Note: The job is a remote job and is open to candidates in USA. Ahura Workforce Solutions is recruiting for an unnamed client seeking a hands-on QA Analyst with EDIFECS experience. The role tests and quality-assures the EDI integration layer of a healthcare core administration platform, including trading partner configurations, HIPAA X12 transaction flows, and production issues.
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
Benefits
- 100% remote work
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