QA Analyst - Health Care

Edifecs QA Analyst

Location: USA – Remote
Experience: 4–6 Years

Job Description

Seeking an experienced Edifecs QA Analyst to test healthcare claims transactions, validate HIPAA EDI files, and ensure accurate end-to-end claims processing.

Key Responsibilities

• Create and execute EDI test cases for positive, negative, and edge-case scenarios.
• Validate HIPAA claims transactions and acknowledgments using Edifecs.
• Perform end-to-end claims testing, including data mapping and adjudication.
• Use SQL to validate claim data in backend databases.
• Identify, report, and track defects to closure.
• Maintain regression test cases and test data.

Key Requirements

• Hands-on experience with Edifecs and HIPAA EDI claims testing.
• Strong knowledge of EDI file creation, modification, and validation.
• Understanding of healthcare claims lifecycle and payer companion guides.
• Experience with SQL and claims data validation.
• Knowledge of medical code sets, trading partner onboarding, and clearinghouse testing.
• Test automation or scripting experience is a plus.
• Strong communication and problem-solving skills.