Automation Test Engineer – US Healthcare

Location: Hyderabad / Pune / Bangalore / Chennai

Work Mode: Hybrid

Employment Type: Full-time

Experience Required: 6+ Years

Domain: US Healthcare – Payer / Claims / Encounters

Primary Focus: Test Automation, API Testing, Database Testing & Healthcare EDI Validation

About the Hiring Organization

We are hiring on behalf of an established technology and digital transformation organization delivering enterprise-grade software, cloud, data, and managed technology solutions to global clients.

The organization supports complex, business-critical applications and works with advanced technologies across enterprise platforms, healthcare systems, digital engineering, and managed technology services.

This is an opportunity to work on high-impact US Healthcare payer applications, with exposure to automation testing, healthcare claims and encounter transactions, EDI validation, APIs, databases, and enterprise-scale quality engineering.

Please Note: This recruitment is being managed confidentially on behalf of our client. The organization’s identity will be shared with shortlisted candidates during the recruitment process.About the Role

We are seeking an experienced and detail-oriented Automation Test Engineer – US Healthcare with strong expertise in test automation, API testing, database testing, healthcare payer workflows, and EDI transaction validation.

The ideal candidate will have at least 6 years of experience in software testing and quality assurance, including hands-on experience with at least one automation framework such as Tosca, Playwright, or Selenium.

The role requires strong knowledge of US Healthcare payer systems, healthcare claims and encounter processing, CMS encounter submission requirements, and healthcare EDI transactions. The candidate should be comfortable validating complex EDI transaction structures, including 837P, 837I, 837D, 277CA, 999, and TA1.

The selected candidate will work closely with business analysts, developers, integration teams, product teams, and quality engineering stakeholders to ensure the accuracy, reliability, compliance, and quality of healthcare applications and data exchanges.

Key Responsibilities1. Test Automation

- Design, develop, execute, and maintain automated test scripts for web-based and enterprise healthcare applications.
- Work with at least one automation framework, including:
- Tosca
- Playwright
- Selenium
- Develop reusable, scalable, and maintainable automation test components.
- Identify suitable test cases for automation based on business criticality, frequency, complexity, and regression requirements.
- Maintain and enhance existing automation suites.
- Execute automated regression testing and analyze test results.
- Troubleshoot automation failures and work with development teams to resolve application defects.
- Support continuous improvement of automation coverage and testing efficiency.

2. Functional & Healthcare Application Testing

- Understand and validate healthcare payer business workflows.
- Perform functional, integration, regression, system, and end-to-end testing.
- Review business requirements, user stories, functional specifications, and acceptance criteria.
- Prepare detailed test scenarios, test cases, test data, and validation checklists.
- Validate healthcare claims, encounters, member eligibility, and related payer processes.
- Identify functional gaps and ensure defects are documented and tracked through closure.
- Participate in test planning, test execution, defect triage, and release validation.

3. API Testing

- Perform functional and integration testing for REST and SOAP APIs.
- Validate API requests, responses, headers, authentication, payload structures, and error handling.
- Verify data flow between healthcare applications and integrated systems.
- Test positive, negative, boundary, and exception scenarios.
- Validate API responses against business rules and expected healthcare transaction outcomes.
- Identify and document API defects and integration issues.
- Collaborate with development and integration teams to troubleshoot failures.

4. Database & SQL Testing

- Perform database testing to validate healthcare claims, encounter, member, provider, and eligibility data.




- Write and execute SQL queries for backend data validation.
- Validate data across:
- Claim headers
- Claim detail or service-line records
- Member eligibility information
- Provider-related data
- Encounter transaction data
- Perform source-to-target data validation and reconciliation.
- Identify data inconsistencies, missing records, duplicate records, and incorrect transformations.
- Support defect analysis through backend data investigation.

5. Healthcare EDI Transaction Testing

- Validate healthcare EDI transactions and transaction structures.
- Review transaction loops, segments, elements, and business rules.
- Perform testing and validation for:
- 837P – Professional Claims
- 837I – Institutional Claims
- 837D – Dental Claims
- 277CA – Claim Acknowledgement
- 999 – Implementation Acknowledgement
- TA1 – Interchange Acknowledgement
- Validate transaction acceptance, rejection, and error conditions.
- Verify EDI transaction compliance with applicable implementation guides and business rules.
- Analyze EDI validation errors and coordinate with technical and business teams for resolution.
- Support end-to-end testing of healthcare claim and encounter data exchanges.

6. Encounter Submission & Acceptance Validation

- Validate healthcare encounter submission and acceptance workflows.
- Test encounter processing rules across programs such as:
- Medicaid
- Medicare Advantage
- TRICARE
- Health Insurance Marketplace
- Validate encounter acceptance, rejection, and error scenarios.
- Review encounter submission outcomes and identify data or business-rule issues.
- Validate compliance with CMS encounter submission requirements.
- Support testing based on state-specific companion guides and payer-specific requirements.
- Collaborate with business and technical teams to resolve encounter processing issues.

7. EDI Validation Tools

- Use Edifecs or equivalent healthcare EDI validation tools.
- Validate EDI transaction structures, syntax, business rules, and compliance requirements.
- Analyze validation reports and identify transaction-level errors.
- Support EDI testing, defect investigation, and remediation validation.
- Work with integration teams to resolve EDI data and transaction issues.

