Senior Healthcare NASCO-Newark, NJ

Job Title: Senior Healthcare NASCO Claims Domain Specialist – UAT Testing
Location: Newark, NJ (Onsite)
Duration: 12+ Months

Short JD:

Seeking a Senior Healthcare NASCO Claims Domain Specialist with 15–20 years of experience in US Healthcare Insurance and deep expertise in NASCO Claims Processing. The ideal candidate will lead UAT, functional, integration, and regression testing for healthcare claims applications. Must have strong knowledge of claims adjudication, EDI transactions (837/835/270/271), Medicare, Medicaid, CMS, HIPAA, and commercial health plans. Experience with test strategy, defect management, stakeholder collaboration, and leading onsite/offshore QA teams is required. Strong domain expertise in healthcare payer claims and the ability to drive end-to-end claims validation and UAT initiatives are essential.

Required Skills:

• 15–20 years of experience in US Healthcare Insurance
• Strong expertise in NASCO Claims Processing and Claims Adjudication
• Extensive experience with UAT, Functional, Integration, System, and Regression Testing
• Deep understanding of the Healthcare Claims Lifecycle (Professional, Institutional, and Pharmacy Claims)
• Experience validating Claims Adjudication, Pricing/Repricing, Deductibles, MOOP, COB, Subrogation, Authorizations, and Claims Edits
• Strong knowledge of EDI Transactions: 837, 835, 270/271
• Experience with CMS, HIPAA, Medicare, Medicaid, and Commercial Health Plans
• Experience creating Test Strategies, Test Plans, Test Scenarios, Test Cases, and Test Data
• Hands-on experience with Defect Management, Root Cause Analysis, and Release Readiness
• Experience with ALM, JIRA, or other test management tools
• Basic SQL skills for backend data validation
• Strong knowledge of Healthcare Payer Systems and Claims Processing Workflows
• Experience leading UAT planning, business readiness, and coordinating onsite/offshore QA teams
• Excellent stakeholder management, communication, mentoring, and leadership skills