Edifecs QA Analyst | USA Remote

Analyze HIPAA implementation guides and payer companion guides to develop comprehensive test scenarios.

Create, maintain, and execute EDI test files covering positive, negative, and edge-case scenarios.

Validate healthcare claims using Edifecs against HIPAA standards, SNIP levels, and payer-specific rules.

Test EDI acknowledgments and responses to ensure accurate error reporting.

Perform end-to-end claims testing, from EDI intake through claims processing and adjudication.

Use SQL to validate claim data, mappings, and downstream processing results.

Hands-on experience with Edifecs for healthcare EDI claims validation.

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Strong understanding of HIPAA EDI transactions and healthcare claims processing.

Experience creating, reading, and modifying EDI test files.

Knowledge of HIPAA SNIP validation levels and payer companion guides.

Proficiency in SQL for backend data validation.

Understanding of claims submission, adjudication, payment, and claim status workflows.