8. Defect Management & Quality Assurance

- Identify, document, prioritize, and track defects through resolution.
- Provide transparent defect details, including test evidence, expected results, actual results, and business impact.
- Participate in defect triage meetings.
- Retest resolved defects and perform regression testing.
- Support root-cause analysis for recurring or high-impact quality issues.
- Ensure defects are closed only after appropriate validation.

9. Collaboration & Reporting

- Work closely with developers, business analysts, product owners, integration teams, and healthcare domain experts.
- Participate in Agile ceremonies, sprint planning, backlog refinement, and test reviews.
- Communicate testing progress, risks, defects, and quality concerns to stakeholders.
- Prepare test execution reports, defect metrics, and quality status updates.
- Provide recommendations to improve test coverage, automation maturity, and product quality.

Required Qualifications

- Minimum 6 years of experience in software testing, quality assurance, or test automation.
- Hands-on experience with at least one automation framework:
- Tosca
- Playwright
- Selenium
- Strong experience in API testing.
- Strong experience in database testing and SQL validation.
- Mandatory experience in the US Healthcare payer domain.
- Strong knowledge of healthcare claims and encounter workflows.
- Hands-on knowledge of:
- 837P – Professional Claims
- 837I – Institutional Claims
- 837D – Dental Claims
- 277CA – Claim Acknowledgement
- 999 and TA1 validation
- Knowledge of EDI transaction structures, loops, segments, and validation rules.
- Experience with Edifecs or equivalent EDI validation tools.




- Experience validating encounter submissions and acceptance rules.
- Knowledge of CMS encounter submission requirements.
- Familiarity with Medicaid, Medicare Advantage, TRICARE, Marketplace, and state-specific companion guides.
- Strong analytical, troubleshooting, and problem-solving skills.
- Good written and verbal communication skills.
- Ability to work effectively in a hybrid and collaborative environment.

Must-Have Skills

- 6+ Years of Software Testing or Test Automation Experience
- US Healthcare Payer Domain Experience
- Tosca, Playwright, or Selenium – At Least One Automation Framework
- Automation Test Script Development and Maintenance
- API Testing
- Database Testing
- SQL Query Writing and Healthcare Data Validation
- Healthcare Claims and Encounter Testing
- 837P, 837I, and 837D EDI Transaction Knowledge
- 277CA, 999, and TA1 Validation
- Healthcare EDI Transaction Structure, Loops, and Segments
- CMS Encounter Submission Rules
- Medicaid, Medicare Advantage, TRICARE, or Marketplace Encounter Processing
- Edifecs or Equivalent EDI Validation Tool

Valuable-to-Have Skills

- Experience with multiple automation frameworks.
- Experience with both REST and SOAP API testing.
- Test automation framework design or enhancement experience.
- CI/CD pipeline integration for automated testing.
- Experience with Agile, Scrum, or DevOps environments.
- Knowledge of healthcare provider and member eligibility workflows.
- Experience with state-specific healthcare companion guides.
- Experience with healthcare data integration and ETL testing.
- Performance or load testing experience.
- Experience with test management and defect tracking tools.
- Knowledge of cloud-based healthcare applications.

Preferred Candidate Profile

- 6+ years of experience in software testing and quality assurance.
- Strong hands-on experience in automation testing using Tosca, Playwright, or Selenium.
- Mandatory experience in the US Healthcare payer domain.
- Strong understanding of healthcare claims and encounter processing.
- Experience validating 837P, 837I, 837D, 277CA, 999, and TA1 transactions.
- Experience using Edifecs or an equivalent EDI validation platform.
- Strong SQL skills for validating claim headers, claim details, member eligibility, and encounter data.
- Experience testing APIs and integrated healthcare applications.
- Strong analytical skills and attention to detail.
- Comfortable working with cross-functional technical and business teams.
- Able to work in a hybrid model from Hyderabad, Pune, Bangalore, or Chennai.

Why Join?

- Work on enterprise-scale US Healthcare payer applications.
- Gain deep exposure to healthcare claims, encounters, EDI transactions, and CMS requirements.
- Build expertise in automation testing, API validation, database testing, and healthcare data quality.
- Collaborate with experienced product, engineering, integration, and healthcare domain teams.
- Work in a technology-driven setting focused on quality, reliability, and continuous improvement.
- Access long-term learning and career-growth opportunities in healthcare technology and quality engineering.

Application Instructions

Please complete all mandatory pre-application questions carefully. Applications with incomplete responses may not be considered.

Only shortlisted candidates will be contacted for the next stage of the recruitment process.

Required Skills6+ Years of Software Testing or Test Automation Experience US Healthcare Payer Domain Experience ToscaPlaywrightor Selenium – At Least One Automation Framework Automation Test Script Development and Maintenance API Testing Database Testing SQL Query Writing and Healthcare Data Validation Healthcare Claims and Encounter Testing 837P837Iand 837D EDI Transaction Knowledge 277CA999and TA1 Validation Healthcare EDI Transaction StructureLoopsand Segments CMS Encounter Submission Rules MedicaidMedicare AdvantageTRICAREor Marketplace Encounter Processing Edifecs or Equivalent EDI Validation ToolToscaSeleniumAPI TestingDatabase TestingSQL Query WritingHealthcare Claims and Encounter TestingEDI Transaction KnowledgeCMS Encounter Submission RulesMedicaid, Medicare Advantage, TRICAREMarketplace Encounter ProcessingEdifecs or Equivalent EDI Validation Tool

Pay: ₹800,000.00 - ₹1,400,000.00 per year

Work Location: In person

📌 Automation Test Engineer – US Healthcare (India)
🏢 Knowledge Artisans Private
📍 India