Health Rules Payor (HRP)Senior Executive Tester- US Healthcare Claims -Testing - 3 Years- Work From Home

We are looking for a skilled HealthRules Payor Senior Executive Tester to support end-to-end testing of healthcare claims, Cotiviti rule validation, and HRP configurations. This is an excellent opportunity to work with a leading global healthcare organization on large-scale payer platforms while working remotely from anywhere in India.

Location: PAN India (Work From Home)

Experience: 35 Years

Must Have- Cotiviti Tool , HRP , HIPPA Regulations

Your Future Employer- A globally recognized organization delivering innovative healthcare technology and business solutions to leading healthcare payers. The company offers exposure to enterprise healthcare platforms, a collaborative work culture, and excellent opportunities for career growth in the US Healthcare domain.

Responsibilities

1. Execute end-to-end testing for HealthRules Payor (HRP) applications and validate Cotiviti rule implementations.
2. Develop detailed test plans, test scenarios, and test cases based on business and functional requirements.
3. Perform unit, integration, regression, and end-to-end testing for HRP configurations and Cotiviti rule changes.
4. Validate claim processing workflows, including Cotiviti edits such as FRE, UNB, MUE, bundled, and non-covered scenarios.
5. Support quarterly CMS dictionary updates and ensure accurate testing of related HRP configurations.
6. Analyze healthcare claims, contracts, member accounts, and product configurations to identify testing gaps.
7. Collaborate with configurators, business teams, and developers to resolve defects and ensure successful implementation.
8. Maintain testing documentation, defect logs, execution reports, and quality metrics throughout the project lifecycle.

Requirements

1. Graduate in any discipline with 3–5 years of experience in the US Healthcare insurance domain.
2. Minimum 2 years of hands-on experience working with HealthRules Payor (HRP).
3.



At least 1 year of experience working with the Cotiviti Tool and related rule testing.
4. Strong understanding of healthcare claims testing, QA processes, and test execution methodologies.
5. Knowledge of Cotiviti edits including FRE, UNB, MUE, bundled, and non-covered scenarios.
6. Experience supporting Quarterly CMS Dictionary Updates.
7. Good understanding of HIPAA regulations and healthcare compliance requirements.
8. Strong knowledge of CPT, ICD, and HCPCS coding standards.
9. Excellent analytical, problem-solving, and communication skills.
10. Ability to work independently while collaborating effectively with cross-functional teams.

What's in it for you?

- Permanent Work From Home opportunity.
- Exposure to enterprise HealthRules Payor and Cotiviti implementations.
- Opportunity to work on large-scale US Healthcare payer projects.
- Collaborative work environment with robust learning and career growth opportunities.
- Competitive compensation and comprehensive employee benefits.

Reach Us

If you feel this opportunity aligns with your experience, please share your updated resume at [email protected].

Disclaimer

Crescendo Global specializes in Senior to C-level niche recruitment. We are committed to delivering exceptional talent solutions while maintaining the highest standards of professionalism and confidentiality.

Note

Due to the high volume of applications, if you do not hear from us within one week, please consider that your profile has not been shortlisted for the current prospect. We truly appreciate your interest and encourage you to apply for future openings that match your experience.

Profile Keywords

HealthRules Payor, HRP, HealthRules Payor Testing, Cotiviti, US Healthcare, Claims Testing, QA Testing, Test Automation, Test Cases, Test Planning, Regression Testing, Unit Testing, Integration Testing, CMS Dictionary Updates, HIPAA, CPT Codes, ICD Codes, HCPCS, Healthcare Claims, US Health Insurance, Payer Testing, Healthcare QA, CXT Tool, Claims Processing, Manual Testing.

📌 Health Rules Payor Senior Executive Tester -US Healthcare -3Years -WFH (Chennai)
🏢 Crescendo Global Leadership Hiring India
📍 Chennai