Project Role : Quality Engineering Lead
Project Role Description : Leads a team of quality engineers through multi-disciplinary team planning and ecosystem integration to accelerate delivery and drive quality across the application lifecycle. Applies business and functional knowledge to develop end-to-end testing strategies through the use of quality processes and methodologies. Applies testing methodologies, principles and processes to define and implement key metrics to manage and assess the testing process including test execution and defect resolution.
Must have skills : Electronic Data Interchange (EDI)
Valuable to have skills : Functional Test Planning, HealthEdge
Minimum 5 year(s) of experience is required
Educational Qualification : 15 years full time education

Summary:
Seeking an experienced Healthcare Claims Functional Tester with strong expertise in healthcare payer operations, medical claims processing, and EDI transactions. The ideal candidate should have hands-on experience creating, editing, validating, and troubleshooting 837 EDI claim files (Institutional, Professional, and Dental), executing end-to-end claims testing, and validating claim adjudication outcomes within a healthcare payer platform, preferably HealthEdge.

Roles & Responsibilities:

- 5+ years of experience in Healthcare Payer Claims Testing.
- Strong understanding of the healthcare claims lifecycle,



including claim intake, validation, pricing, adjudication, accumulators, benefits, and payment processing.
- Hands-on experience with 837 EDI transactions, including creation, modification, and validation of claim files.
- Experience testing claims in healthcare payer platforms, preferably HealthEdge.
- Knowledge of healthcare standards such as HIPAA, ICD, CPT, HCPCS, and X12 EDI transactions.
- Ability to create test scenarios, execute functional testing, analyze defects, and validate claim adjudication results.
- Experience working with eligibility, provider, benefits, and claims modules is preferred.

Qualified & Technical Skills:

- Must To Have Skills: Proficiency in Electronic Data Interchange (EDI).
- Good To Have Skills: Experience with HealthEdge.
- Strong understanding of software development life cycle and agile methodologies.
- Experience in designing and implementing scalable software architectures.
- Ability to troubleshoot and resolve complex technical issues efficiently.
- Familiarity with integration techniques and data exchange protocols.

Additional Information:

- The candidate should have minimum 3 years of experience in Electronic Data Interchange (EDI).
- This position is based at our Hyderabad and Chennai
- A 15 years full time education is required.

15 years full time education

📌 Quality Engineering Lead (India)
🏢 Accenture
📍 India