999, 997, TA1, 277CA) and connectivity validation (AS2, SFTP)
- Identify, document, and track defects using JIRA or equivalent tools; work closely with the EDIFECS development and configuration team to facilitate timely resolution
- Collaborate with the onsite lead and client stakeholders on requirements clarification and design validation
- Validate SpecBuilder specs, maps, and custom validation/business rules against defined requirements and companion guide standards
- Perform database validation across MongoDB, PostgreSQL, and Oracle to verify EDI transaction data integrity at the persistence layer
- Support production defect triage and troubleshooting — analyzing transaction failures and rejections, identifying root causes, and validating fixes
- Create and maintain QA documentation including test plans, test cases, traceability matrices, and defect reports
- Collaborate with the onsite lead, EDIFECS configuration team, and client stakeholders on requirements clarification, test scope definition, and sign-off
- Participate in configuration and code reviews from a quality and testability perspective
- Support broader platform modernization and regression testing initiatives by providing EDI/EDIFECS QA subject matter expertise
Skills
- Bachelor's degree in Computer Science, Engineering, Health Informatics, or a related field
- 8-10 years of experience in healthcare EDI/integration QA, with strong hands-on experience testing EDIFECS configurations (SpecBuilder, XEngine, Transaction/EDI Gateway)
- Strong working knowledge of core HIPAA X12 EDI transactions: 270/271, 834, 835/837, 275, and 276/277 — including segment and element-level validation
- Demonstrated ability to write detailed test plans, test cases, and traceability matrices for EDI/integration testing
- Experience validating trading partner onboarding flows, acknowledgment handling (999/997/TA1/277CA), and connectivity channels (AS2, SFTP)
- Hands-on experience with defect management and test management tools (JIRA, HP ALM, or equivalent)
- Ability to query and validate data in MongoDB, PostgreSQL, and Oracle databases to verify backend EDI transaction integrity
- Experience with API/EDI testing tools such as Postman, SoapUI, or similar for validating transaction payloads
- Strong analytical and debugging skills for diagnosing EDI transaction failures and rejections in high-volume production environments
- Good written and verbal communication skills for collaborating with onsite leads, developers, and client stakeholders
- Daily, practical use of AI coding/assistant tools to accelerate EDIFECS test case generation, test data creation, and defect analysis
- Able to critically review and validate AI-generated test cases, assertions, and configurations for correctness before execution
- Understanding of secure and compliant AI tool usage, including never entering PHI, member data, or other sensitive information into prompts or external AI tools
- Able to identify where AI-driven automation can improve day-to-day EDI testing, regression coverage, or defect triage efficiency
- Experience with health plan/payer core administration systems (e.g., Facets, QNXT, HealthRules) from a QA/testing perspective
- Familiarity with CAQH CORE operating rules and their testing implications
- Exposure to automated testing frameworks applicable to EDI/integration testing pipelines
- Experience with mainframe or cloud-based integration patterns supporting EDI processing
- Relevant certifications: EDIFECS product certifications, ISTQB, or equivalent QA certifications
Company Overview