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)

Good 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 robust 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 preferr

📌 Quality Engineering Lead (Hyderabad)
🏢 Accenture in India
📍 Hyderabad